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1.
J Contemp Dent Pract ; 21(1): 11-16, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381794

RESUMO

AIM: To compare the antimicrobial effects of two different irrigation solutions activated with erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser or an ultrasonic system and a photodynamic therapy (PDT) on Enterococcus faecalis (E. faecalis). MATERIALS AND METHODS: The root canals of 72 single-rooted human permanent incisors were prepared with ProTaper Universal rotary instruments and incubated with E. faecalis (ATCC 29212) for 4 weeks. Then the teeth were randomly divided into seven experimental groups with 10 specimens for canal disinfection procedures. Group I, standard needle irrigation (SNI) with 2.5% sodium hypochlorite (NaOCl); group II, SNI with 2% chlorhexidine gluconate (CHX); group III, laser-activated irrigation (LAI) by Er,Cr:YSGG of NaOCl; group IV, LAI of CHX; and group V, passive ultrasonic irrigation (PUI) of NaOCl; group VI, PUI of CHX; group VII, PDT. The remaining two teeth were used as the control group. After the disinfection procedures were completed, the root canals were filled with phosphate-buffered saline and bacterial samples were taken with sterile paper cones. The cultivation was performed on Mueller-Hinton agar (MHA) plates. The live bacteria were calculated by counting the colonies on these plaques. The statistical analysis was performed using Kruskal-Wallis H test and Miller's multiple comparison technique. RESULTS: Both LAI and PUI of NaOCl and PUI of CHX were more successful than the PDT on root canal disinfection (p < 0.05). CONCLUSION: Within the limitation of the present study, the activation of NaOCl solution by Er,Cr:YSGG laser or an ultrasonic system can be useful in the elimination of the E. faecalis from the canal. The PUI of CHX also has similar results. Photodynamic therapy showed a lower performance compared to these methods. CLINICAL SIGNIFICANCE: The activation of the sodium hypochlorite with Er,Cr:YSGG laser or PUI may be useful for removal of the E. faecalis biofilm layer in the root canal.


Assuntos
Gálio , Fotoquimioterapia , Cromo , Cavidade Pulpar , Enterococcus faecalis , Érbio , Humanos , Irrigantes do Canal Radicular , Escândio , Ultrassom , Ítrio
2.
J Contemp Dent Pract ; 21(2): 178-182, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381824

RESUMO

AIM: To compare the antimicrobial efficacy of sodium hypochlorite (NaClO at 2.5% and 5.25%) and calcium hypochlorite [Ca(ClO)2 at 2.5%] on a biofilm of Enterococcus faecalis ATCC 29212™ and Candida albicans ATCC 10231™. MATERIALS AND METHODS: We performed an experimental in vitro study. Strains of C. albicans and E. faecalis, which had previously been reactivated were used. Then the colonies to be used were standardized in a turbidity standard to guarantee a quantity of 108 (CFU/mL) using the McFarland scale (0.5). Subsequently, the biofilm formed in brain-heart infusion agar was seeded into 42 sterile disks previously embedded with the experimental substances. Both 2.5% NaClO and Ca(ClO)2 solutions were placed in each Petri dish. They were then incubated at 37°C for 24 hours and the inhibition halos were measured using the Kirby-Bauer technique. RESULTS: The means between the halos corresponding to NaClO and Ca(ClO)2 at 2.5% were 13.38 ± 0.64 mm and 13.42 ± 0.62 mm, respectively. According to the Tukey test, no statistically significant differences were found between the hypochlorite groups evaluated (p = 0.989). CONCLUSION: Both Ca(ClO)2 and NaClO have a similar antimicrobial efficacy with biofilm based on E. faecalis and C. albicans, with no statistically significant differences between the two. CLINICAL SIGNIFICANCE: This study demonstrates the effectiveness of Ca(ClO)2 and NaClO as endodontic irrigators to combat the most frequent microorganisms of the root canal.


Assuntos
Anti-Infecciosos , Enterococcus faecalis , Biofilmes , Cálcio , Candida albicans , Irrigantes do Canal Radicular , Hipoclorito de Sódio
3.
Stomatologiia (Mosk) ; 99(2): 7-10, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32441068

RESUMO

The purpose of the study was to evaluate the degree of purification of the deltoid root canal branching during endodontic treatment of teeth. Morphological assessment of dentine of 14 extracted incisors and premolars in patients aged from 24 up to 56 years with the diagnosis chronic apical periodontitis was conducted in two experimental groups: main (1 group, 7 teeth) and control (2 group, 7 teeth). In the 2 group conventional root canal treatment was carried out with processing of 3% solution of sodium hypochlorite and final sealing with gutta-percha pins by lateral condensation. In the 1 group root canals were additionally irrigated by 3% sodium hypochlorite solution by means of the RinsEndo device. Based on the study results we recommend using the hydrodynamic method of irrigation of root canals with 3% sodium hypochlorite solution in endodontic treatment of patients with chronic apical periodontitis.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Dentina , Humanos , Pessoa de Meia-Idade , Irrigantes do Canal Radicular , Obturação do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio
4.
J Contemp Dent Pract ; 21(3): 271-276, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434973

RESUMO

BACKGROUND: The presence of Enterococcus faecalis in root canal is considered as one of the factors causing root canal treatment failure since the bacteria are capable of producing glucosyltransferase enzymes that play a role in forming endodontic biofilms. Hence, the bacteria are resistant to antibiotics. On the other hand, cocoa pod husk extract which is rich in chemical components especially flavonoids, tannins, and saponins, is thought to have an ability to inhibit Enterococcus faecalis glucosyltransferase enzyme activity. AIM: The aim of this research is to analyze the inhibitory ability of cocoa pod husk extract against E. faecalis glucosyltransferase enzyme activity. MATERIALS AND METHODS: A total of 27 research samples were divided into three groups, namely, positive control (chlorhexidine gluconate 2%), negative control (aquades), and cocoa pod husk extract 3.12%. Next the enzymatic activity of each sample group was calculated based on the size of the fructose area read by high-performance liquid chromatography (HPLC) expressed in percent (%) and then converted to µmol/mL fructose which was considered as 1 unit of glucosyltransferase enzyme activity. Subsequently, the data were analyzed statistically using Kruskal-Wallis test. RESULTS: The results of data analysis using the Kruskal-Wallis test showed significant differences between groups of samples (p <0.05). CONCLUSION: Cocoa pod husk extract of 3.12% has inhibitory effect on E. faecalis glucosyltransferase enzyme activity. CLINICAL SIGNIFICANCE: The use of cocoa pod husk extract meets the requirements and is proven useful as an irrigation agent in the treatment of root canals, because it contains antibacterial properties against E. faecalis.


Assuntos
Enterococcus faecalis , Irrigantes do Canal Radicular , Biofilmes , Extratos Vegetais , Tratamento do Canal Radicular
5.
Braz Oral Res ; 34: e020, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236317

RESUMO

This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.


Assuntos
Adesivos Dentinários/farmacologia , Etanol/farmacologia , Técnica para Retentor Intrarradicular , Cimentos de Resina/química , Raiz Dentária/efeitos dos fármacos , Animais , Bovinos , Colagem Dentária , Materiais Dentários/química , Cavidade Pulpar , Vidro , Teste de Materiais , Porosidade , Irrigantes do Canal Radicular/química , Microtomografia por Raio-X
6.
J Appl Oral Sci ; 28: e20190516, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236357

RESUMO

INTRODUCTION: This study investigated the effect of a calcium hydroxide (CH) paste (CleaniCal®) containing N-2-methyl pyrrolidone (NMP) as a vehicle on Enterococcus faecalis (E. faecalis) biofilms compared with other products containing saline (Calasept Plus™) or propylene glycol (PG) (Calcipex II®). METHODOLOGY: Standardized bovine root canal specimens were used. The antibacterial effects were measured by colony-forming unit counting. The thickness of bacterial microcolonies and exopolysaccharides was assessed using confocal laser scanning microscopy. Morphological features of the biofilms were observed using field-emission scanning electron microscopy (FE-SEM). Bovine tooth blocks covered with nail polish were immersed into the vehicles and dispelling was observed. The data were analyzed using one-way analysis of variance and Tukey tests (p<0.05). RESULTS: CleaniCal® showed the highest antibacterial activity, followed by Calcipex II® (p<0.05). Moreover, NMP showed a higher antibacterial effect compared with PG (p<0.05). The thickness of bacteria and EPS in the CleaniCal® group was significantly lower than that of other materials tested (p<0.05). FE-SEM images showed the specimens treated with Calasept Plus™ were covered with biofilms, whereas the specimens treated with other medicaments were not. Notably, the specimen treated with CleaniCal® was cleaner than the one treated with Calcipex II®. Furthermore, the nail polish on the bovine tooth block immersed in NMP was completely dispelled. CONCLUSIONS: CleaniCal® performed better than Calasept Plus™ and Calcipex II® in the removal efficacy of E. faecalis biofilms. The results suggest the effect might be due to the potent dissolving effect of NMP on organic substances.


Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Hidróxido de Cálcio/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Pirrolidinonas/farmacologia , Irrigantes do Canal Radicular/farmacologia , Análise de Variância , Animais , Cloreto de Cálcio/química , Cloreto de Cálcio/farmacologia , Hidróxido de Cálcio/química , Bovinos , Contagem de Colônia Microbiana , Combinação de Medicamentos , Teste de Materiais , Microscopia Confocal , Microscopia Eletrônica de Varredura , Cloreto de Potássio/química , Cloreto de Potássio/farmacologia , Pirrolidinonas/química , Reprodutibilidade dos Testes , Irrigantes do Canal Radicular/química , Bicarbonato de Sódio/química , Bicarbonato de Sódio/farmacologia , Cloreto de Sódio/química , Cloreto de Sódio/farmacologia , Estatísticas não Paramétricas
7.
Indian J Dent Res ; 31(1): 124-128, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246694

RESUMO

Aim: The aim of the study is to compare the antibacterial effectiveness between cinnamon extract as irrigant with neem extract irrigant and sodium hypochlorite against E. fecalis. Materials and Methods: The present study is a randomized controlled in vitro study conducted on 60 extracted permanent single rooted teeth. The teeth were divided into three groups- Group 1 was irrigated with cinnamon extract, Group 2 was irrigated with neem extract irrigant and Group 3 with 3% sodium hypochlorite. The colonies in the reduction of E. feacalis was noted as CFU values per ml. Wilcoxon signed ranked test was used to compare in between the three groups. Mann- Whitney's test was used for inter group comparison between the three groups. Results: Cinnamon extract had the maximum reduction in the CFU colonies followed by sodium hypochlorite. Neem extract irrigant had the least reduction in the colonies of E. feacalis. (P < 0.05). Conclusion: Cinnamon extract irrigant show better reduction in E. fecalis as compared to 3% sodium hypochlorite and neem extract irrigant.


Assuntos
Cinnamomum zeylanicum , Hipoclorito de Sódio , Antibacterianos , Enterococcus faecalis , Extratos Vegetais , Irrigantes do Canal Radicular
8.
Stomatologiia (Mosk) ; 99(1): 33-37, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32125299

RESUMO

In the course of the present study four endodontic treatment schemes were tested and the most effective scheme was determined through the use of calcium hydroxide-based paste being applied three times at an interval of 7-14 days with the subsequent long-term temporary obturation using calcium hydroxide with iodoform, ultrasonic activation of sodium hypochlorite in the root canal, hydrodynamic irrigation and a diode laser. During the entire treatment period, the most effective scheme has revealed a reduction in defect size by 2,57±0,17 (p>0,0001) as well as a 1,84 degree (p>0,0001) decrease in PAI score. Based on optical density data, it was concluded that the application of calcium hydroxide with iodoform in the treatment scheme leads to an 2,2-4,2% improvement in bone tissue regeneration in the periapical zone. The greatest and complete inhibition of microorganisms was determined in patients of the first and third experimental groups in which a diode laser was used. The use of a diode laser in endodontic dental treatment with periapical destruction, enhances antibacterial activity and contributes to the complete inhibition of pathogenic microflora in the root canals.


Assuntos
Periodontite Periapical , Hidróxido de Cálcio , Humanos , Irrigantes do Canal Radicular , Tratamento do Canal Radicular , Hipoclorito de Sódio
9.
Braz Dent J ; 31(1): 37-43, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159704

RESUMO

The objective of this in vivo study was to assess the effect of the root canal irrigation by negative and positive apical pressure on the expression of molecules that are an indicative of cell differentiation with mineralizing phenotype in teeth of dogs with incomplete rhizogenesis and induced periapical lesion. A total of 30 teeth (60 roots) were distributed into 3 groups (n=20): EndoVac®, Conventional and Control. After 90 days, the routine histotechnical procedures were performed and the sections were submitted to immunohistochemical technique for the staining of osteopontin (OPN), alkaline phosphatase (ALP) and the RUNX2 transcription factor in the apical and periapical regions of the roots. A semi-quantitative analysis of the positive immunostaining was performed and the intensity of the expression was classified in absent (0), mild (1), moderate (2), or intense (3). Scores data were statistically analyzed by the Kruskal-Wallis non-parametric test and Dunn post-test, and the significance level was set at 5%. RUNX2 immunostaining revealed that in the negative pressure group there was a significantly stronger (p<0.05) immunostaining in comparison to the control group. Regarding the OPN expression, it was not possible to detect a statistically significant difference between the groups (p>0.05). After analyzing ALP immunostaining, a statistically significant difference was observed between the groups (p<0.05), and the negative pressure group showed a markedly stronger mark immunostaining than the control group. The results of the present in vivo study allowed concluding that negative apical pressure irrigation presents mineralizing potential in immature teeth with apical periodontitis.


Assuntos
Periodontite Periapical , Dente , Animais , Cães , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Tratamento do Canal Radicular
10.
J Indian Soc Pedod Prev Dent ; 38(1): 64-70, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174631

RESUMO

Introduction: The chemomechanical preparation of root canal dentin with hand or rotary instruments creates debris and a smear layer. Root canal preparation (RCP) along with irrigants is not effective in cleaning apical portions, and hence, different laser activation systems were used for better cleaning in the apical third. Aim: The aim of this study is to compare the efficacy of erbium: yttrium-aluminum-garnet (Er:YAG) and diode laser irradiation in smear layer removal and dentin permeability after biomechanical preparation using scanning electron microscopic investigation. Material and Methods: Thirty sound single-rooted human teeth were distributed randomly and equally into three groups (n = 10 each) based upon the type of laser irradiation after RCP: Group I (control group) - RCP with ProTaper rotary system using the standard irrigating protocol; Group II - RCP with ProTaper rotary system using the standard irrigating protocol followed by diode laser irradiation; and Group III - RCP with ProTaper rotary system using the standard irrigating protocol followed by Er:YAG laser irradiation. After root sectioning, specimens were dehydrated, then gold plated and observed using a scanning electron microscopy. Then, the smear layer scores were recorded and performed using the statistical analysis. Results: Smear layer removal efficacy of Er:YAG laser was more at coronal, middle, and apical third when compared to Group I and Group II. Debris removal score of Group III (Er:YAG) was better than Group I (17% ethylenediaminetetraacetic acid) and Group II (diode). Conclusion: Er:YAG laser-activated RCP was comparatively efficient in cleaning the smear layer and dentinal tubules opening.


Assuntos
Camada de Esfregaço , Alumínio , Cavidade Pulpar , Dentina , Permeabilidade da Dentina , Érbio , Humanos , Lasers Semicondutores , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Ítrio
11.
Int Endod J ; 53(6): 742-753, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32034789

RESUMO

AIM: To evaluate the antimicrobial effectiveness of Ca(OH)2 paste combined with Ibuprofen or Ciprofloxacin in infected root canals of teeth with asymptomatic apical periodontitis. METHODOLOGY: Forty-five patients were randomly divided into three groups using a web programme according to the medication selected: Ca(OH)2 : 1 g Ca(OH)2 powder with 1 mL propylene glycol, Ca(OH)2  + Ibuprofen: 50 mg of Ibuprofen was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol, Ca(OH)2  + Ciprofloxacin: 50 mg of Ciprofloxacin was added into 950 mg Ca(OH)2 powder and mixed with 1 mL propylene glycol. Root canal bacteriological samples were collected before root canal treatment (S1) and after chemo-mechanical procedures (S2). After root canal preparation, the intracanal medicaments were placed into the root canals to a level approximately 1 mm short of the working length using K-files and access cavities were filled temporarily. The participants were scheduled for a second visit 7 days later when the medication was removed mechanically, and after irrigation of the root canals, the final samples (S3) were collected. Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the numbers of total bacteria, Enterococcus faecalis and Streptococcus species. For intragroup analysis, a Friedman test was used to compare reduction of counts of total bacteria, Streptococci and E. faecalis amongst the three samples (S1, S2 and S3). The chi-square test was used to compare the number of root canals positive for bacteria in S1, S2 and S3 amongst the groups. RESULTS: Intragroup analysis revealed a significant reduction in the number of intracanal bacterial cells from S1 to S2 and from S2 to S3 in all medication groups (P < 0.01). Although there was no significant difference amongst the groups when comparing quantitative S1 or S2 data, there were significantly lower bacterial counts in the Ca(OH)2  + Ciprofloxacin group (0.49 × 102 ) than the pure Ca(OH)2 (1.25 × 102 ) and Ca(OH)2  + Ibuprofen groups (0.76 × 102 ) at S3. The percentage reduction from S1 to S3 and from S2 to S3 was significantly greater in the Ca(OH)2 + Ciprofloxacin than the pure Ca(OH)2 and Ca(OH)2 + Ibuprofen groups (P < 0.05). In the Ca(OH)2  + Ciprofloxacin group, there were significantly fewer positive cases (8/15) than the pure Ca(OH)2 (13/15) and Ca(OH)2  + Ibuprofen (13/15) groups (P < 0.05). CONCLUSION: The addition of Ciprofloxacin to Ca(OH)2 provided further antibacterial effectiveness when used as an intracanal medicament in vivo during root canal treatment.


Assuntos
Antibacterianos , Hidróxido de Cálcio , Ibuprofeno , Periodontite Periapical , Clorexidina , Ciprofloxacino , Cavidade Pulpar , Humanos , Irrigantes do Canal Radicular , Preparo de Canal Radicular
12.
Int Endod J ; 53(6): 824-833, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32053733

RESUMO

AIM: To evaluate the antibiofilm effect of proanthocyanidin (PA) solution as an irrigant against Enterococcus faecalis (E. faecalis) and its influence on the mechanical properties and biodegradation resistance of demineralized root dentine. METHODOLOGY: Enterococcus faecalis were introduced into human root dentine tubules by a serial centrifugation method and grown for 1 week. Dentine blocks infected with 1-week-old E. faecalis biofilms were treated with the following irrigants: sterile water (control), 2% chlorhexidine (CHX), 2% PA, 5% PA and 10% PA. After treatment, the live and dead bacteria proportions within E. faecalis biofilms were analysed using confocal laser scanning microscopy. To evaluate the biostability of fully demineralized dentine treated by the aforementioned irrigants, the elastic modulus and hydroxyproline release of human dentine incubated in collagenase solution were tested at baseline, after irrigant treatment and after biodegradation, respectively. Furthermore, the surface chemical bond of demineralized dentine collagen treated by various irrigants was characterized by X-ray photoelectron spectroscopy (XPS). Statistical analysis was performed using one-way anova and Tukey's post hoc multiple comparisons with the significance level at 5%. RESULTS: The proportion of dead E. faecalis volume was significantly higher in the PA and CHX groups than that in the control group (P < 0.05). PA irrigation significantly increased the mechanical properties of demineralized dentine (P < 0.05), and the effect was enhanced with increasing PA concentration. CHX and PA groups had significantly less elasticity loss and hydroxyproline release (P < 0.05). The biomodification of dentine collagen by PA was verified by increased C-O/C-N peak percentage under C1s and C-O peak percentage under O1s narrow-scan XPS spectra. CONCLUSIONS: Proanthocyanidin killed E. faecalis within biofilms and enhanced the biostability of the collagen matrix of demineralized root dentine. It might be used as an auxiliary endodontic irrigant with antibiofilm and collagen-stabilizing effects.


Assuntos
Proantocianidinas , Irrigantes do Canal Radicular , Biofilmes , Clorexidina , Colágeno , Dentina , Enterococcus faecalis , Humanos , Microscopia Confocal
13.
Int Endod J ; 53(3): 317-332, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31587303

RESUMO

AIM: To answer the following focused question: 'As regards microorganism load reduction for patients undergoing root canal treatment, is the use of ozone therapy comparable to conventional chemomechanical techniques using sodium hypochlorite (NaOCl)?' DATA SOURCES: A systematic review was conducted using controlled vocabulary and free-text key words in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey until 2 November 2018. Additional studies were sought through hand searching of endodontic journals. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: The inclusion criteria comprised studies that compared microbial reduction in root canals after treatments with ozone and NaOCl in extracted mature human teeth or randomized clinical trials. STUDY APPRAISAL AND SYNTHESIS METHODS: The quality assessment of included laboratory studies was performed with the following parameters: (i) sample size calculation, (ii) samples with similar dimensions, (iii) control group, (iv) standardization of procedures, (v) statistical analysis and (vi) other risk of bias. For randomized clinical trials, the qualitative analysis of the studies was performed from the bias risk assessment using the tool 'Bias Risk Assessment of Randomized Controlled Studies' Cochrane Handbook 5.0.2. RESULTS: The search resulted in 180 published studies. After removal of duplicate studies and full-text analysis, eight studies were selected and seven were considered low risk of bias (seven ex vivo studies and one random clinical trial). Overall, the results demonstrated that ozone therapy provides significantly less microbial load reduction than NaOCl. As an adjunct in chemomechanical preparation, ozone was ineffective in increasing the antimicrobial effect of NaOCl. Ozone performance was strongly associated with the application protocol used: it is dose, time and bacterial strain dependent, besides the correlation with the use of complementary disinfection sources. LIMITATIONS: A restricted number of randomized clinical trial was found, and the difference amongst the methodology of the studies did not allow a meta-analysis to be performed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Although the selected studies had limitations, this review reached a satisfactory methodological and moderate evidence quality contributing to important preliminary information regarding ozone therapy. As regards load reduction of microorganisms for patients undergoing root canal treatment, ozone is not indicated neither to replace nor to complement the antimicrobial action of NaOCl.


Assuntos
Cavidade Pulpar , Ozônio , Irrigantes do Canal Radicular , Desinfecção , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Tratamento do Canal Radicular , Hipoclorito de Sódio
14.
Int Endod J ; 53(3): 366-375, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31566756

RESUMO

AIM: To evaluate the effectiveness of five instruments used for irrigant agitation during the removal of calcium hydroxide [Ca(OH)2 ] paste in simulated internal root resorption (IRR) cavities created in extracted maxillary central incisors. METHODOLOGY: Seventy maxillary central incisors with a single canal were selected. The canals were accessed and instrumented with Reciproc R50, then the roots were split in the bucco-lingual direction and the halves separated. Simulated IRR cavities were created, in both halves of the roots, 5 mm from the apex with a spherical bur. The specimens were reconstructed with cyanoacrylate glue and allocated into seven groups: negative control - no treatment; positive control - filled with Ca(OH)2 without performing any irrigation protocol; the other groups were divided according to the instrument used for irrigant agitation, namely: Ultrasonic, EndoActivator® , EDDY® , XP-endo® Finisher and XP-endo® Shaper. The specimens were cleaved and analysed using optical microscopy and scanning electron microscopy, to compare the Ca(OH)2 remnants between them. Then, the IRR cavities created by the burs were cleaned and subjected to a protocol of demineralization with 20% nitric acid, the roots reconstructed, and the irrigant agitation methods, as well as the microscopic analysis was repeated. Analysis of the images of Ca(OH)2 remaining in the simulated IRR cavities after irrigation was performed by two calibrated examiners based on a previously established scoring system. The data were statistically compared by Kruskal-Wallis test, Mann-Whitney U-test and Wilcoxon tests, with the significance level set at 5%. RESULTS: There was a significant difference in the effectiveness of the instruments in relation to the cavity creation method (bur vs. bur/acid) and evaluation method (optical microscopy and scanning electron microscopy) (P < 0.05). The XP-endo® Finisher and EDDY® groups were associated with significantly more effective removal of Ca(OH)2 when the IRR cavities were created using the acid protocol and analysed by scanning electron microscopy. CONCLUSION: None of the instruments tested were able to completely remove the Ca(OH)2 paste from the simulated IRR cavities; however, the EDDY® and XP-endo® Finisher removed more Ca(OH)2 in the bur/acid cavity creation method analysed by scanning electron microscopy.


Assuntos
Cárie Dentária , Reabsorção da Raiz , Hidróxido de Cálcio , Cavidade Pulpar , Humanos , Incisivo , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Irrigação Terapêutica
15.
Int Endod J ; 53(2): 154-166, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31563148

RESUMO

AIM: This randomized, prospective, double-blind, clinical trial assessed the effect of 1.3% and 5.25% sodium hypochlorite (NaOCl) as irrigants on post-endodontic pain and medication intake following root canal treatment of mandibular molars with nonvital pulps. METHODOLOGY: Three hundred and eight patients, each with one symptomatic or asymptomatic molar, were randomly assigned, using the permuted-block method, into two equal groups according to NaOCl concentration: 1.3% or 5.25% (n = 154). For both groups, syringe irrigation was performed using a 27-gauge needle advanced into the canal to a depth of 3 mm from the working length; 3 mL were used between every two consecutive instruments. All root canal treatments were carried out in two visits, with no intracanal medication, by trained postgraduate students. The canals were prepared using the ProTaper Universal rotary system during the first visit. In the second visit 7 days later, the same irrigant per group was used and the canal walls were reprepared with the final instrument before filling the canal using the modified single-cone technique with an epoxy resin-based sealer. Patients assessed their postoperative pain using a 0-10 numerical rating scale immediately after instrumentation, 3, 24, 48 h and 7 days after the first visit and immediately following root canal filling. The incidence of rescue medication intake (Sham or analgesic) was also recorded; patients received a sham capsule to be used first, but, if pain persisted, an analgesic was prescribed. Outcome data were analysed using Mann-Whitney U-test, Friedman's test, Wilcoxon's rank test and chi-square (χ2 ) test. Relative risk reduction (RRR) and its 95% confidence interval (CI) were calculated for binary data. RESULTS: The incidence and intensity of postoperative pain were significantly lower with 1.3% NaOCl than 5.25% NaOCl at all time-points (P < 0.05). Postoperative pain intensity exceeded preoperative pain at 3 and 24 h with 5.25% NaOCl only (P < 0.05). The RRR in pain incidence was 38% (95% CI: 17%, 54%) immediately after instrumentation, 41% (95% CI: 31%, 49%) at 3 h, 42% (95% CI: 32%, 51%) at 24 h, 59% (95% CI: 45%, 69%) at 48 h, 62% (95% CI: 27%, 80%) at 7 days and 81% (95% CI: 68%, 89%) after root filling. RRR was 38% (95% CI: 1%, 61%) for sham intake and 69% (95% CI: 37%, 85%) for analgesic intake. CONCLUSIONS: Using 1.3% NaOCl was associated with less intense and less frequent post-endodontic pain than 5.25% NaOCl in mandibular molars with nonvital pulps treated in two visits. The incidence of pain was reduced by up to 60% within the week post-instrumentation and 80% after root canal filling and the rescue analgesic intake by about 70% on using 1.3% NaOCl compared to 5.25% NaOCl.


Assuntos
Dente Molar , Hipoclorito de Sódio , Cavidade Pulpar , Método Duplo-Cego , Humanos , Dor Pós-Operatória , Estudos Prospectivos , Irrigantes do Canal Radicular , Preparo de Canal Radicular
16.
Clin Oral Investig ; 24(2): 757-763, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31139978

RESUMO

OBJECTIVES: Evaluate the cytotoxicity and biocompatibility of calcium hydroxide paste [Ca (OH)2] associated with 5% diclofenac sodium, ibuprofen, or amoxicillin. MATERIALS AND METHODS: Pre-osteoblast-like cells were cultivated and the MTT test was used to determine the cytotoxicity of the paste extracts after time intervals of 24, 48, 72 h, and 7 days. Tubes containing Ca (OH)2 pastes associated with the drugs and empty tubes were implanted in subcutaneous tissue of 30 rats. After 7 and 30 days, the specimens were removed and submitted to histological analysis. The data obtained were submitted to Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: All the Ca (OH)2 pastes promoted cell viability after all periods. At 7 days, there was greater inflammatory tissue reaction adjacent to the implants. At 30 days, there was a significant reduction in the number of inflammatory cells, and increase in fibroblasts in all groups. In this period, a lower number of inflammatory cells and a higher number of fibroblasts were observed in the capsules adjacent to the association with diclofenac, when compared with the other mixtures (p ≤ 0.05); the capsule thickness was greater at 7 days than at 30 days. CONCLUSIONS: The Ca (OH)2 pastes associated with the drugs were not cytotoxic and presented biocompatibility after implantation in rat subcutaneous tissues. CLINICAL RELEVANCE: Ca (OH)2 pastes with anti-inflammatory or antibiotic may be clinical alternatives as intracanal medication to reduce resistant microorganisms in root canal system.


Assuntos
Antibacterianos/farmacologia , Anti-Inflamatórios não Esteroides/farmacologia , Animais , Hidróxido de Cálcio , Diclofenaco , Ratos , Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular
17.
Clin Oral Investig ; 24(1): 151-156, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31062167

RESUMO

OBJECTIVES: To investigate the effectiveness of root canal irrigation with chitosan on the dislocation resistance of a root canal sealer (MTA Fillapex) in vitro, measured by the push-out bond strength test. MATERIALS AND METHODS: Root canals of mandibular premolars (n = 57) were prepared using rotary files with 5.25% sodium hypochlorite as the irrigant during instrumentation. Following this, the specimens were randomly divided into three groups (n = 19) based on the final irrigant: group 1, 0.2% chitosan solution; group 2, 17% EDTA solution; group 3, saline. Three specimens from each group were analyzed using scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS). The remaining specimens of each group were divided into two subgroups (n = 8) based on the method of agitation of the final irrigants (chitosan/EDTA/saline): subgroup A, sonic (Endoactivator, Dentsply Maillefer); subgroup B, no activation (control). After irrigation, all specimens obturated with a commercial mineral trioxide aggregate-resin hybrid sealer (MTA Fillapex, Angelus, Londrina, Brazil). Dislocation resistance was measured using the push-out bond strength test after 3 weeks. The data were analyzed using Kruskal-Wallis test (P = 0.05). RESULTS: Immaterial of the irrigant agitation, groups irrigated with chitosan showed significantly higher bond strength values than those irrigated with EDTA (P < 0.05). Groups irrigated with saline showed the least bond strength values (P < 0.05). When EDTA was used, sonic agitation significantly improved the bond strength of the sealer, compared to the control (P < 0.05). There was no significant difference between sonic agitation and the control when chitosan solution was used as the final irrigant (P > 0.05). The nitrogen/carbon ratio was significantly higher in chitosan groups compared to the control group (P < 0.05). CONCLUSION: This study provides the first evidence that chitosan irrigation improves the dislocation resistance of MTA-resin hybrid root canal sealer, compared to EDTA and saline irrigation. CLINICAL RELEVANCE: Chitosan-based irrigation has been previously shown to demonstrate anti-biofilm properties in the root canal. The present study demonstrates that chitosan can improve the bond strength of a root filling material, which may contribute to better sealing of the root canal system.


Assuntos
Quitosana , Colagem Dentária , Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular , Compostos de Alumínio , Brasil , Compostos de Cálcio , Cavidade Pulpar , Dentina , Combinação de Medicamentos , Ácido Edético , Resinas Epóxi , Óxidos , Preparo de Canal Radicular , Silicatos , Hipoclorito de Sódio
18.
Clin Oral Investig ; 24(2): 907-914, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31240405

RESUMO

OBJECTIVES: To evaluate and compare irrigant distribution throughout the root canal system of mesial roots of mandibular molars after application of distinct adjunctive irrigant activation procedures. MATERIALS AND METHODS: Fifteen extracted mandibular molars presenting Fan's type II, III, or IV isthmus configurations were selected. The canals were initially enlarged and cleaned. The same specimens were subjected to conventional positive pressure irrigation (PPI) followed by adjunctive irrigation approaches: passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher instrument, and a control group in which the irrigant remained in the canal with no activation. Retention time for the irrigant was the same for all groups. Sodium hypochlorite mixed with a contrast medium (Omnipaque 300) was used as the irrigant. Before and immediately after the adjunctive irrigation, micro-computed tomographic (micro-CT) scans were taken to evaluate the volume of the entire root canal system that was filled by the irrigant. An exclusive analysis was also done for the isthmus area. RESULTS: Analysis of the entire root canal system showed that the XP-endo Finisher instrument promoted better distribution of the irrigant than PUI and the control group (p < 0.01). PUI was not significantly different from the control group (p > 0.05). A separate analysis of the isthmus area showed no significant difference between the adjunctive irrigation methods and the control (p > 0.05). CONCLUSIONS: The XP-endo Finisher instrument promoted better distribution of irrigant throughout the root canal system, especially in the apical canal segment, when compared to PUI. However, the tested approaches did not differ as to the ability to drive irrigants into the isthmus area. CLINICAL RELEVANCE: This study highlighted that the XP-endo Finisher instrument presented a better performance to distribute irrigant throughout the root canal system, especially in the apical canal segment compared to positive pressure irrigation and PUI.


Assuntos
Cavidade Pulpar , Dente Molar , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio , Irrigação Terapêutica
19.
J Appl Oral Sci ; 28: e20190005, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31800870

RESUMO

other: Chitosan is a natural, biocompatible chelating substance with potential for dental use. This study compared the effects of final canal irrigation with chitosan and EDTA on dentin microhardness, sealer dentin tubules penetration capacity, and push-out strength. METHODOLOGY: Fifty canine roots were distributed according to the final irrigation protocol (n=10): G1- 15% EDTA with conventional irrigation; G2- 15% EDTA with Endovac; G3- 0.2% chitosan with conventional irrigation; G4- 0.2% chitosan with Endovac; and G5- without irrigation. Specimens were obturated (AH Plus) and sectioned in 3 slices per root third. The first slice was used for microhardness and sealer penetration assessments under a laser confocal microscope. The second was utilized in a push-out strength test. The third slice was discarded. Data were analyzed using 2-way ANOVA and Tukey's post hoc test (α<0.05). Failure mode was determined at x40 magnification. RESULTS: Microhardness reduction was more significant in groups G2 and G4 (p<0.05). Sealer penetration through dentin was significantly greater in group G2 (p<0.05). There was no significant difference between groups G1, G3, and G4 (p>0.05). In general, all experimental groups presented similar bond resistance (p>0.05) that significantly differed from the control (p<0.001). Mixed type failures were predominant. CONCLUSIONS: In general, 0.2% chitosan and 15% EDTA solutions act in a similar manner with regard to the variables studied. The use of Endovac potentiates the effect of these solutions.


Assuntos
Quelantes/química , Quitosana/química , Colagem Dentária/métodos , Dentina/efeitos dos fármacos , Ácido Edético/química , Irrigantes do Canal Radicular/química , Análise de Variância , Resinas Epóxi/química , Testes de Dureza , Humanos , Teste de Materiais , Microscopia Confocal , Pessoa de Meia-Idade , Valores de Referência , Reprodutibilidade dos Testes , Materiais Restauradores do Canal Radicular/química , Resistência ao Cisalhamento , Propriedades de Superfície/efeitos dos fármacos
20.
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
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