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1.
J Endod ; 46(12): 1913-1919, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32949559

RESUMO

INTRODUCTION: New tricalcium silicate cements have been shown to induce less coronal discoloration. The purpose of this in vitro study was to evaluate the degree of color change induced by various silicate materials in the presence and absence of blood. METHODS: One hundred human extracted anterior single-canal teeth were sectioned to standardized root lengths, accessed, and instrumented. Eight random experimental groups and 2 control groups were created wherein specimens were filled with experimental materials below the buccal cementoenamel junction as follows: EndoSequence RRM putty (Brasseler USA, Savannah, GA), EndoSequence RRM fast set putty (Brasseler USA), Biodentine (Septodont, Saint-Maur-des-Fossés, France), and white mineral trioxide aggregate (Dentsply Sirona, York, PA) either with the presence or absence of blood. Blood-only and saline-only samples were used for the positive and negative controls. After incubation in 100% humidity at 37°C, color changes were evaluated with a spectrophotometer (Ocean Optics, Dunedin, FL) on days 0, 30, 60, and 180 after material placement. Data were transformed into Commission International de I'Eclairage's L∗a∗b color values, and corresponding ΔE values were calculated. The 1-way analysis of variance test was performed for statistical analysis. RESULTS: Discoloration was observed in all specimens in the presence of blood. There was no statistical significance when comparing different materials in contact with blood. Intragroup observation at various time points, Biodentine, and EndoSequence RRM fast set putty showed significant difference between the presence and absence of blood at 180 days (P < .05). CONCLUSIONS: Contamination with blood of tricalcium silicate materials has the potential to cause coronal tooth discoloration.


Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Dente , Compostos de Alumínio , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , França , Humanos , Óxidos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Descoloração de Dente/induzido quimicamente
2.
J Endod ; 46(2): 301-306, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31889582

RESUMO

The present report describes a case of permanent labiomandibular paresthesia subsequent to a root canal treatment in a molar in which a bioceramic sealer extrusion occurred. A 23-year-old black woman attended the endodontics clinic at university, complaining of loss of sensation in the mucosa and skin on the right side of her face in the lower lip region, which began after an endodontic treatment in the second lower right molar. A bioceramic sealer (MTA; Angelus, Londrina, PR, Brazil) was used to fill the canals. The periapical radiographic examination revealed an amount of extruded sealer by mesial and distal roots reaching the interior of the mandibular canal. Then, treatment with a corticosteroid and a vitamin B complex was initiated, and demarcation of the affected area was performed. One week later, paresthesia was still present in equal intensity in the affected area. Thirty-nine days elapsed after the endodontic therapy; the paresthesia continued, encompassing the same area, although with a small reduction in intensity. In the following 6 months, a very subtle decrease in intensity but not in the affected area was noticed. From 6 months to 1 year, no changes were observed. According to the patient's report, the paresthesia affected her quality of life in several aspects. The short distance between the root apices and the upper cortical bone of the mandibular canal seemed to have acted as a predisponent factor to the present long-term paresthesia. In conclusion, bioceramic sealers may also induce permanent facial paresthesia, if extruded.


Assuntos
Parestesia , Materiais Restauradores do Canal Radicular , Brasil , Feminino , Humanos , Parestesia/etiologia , Qualidade de Vida , Materiais Restauradores do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular , Adulto Jovem
3.
Niger J Clin Pract ; 22(7): 926-931, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293256

RESUMO

Background: This study was performed to evaluate the amount of apically extruded debris removed from a root canal filled with cold lateral condensation (CLC), and warm vertical compaction (WVC) techniques, using b or a phase gutta-percha with AH-Plus (Dentsply DeTrey, Konstanz, Germany) or Resilon (Resilon Research LLC, Madison, WI) with RealSeal SE (SybronEndo, Amersfoort, The Netherlands). Materials and Methods: About 100 human incisor teeth were prepared with a #25.06 NiTi rotary system and divided into five groups according to the filling material used: Group 1: CLC (gutta-percha, AH-Plus); Group 2: WVC (b phase gutta-percha, AH-Plus); Group 3: WVC (a phase gutta-percha, AH-Plus); Group 4: CLC (Resilon, RealSeal SE); and Group 5: WVC (Resilon, RealSeal SE). Extruded debris during the retreatment procedure was collected in preweighed Eppendorf tubes. The times required for retreatment were recorded. Results: The amount of debris extrusion was significantly greater with WVC than CLC in the gutta-percha and Resilon groups (P < 0.001). Using a phase gutta-percha resulted in significantly more debris extrusion than b phase gutta-percha (P < 0.001). In the WVC groups, Resilon caused significantly more debris extrusion than gutta-percha (P < 0.05). Retreatment was faster for CLC than WVC (P < 0.05). Conclusions: In the retreatment procedure, the amount of apically extruded debris and retreatment duration were dependent on the type of obturation material and technique used.


Assuntos
Cavidade Pulpar/cirurgia , Guta-Percha/química , Materiais Restauradores do Canal Radicular/química , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Ligas Dentárias/química , Humanos , Níquel , Retratamento , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/métodos , Titânio/química , Ápice Dentário/patologia
4.
Clin Oral Investig ; 23(5): 2097-2102, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30259191

RESUMO

OBJECTIVES: The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1 month and 1 and 3 years. MATERIALS AND METHODS: The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1 month and 1 and 3 years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α = 0.05). RESULTS: All sealers caused discoloration. At 1 month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p < 0.05). At 1 year, ΔE values were significantly lower in group 3 than in the other groups (p < 0.05). At 3 years, ΔE values were significantly higher in group 1 than in the other groups (p < 0.05). CONCLUSIONS: All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration. CLINICAL RELEVANCE: Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.


Assuntos
Materiais Restauradores do Canal Radicular/efeitos adversos , Coroa do Dente/patologia , Descoloração de Dente/induzido quimicamente , Resinas Compostas/efeitos adversos , Estética Dentária , Humanos , Distribuição Aleatória , Cimento de Óxido de Zinco e Eugenol/efeitos adversos
5.
São José dos Campos; s.n; 2019. 76 p. il., tab., graf..
Tese em Português | BBO - Odontologia | ID: biblio-1016597

RESUMO

Este estudo analisou a interface de união e a força de adesão dos pinos de fibra de vidro Rebilda Post (RP) (VOCO) e Rebilda Post GT (GT) (VOCO) após cimentação em dentes com Reabsorção Radicular Interna (RRI) simulada. Quarenta e cinco raízes de pré-molares inferiores humanos foram padronizadas em 16 mm e incluídas em resina acrílica. Os canais radiculares (CR) foram preparados biomecanicamente, as raízes foram seccionadas em sua metade e a RRI foi simulada. Os segmentos foram retornados à posição original com auxílio de parafusos. Uma pasta de Ca(OH)2 permaneceu como MIC por 15 dias. A remoção foi feita por PUI e a qualidade da limpeza foi avaliada por estereomicroscopia. Os CR das amostras foram obturados e o preparo foi feito de forma padronizada. Os espécimes foram divididos em 2 grupos (n=20), de acordo com o tipo de pino cimentado. A resistência de união foi avaliada aos níveis cervical e da RRI pelo teste push-out. Para a análise estatística só foram incluídas falhas adesivas e predominantemente adesivas. Os resultados foram submetidos ao teste de Kruskal-Wallis, Mann Whitney e teste de Dunn (α = 0,05). Foi realizada MEV para análise da interface de união entre cimento e dentina radicular (n=1) e análise por microtomografia computadorizada (microCT) do pino GT (n=3). PUI não foi capaz de limpar completamente a maioria das RRI (62,5%). Houve alteração da resistência adesiva entre todos os grupos (p <0,05). Os valores de resistência de união para ambos os grupos na região cervical foram maiores em relação aos grupos na região de RRI. A MEV mostrou formação de tags resinosas na interface de união entre cimento resinoso e dentina radicular para ambos os grupos. Em análise por micro-CT, presença de bolhas no cimento e espaços na interface de união entre cimento são visíveis. A adesão de ambos os pinos foi afetada negativamente pelo nível da cimentação, adaptação do pino no canal radicular e presença de RRI. Rebilda Post apresentou melhores resultados de resistência adesiva no nível cervical enquanto que no Rebilda Post GT apresentou melhores resultados a nível de RRI(AU)


This study analyzed the adhesion interface and bond strength of Rebilda Post (RP) (VOCO) and Rebilda Post GT (GT) (VOCO) glass fibers after cementation in teeth with simulated Internal Root Resorption (IRR). Forty-five roots of lower human premolars were standardized at 16 mm and included in acrylic resin.The root canals (RC) were prepared biomechanically, the roots were sectioned and the IRR was simulated.The segments were returned to original position with the aid of screws. A Ca(OH)2 paste remained as MIC for 15 days.The removal was done by PUI and the quality of the cleaning was evaluated by stereomicroscopy. The RC of the samples were filled and the preparation was done in standardized way. The specimens were divided into 2 groups (n=20), according to the type of cemented post. The bond strength was evaluated at the cervical and RRI levels by the push-out test. For the statistical analysis only adhesive and predominantly adhesive failures were included. The results were submitted to Kruskal-Wallis test, Mann Whitney test and Dunn test (α =.05). SEM was used to analyze the bond interface between cement and dentin root (n=1) and Microcomputed tomography (micro-CT) analysis of the GT post (n=3). PUI was not able to clear completely the majority of RRI (62.5%). There was alteration of the adhesive resistance between all groups (p <.05). The values of bond strength for both groups in the cervical region were higher in relation to the groups in the RRI region.The SEM showed formation of resin tags at the bond interface between resin cement and root dentin for both groups. In micro-CT analysis, the presence of bubbles in the cement and spaces in the bond interface between cement are visible. The adhesion of both posts was affected negatively by the level of cementation, post adaptation in the root canal and presence of IRR. Rebilda Post presented better results of adhesive resistance at the cervical level while that Rebilda Post GT presented better results at RRI level(AU)


Assuntos
Humanos , Endodontia/classificação , Materiais Restauradores do Canal Radicular/efeitos adversos , Reabsorção da Raiz/diagnóstico por imagem
6.
J Mater Sci Mater Med ; 29(12): 190, 2018 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-30536136

RESUMO

The aim of this study was to investigate the biocompatibility of nanostructured materials based on highly active calcium silicates mixed with different radiocontrast agents in comparison to MTA+ using in vitro and in vivo model. Morphology of materials' samples was analyzed using SEM while the phase compositions were identified by XRD. pH values of materials' suspensions were conducted by pH-meter. The cytotoxicity of materials' solutions was tested by MTT test (100, 50, 25 and 12.5 mg/ml). LDH and 3H-thymidine assay were utilized for biocompatibility investigations of materials' eluates (24 h, 7 day and 21 day). Eighteen Guinea pigs were used for intramuscular implantation, as teflon tubes with freshly prepared materials were placed into intramuscular pockets. All samples were composed of round and needle-like particles equally distributed with Ca/Si ratio ~2.7 at%, with the presence of hydrated calcium silicate phases. The pH values of ALBO-MPCA1 and ALBO-MPCA2 were high alkaline, while in case of MTA+ they were lower and continuously declined (p < 0.05). Investigated materials didn't exhibit dose-dependent effect on metabolic activity of L929 cells (p > 0.05). Significant differences in the percentage of cytotoxicity between diluted and undiluted extracts between all tested materials after 24 h and 7 day were noticed (p < 0.05). Increase in L929 cells proliferation was noticed in case of undiluted eluates of ALBO-MPCA1 and ALBO-MPCA2 after 7 day (p < 0.05). There were no statistically significant differences in the intensity of inflammatory response between investigated materials and control group after 60 day (p > 0.05). Evaluation of biocompatibility of both ALBO-MPCA1 and ALBO-MPCA2 indicate their potential clinical use.


Assuntos
Meios de Contraste , Nanoestruturas/efeitos adversos , Nanoestruturas/química , Materiais Restauradores do Canal Radicular/efeitos adversos , Materiais Restauradores do Canal Radicular/química , Animais , Materiais Biocompatíveis/efeitos adversos , Materiais Biocompatíveis/química , Cobaias , Concentração de Íons de Hidrogênio , Microscopia Eletrônica de Varredura , Propriedades de Superfície
7.
Braz Dent J ; 29(5): 409-418, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30517438

RESUMO

This systematic review aimed to evaluate whether alternative materials to conventional triple antibiotic paste (TAP - metronidazole, ciprofloxacin, and minocycline) and grey mineral trioxide aggregate (GMTA) could avoid tooth discoloration in teeth submitted to Regenerative Endodontic Procedure (REP). It was also investigated if dental bleaching is able to reverse the color of darkened teeth due to REP. The search was conducted in four databases (Medline via PubMed, Scopus, ISI Web of Science and BVS - Virtual health library), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The retrieved papers were uploaded in the software EndNoteTM and two reviewers independently selected the studies and extracted the data. Only studies in humans (case reports, case series, clinical trials) were included in the review. From 1,122 potentially eligible studies, 83 were selected for full-text analysis, and 38 were included in the review. The included studies were mainly case reports (76.3 %). The studies described a total of 189 teeth submitted to REP. From these, about 54% of teeth presented some degree of discoloration. Most teeth presenting color alteration were treated with TAP, especially when combined with GMTA. Only three studies performed dental bleaching to restore the color of teeth and neither bleaching technique was able to restore the original color of the crowns. The use of alternative materials to TAP and GMTA, such as double antibiotic paste or Ca(OH)2 pastes and white mineral trioxide aggregate or BiodentineTM, reduces the occurrence of tooth discoloration.


Assuntos
Endodontia Regenerativa , Descoloração de Dente/induzido quimicamente , Descoloração de Dente/prevenção & controle , Compostos de Alumínio/efeitos adversos , Antibacterianos/efeitos adversos , Compostos de Cálcio/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Clareamento Dental
8.
J Endod ; 44(10): 1487-1491, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30174106

RESUMO

INTRODUCTION: This microsurgical clinical study evaluated if teeth that have undergone endodontic retreatment are associated with more dentinal defects than primary root canal-treated teeth. METHODS: One hundred fifty-five patients who underwent periapical microsurgery treatment in a private practice setting were evaluated. The root ends were resected, and the roots were inspected for the presence of dentinal defects through the surgical operating microscope with the help of a 0.8-mm-diameter light-emitting diode probe light and methylene blue dye. The root canal treatment history (primary vs retreatment) of the teeth was documented and related to the presence or absence of dentinal defects. Bivariate analysis was performed using the chi-square test, and a multivariate analysis was performed using logistic regression to evaluate possible confounding effects of patient age, sex, and tooth location on the association between treatment and the presence of dentinal defects. RESULTS: Of the 155 treated teeth, 33 were excluded (3 fractured and 30 missing treatment history). Of the remaining 122 included teeth, 73 (59.8%) had undergone primary root canal treatment and 49 (40.2%) retreatment. Sixteen teeth (22.5%) of the primary root canal group versus 33 (64.7%) of the retreatment group had dentinal defects. The proportion of retreated teeth with dentinal defects compared with primary treatment was statistically significant (P < .001) with a higher proportion of retreated teeth having dentinal defects. In the multivariate analysis, only the type of treatment was statistically significant (P < .001). CONCLUSIONS: This clinical study showed that root canal-retreated teeth are associated with more dentinal defects than primary root canal-treated teeth.


Assuntos
Displasia da Dentina/epidemiologia , Displasia da Dentina/etiologia , Dentina/lesões , Dentina/patologia , Microcirurgia , Retratamento/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Ápice Dentário/cirurgia , Dente não Vital/patologia , Adulto , Feminino , Humanos , Masculino , Materiais Restauradores do Canal Radicular/efeitos adversos
9.
J Contemp Dent Pract ; 19(7): 847-852, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30066690

RESUMO

AIM: To evaluate and compare the cytotoxic effects of different types of root canal. MATERIALS AND METHODS: The sealers were eluted with culture medium for 1 hour, 7 days, and 14 days. Cell viability was estimated by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and trypan blue exclusion method on human periodontal ligament (PDL) fibroblast cells. Sealers used are mineral trioxide aggregate (MTA)-based sealer (MTA Fillapex, Angelus), calcium hydroxide-based sealer (Apexit Plus, Ivoclar Vivadent), resin-based sealer (AH Plus, Dentsply), and zinc oxide eugenol-based sealer (Tubli Seal, SybronEndo). RESULTS: The order of cytotoxicity through MTT assay, at the end of the second week, was observed as MTA Fillapex> Tubli Seal> Apexit Plus > AH Plus. The percentage cell viability obtained after trypan blue exclusion method decreased in the order of Apexit Plus> Tubli Seal> AH Plus> MTA Fillapex, which was similar to the reported cytotoxicity from the MTT assay after 1 hour. CONCLUSION: Each type of sealer showed moderate-to-severe cytotoxic response when compared with the control. The MTA Fillapex was found to be the most cytotoxic sealer. Use of resin-based material as a root canal sealer may result in a more favorable response to PDL fibroblasts. CLINICAL SIGNIFICANCE: Having knowledge of the cytotoxicity of various sealers will help in increasing patient's comfort.


Assuntos
Compostos de Alumínio/toxicidade , Compostos de Cálcio/toxicidade , Sobrevivência Celular/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Óxidos/toxicidade , Ligamento Periodontal/citologia , Materiais Restauradores do Canal Radicular/toxicidade , Silicatos/toxicidade , Hidróxido de Cálcio/toxicidade , Células Cultivadas , Combinação de Medicamentos , Humanos , Técnicas In Vitro , Materiais Restauradores do Canal Radicular/efeitos adversos , Fatores de Tempo , Cimento de Óxido de Zinco e Eugenol/toxicidade
10.
PLoS One ; 13(3): e0194467, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29579090

RESUMO

The aim of this study was to evaluate the effect of an epoxy resin-based (AH-Plus), a zinc oxide eugenol containing (Pulp-Canal-Sealer) and two calcium silicate containing (MTA-Fillapex and BioRoot-RCS) sealers on primary human osteoblasts (hOB) in freshly mixed and set state. All sealers were mixed strictly according to the manufacturers´ instructions and identically samples were produced. In a pretest cytotoxic sealer concentrations were determined. Thus, for the main cell culture study, dilutions of sealer extract 1:1, 1:2, and 1:10 were used. To simulate a clinical scenario, extracts from freshly mixed sealer were added to the cells on day one. Extracts form set sealers were used for subsequent culturing for 24h, 7d, 14d, and 21d. Cell viability was analyzed by living-cell-count, MTT-assay, and living/dead-staining, cytotoxicity by LDH-assay, and changes by Richardson-staining. All data were statistically evaluated by one way ANOVA and a posthoc analysis with Bonferroni-Holm testing (p<0.05). AH-Plus was cytotoxic in a freshly mixed state, but not when the sealer was set. MTA-Fillapex and Pulp-Canal-Sealer were cytotoxic in a fresh as well as in a set state. BioRoot-RCS showed the lowest toxicity in both states; where as a regeneration of the cells could be observed over time (p<0.05). Contact of freshly mixed AH-Plus to osteoblasts should be avoided. Pulp Canal Sealer and MTA-Fillapex showed no biocompatibility in contact with osteoblasts at all. BioRoot-RCS had a positive influence on the cell metabolism (bioactivity) and is biocompatible.


Assuntos
Teste de Materiais , Osteoblastos/metabolismo , Materiais Restauradores do Canal Radicular/farmacologia , Células Cultivadas , Feminino , Humanos , Masculino , Osteoblastos/citologia , Materiais Restauradores do Canal Radicular/efeitos adversos
11.
Int Endod J ; 51(7): 808-815, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29363142

RESUMO

AIM: To evaluate ex vivo the efficacy of ProTaper Universal Retreatment files (Dentsply Sirona, Ballaigues, Switzerland) in removing Thermafil, GuttaCore (both Dentsply Sirona) or vertically compacted gutta-percha from curved root canals using micro-CT. METHODOLOGY: Sixty curved molar roots with the same mean canal curvatures and radii in two directions were prepared using ProFile instruments (Dentsply Sirona) to size 30 with .04 taper and obturated with either Thermafil, GuttaCore or vertically compacted gutta-percha and AH Plus (n = 20). Specimens were retreated using the ProTaper Universal Retreatment files D1, D2 and D3 to working length, and root canal preparation was completed with ProTaper Next (Dentsply Sirona) to size ×4. Percentages of residual filling material and dentine removal were assessed using micro-CT imaging. Working time and procedural errors were recorded. Statistical analysis was performed using Kruskal-Wallis and Wilcoxon tests. RESULTS: No significant differences between carrier-based and warm vertical compaction regarding residual filling material (14.2-19.3%) and dentine removal (2.7-3.2 mm3 ) were detected (P > 0.05). Time to reach working length was significantly faster for canals filled with GuttaCore than that observed for Thermafil and warm vertical compaction (P < 0.05). Five lateral perforations with the D3 file occurred during retreatment, one in the Thermafil and four in the vertical compaction group. CONCLUSIONS: Remaining filling material and dentine removal were similar for all canal filling techniques. Regaining working length was significantly faster for GuttaCore compared with Thermafil and vertically compacted gutta-percha. Procedural errors occurred during retreatment of severely curved root canals with the ProTaper Universal Retreatment files in 5 of 60 canals (8%).


Assuntos
Cavidade Pulpar/cirurgia , Guta-Percha/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Cavidade Pulpar/diagnóstico por imagem , Guta-Percha/uso terapêutico , Humanos , Radiografia Dentária , Reoperação/instrumentação , Reoperação/métodos , Obturação do Canal Radicular/efeitos adversos , Preparo de Canal Radicular/métodos , Microtomografia por Raio-X
12.
Int Endod J ; 51(3): 284-317, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28846134

RESUMO

Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Compostos de Alumínio/efeitos adversos , Animais , Compostos de Cálcio/efeitos adversos , Cimentos Dentários/efeitos adversos , Combinação de Medicamentos , Humanos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos
13.
Clin Oral Investig ; 22(4): 1725-1731, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29090391

RESUMO

OBJECTIVES: The aim of this study was to assess the effect of sealing the pulp chamber walls with a dentin-bonding agent (DBA) on prevention of discoloration induced by regenerative endodontic procedures (REPs) in an ex vivo model. MATERIALS AND METHODS: Ninety-six bovine incisors were prepared and randomly divided into two groups. In one group, the pulp chamber walls were sealed with DBA before placement of triple antibiotic paste (TAP) containing minocycline inside the root canals, but in the other group, DBA was not applied. After 4 weeks, the root canals were filled with human blood and each group was then randomly divided into four subgroups (n = 12) according to the endodontic cements placed over the blood clot (ProRoot MTA, OrthoMTA, RetroMTA, or Biodentine). The color changes (∆E) were measured at different steps. The data were analyzed using t test and two-way ANOVA. RESULTS: The specimens in which dentinal walls of pulp chamber were sealed with DBA showed significantly less coronal discoloration at each step of regenerative treatment (p < 0.001). However, application of DBA did not completely prevent the clinically perceptible coronal color change. Sealing the blood clot with different endodontic cements did not result in significant difference in coronal discoloration (p > 0.05). CONCLUSIONS: Sealing the pulp chamber walls before insertion of TAP decreased coronal discoloration following REP using different endodontic cements but did not prevent it. CLINICAL RELEVANCE: Discoloration of teeth undergoing REPs is an unfavorable outcome. Considering the significant contribution of TAP containing minocycline to the coronal tooth discoloration even after sealing the pulp chamber walls, the revision of current guidelines in relation to the use of TAP with minocycline might need to be revised.


Assuntos
Adesivos Dentinários/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Descoloração de Dente/induzido quimicamente , Descoloração de Dente/prevenção & controle , Compostos de Alumínio , Animais , Antibacterianos/farmacologia , Compostos de Cálcio , Bovinos , Combinação de Medicamentos , Técnicas In Vitro , Incisivo , Óxidos , Distribuição Aleatória , Silicatos
14.
BMC Oral Health ; 17(1): 167, 2017 12 29.
Artigo em Inglês | MEDLINE | ID: mdl-29284463

RESUMO

BACKGROUND: This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment. METHODS: Keywords of "(core carrier OR Thermafil) OR (cold lateral condensation OR lateral condensation) OR (warm vertical condensation OR vertical condensation) AND (obturation OR root canal filling) AND clinical study" were searched for all obtainable publications up to year 2017 in the databases of PubMed, ScienceDirect, EMBASE, Scopus and Web of Science. The success rate, short-term postoperative pain, overfilling and adaptation of core-carrier obturation from clinical studies were selected. Reviews, laboratory studies, animal studies and irrelevant reports were excluded. RESULTS: 1349 relevant articles were identified with 149 duplicated articles removed and 1173 irrelevant articles were excluded after screening. The titles and abstracts of the 19 identified articles were screened in the systematic review. The full texts of remaining articles were retrieved with data extracted for meta-analysis on the success rate, postoperative pain, overfilling and adaptation of obturation. The pooled success rate of core-carrier obturation was 83% (95% CI: 69%-91%). The pooled incidence of 1-day and 7-day short-term postoperative pain were 35% (95% CI: 15%-62%) and 6% (95% CI: 1-35%). The pooled proportion of teeth with overfilling and adequate adaptation of the obturation material were 31% (95% CI: 18%-50%) and 85% (95% CI: 75%-91%), respectively. CONCLUSIONS: The success rate of endodontic treatment using core-carrier obturation was 83%. Short-term postoperative pain was not uncommon (24%). Most teeth (85%) had adequate adaptation using core-carrier obturation material, but a considerable amount of teeth (31%) had overfilling.


Assuntos
Obturação do Canal Radicular , Humanos , Materiais Restauradores do Canal Radicular/efeitos adversos , Materiais Restauradores do Canal Radicular/uso terapêutico , Obturação do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/métodos
16.
J Stomatol Oral Maxillofac Surg ; 118(6): 389-392, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28893717

RESUMO

The authors report the case of a 43-year-old woman who underwent endodontic treatment of the right second mandibular molar with substantial extrusion of endodontic material into the mandibular canal. The patient presented at the Department of Oral and Maxillofacial Surgery with a persistent total anaesthesia of the lower lip and chin after two months. 2D panoramic view and 3D CT-scan examination highlighted the overfilling into the mandibular canal with a more than 50% stenosis of the canal and a consequently significant compression of the dental pedicle. A surgical decompression of the inferior alveolar nerve was performed through an inferior vestibular approach, using PiezoSurgery®. The tooth was conserved. After a period of 8days, paraesthesia of the lower lip and chin appeared. Thermoalgic sensitivity was recovered at 1month. At 3months postoperatively, the patient had recovered protopathic and epicritic sensitivity. Dental prosthetic rehabilitation was finally achieved one year postoperatively. The authors discuss the physiopathology of nervous injuries during dental procedures, and further strategies in the case of persistent neurologic disorders.


Assuntos
Descompressão Cirúrgica , Nervo Mandibular/cirurgia , Materiais Restauradores do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Traumatismos do Nervo Trigêmeo/cirurgia , Adulto , Feminino , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Nervo Mandibular/patologia , Reoperação/métodos , Tratamento do Canal Radicular/métodos , Traumatismos do Nervo Trigêmeo/etiologia
17.
J Appl Biomater Funct Mater ; 15(4): e382-e386, 2017 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-28525679

RESUMO

BACKGROUND: During the apexification procedure for teeth with open apices, mineral trioxide aggregate (MTA) may be unintentionally extruded. The aim of the present study was the retrospective evaluation of the healing of periapical lesions in permanent incisor teeth with open apices after the unintentional extrusion of MTA. METHODS: The clinical and radiographic records of 55 maxillary permanent central teeth treated by MTA apexification were evaluated. Filled teeth with unintentionally extruded MTA were selected as group 1 (n = 21), whereas the teeth with no MTA extrusion were selected as group 2 (n = 34). For each tooth, the clinical and radiographic records from a 3-year follow-up were investigated. RESULTS: Complete healing (CH) was observed in 19 teeth (90.4%) in group 1, whereas the same type of healing was observed in all 34 teeth (100%) in group 2 (p>0.05). At the 6-month follow-up appointment, 25 teeth (73.5%) showed CH in group 2, whereas 15 teeth (71.4%) showed CH at the 1-year follow-up in group 1 (p<0.001). At the end of the 3-year follow-up period, the amount of MTA extrusion was reduced in 17 teeth (85%) (p<0.05), whereas it was almost absent in 2 teeth (10%). CONCLUSIONS: The unintentional extrusion of MTA does not prevent the healing of periapical lesions, but may be a delaying factor for periapical healing.


Assuntos
Compostos de Alumínio/efeitos adversos , Apexificação/efeitos adversos , Compostos de Cálcio/efeitos adversos , Óxidos/efeitos adversos , Doenças Periapicais/etiologia , Doenças Periapicais/reabilitação , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Cicatrização/fisiologia , Apexificação/métodos , Criança , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Masculino , Doenças Periapicais/cirurgia , Estudos Retrospectivos , Materiais Restauradores do Canal Radicular/química , Materiais Restauradores do Canal Radicular/uso terapêutico
18.
J Endod ; 43(7): 1170-1175, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28527853

RESUMO

INTRODUCTION: Investigating the vertical root fracture (VRF) pathway under different clinical scenarios may help to diagnose this condition properly. We aimed to determine the capability and intrareliability of VRF pathway detection through cone-beam computed tomographic (CBCT) imaging as well as analyze the influence of different intracanal and crown materials. METHODS: VRFs were mechanically induced in 30 teeth, and 4 clinical situations were reproduced in vitro: no filling, gutta-percha, post, and metal crown. A Prexion (San Mateo, CA) 3-dimensional tomographic device was used to generate 104 CBCT scans. The VRF pathway was determined by using landmarks in the Avizo software (Version 8.1; FEI Visualization Sciences Group, Burlington, MA) by 1 observer repeated 3 times. Analysis of variance and post hoc tests were applied to compare groups. RESULTS: Intrareliability demonstrated an excellent agreement (intraclass correlation coefficient mean = 0.93). Descriptive analysis showed that the fracture line measurement was smaller in the post and metal crown groups than in the no-filling and gutta-percha groups. The 1-way analysis of variance test found statistically significant differences among the groups measurements. The Bonferroni correction showed statistically significant differences related to the no-filling and gutta-percha groups versus the post and metal crown groups. CONCLUSIONS: The VRF pathway can be accurately detected in a nonfilled tooth using limited field of view CBCT imaging. The presence of gutta-percha generated a low beam hardening artifact that did not hinder the VRF extent. The presence of an intracanal gold post made the fracture line appear smaller than it really was in the sagittal images; in the axial images, a VRF was only detected when the apical third was involved. The presence of a metal crown did not generate additional artifacts on the root surface compared to the intracanal gold post by itself.


Assuntos
Materiais Restauradores do Canal Radicular/efeitos adversos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/lesões , Dente não Vital/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Coroas/efeitos adversos , Humanos , Radiografia Dentária , Reprodutibilidade dos Testes , Materiais Restauradores do Canal Radicular/metabolismo , Raiz Dentária/diagnóstico por imagem
19.
J Endod ; 43(6): 1001-1007, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28416317

RESUMO

INTRODUCTION: The aim of the study was to investigate the addition of variable amounts of zinc oxide to inhibit dental discoloration caused by mineral trioxide aggregate (MTA) Angelus. METHODS: MTA Angelus and MTA with additions of 5%, 15%, and 45% zinc oxide (ZnO) in weight were tested. The set cements were characterized by using a combination of scanning electron microscopy, energy dispersive spectroscopy, and x-ray diffraction. Radiopacity and setting time were analyzed according to American National Standards Institute/American Dental Association (57/2012) and American Society for Testing and Materials (C266-08). Volume change was evaluated by using micro-computed tomography analysis. The pH and calcium ion release were measured after 3 hours, 24 hours, and 28 days. Dental discoloration in contact with the cements was measured after 24 hours, 28 days, and 90 days. Biocompatibility to subcutaneous implantation in rats was verified after 30 and 60 days. RESULTS: Addition of ZnO did not alter significantly the radiopacity, setting time, volume change, pH, and biocompatibility compared with MTA Angelus (P > .05). Calcium ion release increased with addition of ZnO (P < .05). Proportions of 15% and 45% ZnO interfered in hydration. The 5% ZnO addition was sufficient to prevent the dental discoloration observed with MTA Angelus. CONCLUSIONS: The addition of 5%, 15%, or 45% zinc oxide to MTA Angelus inhibits dental discoloration without modifying the radiopacity, setting time, volume change, pH, and biocompatibility.


Assuntos
Bismuto/efeitos adversos , Óxidos/efeitos adversos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Descoloração de Dente/prevenção & controle , Óxido de Zinco/uso terapêutico , Animais , Bovinos , Relação Dose-Resposta a Droga , Humanos , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Descoloração de Dente/induzido quimicamente , Difração de Raios X , Óxido de Zinco/administração & dosagem
20.
J Endod ; 43(5): 816-822, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28343929

RESUMO

INTRODUCTION: The aim of the present study was to evaluate the in vitro cytotoxicity of endodontic sealers (GuttaFlow Bioseal, GuttaFlow2, and MTA Fillapex) on human periodontal ligament stem cells (hPDLSCs). As a reference, AH Plus was compared with the more recent endodontic sealers regarding cell viability and cell attachment. METHODS: Biological testing was carried out in vitro on hPDLSCs. Cell viability assay was performed by using eluates from each endodontic sealer. To assess cell morphology and attachment to the different sealers, the hPDLSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. Chemical composition of the sealers was determined by energy-dispersive x-ray, and eluates were analyzed by inductively coupled plasma mass spectrometry. Statistical differences were assessed by analysis of variance and Tukey test (P < .05). RESULTS: Cell viability was evident after 24 hours in the presence of GuttaFlow Bioseal and GuttaFlow 2 but not in the case of AH Plus or MTA Fillapex. At 168 hours, GuttaFlow Bioseal and GuttaFlow 2 exhibited high and moderate cell viability, respectively, whereas AH Plus and MTA Fillapex revealed low rates of cell cell viability (P < .001). Finally, scanning electron microscopy studies revealed a high degree of proliferation, cell spreading, and attachment, especially when using GuttaFlow Bioseal disks. CONCLUSIONS: GuttaFlow Bioseal and GuttaFlow2 showed lower cytotoxicity than MTA Fillapex and AH plus. Further in vitro and in vivo investigations are required to confirm the suitability of GuttaFlow Bioseal for clinical application.


Assuntos
Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Dimetilpolisiloxanos/efeitos adversos , Resinas Epóxi/efeitos adversos , Guta-Percha/efeitos adversos , Óxidos/efeitos adversos , Ligamento Periodontal/efeitos dos fármacos , Materiais Restauradores do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Células-Tronco/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Combinação de Medicamentos , Humanos , Ligamento Periodontal/citologia
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