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J Dent Child (Chic) ; 88(1): 46-51, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33875052


Purpose: To assess retrospectively the success rate of calcium hydroxide with iodoform as a filling material in pulpectomies of primary molars with irreversible pulpitis or pulp necrosis, and to evaluate factors that affect outcomes.
Methods: This study consisted of records of 73 patients with primary molars treated with pulpectomy with high quality radiographs. Treatment was considered successful clinically if the tooth was not extracted and radiographs showed a decrease or no change in preexisting pathologic radiolucent defects.
Results: Follow-up ranged from three to 39 months (median: 21.5 months). The success rate of teeth restored with a stainless steel crown (SSC) on the same appointment (88.9 percent) was higher than for teeth that received a temporary restoration (P =0.001). There was no statistically significant difference between the success rate and the extent of resorption of root canal filling material. Primary second molars had a higher success rate than first molars (P =0.018). No difference was found between the level of pulpectomy filling and treatment success (P =0.17).
Conclusion: Pulpectomies done with calcium hydroxide and iodoform had an overall success rate of 74 percent. If restored with an SSC, the success rate increased to 88.9 percent. Resorption of the paste did not affect the success rate.

Pulpectomia , Materiais Restauradores do Canal Radicular , Hidróxido de Cálcio/uso terapêutico , Humanos , Hidrocarbonetos Iodados , Estudos Retrospectivos , Materiais Restauradores do Canal Radicular/uso terapêutico , Dente Decíduo , Resultado do Tratamento , Cimento de Óxido de Zinco e Eugenol
Compend Contin Educ Dent ; 42(2): e1-e4, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33740381


This case report describes the nonsurgical endodontic management of a distolingual floor perforation in a mandibular first molar using an internal matrix and mineral trioxide aggregate (MTA) cement. The pulp chamber was properly cleaned, and after placement of a synthetic collagen material that served as a barrier at the level of furcation, MTA was used to repair the perforation defect. Root canal treatment was completed and the tooth was restored with a composite restoration followed by a porcelain-fused-to-metal crown.

Materiais Restauradores do Canal Radicular , Cimento de Silicato , Compostos de Alumínio/uso terapêutico , Cálcio , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Combinação de Medicamentos , Humanos , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico
J Mater Chem B ; 9(5): 1370-1383, 2021 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-33459325


To solve the high instances of failure caused by endodontic reinfection, herein, an improved root filling material was produced to meet the multi-functional demand of sealers for root canal therapy. In this study, polyurethane (PU)-based nanocomposites were prepared by loading bismuth oxide, hydroxyapatite and antibacterial agents, namely Ag3PO4 and ZnO nanoparticles, which were named CP-Ag and CP-Zn sealers, respectively. A parallel biological evaluation at bacterial and cellular levels was performed to determine the fate of the different components of the PU-based sealers. Furthermore, the composition of sealers was quantified by screening their antibacterial activity and apoptotic factors, considering the potential toxicity of the nanoparticles and high dosage of metals. The in vitro optimization investigation was conducted systematically against Streptococcus mutans and Staphylococcus aureus, including bacteriostatic and dynamic tests, and the expression of the B-cell lymphoma-2 gene family and caspase proteases in the mitochondria-mediated apoptotic pathway was evaluated using the commercial AH Plus® and Apexit® Plus sealers for comparison. Additionally, the physical properties and sealing ability of sealers were assessed. The results showed that all PU-based sealers could meet the requirements of ISO 6876:2012 for root canal sealing materials. Based on the evaluation system, CP-Zn sealers expressed longer lasting antibacterial activity and lower toxic effect on cells compared to CP-Ag sealers. Especially, the CP-Zn5 sealer exhibited selective antimicrobial efficacy and hypo-toxicity, which were better than that of the two commercial sealers. According to the two-dimensional and three-dimensional methods, the good sealing ability of the CP-Zn5 sealer is the same as the excellent filling characters of AH Plus, which adapts to irregular root canals.

Antibacterianos/uso terapêutico , Nanopartículas/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Antibacterianos/farmacologia , Apoptose , Humanos
Endodoncia (Madr.) ; 38(2): 6-12, oct. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198454


Las perforaciones radiculares son complicaciones no deseadas que pueden ocurrir durante el tratamiento de conductos. Los principales factores que afectan el pronóstico de un diente que presenta una perforación son la localización y el tamaño de esta, el tiempo transcurrido hasta su reparación, el grado de contaminación previa, y la presencia de una radiolucidez adyacente. La aparición de materiales biocompatibles como el agregado de trióxido mineral (MTA) incrementó de forma sustancial el pronóstico de estos dientes alcanzando tasas de éxito de alrededor del 90%. El objetivo de este artículo es describir el manejo ortógrado de dos casos con perforaciones radiculares laterales en los que se utilizaron materiales y técnicas distintas para su sellado. En ambos casos, previamente al sellado ortógrado de las perforaciones, se realizó una desinfección abundante con hipoclorito de sodio (NaOCl) al 2,5%. En el primer caso, se realizó la obturación del tercio apical del conducto usando una técnica de condensación vertical con gutapercha caliente, y posteriormente se obturó el resto del conducto, incluida la perforación, mediante MTA blanco (Angelus, Londrina, PR, Brasil). En el segundo caso, que además presentaba la dificultad añadida de un instrumento fracturado, se utilizó Biodentine (Septodont, Saint-Maur-des-Fosses, Francia) en toda la longitud del conducto radicular donde se encontraba la perforación. La ausencia de signos y síntomas clínicos y la curación radiográfica en progreso revelan unos resultados satisfactorios en las revaluaciones postoperatorias a los 6 y 18 meses

Root perforations are undesired complications that can occur during root canal treatments. The prognosis of teeth with root perforations could be affected by several factors described in the literature, such as location, size, immediacy in the repair, previous microbial contamination and the presence of a radiolucency adjacent to perforation. However, the introduction of mineral trioxide aggregate (MTA) resulted in an improved prognosis and higher success rates. The purpose of this case report was to describe two nonsurgical endodontic retreatments with lateral root perforations using two different materials and techniques for filling. A disinfection with 2,5% sodium hypochlorite was carried out in both root canals with root perforation. In the first case, the apical third of the canal was filled with vertically compacted warm gutta-percha, while the rest of the canal was sealed with white MTA (Angelus, Londrina, PR, Brazil) for proper sealing of the perforation. In the second case, in addition to presenting the added difficulty of a separated instrument, the complete root canal filling with perforation was performed using Biodentine (Septodont, Saint-Maur-des-Fosses, France). The absence of clinical signs and symptoms and the radiographic healing in progress revealed satisfactory results after 6 and 18 months of follow-up

Humanos , Adulto , Idoso , Cavidade Pulpar/lesões , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Cavidade Pulpar/diagnóstico por imagem , Tratamento do Canal Radicular/efeitos adversos , Radiografia Dentária , Tomografia Computadorizada de Feixe Cônico , Resultado do Tratamento , Combinação de Medicamentos , Óxidos/uso terapêutico , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Silicatos/uso terapêutico
J Vet Dent ; 37(2): 77-87, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32856554


Intentional or unintentional pulp exposure of cat canines can lead to periapical disease, osteomyelitis, and oral pain. Root canal therapy (RCT) allows the retention of cat canines with pulp exposure by removing the infected pulp and replacing it with an inert material. This study used MTA Fillapex™ as a root canal sealant with gutta percha single cone obturation in 37 cats (50 canine teeth). Roots were classified as "successful," "no evidence of failure (NEF)," or "failed" at 6-month radiographic reviews. Therapy was considered "successful" if a preoperative periapical lucency had healed or not formed after treatment and any preoperative external inflammatory root resorption (EIRR) had stabilized without progression. Therapy was categorized as "NEF" if a periapical lucency had remained the same or decreased in size but not completely resolved and any preoperative EIRR had stabilized without progression. "Failed" if a periapical lucency had occurred or increased in size posttreatment or if EIRR had developed or progressed posttreatment. Thirty-two canine teeth (64%) were classified as "successful," 14 canine teeth (28%) were classified as "NEF," and 4 canine teeth (8%) were classified as "failed". The study concluded that RCT using MTA Fillapex as a root canal sealant is a suitable endodontic treatment for fractured cat canines, especially those that are periodontally or endodontically challenged.

Materiais Restauradores do Canal Radicular , Animais , Gatos , Dente Canino , Guta-Percha , Pemetrexede , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/veterinária
Cient. dent. (Ed. impr.) ; 17(2): 115-120, mayo-ago. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195099


INTRODUCCIÓN: el tratamiento de conductos produce cambios físico-químicos en la dentina y una pérdida estructural significativa para el diente, lo que lo hace más susceptible a la fractura. MATERIAL Y MÉTODOS: 64 premolares mandibulares fueron decoronados y divididos aleatoriamente en cuatro grupos (n = 16): grupo control (CG) no tratado, grupo instrumentado ProTaperGold® (PTG®) (25.08), grupo instrumentado ProTaperNext® (PTN®) (25.06) y grupo instrumentado WaveOne Gold PRIMARY® (WOG®) (25.07). Durante la instrumentación, se realizó la irrigación con NaOCl al 5,25% con una jeringa Monoject® y tras la instrumentación, las muestras se irrigaron con NaOCl, EDTA 17% y NaOCl activado sónicamente. Los conductos radiculares se obturaron utilizando el sistema B&L®, y posteriormente se colocaron en bloques de resina acrílica estandarizados para ser cargados con una fuerza vertical constan-te de 0,02 mm/s hasta que se produjo la fractura de la raíz, mediante una máquina de ensayo universal (ME-405/20, Servo-sis®). Las comparaciones entre grupos se analizaron con la prueba ANOVA.RESULTADOS: No hubo diferencias esta-dísticamente significativas (p > 0,05) entre el GC y los grupos instrumentados con PTN® y WOG®; tampoco entre los grupos PTN® y WOG®. Sin embargo, se obtuvieron diferencias estadísticamente significativas entre el grupo instrumentado con PTG® y el resto de los grupos, siendo el grupo PTG® el más susceptible a la frac-tura. CONCLUSIONES: El sistema PTG® fue el que más debilitó las raíces después de la instrumentación, en comparación con los sistemas WOG® y PTN®

INTRODUCTION: root canal treatment produces physicist-chemist changes in the dentine and a significant structural loss for the tooth what makes it more susceptible to fracture. MATERIAL AND METHODS: 64 mandibular premolar were decoronated and randomly divided into four groups (n = 16): control group (CG) non-treated, ProTaper Gold(TM) (PTG(TM)) instrumented group (25.08), ProTaper Next(TM) (PTN(TM)) instrumented group (25.06) and WaveOne Gold(TM) PRIMARY (WOG(TM)) instrumented group (25.07). While shaping, cleaning was done with NaOCl 5,25% using a Monoject(TM) syringe and after shaping, roots were irrigated with NaOCl, EDTA 17% and NaOCl sonically activated. Root canals were obturated using B&L(TM) system, embedded into standardized acrylic resin blocks and load with a constant vertical force of 0,02 mm/s until root fracture was produced using a universal testing machine (ME-405/20, Servosis(TM)). Comparisons among groups were analyzed with ANOVA test. RESULTS: There were no statistically significant differences (p > 0.05) between the CG and the groups instrumented with PTN(TM) and WOG(TM); neither among PTN(TM) and WOG(TM) groups. However, statistically significant differences were obtained between the group instrumented with PTG(TM) and the rest of the groups being PTG(TM) group the most susceptible to fracture. CONCLUSIONS: PTG(TM) system was the one that weakened more the roots after the instrumentation in comparison with the WOG(TM) and PTN(TM) systems

Humanos , Preparo da Cavidade Dentária/métodos , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapia , Dente Pré-Molar/lesões , Preparo de Canal Radicular/instrumentação , Materiais Restauradores do Canal Radicular/uso terapêutico , Restauração Dentária Permanente/métodos , Análise de Variância , Irrigantes do Canal Radicular/uso terapêutico
Rev. Asoc. Odontol. Argent ; 108(2): 63-67, mayo-ago. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1121413


Objetivo: Presentar un caso clínico de dos premolares inferiores con perforación radicular iatrogénica obturadas con Biodentine. Caso clínico: Una paciente de 54 años de edad fue derivada para realizar el tratamiento endodóntico en las piezas dentarias 44 y 45. Los exámenes clínico y radiográfico revelaron la presencia de perforaciones radiculares, cuya localización fue confirmada por medio de una tomografía computarizada de haz cónico. Luego de la desinfección y la instrumentación de los conductos radiculares, ambas perforaciones fueron selladas con Biodentine. Finalmente, los conductos fueron obturados, y las cavidades de acceso, restauradas con resina compuesta. Una semana después los dientes se encontraban asintomáticos y sin tumefacción. La paciente fue controlada nuevamente a los 20 meses postratamiento. Al examen clínico, ambos dientes estaban asintomáticos y funcionales. No hubo signos de infección, inflamación o sensibilidad a la percusión y la palpación. Las imágenes radiográficas y tomográficas revelaron espacio periodontal y cortical ósea normales. Conclusión: En el presente caso clínico, el Biodentine resultó un material adecuado para la obturación de perforaciones radiculares de origen iatrogénico ubicadas en la unión de los tercios medio y coronal (AU)

Aim: To present a clinical case of two lower premolars with iatrogenic root perforations in which both defects were repaired with Biodentine. Clinical case: A healthy 54-year old female was referred for endodontic treatment of teeth number 44 and 45. Clinical and radiographic examination revealed the presence of root perforations whose buccal localization was confirmed by a cone beam computed tomography scan. After the root canals were instrumented, both perforations were filled with Biodentine. The canals were obturated and the endodontic accesses were restored. A week later, the teeth were asymptomatic and without the presence of swelling. The patient was recalled 20-months after treatment and both teeth were asymptomatic and functional with no signs of infection, inflammation or sensitivity to percussion and palpation. Radiograph and cone beam computed tomography images showed a normal periodontal width and an intact lamina dura. Conclusion: Based on the outocome of this clinical case, Biodentine was an adequate material to repair iatrogenic root perforations (AU)

Humanos , Feminino , Pessoa de Meia-Idade , Materiais Restauradores do Canal Radicular/uso terapêutico , Cimento de Silicato/uso terapêutico , Raiz Dentária/lesões , Doença Iatrogênica , Tratamento do Canal Radicular , Sinais e Sintomas , Dente Pré-Molar/diagnóstico por imagem , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico
Pain Res Manag ; 2020: 5853412, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32676136


This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

Dor Pós-Operatória/etiologia , Pulpotomia/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Adulto , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Masculino , Dente Molar , Óxidos/uso terapêutico , Dor Pós-Operatória/epidemiologia , Prevalência , Pulpotomia/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Silicatos/uso terapêutico , Resultado do Tratamento
Niger J Clin Pract ; 23(6): 798-804, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525114


Aims: The aim of this study was to evaluation the treatment success of the short post technique (mushroom restoration) using a composite resin in severely decayed primary anterior teeth after 6, 12, and 18 months after treatment. Methods: Eighteen children aged 3-5 years with severely decayed primary maxillary anterior teeth (60 anterior maxillary primary teeth in total) were included. Patients were treated under general anesthesia (GA). After pulpectomy, a "mushroom shape" was formed in the root canals for the purpose of retention, and the root canals were filled with zinc oxide-eugenol (ZOE), and the teeth were restored with composite resin. The status of treatment was evaluated clinically and radiographically for periapical radiolucency, pathological root resorption, marginal fracture, and loss of restoration for each treated tooth. All findings were recorded. Results: As a result of the evaluation criteria, the success rates at 6, 12 and 18 months were 86%, 80%, and 71%, respectively. None of the teeth showed apical radiolucency or pathological root resorption at the end of the 18th month period. Conclusion: The short-post (mushroom restorations) technique is a clinically acceptable alternative method for restoration of severely decayed primary teeth. This study supports the feasibility of treatment with this technique for pediatric patients treated under GA.

Restauração Dentária Permanente/métodos , Técnica para Retentor Intrarradicular , Pulpectomia/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Dente Decíduo/cirurgia , Cimento de Óxido de Zinco e Eugenol/uso terapêutico , Anestesia Geral , Pré-Escolar , Resinas Compostas/química , Cárie Dentária/complicações , Preparo da Cavidade Dentária , Extravasamento de Materiais Terapêuticos e Diagnósticos/complicações , Feminino , Humanos , Masculino , Maxila , Pulpectomia/efeitos adversos , Reabsorção da Raiz , Traumatismos Dentários/complicações , Resultado do Tratamento
Endodoncia (Madr.) ; 38(1): 28-43, jun. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199207


OBJETIVO: Los materiales que se emplean para procedimientos dentales en los que el material contacta directamente con el tejido pulpar y tejidos periodontales han de cumplir una serie de propiedades, entre ellas la biocompatibilidad. A su vez, han de ser materiales que eviten el paso de fluidos y microorganismos con el fin de preservar las condiciones óptimas de los tejidos. El objetivo de esta revisión sistemática fue evaluar la porosidad de los diferentes cementos de agregado trióxido mineral (MTA). MÉTODO: Dos investigadores realizaron búsquedas avanzadas en: PubMed Central, PubMed, Web of Science, Scopus, Cochrane Li-brary, Science Direc y Science Database (Proquest) siguiendo los criterios PRISMA. Los criterios de inclusión contemplaban los es-tudios in vitro, publicados en inglés desde enero de 1993 hasta abril de 2019, que analizaran y midieran la porosidad del MTA. Se excluyeron los estudios in vivo, piloto, editoriales, cartas, revisiones sistemáticas, reseñas literarias, resúmenes de conferencias y trabajos de fin de grado. RESULTADOS: Un total de 853 artículos resultó de la búsqueda inicial, de los que solo 19 pasaron los criterios de inclusión, exclusión y el análisis del riesgo de sesgo. En ellos, se analizan distintas técnicas de condensación del MTA, radiopacificadores, sustratos, etc., en busca de materiales que presenten menor porosidad. CONCLUSIONES: La elevada heterogeneidad de los estudios sobre porosidad y el hecho de que éstos no estén estandarizados, pue-de condicionar la validez externa o generalización de los resultados entre los distintos investigadores para un mismo material y procedimiento. En los estudios que realizan una comparación entre varios materiales, concluyen que tanto MTA ProRoot® y Bio-dentineTM obtuvieron mejores resultados en cuanto a porosidad. Número de solicitud (PROSPERO): 124340

OBJECTIVE: Materials used for dental procedures in which the material directly contacts the pulp and periodontal tissues must have a series of characteristics, such as biocompatibility. Equally, they must be materials that prevent the passage of fluids and microorganisms aiming at keeping the optimal conditions of the tissues intact. The objective of this systematic review was to evaluate the porosity of the different cements of mineral trioxide aggregate (MTA). METHOD: Two researchers conducted advanced searches in: PubMed Central, PubMed, Web of Science, Scopus, Cochrane Library, ScienceDirect and ScienceDatabase (Proquest) following the PRISMA criteria. Inclusion criteria took into account in vitro studies, published in English from January 1993 to April 2019, to analyse and measure the porosity of the MTA. In vivo and pilot studies were excluded, as well as editorials, letters, systematic reviews, literary reviews, conference abstracts and dissertations. RESULTS: A total of 853 articles resulted from the initial search, of which only 19 met the criteria for inclusion, exclusion and analysis of the risk of bias. In them, different condensation techniques of the MTA, radiopacifiers, substrates, etc., are analysed in quest of materials with less porosity. CONCLUSIONS: The high heterogeneity of the studies on porosity and the fact that they are not standardised, can condition the external validity or generalisation of the results among the different researchers for the same material and procedure. In the studies that make a comparison between several materials, they conclude that both MTA ProRoot® and BiodentineTM obtained better outcomes in terms of porosity as compared with other marketed brands. Application number (PROSPERO): 124340

Humanos , Cimentos Dentários/química , Materiais Restauradores do Canal Radicular/química , Compostos de Cálcio/química , Compostos de Alumínio/química , Materiais Restauradores do Canal Radicular/uso terapêutico , Cimentos Dentários/uso terapêutico , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Materiais Biocompatíveis/química , Materiais Biocompatíveis/uso terapêutico , Porosidade
BMC Oral Health ; 20(1): 111, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32299409


BACKGROUND: Evaluate the fracture resistance of endodontically treated teeth after cervical preflaring and root canal preparation and to assess the volume of the root canal and the amount of remaining root dentin before and after cervical preflaring. METHODS: Forty-four mandibular incisors were selected using micro-CT scanning and distributed into 4 groups (n = 11) according to the instrument used for cervical preflaring: control group - no cervical preflaring; Gates Glidden - burs size #2 and #3; WXN - 25.07 Navigator instrument; and Easy - 25.08 ProDesign S instrument. Coronal opening was performed, and the canals were prepared with Wave One Gold Primary and filled with an epoxy-resin based sealer and gutta-percha cones. Micro-CT scans were performed before and after root canal instrumentation. All images were reconstructed and assessed for the thickness of mesial and distal root dentin at 3 mm and 5 mm from the cement -enamel junction and for the volume of cervical portion of the canal after preparation. Fracture resistance test was performed applying compressive loads at a crosshead speed of 0.5 mm/min, applied on the palatal aspect of specimens at 135° along the long axis of the tooth. The data were analyzed using ANOVA and Tukey's test (P = .05). RESULTS: Cervical preflaring and canal preparation reduced the dentin thickness (P < .05) and increased the canal volume (P < .05) in all groups at 3 mm an 5 mm. Cervical preflaring with Gates Gliden burs reduced the fracture resistance of endodontically treated teeth (P < .05). CONCLUSIONS: All instruments reduced the dentin thickness and increased the canal volume in the cervical at 3 mm and 5 mm. Gates Glidden reduced fracture resistance of mandibular incisors submitted to cervical preflaring, whereas NiTi instruments did not. CLINICAL RELEVANCE: Cervical preflaring assumes particular importance previously to the root canal preparation because it minimizes the occurrence of operative accidents, and permits more accurate determination of working length and the apical diameter.

Cavidade Pulpar/patologia , Guta-Percha/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/instrumentação , Dente não Vital/fisiopatologia , Resinas Epóxi/uso terapêutico , Humanos , Preparo de Canal Radicular/métodos , Fraturas dos Dentes , Dente não Vital/diagnóstico por imagem
Gen Dent ; 68(3): 46-49, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348243


Three-dimensional sealing of root canals is essential for long-term endodontic success. It is sometimes difficult to achieve a fluid-tight seal in cases such as furcation defects, resorption lesions, open apices, and root fractures. Such cases require restorative materials that not only are biocompatible and well accepted by the surrounding periodontium but also will set in the wet oral environment without losing their properties. This case series describes management of an open apex, a furcal perforation, and a horizontal root fracture with a bioactive calcium silicate‒based cement (Biodentine) as root repair material. To prevent extrusion of the cement, platelet-rich fibrin was used as an external matrix. The patients were followed for 2-3 years, and the teeth demonstrated remarkable healing.

Fibrina Rica em Plaquetas , Materiais Restauradores do Canal Radicular/uso terapêutico , Cálcio , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Cimentos de Ionômeros de Vidro , Humanos , Silicatos/uso terapêutico
Rev. Asoc. Odontol. Argent ; 108(1): 19-24, ene.-abr. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1096713


Objetivo: Presentar la terapia regenerativa como una al- ternativa para la resolución de un caso de traumatismo denta- rio en un diente permanente incompletamente desarrollado. Caso clínico: Se realizó el tratamiento de un incisivo central superior con mortificación pulpar y periodontitis api- cal aguda subsecuente a trauma dental en un paciente de 8 años de edad. Se aplicó el protocolo de regeneración pulpar recomendado por la Asociación Americana de Endodoncia. Se estimuló la formación de un coágulo en el interior del con- ducto a partir de los tejidos periapicales, previa desinfección con la pasta triple antibiótica, y finalmente se colocó mineral trióxido agregado coronal a este. Se obtuvo así una matriz es- teril que permitió el crecimiento de nuevo tejido y se realiza- ron controles periódicos durante 4 años. Se constató silencio clínico. Radiográficamente, se observó la formación de tejido sobre las paredes del conducto y el cierre apical. Conclusión: La terapia regenerativa como alternativa de tratamiento, en este caso, permitió la disminución de la luz del conducto por el depósito de tejidos calcificados y el cierre del foramen apical, mejorando el pronóstico de la pieza dentaria (AU)

Aim: To present pulp regeneration therapy as an alter- native to resolve dental trauma in immature permanent teeth. Clinical case: We report a clinical case of an immature central superior incisor with pulp mortification and acute api- cal periodontitis subsequent to dental trauma, in an 8 year old patient. The pulp Regeneration protocol recommended by the American Endodontics Association was applied. We stimulated a clot formation inside the duct from periapical tissues and after disinfection with a mixture of three antibi- otics mineral trioxide aggregated was finally place coronal to the clot. Thus a sterile matrix was obtained that allowed new tissue's growth. Periodic check-up visits were carried out over a 4 years period. Clinical silence was observed. Tissue formation on duct walls and apical closure were radiograph- ically detected (AU) Conclusion: Regenerative therapy is an alternative for the treatment of immature permanent teeth, in ths clinical case it allowed the reduction of the width of the duct by the opposition of hard tissues and the closure of the apical fora- men improving the forecast of these teeth.

Regeneração , Dentição Permanente , Incisivo/lesões , Periodontite Periapical , Argentina , Materiais Restauradores do Canal Radicular/uso terapêutico , Cicatrização/fisiologia , Traumatismos Dentários/complicações , Necrose da Polpa Dentária , Ápice Dentário/crescimento & desenvolvimento , Unidade Hospitalar de Odontologia
PLoS One ; 15(2): e0227347, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32012166


This trial assessed post-operative pain and healing of apical periodontitis following endodontic therapy with a reciprocating system compared to a crown-down technique with hand files and lateral compaction filling. One-hundred and twenty nonvital anterior teeth with apical periodontitis were randomly treated using either a reciprocating single file followed by matching-taper single-cone filling or a hand file and lateral compaction filling. Postoperative pain was assessed during the 7 days after the treatment, using a visual analogue scale and a verbal rating scale. Apical healing was assessed using the periapical index score after a 12-month follow-up. The hypothesis tested was that both protocols were equivalent and present similar effectiveness in healing periapical lesions. Data were analyzed through two one-sided tests, t-tests, as well as Mann-Whitney and Chi-squared tests (α = 0.05). Logistic regression was used to investigate the association of clinical and demographic factors with the success of treatment. Regardless of the assessment time, no difference in incidence (38%-43% at first 24h), intensity of postoperative pain, and incidence of flare-up (≈ 3%) was observed between the two endodontic protocols. Both protocols resulted in a similar healing rate of apical periodontitis. After 12 months, the success rate ranged from 73% to 78% and the difference between the treatments fell within the pre-established equivalence margin (-0.1; -0.41 to 0.2). Endodontic treatment combining a reciprocating single file with matching-taper single cone showed similar clinical effectiveness to the treatment using hand-file instrumentation and the lateral compaction filling.

Periodontite Periapical/cirurgia , Endodontia Regenerativa/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Adulto , Feminino , Humanos , Masculino , Medição da Dor/métodos , Dor Pós-Operatória/patologia , Periodontite Periapical/patologia , Tratamento do Canal Radicular/métodos , Dente/fisiopatologia , Dente/cirurgia , Cicatrização
J Contemp Dent Pract ; 21(10): 1091-1097, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33686028


AIM: To assess the sealing ability of two calcium silicate-based materials in the treatment of iatrogenic furcal perforations using a dye-penetration leakage model. MATERIALS AND METHODS: Furcation perforations were performed using a size 12 round burr on the pulp chamber floor of 20 first mandibular molars. The teeth were then randomly divided into two groups, two additional molars served as negative controls. The defects were then filled with mineral trioxide aggregate (MTA) Angelus in the first group and Biodentine in the second group. Leakage at the repaired sites was then evaluated using the methylene blue dye penetration technique. RESULTS: Significant differences in microleakage were found between the two groups at 72 hours (p < 0.001). MTA Angelus had greater dye penetration than Biodentine with a statistically significant difference. Subsequently, the sealing ability of Biodentine was significantly better than MTA Angelus (p < 0.001). However, the mean values of leakage and inadequate adhesion were significantly different from the theoretical value for both the MTA Angelus (p < 0.001) and Biodentine (p < 0.001). CONCLUSION: The current results suggested that Biodentine possesses higher sealing quality than MTA Angelus. Yet, both materials are not ideal and still need improvement to ensure perfect adhesion in case of furcal perforation. CLINICAL SIGNIFICANCE: This article aims to compare the sealing ability of one dental repair material over another, after iatrogenically producing a furcal perforation. Leakage resistance and sealing ability are important factors in favoring the outcome of an endodontic treatment of a tooth that could otherwise be condemned for extraction.

Laboratórios , Materiais Restauradores do Canal Radicular , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cavidade Pulpar , Combinação de Medicamentos , Dente Molar/cirurgia , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico
J Med Life ; 13(4): 635-640, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33456616


Microscopic studies performed on extracted human teeth after their preparation in advance is helpful in a relatively good reestablishment of the treatment steps that have been applied to these teeth, as well as an evaluation of the quality of such treatments. Therefore, we have used stereo- and optical microscopy, highlighting aspects of external morphology, as well as root canal space of an extracted mandibular second premolar, subjected to prosthetic and endodontic treatment. In order to verify some technical errors that might occur during the endodontic and restorative treatment, we tried to appreciate the quality of the root canal filling and cervical defect and access cavity restoration of an extracted premolar #45.Without having the data from clinical records, we concluded that the method used for root canal filling was the warm lateral condensation technic; we also appreciated the quality of the fusion of the gutta-percha cones used, so the introduction of heated spreaders only in the central part of the bunch of cones makes it possible to clearly detect the boundaries between these cones towards the outside of the filling.

Dente Pré-Molar/patologia , Doença Iatrogênica , Mandíbula/patologia , Microscopia , Cavidade Pulpar/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular
Wiad Lek ; 72(9 cz 2): 1757-1760, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622261


OBJECTIVE: Introduction: Treatment of destructive forms of chronic periodontitis is extremely topical. Its relevance is associated with the features of treatment, which depends on the stage of the exacerbation process. The issue of the problem is also in the fact that the destructive seat of periodontitis is a source of chronic infection. The aim: The task of the research was to evaluate the conservative treatment of chronic destructive forms of periodontitis with a dental kit "Cupratin", developed for professional usage in dental practice. PATIENTS AND METHODS: Materials and methods: "Cupratin" is a complex medicament based on suspensions of calcium hydroxide, copper-calcium hydroxide and powder, which contains hydroxide aluminosilicate and calcium sulphate, radiopaque filler. It has bactericidal and osteoplastic effect. The treatment involved 44 patients (44 teeth) in the age group of 37 to 50 years suffering from chronic granulating periodontitis without concomitant diseases. Patients were divided into two groups: investigated and control. In the main group of patients, a suspension on the basis of copper-calcium was used for treatment (root canals were filled with "Cupratin" as a temporary filling material). Obturation of canals was preceded by chemical and mechanical treatment. The medical material was in direct contact with periodontal tissues for 20-55 days. Intraoral X-ray radiography was taken from the patients within the intervals of 3 and 6 months. RESULTS: Results and conclusions: Positive results were obtained, which were characterized by the disappearance of subjective symptoms, intensive bone tissue reconstruction in the site of destruction and a decrease in the size of the destruction respectively.

Anti-Infecciosos Locais/uso terapêutico , Periodontite/tratamento farmacológico , Materiais Restauradores do Canal Radicular/uso terapêutico , Adulto , Hidróxido de Cálcio/uso terapêutico , Humanos , Pessoa de Meia-Idade
Photodiagnosis Photodyn Ther ; 28: 253-255, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31518699


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.

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
Endodoncia (Madr.) ; 37(2): 22-28, sept. 2019. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-186296


Objetivos. El propósito de este trabajo fue evaluar los efectos biológicos de MTA Repair HP y ProRoot MTA en células madre procedentes de ligamento periodontal (hPDLSCs) tras ser ex-puestos los cementos a ambiente ácido y neutro. Material y Métodos: Discos de cada material (n=30) fueron ex-puestos a un tampón fosfato-salino (pH 7.4) o a ácido butírico (pH 5.2) durante 7 días, posteriormente se realizaron pruebas biológicas in vitro usando hPDLSCs. A partir de eluatos de los diferentes materiales de obturación a retro, se analizaron pruebas de viabilidad celular y apoptosis. Para evaluar la adhesión celular, hPDLSCs se sembraron directamente sobre la superficie de los materiales y se observaron bajo microscopio electrónico de barrido. Para analizar estadísticamente los resultados se usaron los test ANOVA y Tukey test (p < 0.05). Resultados: Los cementos endodónticos expuestos a ambiente ácido mostraron un similar grado de adhesión celular, y sorprendentemente, MTA Repair HP a pH 5.2 exhibió una mayor viabilidad celular que ProRootMTA (p<0.05). A pH 7.4, ProRooT MTA obtuvo una tasa mayor de viabilidad celular que con MTA Repair HP. Conclusiones: Los materiales ProRoot MTA y MTA Repair HP presentaron adecuadas propiedades biológicas en los diferentes ambientes, en términos de viabilidad celular, apoptosis y adhesión

Objectives: The purpose of this work was to evaluate the biolo-gical effects of MTA Repair HP and ProRoot MTA on stem cells from periodontal ligament (hPDLSCs) after exposure to acidic and neutral environments. Material and Methods: Discs of each material (n=30) were ex-posed to phosphate buffered saline (pH = 7.4) or butyric acid (pH = 5.2) for 7 days, and biological testing was carried out in vitro on hPDLSCs. Cell viability and apoptosis assays were performed using eluates of each root-end filling material. To evaluate cell attachment to the different materials, hPDLSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. Statistical differences were assessed by ANOVA and Tukey test (p < 0.05).Results: Endodontic cements exposure to an acidic environment showed a similar degree of cell adherence, and, surprisingly, MTA Repair HP exhibited higher cell viability rates at pH 5.2 than Pro-Root MTA, whereas ProRoot MTA 7.4 showed higher cell viability rates than MTA Repair HP. Conclusions: Adequate biological properties of ProRoot MTA and MTA Repair HP in terms of cell viability, cell death and cell attach-ment were observed in both environments

Humanos , Adolescente , Adulto Jovem , Adulto , Cimentos Dentários/uso terapêutico , Concentração de Íons de Hidrogênio , Ligamento Periodontal , Células-Tronco , Reações Biológicas , Separação Celular , Sobrevivência Celular , Apoptose , Materiais Restauradores do Canal Radicular/classificação , Materiais Restauradores do Canal Radicular/uso terapêutico , Obturação do Canal Radicular/métodos
BMC Oral Health ; 19(1): 181, 2019 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395103


BACKGROUND: The purpose of this experiment was to assess the push out bond strength of Polydimethylsiloxane sealers (GuttaFlow 2 and GuttaFlow Bioseal by Colte'ne/Whaledent, Altstätten, Switzerland). AH Plus (Dentsply, DeTrey, Konstanz, Germany) was used as a reference material for comparison. METHODS: Thirty root slices were prepared from the middle third of 10 mandibular premolars. Each slice was 1 ± 0.1 mm thick. Three holes, 0.8 mm wide each, were drilled on the axial side of each root slice. These holes were subjected to standardized irrigations and then dried using paper points. Finally, for each root slice, each hole was filled with exactly one of the following three root canal sealers: AH Plus, GuttaFlow 2 and GuttaFlow Bioseal. After all the holes were filled in that way, the root slices were stored on top of phosphate-buffered saline solution (pH 7.2) soaked gauze for 7 days at the temperature of 37 degrees Celsius. Then, for each root canal sealer on a root slice, the universal testing machine was used to measure the push out bond strength. The differences in push out bond strengths between the three sealer samples were assessed using the Friedman test, while the paired comparisons were assessed using Wilcoxon signed rank test with Bonferroni correction. All statistical tests were two-tailed and the significance level was set at the 5%. RESULTS: According to the Friedman test the distributions of push out bond strengths of AH Plus, GuttaFlow 2 and GuttaFlow Bioseal were different (P < 0.05). Paired comparisons indicated that AH Plus had a significantly superior push out bond strength than GuttaFlow 2 and GuttaFlow Bioseal, while the push out bond strength of GuttaFlow Bioseal was significantly stronger than that of GuttaFlow 2 (P < 0.01). CONCLUSIONS: Based on these findings, AH Plus is a better root canal sealer than GuttaFlow 2 and GuttaFlow Bioseal.

Colagem Dentária/métodos , Dimetilpolisiloxanos/química , Materiais Restauradores do Canal Radicular/química , Silicatos/uso terapêutico , Dentina/química , Combinação de Medicamentos , Resinas Epóxi , Guta-Percha , Humanos , Teste de Materiais , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/química , Cimento de Óxido de Zinco e Eugenol