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1.
J Contemp Dent Pract ; 21(2): 113, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381811

RESUMO

The role of nickel-titanium (NiTi) in the production of endodontic instruments increased in the last few decades; therefore, the way of evaluation of its performance increased as well. Nowadays, there are several ways to evaluate NiTi instruments, divided into static and dynamic tests. The static ones are cyclic fatigue tests, torsional resistance tests, flexibility, and cutting efficiency tests. These methodologies have been deeply used to evaluate some of the metallurgical properties of the instruments on the market. Up-to-date, we know very well the behavior of NiTi under static conditions, but these knowledges are too fragmented to be relevant for understanding and evaluating the complexities of intracanal instrumentation. Starting from the purpose to introduce the variable of movement in the testing procedure, some dynamic tests have been proposed, such as dynamic cyclic fatigue test.1,2 Although these kinds of studies were capable of evaluating more precisely the behavior of rotary instruments inside the root canal, they could not take into account, at this moment, the complexities of stresses that instruments undergo during the shaping procedure.3-5 Therefore, some of these tests are not accepted anymore by the scientific community and on the contrary they do not help the general practitioner to orientate in the large amount of rotary instruments present on the market.6 This tends to withdraw the general dentistry from the scientific literature, wearing a groove between the practice and the science.7 Starting from these ideas, in the last couple of years some authors started to think the proper way to real-time evaluation of the performance of NiTi rotary instruments inside the root canal. To do so, a countable and repeatable measurement of instrument's developed stresses was needed. Setzer and Böhme8 first used the torque generated by Revo-S, Vortex, and ProFile to evaluate their performance during instrumentation. The so-called "operative torque" is the summation of torque generated in each point of the instrument during its simultaneous movement around its own axis and up and down inside the canal. The recorded values are influenced by both torsional and flexural stresses, becoming this way a reliable method to analyze, evaluate, and compare the performance of NiTi instruments inside the root canal.9 This methodology is applicable for not only in vitro but also in vivo measurement, as demonstrated by Gambarini et al.10 The main drawback of this kind of evaluation is the not well-determined correlation between the torsional and the flexural stresses; therefore, it is still unpredictable how each influence the other. In conclusion, the potential of real-time torque measurement is wide and still unexplored, but further studies are needed to better understand how torque is developed inside the root canal.


Assuntos
Níquel , Titânio , Ligas Dentárias , Preparo de Canal Radicular , Torque
2.
J Contemp Dent Pract ; 21(2): 124-128, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381814

RESUMO

AIM: The aim of this study was to compare the effectiveness of Mtwo and RaCe rotary instruments in cleaning and shaping root canals curvature. MATERIALS AND METHODS: The present study was conducted on 160 simulated canals in resin blocks with an angle curvature of 15°-30°. These 160 simulated canals were divided into two groups, where each group consisted of 80 blocks. In the first group, the canals were prepared using Mtwo rotary system (VDW, Munich, Germany). In the second group, the canals were prepared using RaCe instruments (La Chaux-De-Fonds, Switzerland). The data were recorded using SPSS version 23 software (Microsoft, IL, USA). RESULTS: The results obtained by using the Mtwo rotary instruments showed that these instruments were able to clean and shape in the right-to-left motion curved canals, at different levels, without any deviation and in perfect symmetry, with a p value = 0.000. The data showed that greater the depth of the root canal, greater the deviations of the RaCe rotary instruments. These deviations occurred in three levels, which are the following: S2 (p = 0.004), S3 (p = 0.007), and S4 (p = 0.009). The Mtwo files can go deeper and create a greater angle in S4 level (21°-28°) compared to RaCe instruments with an angle equal to 19°-24°. CONCLUSION: The present study noted a clinical significant difference between Mtwo rotary instruments and RaCe rotary files used for the canal preparation and indicated that Mtwo instruments are a better choice for the curved canals. CLINICAL SIGNIFICANCE: There are a large number of procedures and instruments used in the preparation of the root canal. Mtwo and RaCe rotary files were the instruments taken under comparison, in order to determine which of them would perform better.


Assuntos
Cavidade Pulpar , Níquel , Alemanha , Preparo de Canal Radicular , Titânio
3.
J Contemp Dent Pract ; 21(2): 171-177, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381823

RESUMO

AIM: Nickel-titanium (NiTi) instruments were designed to be used in continuous rotation mode with controlled speed and torque and a sequence of different sizes. The reciprocating motion was purposed to improve cyclic fatigue of rotary instruments if compared to the conventional rotation. The purpose of this work was to compare the shaping ability of Reciproc R25, Mtwo #25/0.06 used as a single file, and Mtwo sequence used in reciprocating motion and in continuous rotation. MATERIALS AND METHODS: Forty-eight endodontic training resin blocks ISO 15, 2% taper, 7 mm radius, and a 60° angle of curvature were shaped with four different protocols. Group I (Rrsf) was shaped with Reciproc R25 used as a single file in a reciprocating motion. Group II (Mrsf) was shaped with Mtwo #25/0.06 used as a single file in a reciprocating motion. Group III (MSrec) was shaped with Mtwo sequence in reciprocating motion, and finally, group IV (MSrot) was shaped with the Mtwo sequence used in continuous rotation. Preoperative and postoperative images of the simulated canals were taken under standardized conditions and combined exactly. The amount of resin removed was determined at both the inner and outer sides of the canal curvature. The ability of the instruments to remain centered in the canal was determined by calculating a centering ratio. These data were analyzed statistically using two factors analysis of variance (ANOVA) with Bonferroni correction (Bonferroni post-hoc test). RESULTS: Group Rrsf produced a greater enlargement of the canal, especially on the outer side, in the apical and middle third (p < 0.05). Group MSrot produced a lower enlargement in the middle third (p < 0.05). Group Rrsf displayed a lower centering ratio in the apical third (p < 0.05). Group MSrot displayed a lower centering ratio in the coronal third (p < 0.05). CONCLUSION: The shaping of simulated canals using a sequence of instruments in continuous rotation resulted in a more centered preparation of the apical third. The reciprocating motion for all tested instruments produced a bigger enlargement of the canals. CLINICAL SIGNIFICANCE: Reciprocating movement results in a more pronounced canal enlargement but appears to be less respectful of the original canal curvature and produces more apical transportation than a sequence of rotary NiTi files with the same ending apical size.


Assuntos
Instrumentos Odontológicos , Preparo de Canal Radicular , Desenho de Equipamento , Teste de Materiais , Rotação
4.
Braz Oral Res ; 34: e039, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374813

RESUMO

To compare the shaping ability of different single-file systems in the preparation of mesial curved canals of mandibular molars using micro-CT technology. Fifteen mesial roots of mandibular molars with two independent and curved canals (n = 30) were selected, scanned at a resolution of 26.7 µm anatomically matched, and distributed into three groups (n = 10), according to the preparation system: WaveOne 25.08, Reciproc 25.08, and OneShape 25.06. A final micro-CT scanning was performed, data sets were registered with their respective counterparts, and compared regarding the three-dimensional (volume, surface area, and structure model index - SMI) and two-dimensional (perimeter, area, roundness, major and minor diameters) parameters, as well as, canal transportation, using ANOVA and post hoc Tukey tests (α = 5%). Overall, no difference was observed between groups regarding area, perimeter, volume, surface area, and canal transportation (p > 0.05). Within group, no canal transportation was significantly higherobserved in the apical third (0.10 ± 0.05 mm) compared to coronal (0.08±0.040 mm) and middle (0.07 ± 0.03 mm) thirds (p < 0.05). Structure model index (SMI) was statistically higher after preparation with OneShape instrument (0.36 ± 0.26) compared to other systems (p < 0.05). Within the parameters of this study, similar shaping ability was observed in the preparation of mesial curved root canals of mandibular molars with Reciproc, OneShape and WaveOne systems.


Assuntos
Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Preparo de Canal Radicular/instrumentação , Análise de Variância , Instrumentos Odontológicos , Desenho de Equipamento , Humanos , Teste de Materiais , Dente Molar/anatomia & histologia , Valores de Referência , Estatísticas não Paramétricas , Microtomografia por Raio-X/métodos
5.
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
6.
J Contemp Dent Pract ; 21(3): 238-241, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434967

RESUMO

AIM: The objective of this study was to assess apical extrusion after filling material removal using two systems, one rotary and one reciprocating. MATERIALS AND METHODS: A total of 34 extracted mandibular premolars with single roots were selected and, posteriorly, prepared and filled. Following material aging for 60 days, teeth were divided into two groups, according to the method used to remove root filling material: group I, ProTaper® Universal Retreatment instruments plus refining with the Hero 642® sequence and group II, WaveOne® instruments. The teeth were fixed in an apparatus designed to collect the extruded material during removal procedure. Data on the amount of debris extruded (mg/weight) were analyzed using the Student's t test with a significance level of 5%. RESULTS: No significant differences were found between the groups with regard to the amount of material extruded during root canal retreatment. CONCLUSION: The present findings suggest that the extrusion of debris during apical root canal retreatment does not depend on the instrument design or the protocol employed. CLINICAL SIGNIFICANCE: Regardless of root canal clearance techniques, debris extrusion eventually occurs during endodontic retreatment and may be related to postoperative pain.


Assuntos
Materiais Restauradores do Canal Radicular , Preparo de Canal Radicular , Cavidade Pulpar , Humanos , Retratamento , Tratamento do Canal Radicular
7.
J Contemp Dent Pract ; 21(3): 277-279, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434974

RESUMO

AIM: To evaluate the cyclic fatigue resistance of Reciproc blue (RB) 40/0.06 instruments tested at room temperature (20° ± 0.5°C) and at body temperature (37° ± 0.5°C) in a simulated stainless steel canal. MATERIALS AND METHODS: Twenty-four new RB 40/0.06 instruments were randomly divided into two groups (n = 12) according to the temperature used. Dynamic fatigue testing was performed using an artificial stainless steel canal with a 60° curvature angle and a 5-mm radius of curvature. The temperature was controlled throughout the experiment with an underwater thermometer and a thermostat. The data were analyzed descriptively using the IBM SPSS 23.0 program, considering p < 0.05. RESULTS: The time to fracture of the RB instruments differed significantly between the two temperatures (1083.82 seconds at 20°C and 403.80 seconds at 37°C). No significant differences were found in fragment size. CONCLUSION: An increase in temperature reduces the cyclic fatigue resistance of RB 40/0.06 instruments. The results of the study suggest that an intracanal cooling system can be favorable to the fracture resistance of the tested instruments. CLINICAL SIGNIFICANCE: A cooling system of the root canal system is important in endodontic as it favors the cyclic fatigue resistance of Ni-Ti instruments.


Assuntos
Instrumentos Odontológicos , Preparo de Canal Radicular , Desenho de Equipamento , Falha de Equipamento , Temperatura
8.
J Contemp Dent Pract ; 21(3): 291-295, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434977

RESUMO

AIM: To evaluate the sealing ability of three different types of sealers using confocal laser microscopy. MATERIALS AND METHODS: Sixty extracted single-root premolars were selected and divided into three groups (20 teeth in each group) according to the type of sealer used, namely, mineral trioxide aggregate (MTA) Fillapex, AH Plus, and Bio C Sealer. Root canal preparation and obturation were done in all the samples. Roots was dissected transversely in apical plane. Percentage of gap from region to canal circumference was calculated using a confocal laser microscope. Samples were subjected to statistical analysis. RESULTS: High dye penetration was seen with AH Plus compared to MTA Fillapex and least with Bio C Sealer. The AH Plus is the best sealer with respect to seal ability of all the three. CONCLUSION: This study helps to appraise the sealing ability of the different types of sealers using confocal laser microscopy which is useful for the success of root canal treatment. CLINICAL SIGNIFICANCE: As sealer has to seal voids, foramina, and canals, it should have good penetration for the success of root canal treatment.


Assuntos
Materiais Restauradores do Canal Radicular , Dente Pré-Molar , Cavidade Pulpar , Preparo de Canal Radicular , Tratamento do Canal Radicular
9.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(2): 160-165, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32314889

RESUMO

OBJECTIVE: This study aims to compare the efficiency of three kinds of microtube extraction devices, namely, instrument removal system (IRS), micro-retrieve and repair (MR&R) system, and MR&R system using modified microtube in removing separated instruments with different exposure lengths. METHODS: After a cross-section platform model was established, the IRS, MR&R, and MR&R modified microtube system with sidewall window reduced to 0.20 mm were used to retrieve various separated instrument models, and the differences in extraction effects were statistically analyzed by Chi-square test. The separated instrument models were divided into two groups: stainless steel and nickel-titanium instrument groups. In total, 23 instruments were tested for three times each. RESULTS: When the exposed length of separated instrument was 0.50 mm, the removal efficiency of the modified MR&R system group was significantly higher than those of the IRS and MR&R system groups (P<0.001). When the broken end of the fracture instrument was up to 1.00 mm, the success rates of the MR&R system and modified MR&R groups were significantly higher than that of the IRS group (P<0.01). No difference was observed among these three devices when the exposure length of separated instruments was 1.50 mm or higher. CONCLUSIONS: The MR&R and modified MR&R systems have good removal effect when the exposed length of separated instrument is small.


Assuntos
Instrumentos Odontológicos , Preparo de Canal Radicular , Ligas Dentárias , Cavidade Pulpar , Desenho de Equipamento , Falha de Equipamento , Aço Inoxidável , Titânio
10.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(2): 205-210, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32314896

RESUMO

Primary tooth root canal therapy is a treatment performed on primary teeth diagnosed with pulpitis or periapical periodontitis. This procedure requires perfect instrumentation, disinfection, and filling of root canals to eliminate infection, control inflammation, relieve pain, prevent pathological effects on inherited permanent tooth, and prolong primary tooth preservation. This paper reviews the research history on primary tooth root canal treatment and summarizes the progress on primary tooth root canal treatment, including anatomical morphology, root canal preparation, root canal disinfection, root canal filling, and application of antibiotics.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Humanos , Obturação do Canal Radicular , Preparo de Canal Radicular , Tratamento do Canal Radicular , Dente Decíduo
11.
Indian J Dent Res ; 31(1): 160-163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246702

RESUMO

Endodontic treatment of fused teeth needs special care and attention due to its complex anatomy. The aim of this article is to highlight the problems encountered and the strategy in treating such cases. We report a case of unilateral fusion of the left mandibular central incisor and lateral incisor, with a single pulp chamber. The single pulp chamber separates into two root canals and a large communication exists at the apical third of the root canals. This is the first time fused teeth with a large communication is reported. CBCT analysis was effective in confirming the morphological aberrations and aided in accurate planning and treatment. Chemomechanical preparation with manual dynamic irrigation coupled with passive ultrasonic activation of the irrigant and obturation with thermoplasticised gutta percha helped in successful outcome of the case.


Assuntos
Dentes Fusionados , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Estética Dentária , Guta-Percha , Humanos , Obturação do Canal Radicular , Preparo de Canal Radicular
12.
Braz Dent J ; 31(1): 25-31, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159701

RESUMO

The purpose of this study was to evaluate the presence of residues after post space preparation (PSP) and establish whether the apical displacement of the gutta-percha was affected by the moments and methods of PSP in teeth filled by the single-cone technique. The root canals of 20 bovine incisor teeth were instrumented with Reciproc and filled with single-cone and AH Plus. The specimens were divided into 4 groups according to the moment and method of PSP (n=5): immediate with drill, immediate with thermoplasticizer, delayed with drill and delayed with thermoplasticizer. Micro-CT scans were performed before and after the PSP for residues of the root canal filling (1) and analysis of apical displacement (2). Data were analyzed by using 2-way repeated measurement ANOVA (1) and 2-way ANOVA (2) followed by the Tukey's test (a=0.05). Significance effect on the residues percentage remaining for methods (p=0.044), for moments (p=0.006), for thirds repetition (p<0.001), and for interaction between methods and thirds (p<0.001), and moments and thirds (p=0.044). Significance effect on the apical displacement of root canal filing was detected for methods (p=0.008), however no difference was found between moments (p=0.617). In general, PSP using drill resulted in more homogeneous root canal preparation, mainly when made immediately. For all other combinations between methods and moments for PSP, the middle and apical thirds presented significant higher residues remaining. Thermo method performed in both moments and the drill method performed immediately had displacement in the apical direction, representing extrusion of the root filling material.


Assuntos
Cavidade Pulpar , Materiais Restauradores do Canal Radicular , Animais , Bovinos , Guta-Percha , Retratamento , Obturação do Canal Radicular , Preparo de Canal Radicular , Microtomografia por Raio-X
13.
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
14.
J Indian Soc Pedod Prev Dent ; 38(1): 48-55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174629

RESUMO

Background: Residual root dentin thickness (RDT) in endodontically treated teeth is a major factor that is responsible for longevity of treated tooth. Aims and Objectives: To evaluate and compare the amount of RDT during endodontic treatment using manual K-files and rotary Mtwo, ProTaper Next, and Hero shaper instruments. Settings and Design: Anin vitro study was carried out on a sample of 100 freshly extracted human single straight rooted mandibular first premolar teeth. Methodology: The teeth were divided into five groups of twenty each and mounted on wax rims for a preoperative cone beam computed tomography scan to calculate the dentin thickness 3 and 6 mm from the apex. All the teeth were treated according to their groups. Statistical Analysis: The observations were then statistically analyzed using one-way ANOVA to evaluate the difference among four groups followed by post hoc test for pairwise comparison. Results: Maximum preservation of dentin was seen in Group V (cleaning and shaping done with rotary Hero shaper files) at 3 and 6 mm from the apex, whereas minimum preservation of dentin was seen in Group IV at 3 mm (cleaning and shaping done with rotary ProTaper Next files) and Group II at 6 mm (cleaning and shaping done with hand K-stainless steel files) from the apex. Overall there was a statistically significant difference in RDT values between Group V and Groups I, II, III, IV both at 3 and 6 mm from the apex. Conclusion: Cleaning and shaping with rotary Hero shaper files preserved more amount of dentin when compared to hand K-files, rotary Mtwo, ProTaper Next.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Tomografia Computadorizada de Feixe Cônico , Dentina , Desenho de Equipamento , Humanos
15.
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
16.
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
17.
J Endod ; 46(3): 391-396, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32029265

RESUMO

INTRODUCTION: Information is scarce regarding current usage practices of nickel-titanium (NiTi) engine-driven instruments in clinical practice. Therefore, the specific purpose of this survey was to assess trends among endodontists regarding the use and reuse of NiTi instruments. METHODS: A 16-question survey was sent by e-mail to about 4000 active members of the American Association of Endodontists. Data were collected over a 6-month period and compared using chi-square tests. RESULTS: A total of 957 surveys were collected (response rate = 23%). Of the respondents, 40.2% worked in solo practices; among them, there were significantly fewer recent graduates (<10 years) compared with those who graduated more than 10 years ago. Furthermore, 41.7% were in a group practice, 4.3% in corporate practice, 10.7% in university settings, and 3% in the military. Overall, 98.3% of respondents reported using NiTi instruments. Respondents who graduated less than 25 years ago use NiTi instruments significantly more (99%) than those who graduated more than 25 years ago (92.6%). Although 22.9% of respondents buy presterilized instruments, 41.6% sterilize them before use, and 35.5% do not sterilize new instruments before use; dental officers in the military reported that they use sterile new instruments in 100% of cases. NiTi instruments were reused by 74% of respondents. The 2 largest segments of the specialist endodontic instrument market belonged to Dentsply (York, PA; 56.9%) and EdgeEndo (Albuquerque, NM; 28.8%). CONCLUSIONS: There are significant differences in the use of NiTi instruments among types of practice and years since graduation. There were noticeable changes compared with findings reported about 10 years ago.


Assuntos
Ligas Dentárias , Instrumentos Odontológicos , Endodontistas , Desenho de Equipamento , Humanos , Níquel , Padrões de Prática Odontológica , Preparo de Canal Radicular , Inquéritos e Questionários , Titânio , Estados Unidos
18.
J Endod ; 46(3): 425-430, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32037054

RESUMO

INTRODUCTION: The purpose of this study was to investigate the influence of both polymerization cycles and mechanical exposure procedures on the adhesion of instrument fragments using a modified tube technique with a light-curing composite. METHODS: Eighty Mtwo instruments (size 15.05; VDW, Munich, Germany) were cut at a diameter of 35/100 mm and clamped in a vice with an overlap of 2 mm. Matching cannulas were filled with SDR composite (Dentsply, York, PA) and placed over the instruments. Prime & Bond Active (Dentsply Sirona, Bensheim, Germany) was used as the bonding material. Glass fiber was inserted from the opposite side into the cannula, and 1, 2, 4, or 6 polymerization cycles of 30 seconds were applied (800 mW/mm2) (n = 20/group). Sixty further identical instruments (n = 20/group) were divided into the following groups: group 1, cut at 10 mm and left unprepared (taper = 5%); group 2, parallelized using diamond instruments (taper = 0%); and group 3, prepared in a way that an inverted conical taper resulted (taper = 2%). Polymerization was performed for 2 minutes. The failure load and mode of failure were determined using a tensile testing device (2 mm/min). Data were statistically analyzed using the Kruskal-Wallis or chi-square test. RESULTS: The failure load increased significantly with the number of polymerization cycles (P < .0001). More than 4 polymerization cycles had no further benefit (P > .05). The failure load in the inverted conical group was significantly lower (P < .0001) compared with the parallel and the unprepared groups. Adhesive failure was significantly more frequent in groups 2 and 3 (20/20) than in group 1 (16/20) (P < .05). CONCLUSIONS: Both the number of polymerization cycles and the mechanical exposure procedures had a significant impact on the adhesive force when using the tube technique.


Assuntos
Luzes de Cura Dentária , Cavidade Pulpar , Preparo de Canal Radicular , Alemanha , Teste de Materiais , Polimerização , Estresse Mecânico , Titânio
19.
PLoS One ; 15(2): e0227347, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32012166

RESUMO

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.


Assuntos
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
20.
J Endod ; 46(2): 244-251.e1, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32040423

RESUMO

INTRODUCTION: This study evaluated and compared the shaping ability of the WaveOne Gold (Dentsply/Tulsa Dental Specialties, Tulsa, OK), TRUShape 3D Conforming File (Dentsply/Tulsa Dental Specialties), EdgeCoil (EdgeEndo, Albuquerque, NM), and XP-3D Shaper (Brasseler USA, Savannah, GA) endodontic file systems on oval-shaped canals using micro-computed tomographic (micro-CT) technology. METHODS: Thirty-two oval-shaped, single-canal extracted human teeth were decoronated 1 mm coronal to the cementoenamel junction and scanned via a micro-CT scanner (µCT100; Scanco Medical, Bassersdorf, Switzerland). Teeth were divided into 4 groups (n = 8) and instrumented according to the manufacturer's instructions. Coregistered images, before and after root canal preparation, were evaluated for morphometric measurements of the surface area, volume, structure model index (SMI), conicity, and percent of walls untouched using the manufacturer's evaluation software (IPL Register, Scanco Medical). Data were statistically compared between groups using 1-way analysis of variance and within groups using a paired sample t test. RESULTS: Instrumentation with all file types increased the surface area, volume, and conicity between and within groups. There was no statistically significant difference between the groups for any of the rotary instruments used (P < .05). CONCLUSIONS: Instrumentation of oval-shaped canals with WaveOne Gold, TRUShape, EdgeCoil, and XP-3D Shaper rotary endodontic instruments similarly increase the volume, surface area, and conicity. None of the file systems were capable of contacting all of the surface area in any canal.


Assuntos
Cavidade Pulpar , Ouro , Preparo de Canal Radicular , Desenho de Equipamento , Humanos , Microtomografia por Raio-X
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