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1.
Rev. cuba. estomatol ; 57(4): e3076, Oct.-Dec. 2020. tab
Artigo em Português | LILACS, CUMED | ID: biblio-1144450

RESUMO

Resumo Introdução: Os pinos de fibra de vidro têm sido amplamente utilizados na reconstrução de elementos com perda excessiva de estrutura dentária. Objetivo: Avaliar a força de adesão de pinos de fibra de vidro após diferentes tratamentos radiculares em diferentes regiões (terço cervical, médio e apical) da dentina radicular. Métodos: Este é um estudo experimental in vitro. Quarenta dentes bovinos foram selecionados, preparados e distribuídos em quatro grupos de acordo com o tratamento de superfície utilizado: adesivo (1), agente quelante (2), ácido poliacrílico (3), não tratado (4). A cimentação dos pinos de fibra de vidro foi realizada com cimento resinosante autocondicionante. Após vinte dias, cada raiz foi cortada em três fatias (um milímetro de espessura) obtidas de três regiões. A resistência de união de cada seção foi determinada usando um teste de resistência da junta de encaixe. Os dados de resistência à flexão (MPa) foram analisados pelos testes ANOVA e Tukey (α = 0,05). Resultados: Na porção cervical, o grupo com tratamento prévio com ácido poliacrílico apresentou menor resistência ao cisalhamento por extrusão (push-out) do que o grupo sem tratamento prévio. O grupo com aplicação do sistema adesivo (28,89 ± 6,64 MPa) e o grupo com tratamento prévio com EDTA (21,58 ± 6,39 MPa) não apresentaram diferenças estatisticamente significantes em relação ao grupo sem tratamento prévio (grupo controle) no terço cervical. Nas porções média e apical, o grupo tratado com adesivo FGM Ambar apresentou maiores valores de ligação em comparação com os outros grupos. Conclusão: A aplicação prévia do adesivo aumentou a resistência de união nos terços médio e apical, em comparação aos outros grupos, podendo ter um efeito benéfico no sucesso clínico do tratamento restaurador(AU)


Resumen Introducción: Los postes de fibra de vidrio se han utilizado ampliamente en la reconstrucción de elementos con pérdida excesiva de estructura dental. Objetivo: Evaluar la fuerza de adhesión de postes de fibra de vidrio después de distintos tratamientos de raíz en diferentes regiones (tercios cervical, medio y apical) de dentina de raíz. Métodos: Estudio experimental in vitro. Se seleccionaron cuarenta dientes bovinos, se prepararon y se distribuyeron en cuatro grupos de acuerdo con el tratamiento de superficie utilizado: (1) adhesivo, (2) agente quelante, (3) ácido poliacrílico, (4) sin tratar. La cementación de los postes de fibra de vidrio se realizó con cemento de resina autograbante. Después de 20 días, cada raíz se seccionó transversalmente en tres rodajas (1 mm de espesor) obtenidas de tres regiones. La resistencia a la unión de cada sección se determinó usando una prueba de resistencia al corte por extrusión (push-out). Los datos de resistencia a la flexión (MPa) se analizaron mediante pruebas ANOVA y Tukey (α = 0,05). Resultados: En la porción cervical, el grupo con tratamiento previo de ácido poliacrílico mostró menor resistencia que el grupo sin tratamiento previo. El grupo con aplicación del sistema adhesivo (28,89 ± 6,64 MPa) y el grupo con tratamiento previo de EDTA (21,58 ± 6,39 MPa) no presentaron diferencias estadísticamente significativas en comparación con el grupo sin tratamiento previo (grupo control) en el tercio cervical. En las porciones media y apical, el grupo tratado con adhesivo Ambar® de FGM Dental Group mostró valores más altos de unión en comparación con los otros grupos. Conclusión: La aplicación previa del adhesivo aumentó la fuerza de unión en los tercios medio y apical, en comparación con los otros grupos, puede tener un efecto beneficioso sobre el éxito clínico del tratamiento restaurador(AU)


ABSTRACT Introduction: Glass fiber posts have been widely used for the reconstruction of elements with excessive dental structure loss. Objective: Evaluate the bond strength of glass fiber posts after various root dentin treatments in different regions (cervical, middle and apical thirds). Methods: An experimental in vitro study was conducted. Forty bovine teeth were selected, prepared and distributed into four groups according to the surface treatment used: (1) adhesive, (2) chelating agent, (3) polyacrylic acid, (4) not treated. The glass fiber posts were cemented with self-etch resin cement. After 20 days, each root was sectioned crosswise into three slices (1 mm in thickness) obtained from three regions. Bond strength was determined in each section with a push-out bond strength test. Flexural strength data (MPa) were analyzed with ANOVA and Tukey's tests. Results: In the cervical portion, the group with previous polyacrylic acid treatment displayed lower push-out strength than the group without previous treatment. The group with application of the adhesive system (28.89 ± 6.64 MPa) and the group with previous EDTA treatment (21.58 ± 6.39 MPa) did not exhibit any statistically significant differences in comparison with the group without previous treatment (control group) in the cervical third. In the middle and apical portions, the group treated with the adhesive Ambar® of FGM Dental Group showed higher bond values in comparison with the other groups. Conclusion: Previous adhesive application increased bond strength in the middle and apical thirds in comparison with the other groups, and may thus have a beneficial effect on the clinical success of the restorative treatment(AU)


Assuntos
Humanos , Reabsorção da Raiz/terapia , Preparo de Canal Radicular/métodos
2.
J Med Life ; 13(3): 393-398, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072214

RESUMO

This study aims to analyze the performance of rotary root canal preparation, conducted by beginner operators (students). After acquiring the necessary skills involved in applying endodontic preparation techniques on extracted teeth, all students from a cohort learned to use ProTaper Universal files (Dentsply Maillefer). The preclinical training had several stages. Experience 1: instrumentation on extracted single-root teeth; Experience 2: instrumentation on EndoTraining blocks (Dentsply Maillefer); Experience 3: instrumentation on EndoTraining blocks (Dia Dent Group International); Experience 4: Instrumentation on extracted multiradicular teeth. Preparation was done according to the manufacturer's instructions, the initial file is Sx, followed by S1, S2, F1, F2 and the last file is F3. A batch of 50 teeth (E1, E2, E3, E4) was randomly selected to evaluate the onset of the rotary preparation of young operators. Two independent evaluators analyzed the array radiologically by stereomicroscope evaluation (E1, E4) and photo-analysis of the resulting Endo Training blocks (E2, E3). The success rate was 80% for E1, 72% for E2, 64% for E3 and 76% for E4 (p<0.05). The following were considered a failure: ledge formation and apical transportation in 10.66%, over instrumentation in 6.66%, zipping in 3.33%, and instrument fracture in 4% of cases. Endodontic instrumentation techniques require training to acquire the necessary skills. Rotary root canal instrumentation techniques used almost exclusively in modern endodontics require adequate preclinical training.


Assuntos
Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Desempenho Profissional , Cavidade Pulpar/cirurgia , Endodontia , Feminino , Humanos , Masculino , Extração Dentária
3.
Acta Odontol Latinoam ; 33(2): 117-124, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920614

RESUMO

The aim of this study was to evaluate the ability of different irrigation protocols to remove from the walls of the root canal and entrance to dentinal tubules the smear layer produced during preparation for a fiber post. Fifty decoronated human lower premolars were treated endodontically and the apical third of the canal was filled with a single gutta-percha point using warm vertical compaction. Ten millimeters were left free for post preparation, which was done by sequential use of a Largo #1 drill and Exacto #3 pilot drill (Angelus, Brazil), with irrigation with distilled water upon each instrument change. Samples were distributed randomly into 5 groups (n=10). G 1: No irrigation after post preparation. G 2: Distilled water activated for 60 s + distilled water. G 3: 5.25% NaOCl 15 s+ distilled water. G 4: 17% EDTA (Farmadental, Argentina) 60 s + 5.25% NaOCl 15 s + distilled water. G 5: 10% polyacrylic acid (Densell) 15 s + distilled water. Irrigant was activated mechanically with a low-speed conical brush. Roots were then split longitudinally in vestibular-lingual direction. Each surface was observed under SEM in its different thirds. Microphotographs were taken at 150X and 600X magnification and results analyzed statistically using Kruskall Wallis and Friedman tests (p<0.05). The results [mean (standard deviation)] were: for 150X: G1 11.00 (1.33), G2 7.50 (3.13), G3 6.30 (2.58), G4 2.20 (2.80), G5 4.30 (1.50), and for 600X G1 11.40 (0.84), G2 10.00 (1.94), G3 7.70 (3.33), G4 5.80 (3.70), G5 7.20 (2.65). The statistical analysis showed significant differences between irrigants (p<0.05) but not between root thirds (p>0.05). The EDTA+NaOCl combination and polyacrylic acid showed greater capacity to remove the smear layer created during post preparation.


Assuntos
Cavidade Pulpar/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular/métodos , Cavidade Pulpar/diagnóstico por imagem , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/administração & dosagem , Camada de Esfregaço
4.
Niger J Clin Pract ; 23(9): 1237-1242, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913162

RESUMO

Aims: We evaluated and compared EndoActivator, CanalBrush, and passive ultrasonic irrigation (PUI) in the removal of calcium hydroxide and calcium hydroxide with iodoform and p-chlorophenol paste (Calcipast Forte) from artificial standardized grooves in the apical third of root canals. Materials and Methods: A total of 34 mandibular premolars were prepared and then split longitudinally. A standardized groove was prepared in the apical part of both segments. The grooves were filled with either calcium hydroxide or Calcipast Forte, and the segments were reassembled. CanalBrush, EndoActivator, or PUI were used. The amount of remaining medicament was evaluated using a four-grade scoring system. Results: None of the irrigation methods could completely remove the pastes from the grooves. More Calcipast Forte paste was detected compared with calcium hydroxide (P < 0.01). PUI was the least effective method in removing Calcipast Forte. Conclusions: It was more difficult to remove Calcipast Forte than a water-based calcium hydroxide paste.


Assuntos
Hidróxido de Cálcio/química , Clorofenóis , Cavidade Pulpar/patologia , Hidrocarbonetos Iodados , Materiais Restauradores do Canal Radicular/química , Irrigantes do Canal Radicular/administração & dosagem , Terapia por Ultrassom/métodos , Humanos , Irrigantes do Canal Radicular/química , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Irrigação Terapêutica/métodos , Terapia por Ultrassom/instrumentação , Ultrassom , Água
5.
BMC Oral Health ; 20(1): 175, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32571285

RESUMO

BACKGROUND: Preliminary canal enlargement (glide path preparation) may play a significant role in the development of pain. The aim of this systematic review of randomized clinical trials was to assess the influence of glide path kinematics during endodontic treatment on the occurrence and intensity of intraoperative and postoperative pain. METHODS: A search was performed in June 2019 in six electronic databases (PubMed, Scopus, LILACS, SciELO, Embase and Web of Science) and two grey literature databases (OpenGrey and OpenThesis). The bibliographic references of the eligible articles were also hand-searched. The included clinical studies assessed the occurrence and intensity of intraoperative and/or postoperative pain after root canal preparation without glide path preparation (WGP) or with glide path preparation using manual (M-GP), continuous rotary (CR-GP), or reciprocating (R-GP) instruments. The primary outcome was the occurrence and intensity of intraoperative and postoperative pain, while analgesic consumption was the secondary outcome. The full texts of the eligible studies were analyzed by two reviewers who performed calibration exercises to verify the risk of bias and quality of the individual studies using the Joanna Briggs Institute Critical Appraisal tool. RESULTS: From 1283 identified articles, only six studies were included in the qualitative analysis of the results, with a total sample of 884 patients/teeth. Three studies presented a high risk of bias, while three studies presented a moderate risk. Two studies reported that CR-GP causes lower pain levels than M-GP and WGP, and three studies showed no differences between CR-GP and R-GP. Regarding analgesic consumption, two studies found no differences among glide path kinematics, and one study reported lower consumption for CR-GP than for M-GP. Because of the limited number of studies and methodological differences, no statistical analyses were performed for the glide path kinematics comparisons. CONCLUSIONS: Compelling evidence indicating a significantly different occurrence and intensity of pain among glide path kinematics is lacking. The systematic review protocol was registered in the PROSPERO database [CRD42020139989].


Assuntos
Dor Pós-Operatória/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Tratamento do Canal Radicular/métodos , Fenômenos Biomecânicos , Humanos
6.
Niger J Clin Pract ; 23(6): 811-816, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525116

RESUMO

Background: An optimum bonding between the sealer and dentin is important for impermeable root canal filling and many procedures were applied to improve root canal dentin and in turn the bond strength between the sealer and dentine. There is lack of sufficient data on the effect of nonthermal plasma application on the bond strength of sealers to the root canal dentin. Aim: The purpose of this study was to evaluate the effect of NAP on the push-out bond strength (PBS) of a bioceramic and resin-based root canal sealer (RCS) to root canal dentin. Materials and Methods: Forty single-rooted mandibular premolars were decoronated. After preparation and final irrigation, the specimens were divided into four groups (n = 10). Group AH: Root canals were filled with gutta-percha (GP) and AH Plus RCS, Group P-AH: Root canals were filled with GP and AH Plus RCS following the NAP application, Group BC: Root canals were filled with GP and Endosequence BC RCS, and Group P-BC: Root canals were filled with GP and Endosequence BC RCS following the NAP application. Then roots were sectioned horizontally to obtain ~1 mm thick dentin disks. PBS test was performed to the second (coronal) and fourth (middle) slices. Data were analyzed with the Kruskal-Wallis and t-test. Results: There was a statistically significant difference among the groups for both coronal and middle regions (P < 0.05). P-BC group showed higher PBS than AH and P-AH groups in the coronal region. P-BC group showed higher PBS than the other groups in the middle region. Conclusions: The use of NAP did not influence the push-out bond strength of AH-Plus sealer to the root canal dentin. The Endosequence-BC sealer showed a better bond strength than the AH-Plus sealer after NAP application.


Assuntos
Cavidade Pulpar , Materiais Restauradores do Canal Radicular/química , Obturação do Canal Radicular/métodos , Cimento de Óxido de Zinco e Eugenol , Dente Pré-Molar , Colagem Dentária , Dentina , Resinas Epóxi/química , Guta-Percha/química , Humanos , Teste de Materiais , Pressão , Preparo de Canal Radicular/métodos , Temperatura
7.
Niger J Clin Pract ; 23(5): 697-703, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367879

RESUMO

Background: The purpose of this study was to assess the quantity of the chelated calcium ions and the smear layer removal efficiency after root canal final irrigation with three different solutions. Materials and Methods: Forty-five teeth were instrumented with rotary-files, then randomly divided into 3 equal groups (n = 15) depending on the final irrigation solution; group I: 17% ethylenediaminetetraacetic acid (EDTA), group II: 0.2% chitosan, and group III: 10% trisodium citrate. According to the time of application, every group was divided into 3 subgroups (1 min, 5 min, and 24 h). The quantification analysis of chelated calcium ions was performed by flame atomic absorption spectrometry (FAAS). Then, the presence of smear layer was examined by splitting the samples longitudinally and using scanning electron microscopy (SEM) to examine coronal, middle, and apical root canal levels. One-way analysis of variance (ANOVA) test was used for the evaluation of treatment effect. Kruskal-Wallis test was executed to detect a significant difference between groups, while Mann-Whitney U test has determined the difference between each two groups for smear layer. Results: Both 17% EDTA and 0.2% chitosan had not been statistically significant difference for smear layer removal efficiency and observed calcium ion concentrations. Although, they were more efficient of 10% trisodium citrate with a significant difference (P < 0.05). Conclusion: The application time of the chelators' solutions must not exceed 5 min to completely remove smear layer, and 0.2% chitosan is a natural substitute for 17% EDTA with a safety application for 24 h.


Assuntos
Quitosana/química , Ácido Edético/química , Irrigantes do Canal Radicular/química , Preparo de Canal Radicular/métodos , Humanos , Microscopia Eletrônica de Varredura , Camada de Esfregaço/diagnóstico por imagem , Camada de Esfregaço/cirurgia , Dente/cirurgia
8.
BMC Oral Health ; 20(1): 111, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32299409

RESUMO

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.


Assuntos
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
9.
Niger J Clin Pract ; 23(4): 510-514, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32246658

RESUMO

Background: There were no comparing data about the effect of recently developed file system OneCurve on apical debris extrusion. Aim: The aim of this in vitro study was to compare the influence of the rotary nickel-titanium (Ni-Ti) files on apical debris extrusion after cervical preflaring. Materials and Methods: Sixty-six lower incisor teeth with a single root canal were used in this study. After the determination of working length, the specimens were divided into six experimental groups according to root canal preparation. G1: ProTaper-Next, G2: EndoFlare + ProTaper-Next, G3: 2Shape, G4: EndoFlare + 2Shape, G5: OneCurve, and G6: EndoFlare + OneCurve. Each specimen was inserted into separate preweighed Eppendorf tubes to collect apically extruded debris. A total of 8 mL of distilled water was used for each specimen for irrigation. After the completion of root canal preparation, the Eppendorf tubes were weighed again after evaporation to calculate the amount of extruded debris. The data were statistically analyzed with one-way analysis of variance (P > 0.05). Results: There was no statistically significant difference between the experimental groups. The amount of apically extruded debris was similar after preparing root canals with ProTaper-Next, 2Shape, and OneCurve with and without cervical preflaring. Conclusion: Under the conditions of this in vitro study, ProTaper-Next, 2Shape, and OneCurve files had similar apical debris extrusion values. Cervical preflaring of root canals did not affect the amount of apically extruded debris.


Assuntos
Preparo de Canal Radicular , Humanos , Incisivo/cirurgia , Níquel , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Titânio , Ápice Dentário/cirurgia
10.
Niger J Clin Pract ; 23(2): 212-218, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32031096

RESUMO

Objectives: This single-blind, randomized clinical trial (RCT) aimed to compare the duration, intensity, and incidence of postoperative pain after foraminal enlargement (FE) with continuous rotary systems and reciprocating instruments. Materials and Methods: Sixty qualified patients were randomly divided into the following two groups: the ProTaper Next group and the WaveOne group. Participants were selected from patients who had both asymptomatic necrosis and asymptomatic apical periodontitis with a single root canal. Endodontic treatment was performed in one visit, and the patients were asked to record their pain severity and analgesic consumption during a 7-day follow-up period using a visual analog scale (VAS). The data were analyzed using the Mann-Whitney U-test and Chi-square test (P < 0.05). Results: A significant difference was observed between the two groups during the first two days of follow-up (P < 0.05). Pain experience was higher in FEs that had been created by reciprocating instruments than by continuous rotary systems. There were no significant differences in VAS pain scores over the other days (P > 0.05). None of the patients had severe postoperative pain during the follow-up period. No significant differences were observed in the prevalence of analgesic consumption between either group (P > 0.05). Conclusions: This RCT indicates that in the 2-day follow-up period after endodontic treatment, FEs created by reciprocated instruments associated more postoperative pain than continuous rotary systems.


Assuntos
Cavidade Pulpar/cirurgia , Necrose da Polpa Dentária/terapia , Dente Molar/cirurgia , Dor Pós-Operatória/epidemiologia , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Adulto , Analgésicos/uso terapêutico , Cavidade Pulpar/patologia , Feminino , Humanos , Incidência , Masculino , Dor Pós-Operatória/etiologia , Irrigantes do Canal Radicular/uso terapêutico , Método Simples-Cego , Resultado do Tratamento , Escala Visual Analógica
11.
BMC Oral Health ; 20(1): 38, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019522

RESUMO

BACKGROUND: The purpose of this study was to compare the cyclic fatigue resistance of newly developed TruNatomy instruments (TRN) in single and double (S-shaped) curvature canals with HyFlex CM (HCM), Vortex Blue (VB) and RaCe (RC) instruments. METHODS: Size 20/.04 taper and size 25/0.04 of HCM, VB and RC were used. For TRN instruments, size 20/.04 taper (small) and size 26/.04 taper (prime) were used. The instruments were tested in artificial canals with double curvature (coronal curve; 60° curvature, 5 mm radius and apical curve; 70° curvature and 2 mm radius) and single curvature (60° curvature, 5 mm radius). The number of cycles to failure (NCF) was recorded. Data were statistically analyzed by Kruskal-Wallis and Dunn's multiple comparison tests. Weibull analysis was performed on NCF data. Statistical significant was set at p < 0.05. RESULTS: TRN and HCM revealed higher NCF compared with the other instruments for both tested sizes in single and double curvature canals (p < 0.05). TRN and HCM showed no statistically significant difference in the NCF (p > 0.05). The probability of survival was higher for HCM and TRN instruments than VB and RC instruments. CONCLUSIONS: HCM and TRN instruments were more resistant to cyclic fatigue than VB and RC instruments in single and double curvature canals. HCM and TRN instruments were anticipated to survive with higher number of cycles than the other tested instruments. RC instrument had the lowest fatigue resistance than the other instruments.


Assuntos
Ligas Dentárias , Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Níquel , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Titânio , Análise do Estresse Dentário , Desenho de Equipamento , Falha de Equipamento , Humanos , Teste de Materiais
12.
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
13.
J Endod ; 46(3): 419-424, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31980201

RESUMO

INTRODUCTION: The aim of this study was to evaluate the effect of using the XP-endo Finisher (XPF; FKG Dentaire, La Chaux de Fonds, Switzerland) in teeth that have a traditional access cavity (TEC) and a contracted access cavity (CEC) design on the amount of decrease in the number of Enterococcus faecalis bacteria within the root canal system. METHODS: Eighty mandibular first molar teeth were selected and randomly divided into 2 groups: TEC and CEC (n = 40/group). After access cavity preparation in the 2 groups, 80 mesiobuccal root canals were contaminated with Enterococcus faecalis for 4 weeks. After the first sampling (S1), in order to perform root canal instrumentation, the TEC and CEC groups were further divided into 4 subgroups (10 teeth/group): Reciproc (VDW GmbH, Munich, Germany) and ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) with or without XPF. Bacterial sampling from the root canals was performed with sterile paper points before (S1) and after (S2) instrumentation to determine the bacterial load. The bacterial reduction was counted as colony-forming units/mL and analyzed statistically by 3-factor repeated measures analysis of variance. Multiple comparisons of the main factor effect were performed using the Bonferroni correction (α < .05), all at 5% significance. RESULTS: The number of E. faecalis bacteria in all the samples with different cavity designs were significantly reduced after instrumentation. The lowest value of bacterial decrease percentage was observed in the CEC-Reciproc-XPF (82.8%) group. CONCLUSIONS: The bacterial reduction counts of E. faecalis were a similar level in the TEC and CEC cavities, and the use of XPF did not show significant differences between groups.


Assuntos
Cavidade Pulpar , Enterococcus faecalis , Preparo de Canal Radicular , Instrumentos Odontológicos , Enterococcus faecalis/isolamento & purificação , Alemanha , Preparo de Canal Radicular/métodos
14.
Niger J Clin Pract ; 23(1): 79-83, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929211

RESUMO

Objectives: The aim of this study was to evaluate the quantity of apically extruded debris after canal shaping with three single-file systems. Materials and Methods: Sixty mesiobuccal canals of mandibular molars were divided into three experimental groups according to the used file systems-WaveOne Gold, RECIPROC Blue, and HyFlex EDM One file. Debris extruded during canal shaping were collected in preweighed vials. Each canal was irrigated with 5 mL of distilled water via a 30 G side-vented needle. The amount of the debris extruded from each canal was calculated by subtracting the preinstrumentation from postinstrumentation measurement. The preparation times were recorded. Data were analyzed using analysis of variance (ANOVA) and posthoc Tukey tests with α = 0.05. Results: WaveOne Gold extruded the least amount of debris. Results between WaveOne Gold and HyFlex EDM were significantly different. No significant differences in canal shaping time were detected among the three groups (P > 0.05). Conclusion: WaveOne Gold showed the best results regarding apical debris extrusion. Difference between WaveOne Gold and HyFlex EDM suggests that file design and motion kinematics affect the quantity of debris extrusion.


Assuntos
Cavidade Pulpar/cirurgia , Preparo de Canal Radicular/instrumentação , Ápice Dentário/cirurgia , Fenômenos Biomecânicos , Cavidade Pulpar/anatomia & histologia , Desenho de Equipamento , Humanos , Dente Molar/anatomia & histologia , Dente Molar/cirurgia , Preparo de Canal Radicular/métodos
15.
Lasers Med Sci ; 35(3): 719-728, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31782022

RESUMO

The aim was to validate an artificial resin 'root canal wall groove model' (RCWGM) mimicking the situation of natural roots with a groove of identical dimensions on debris removal out of these grooves, and to evaluate Erbium 'laser-activated irrigation' (LAI) with two conical tips at PIPS (photon-induced photoacoustic streaming) settings, with different activation times and different root canal positions on debris removal out of the grooves. A split RCWGM was used (resin blocks and roots of maxillary canines) with a canal size 40/0.06. The grooves in the apical third were filled with stained dentinal debris. Seventeen irrigation protocols (n = 20) were used: syringe-needle irrigation (3× 20 s), manual dynamic activation (1× 60 s), ultrasonically activated irrigation (UAI) with 25/25 Irrisafe (3× 20 s) and LAI (2940 nm Er:YAG) with X-Pulse or PIPS tips at PIPS settings (20 mJ, 50 µs, 20 Hz) and with the fibre (IN) or (OUT) the canal: IN during 1× 20 s, and OUT during 1× 20 s, 2× 20 s, 3× 20 s, 30 s, 2× 30 s and 1× 60 s. The quantity of remaining dentine debris in the groove was evaluated on a numerical scale. Statistical analysis was performed by means of proportional odds logistic regression, equivalence testing and Wald tests. The level of significance was set at 0.05. Resin models and the RCWGM with natural teeth can be called equivalent (log odds ratio 0.185). There were mostly no statistically significant differences for debris removal between UAI and LAI (p > 0.05) and between LAI with PIPS and X-Pulse (p > 0.05). Although not statistically different, the numbers of completely cleaned grooves were higher with LAI than with UAI for a 1-min activation, confirming findings from other studies. There is no difference in cleaning efficacy between X-Pulse and PIPS tips at PIPS settings.


Assuntos
Acústica , Dentina/patologia , Fótons , Irrigantes do Canal Radicular/farmacologia , Tratamento do Canal Radicular , Ultrassom , Humanos , Lasers , Razão de Chances , Preparo de Canal Radicular/métodos
16.
Gen Dent ; 68(1): 41-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859661

RESUMO

The objective of this study was to evaluate the antimicrobial capacity of glycolic acid (GA) at different concentrations as a final irrigant during the preparation of root canals. The sample consisted of 77 extracted single-rooted human teeth with complete root formation, no previous endodontic treatment, and a root length of at least 14 mm. The root canals were prepared in a standardized manner with a rotary file system. During this process, irrigation was performed with 2.5% sodium hypochlorite (NaOCl), and the final irrigant was 17% ethylenediaminetetraacetic acid (EDTA). After the root canal sterilization procedure, Enterococcus faecalis was cultured in a Petri dish, and 70 sterilized root canals were inoculated with a suspension containing 3.0 × 108 colony-forming units (CFUs) per milliliter. The roots were divided into 7 groups (n = 10) according to the following solutions: 0.9% sodium chloride (NaCl); 6% NaOCl; 17% EDTA; 10%, 17%, or 25% GA; or 17% citric acid (CA). The capacity of the different substances to reduce E faecalis was evaluated by counting the CFUs before and after treatment with the final irrigant solutions. Data were subjected to an analysis of variance and the Tukey test at a 5% significance level. The greatest bacterial reduction was observed in the group irrigated with NaOCl (P < 0.05). There were no statistically significant differences among the groups irrigated with GA in different concentrations (P > 0.05), but they all demonstrated greater disinfection capacity than CA and EDTA (P < 0.05). CA showed significantly greater antimicrobial capacity than EDTA (P < 0.05). EDTA showed significantly greater antimicrobial capacity only in relation to NaCl (P < 0.05). At different concentrations, GA demonstrated greater capacity to eliminate E faecalis from root canals than did EDTA.


Assuntos
Anti-Infecciosos , Glicolatos , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Anti-Infecciosos/farmacologia , Cavidade Pulpar , Ácido Edético , Enterococcus faecalis , Glicolatos/farmacologia , Humanos , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio
17.
Clin Oral Investig ; 24(7): 2445-2450, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31673858

RESUMO

OBJECTIVES: The aim of this prospective clinical trial was to investigate the incidence of postoperative pain after initial root canal treatment using Twisted File Adaptive (TFA) and Reciproc systems. MATERIALS AND METHODS: A total of sixty-four previously initiated or necrotic posterior teeth were randomly assigned to two groups based on the rotary system used; TFA (SybronEndo, Orange, Ca) (n = 35) and Reciproc (VDW, Munich, Germany) (n = 29). All teeth were treated in a single visit. Patients were contacted to assess the level of postoperative pain on a visual analog scale after treatment by 6 h, 24 h, 48 h, 72 h, and 1 week. Patients were also asked to report if any medication was taken during the follow-up period. The postoperative pain scores were analyzed by Mann-Whitney test with respect to follow-up interval at a significance level of 0.05. RESULTS: Patients treated with TFA reported significantly lower postoperative pain levels at 24 h, 48 h, and 72 h compared with those in Reciproc group (p < 0.01). There were no significant differences between the two groups at 6 h and 1-week follow-up intervals (p > 0.05). About 11% (TFA) and 24% (Reciproc) of the treated patients took analgesics, but none of them took antibiotics during the follow-up period. CONCLUSIONS: The tested rotary systems induced postoperative pain after root canal treatment. The TFA system was found to induce less pain scores compared with the Reciproc system after the treatment by 24 h, 48 h, and 72 h. CLINICAL RELEVANCE: The level of postoperative pain was low after the root canal treatment with the Twisted File Adaptive system compared with the Reciproc system.


Assuntos
Dor Pós-Operatória , Preparo de Canal Radicular , Tratamento do Canal Radicular , Humanos , Incidência , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/métodos
18.
Technol Health Care ; 28(1): 35-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31104033

RESUMO

BACKGROUND: Clinicians routinely encounter the endodontically treated teeth with wide flared canals and mineral trioxide aggregate (MTA) repair on the canal wall. OBJECTIVE: To assess the effect of customized glass reinforced composite (FRC) post and reshaped root canal along with different acid etching protocol of MTA surface on push-out bond strength (PBS) in flared, MTA repaired root canal. METHODS: Ninety recently extracted single-rooted premolar teeth were sequentially subjected to root canal obturation, post space preparation, flaring, and MTA application. The samples were randomly divided into 3 groups of control (no relining or reshaping), customized FRC post by relining with self-adhesive resin cement and reshaping the canal with flowable composite. Each group was subdivided into 3 subgroups (n= 10) as no surface treatment, 37% H3PO4 and 19% EDTA etching of MTA surface. Teeth samples cemented with FRC post were sectioned into 2 mm and push-out testing. RESULTS: Control group had the lowest PBS at 1.988 N. The PBS values for the groups with customized post relining were 8.489 N, 8.888 N and 7.911 N for control, H3PO4 etch and EDTA etch. The corresponding PBS values for root canal reshaping were 7.323 N, 8.318 N and 7.785 N. CONCLUSIONS: Customized FRC post with 37% H3PO4 etching is advised for the flared and MTA repaired root canals.


Assuntos
Compostos de Alumínio/química , Compostos de Cálcio/química , Materiais Dentários/química , Vidro/química , Óxidos/química , Preparo de Canal Radicular/métodos , Silicatos/química , Combinação de Medicamentos , Humanos
19.
Lasers Med Sci ; 35(1): 205-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31321596

RESUMO

The aim of this study was to determine the amount of extruded endodontic irrigant among needle-syringe irrigation (NSI) and laser-activated irrigation (LAI) regimens. Twenty extracted maxillary central incisors were prepared utilizing GT professional rotary files (size 40, taper 0.06). Irrigation was performed with two 27 G irrigation needles (notched open ended (ON) and single side vented (SV)) each at two different irrigant volumetric flow rates (VFR)-0.05 ml/s (3 ml/min) and 0.10 ml/s (6 ml/min). LAI was performed with Er:YAG (erbium-doped yttrium aluminum garnet) using different fiber types (X-Pulse-14/400 cylindrical tip, Preciso- 14/300 flat cylindrical tip, PIPS- 14/400 quartz tapered tip). The Er:YAG laser with a wavelength of 2940 nm (Lightwalker AT, Fotona, Ljubljana, Slovenia) was used according to the following protocol: 10 mJ per pulse, 15 Hz, pulse duration 50 µs. Irrigation time was 60 s for all protocols. Precision syringe pump (PSP) maintained constant irrigant volumetric flow rate. Apically extruded irrigant was collected and net weighed for each protocol (N = 10). Data were analyzed by t tests and Kruskal-Wallis. All LAI regimens had statistically significant lower irrigant extrusion compared with NSI except for the SV 27 G needle used with 0.05 ml/s VFR when compared with the Preciso fiber tip (p = 0,230). The largest amount of extruded irrigant was with the ON 27 G needle at the 0.10 ml/s VFR, while the smallest was after LAI with PIPS fiber tip. The lower quantity of apically extruded irrigant during LAI (X-Pulse and PIPS) points out a safer endodontic irrigation method compared with conventional irrigations.


Assuntos
Lasers de Estado Sólido , Irrigantes do Canal Radicular/metabolismo , Preparo de Canal Radicular/métodos , Cavidade Pulpar/metabolismo , Cavidade Pulpar/efeitos da radiação , Humanos , Agulhas , Preparo de Canal Radicular/instrumentação
20.
Rio de Janeiro; s.n; 2020. 61 p. ilus, tab.
Tese em Português | BBO - Odontologia | ID: biblio-1147966

RESUMO

O objetivo deste trabalho foi avaliar o resultado do preparo biomecânico da instrumentação endodôntica em protótipos de dentes decíduos intactos com sistemas mecanizados através de microtomografia computadorizada. Foram utilizados 50 protótipos de um incisivo central superior decíduo produzido através de impressão 3D. Os sistemas de limas empregados foram o manual (MN), WaveOne Gold (WOG), XP Endo Shaper (XPS), XP Endo Finisher (XPF) e XP Clean (XPC). Cada grupo contou com 10 dentes e foram instrumentados de acordo com as recomendações dos fabricantes. O escaneamento dos protótipos pelo micro-CT foi realizado antes e após a instrumentação e as reconstruções foram padronizadas para cada conjunto de imagens. O teste de Shapiro-Wilk foi utilizado para verificar a normalidade dos dados. O ANOVA seguido do teste de Tukey foi utilizado para comparar as médias de volume final do canal, formação de debris, volume de dentina removida e área não instrumentada das paredes do canal. O teste T de Student foi usado para comparar os volumes inicial e final do canal entre cada grupo de instrumentação. A presença de trincas e/ou perfurações ao longo do canal foi registrada e realizada uma descrição qualitativa da sua presença. Todos os grupos apresentaram uma diferença significativa no volume do canal após a instrumentação. O maior aumento de volume do canal foi com as limas manuais, que teve uma diferença estatística significativa quando comparado com os rotatórios, que não apresentaram diferença entre si. Em relação ao acumulo de debris e aréas não tocadas não houve diferença estatística entre os grupos. O maior volume de dentina removido foi quando utilizado as limas manuais. Apenas os grupos manual e WOG apresentaram trincas. Perfuração radicular foi observado apenas no grupo manual. Concluimos que o uso de sistemas rotatórios apresentou melhores resultados no preparo biomecânico do canal de incisivos superiores decíduos quando comparado à limas manuais. O sistema XP Clean combinou bons resultados, com pouco acumulo de debris e maior área tocada pelo instrumento no interior do canal. (AU)


The aim of this study was to evaluate the result of biomechanical preparation of endodontic instrumentation in prototypes of intact primary teeth with mechanized systems using computerized microtomography. 50 prototypes of a primary maxillary central incisor produced using 3D printing were used. The file systems used were hand files, WaveOne Gold (WOG), XP-Endo Shaper (XPS), XP-Endo Finisher (XPF) and XP Clean (XPC). Each group had 10 teeth and were instrumented according to the manufacturers' recommendations. The scanning of the prototypes by micro-CT was performed before and after instrumentation and the reconstructions were standardized for each set of images. The Shapiro-Wilk test was used to verify the normality of the data. ANOVA followed by the Tukey test was used to compare the averages of final canal volume, debris formation, dentin volume removed and untouched area of the canal walls. Student's t-test was used to compare the initial and final volumes of the canal between each instrumentation group. The presence of cracks and / or perforations along the canal was recorded and a qualitative description was made. All groups showed a significant difference in volume of the canal after instrumentation. The greatest increase in volume of the canal was with hand files, which had a statistically significant difference when compared to rotary files, which showed no difference among them. Regarding the accumulation of debris and noninstrumented areas, there was no statistical difference between the groups. The largest volume of dentin removed was when using hand files. Only the hand files and WOG groups showed cracks. Root perforation was observed only in the hand file group. We concluded that the use of rotary systems showed better results in the biomechanical preparation of the canal of primary maxillary incisors when compared to hand files. The XP Clean system combined good results, with little debris accumulation and a larger area played by the instrument inside the canal. (AU)


Assuntos
Dente Decíduo , Preparo de Canal Radicular/instrumentação , Instrumentos Odontológicos/normas , Microtomografia por Raio-X , Incisivo , Fenômenos Biomecânicos , Preparo de Canal Radicular/métodos
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