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1.
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
2.
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
3.
J Appl Oral Sci ; 28: e20190100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31800872

RESUMO

OBJECTIVE: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. METHODOLOGY: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. RESULTS: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). CONCLUSION: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Cavidade Pulpar/microbiologia , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Adolescente , Adulto , Análise de Variância , Bactérias/isolamento & purificação , Carga Bacteriana , Contagem de Colônia Microbiana , Tomografia Computadorizada de Feixe Cônico , Sondas de DNA , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos , Resultado do Tratamento , Terapia por Ultrassom/métodos , Adulto Jovem
4.
J. appl. oral sci ; 28: e20190100, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1056594

RESUMO

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Cavidade Pulpar/microbiologia , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Bactérias/isolamento & purificação , Terapia por Ultrassom/métodos , Contagem de Colônia Microbiana , Sondas de DNA , Modelos Lineares , Análise de Variância , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico , Carga Bacteriana , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos
5.
J. appl. oral sci ; 28: e20190100, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090785

RESUMO

Abstract Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Periodontite Periapical/terapia , Tratamento do Canal Radicular/instrumentação , Terapia por Ultrassom/instrumentação , Cavidade Pulpar/microbiologia , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Bactérias/isolamento & purificação , Terapia por Ultrassom/métodos , Contagem de Colônia Microbiana , Sondas de DNA , Modelos Lineares , Análise de Variância , Resultado do Tratamento , Tomografia Computadorizada de Feixe Cônico , Carga Bacteriana , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos
6.
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1135481

RESUMO

Abstract Objective: To verify the concordance in the evaluation of the apical limit of obturation (ALO) in filled root canals of primary teeth between digital and visual methods. Material and Methods: Twenty periapical radiographs of endodontically treated primary teeth were digitalized and evaluated by an endodontics specialist (E1), a PhD pediatric dentist (E2), and a MSc general dentist (E3). Calibrated evaluators (Kappa = 1.00) analysed the images in a light-isolated environment two times (D1 and D2) with a one-week interval between evaluations. ALO scores were categorized as overfilled, flush-filled and underfilled. Results: The intra-rater reliability between methods was 0.82 (D1) and 0.75 (D2) for E1, 0.93 (D1 and D2) for E2, and 0.94 (D1 and D2) for E3. Inter-rater reliability ranged from 0.71 (E1 × E3) and 1.00 (E1 × E2) for the visual method to 0.76 (E1 × E3) and 0.88 (E1 × E2) for the digital method. Spearman correlation coefficients showed a similar ranking among the evaluators. There was greater disagreement among the underfilled and ideal scores. For all evaluators, the digital method favoured the identification of the ideal score. Conclusion: Both methods are suitable for the determination of the ALO of filled primary teeth and can be used in clinical practice.


Assuntos
Humanos , Obturação do Canal Radicular , Tratamento do Canal Radicular/instrumentação , Dente Decíduo , Projetos Piloto , Cavidade Pulpar , Precisão da Medição Dimensional , Brasil , Radiografia Dentária/instrumentação , Estatísticas não Paramétricas , Odontólogos
7.
Niger J Clin Pract ; 22(7): 926-931, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293256

RESUMO

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


Assuntos
Cavidade Pulpar/cirurgia , Guta-Percha/química , Materiais Restauradores do Canal Radicular/química , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Ligas Dentárias/química , Humanos , Níquel , Retratamento , Materiais Restauradores do Canal Radicular/efeitos adversos , Obturação do Canal Radicular/métodos , Titânio/química , Ápice Dentário/patologia
8.
J Endod ; 45(2): 199-204, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711178

RESUMO

INTRODUCTION: The aim of this study was to compare the cyclic fatigue, torsional resistance, and bending stiffness of single-file glide path preparation nickel-titanium instruments. METHODS: ProGlider (#16/progressive taper; Dentsply Sirona, Ballaigues, Switzerland), One G (#14/.03; Micro-Mega, Besancon, France), and EdgeGlidePath (#16/progressive taper; Edge Endo, Albuquerque, NM) were tested. For the bending stiffness test, the instrument was bent to a 45° angle along the main axis while 3 mm of the tip was secured. Cyclic fatigue resistance was measured during pecking movement, whereas the file was rotated within a reproducible simulated canal with a 3-mm radius and a 90° angle of curvature. The ultimate torsional strength and toughness were evaluated using a custom device. While tightly holding the end of the file at 3 mm, a rotational load of 2 rpm speed was applied until fracture. The results were analyzed using 1-way analysis of variance and Tukey post hoc comparison. A microscopic inspection was performed on the surface of a separate instrument using a scanning electron microscope. RESULTS: EdgeGlidePath showed superior cyclic fatigue resistance compared with the other systems. One G showed higher maximum torsional strength than the others. One G showed the largest distortion angle and the highest toughness followed by EdgeGlidePath and ProGlider (P < .05). One G also showed larger bending stiffness than the others, whereas EdgeGlidePath showed a larger residual angle than the others (P < .05). CONCLUSIONS: Conventional wire showed higher toughness and torsional resistance than M-Wire and heat-treated nickel-titanium instruments. However, heat-treated wire showed higher cyclic resistance than conventional wire and M-Wire.


Assuntos
Ligas , Instrumentos Odontológicos , Desenho de Equipamento , Tratamento do Canal Radicular/instrumentação , Rotação , Falha de Equipamento , Teste de Materiais/métodos , Estresse Mecânico
9.
J Endod ; 45(2): 205-208, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711179

RESUMO

INTRODUCTION: The aim of this study was to evaluate the effect of different temperatures of sodium hypochlorite (NaOCl) on the cyclic fatigue resistance of the heat-treated file systems. METHODS: The cyclic fatigue resistance of Reciproc 25 (VDW Dental, Munich, Germany), Reciproc Blue R25 (VDW), WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland), WaveOne Gold Primary (Dentsply Maillefer), and One Shape (25.06; Micro Mega, Besançon, France) was tested in the following conditions: control (no immersion), immersion in distilled water (DW) at 37°C ± 1°C, immersion in DW at 60°C ± 1°C, immersion in NaOCl at 37°C ± 1°C, and immersion in NaOCl at 60°C ± 1°C. The immersion period was 5 minutes for all conditions. A stainless steel artificial canal with a curvature of 60° and a 5-mm radius was used. The time to failure and fragment lengths were recorded for each instrument, and data were subjected to statistical analysis. RESULTS: Reciproc Blue showed greater cyclic fatigue resistance in all conditions compared with the other systems (P < .05). Immersion in NaOCl at 60 °C negatively affected all instruments' cyclic fatigue resistance except Reciproc Blue. Immersion in DW at 60 °C increased the cyclic fatigue resistance of Reciproc Blue. Heat-treated files presented higher fatigue resistance than traditional files. CONCLUSIONS: A high temperature of NaOCl affected the cyclic fatigue life of the file systems. Instruments produced with heat treatment presented a longer fatigue life.


Assuntos
Instrumentos Odontológicos , Falha de Equipamento , Irrigantes do Canal Radicular , Tratamento do Canal Radicular/instrumentação , Hipoclorito de Sódio , Temperatura , Corrosão , Temperatura Alta , Irrigantes do Canal Radicular/efeitos adversos , Hipoclorito de Sódio/efeitos adversos
10.
Cochrane Database Syst Rev ; 2: CD006384, 2019 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-30730577

RESUMO

BACKGROUND: Endodontic treatment of root canals or root canal treatment is a frequently performed dental procedure and is carried out on teeth in which irreversible pulpitis has led to necrosis (death) of the dental pulp (nerve). Removal of the necrotic tissue remnants and cleaning and shaping of the root canal are important phases of root canal treatment. Treatment options include the use of hand and rotary instruments and methods using ultrasonic or sonic equipment. OBJECTIVES: The objectives of this review were to determine the relative clinical effectiveness of hand instrumentation versus ultrasonic instrumentation alone or in conjunction with hand instrumentation for orthograde root canal treatment of permanent teeth. SEARCH METHODS: We searched the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS. We searched the reference lists of relevant articles in an attempt to locate additional published and unpublished trials. No language restriction was applied. The last electronic search was conducted in December 2007. SELECTION CRITERIA: Randomised controlled trials involving people over 18 years of age with single and multiple permanent teeth with a completely formed apex and with no evidence of internal resorption requiring root canal treatment were included. Patients undertaking re-treatment of a tooth were excluded. DATA COLLECTION AND ANALYSIS: Screening of eligible studies was conducted in duplicate and independently. Results were to be expressed as fixed-effect or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No eligible randomised controlled trials were identified. AUTHORS' CONCLUSIONS: This review illustrates the current lack of published or ongoing randomised controlled trials and the unavailability of high level evidence, based on clinically relevant outcomes, for the effectiveness of ultrasonic instrumentation used alone or as an adjunct to hand instrumentation for orthograde root canal treatment.Future randomised controlled trials might focus more closely on evaluating the effectiveness of combinations of these interventions with an emphasis on not only clinically relevant but also patient-centred outcomes.


Assuntos
Instrumentos Odontológicos , Dentição Permanente , Tratamento do Canal Radicular/métodos , Terapia por Ultrassom/instrumentação , Adulto , Humanos , Tratamento do Canal Radicular/instrumentação
11.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 3902, 01 Fevereiro 2019. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-997921

RESUMO

Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.


Assuntos
Humanos , Criança , Adolescente , Pulpectomia/métodos , Obturação do Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Dente Decíduo , Registros Médicos , Serviços de Saúde Bucal , Brasil , Análise de Sobrevida , Estudos Retrospectivos , Estatísticas não Paramétricas
12.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4651, 01 Fevereiro 2019. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-998212

RESUMO

Objective: To compare the amount of apical debris extrusion in samples instrumented by EndoStar E5, ProTaper Universal, and M-two rotary files. Material and Methods: Forty-five freshly extracted non-carious mandibular premolar teeth with single roots and single canals were acquired, and randomly divided into 3 groups (n=15). Samples in Groups 1, 2, and 3 were instrumented using EndoStar E5 (EE5), ProTaper Universal (PTU), and M-two (MTO) rotary file, respectively. Following instrumentation, the debris extruded was collected in pre-weighed Eppendorf tubes and stored in an incubator at 70°C for 5 days. Tubes containing the dry extruded debris were then weighed. One-way analysis of variance was applied to the weights obtained followed by Tukey's post hoc test for multiple comparison. Results: The mean debris extruded (mg) for the 3 groups were 1.23 (±0.72), 2.16 (±0.66), and 1.39 (±0.86) for EE5, PTU, and MTO respectively. Samples instrumented with PTU were associated with significantly higher debris extrusion (p<0.01) compared to EE5 and MTO. The groups EE5 and MTO did not differ in the amounts of debris extrusion (p>0.05). Conclusion: The novel EE5 and M-two rotary files result in less debris extrusion compared to PTU in mandibular premolars.


Assuntos
Tratamento do Canal Radicular/instrumentação , Técnicas In Vitro/métodos , Estudo Comparativo , Preparo de Canal Radicular , Endodontia , Análise de Variância , Estatísticas não Paramétricas , Índia
13.
Int Endod J ; 52(2): 139-148, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30040127

RESUMO

AIM: To compare the impact of the two different root canal preparation systems on the quality of life of patients and correlate postoperative pain with the impact on quality of life. METHODOLOGY: A randomized clinical trial was conducted with 58 patients allocated into two groups based on the root canal preparation system employed: ProTaper Next (PN) or Reciproc (R). Data collection involved the administration of a questionnaire addressing demographic and clinical characteristics, the OHIP-14 (quality of life) and a visual analog scale (pain). The latter two were the outcomes of interest and were administered in the first 24 h after root canal treatment. The data were submitted to descriptive analysis, bivariate analysis, Poisson univariate and multiple regression, and Spearman's correlation test, with a 5% significance level. RESULTS: A greater frequency of impact after treatment was found for the items 'uncomfortable to eat food' and 'felt self-conscious'. No significant difference between groups was found regarding the severity of impact for total OHIP-14 score or any of the domain scores. CONCLUSIONS: The two root canal preparation systems exerted a similar impact on quality of life. Postoperative pain was correlated with impact on quality of life, affecting chewing function, self-consciousness and stress. Thus, it is important for dentists to provide care capable of preventing or treating the negative consequences of such therapy.


Assuntos
Qualidade de Vida/psicologia , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Tratamento do Canal Radicular/métodos , Adolescente , Adulto , Idoso , Estado de Consciência , Odontólogos , Método Duplo-Cego , Endodontia , Humanos , Masculino , Mastigação , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Fatores de Risco , Estresse Psicológico/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
14.
J Prosthodont ; 28(1): e181-e185, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28257161

RESUMO

PURPOSE: In clinical prosthetics procedures, including endodontics and post fixation, the presence of a smear layer can reduce the post bond strength. An Er,Cr:YSGG laser, which emits at 2780 nm, can promote a smear-layer-free surface due to the ablation process. Considering these aspects, the purpose of this work was to evaluate the influence of Er,Cr:YSGG laser irradiation using either a radial or an axial fiber tip on the bond strength of three resin cements to the fiber-reinforced composite posts. MATERIALS AND METHODS: Ninety recently extracted single rooted human teeth had their root canal instrumented and were randomly distributed into nine experimental groups, in which three resin cements (total-etching Variolink II, self-etching Panavia F, and self-adhesive RelyX Unicem Aplicap) and three root canal treatments (no treatment, laser irradiation using the radial fiber tip, laser irradiation using the axial fiber tip) were used. Specimens were then sectioned into three sections (cervical, middle, and apical thirds) with two slices on each section. A push-out test was performed on each slice, and the values were recorded as MPa. The push-out data were analyzed by a Ryan-Joiner normality test followed by a two-way ANOVA test and Tukey pairwise comparison. The statistical analysis was performed on each third section separately, with a 5% significance level. RESULTS: Laser irradiation with axial fiber tip significantly increased the post bond strength of RelyX Unicem Aplicap on middle third of specimens (p < 0.001) when compared to other root canal treatments (unlased or irradiated with radial tip). Considering the Panavia resin cement, laser irradiation with either axial or radial tips promoted a significant increase on the post bond strength of middle third when compared to unlased specimens (p < 0.001); however, laser irradiation did not influence the post bond strength of Variolink resin cement. CONCLUSIONS: The use of the Er,Cr:YSGG laser for clinical prosthetics procedures enhances the post bond strength of Panavia and RelyX Unicem Aplicap resin cements, mainly at middle third of roots, and does not interfere with the bond strength of Variolink resin cement. For the RelyX Unicem Aplicap system, the use of axial tip is most advantageous and can be recommended for future clinical application.


Assuntos
Colagem Dentária/métodos , Lasers de Estado Sólido/uso terapêutico , Cimentos de Resina/química , Cimentos de Resina/efeitos da radiação , Tratamento do Canal Radicular/instrumentação , Tratamento do Canal Radicular/métodos , Raiz Dentária/efeitos da radiação , Corrosão Dentária/métodos , Cavidade Pulpar/efeitos da radiação , Análise do Estresse Dentário , Vidro , Humanos , Teste de Materiais , Técnica para Retentor Intrarradicular/instrumentação , Doses de Radiação , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Autocura de Resinas Dentárias , Estresse Mecânico
15.
J Endod ; 44(12): 1872-1877, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30390968

RESUMO

INTRODUCTION: This study evaluated the accuracy of 3 electronic apex locators (EALs) (CanalPro [Coltene-Endo, Cuyahoga Falls, OH], Apex ID [SybronEndo, Glendora, CA], and Root ZX Mini [J Morita, Tokyo, Japan]) in curved mesial canals of extracted mandibular molars using micro-computed tomographic (micro-CT) scanning. METHODS: The root canal length and the actual working length of 58 canals were measured using the visual method and 3-dimensional micro-CT reconstructions. The measurements of the EALs at marks "APEX/0.0" and "0.5 mark" were recorded as the electronic root canal length and the electronic working length, respectively. The absolute mean values and the percentages of distribution of the electronic measurements were compared with the actual lengths of the canals. The presence of isthmuses, accessory canals, foramen position, and the distance between the apical constriction and the apical foramen were recorded from the micro-CT scans, and their correlation to the accuracy of the EALs was determined. RESULTS: All electronic measurements showed high agreement with their respective gold standard, except the electronic root canal length of the Apex ID (P < .05). No difference in the percentage of precise measurements (within the ±0.5 mm) was found among the devices (χ2 and z tests, P > .05). Of the anatomic parameters evaluated, the presence of a lateral foramen negatively affected the 0.0 mark of the Apex ID (Wilcoxon test, P < .05). CONCLUSIONS: The Root ZX Mini and CanalPro were precise for both root canal length and working length determination in mesial curved canals of mandibular molars, whereas the Apex ID was accurate for the working length when using the 0.5 mark.


Assuntos
Instrumentos Odontológicos , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Odontometria/instrumentação , Tratamento do Canal Radicular/instrumentação , Ápice Dentário/anatomia & histologia , Ápice Dentário/diagnóstico por imagem , Microtomografia por Raio-X/métodos , Precisão da Medição Dimensional , Eletrônica Médica , Humanos , Mandíbula
16.
JNMA J Nepal Med Assoc ; 56(210): 616-620, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30376007

RESUMO

INTRODUCTION: Canals can be of different shapes in cross section including round canals, oval canals, long oval canals or ribbon shaped canals. Recesses of nonround canals may not be included in the round preparation created by rotary instruments and thus they remain unprepared. The aim of this study included determination of shape and taper of the apical root canal based on diameter at different levels. Measurement of the diameter of the root canal at one, two and three mm cross sections from the apex of the tooth were done such that apical instrumentation in root canal treatment could be modified based on the results obtained. METHODS: This was a cross sectional study which used convenient sampling technique to determine the sample size. Seventy extracted teeth were sectioned horizontally at one, two and three millimeter from the apex using the diamond disc which was observed under trinocular research microscope for the determination of diameter of root canal under 10x magnification. Digital images of the sections were taken by a camera attached to the research microscope and analysis done using DigiPro 4.0 software. RESULTS: The most common canal configuration was oval. The taper of the canals was 25% in mesial root and 20% in distal in bucco-lingual orientation and 14% in mesial root and 15% in distal in mesio-distal orientation. CONCLUSIONS: The most prevalent canal configuration in this study was non round, however, most of the rotary instruments tend to prepare root canals into round shape making their use questionable. The taper of the root canals was found to be higher in our study than what most of the shaping instruments have to offer. So it would be advisable to consider this fact while selecting instruments and preparing these non-round canals as far as the Nepalese subpopulation is considered.


Assuntos
Assistência Odontológica/instrumentação , Cavidade Pulpar/anatomia & histologia , Erros Médicos/prevenção & controle , Preparo de Canal Radicular , Tratamento do Canal Radicular , Pesos e Medidas Corporais/métodos , Pesos e Medidas Corporais/normas , Desenho de Equipamento , Humanos , Nepal , Preparo de Canal Radicular/efeitos adversos , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/instrumentação , Tratamento do Canal Radicular/métodos
17.
Braz Oral Res ; 32(suppl 1): e76, 2018 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-30365617

RESUMO

Endodontic treatment is a common dental procedure used for treating teeth which the pulp tissue has become irreversibly inflamed or necrotic as a result of the carious process or dental trauma. This procedure which involves mechanical and chemical preparation of root canal may affect several mechanical and physical properties of the tooth structure. The endodontic treatment can also influence the longevity of the rehabilitation of endodontically treated teeth and biomechanics during the oral function. For restoring endodontically treated teeth several factor and clinical decisions should be observed. The decision of the fiberglass post usage and the restorative materials are related to several factors such as the quantity and quality of remaining dental structure, presence of ferrule, post cementation length and final coronal restoration. In this review, the authors will address the effect of the endodontic treatment procedures on canal shape and mechanical properties of a tooth, and also discuss the parameters and the biomechanical principles of root canal treated teeth.


Assuntos
Restauração Dentária Permanente/métodos , Técnica para Retentor Intrarradicular , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Dente não Vital/terapia , Fenômenos Biomecânicos , Análise do Estresse Dentário , Dentina/química , Dentina/patologia , Vidro , Humanos , Tratamento do Canal Radicular/instrumentação , Dente não Vital/patologia , Resultado do Tratamento
18.
Braz Oral Res ; 32: e94, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30231174

RESUMO

This study analyzed the influence of different retreatment protocols on amount of remaining filling material and amount of new sealer after endodontic retreatment. Forty mandibular molars with curved mesial roots were prepared with ProTaper Universal system, and filled with AH Plus sealer mixed with 0.1% rhodamine B and gutta-percha. After 7 days, the specimens were randomized according to the retreatment protocol (n = 10): ProTaper Retreatment System (PTR); PTR+Orange Oil (PTR+OO); PTR+Passive Ultrasonic Irrigation (PTR+PUI). No retreatment was performed in the control group (CG). After retreatment, the root canals were filled with AH Plus mixed with 0.1% fluorescein and gutta-percha. Samples were evaluated under confocal laser scanning microscopy and analyzed using Image J software. Data were analyzed using Kruskal-Wallis and Dunn tests (p < 0.05). Regarding presence of residual filling, the Kruskal-Wallis test indicated no differences among the different retreatment techniques in the perimeter and the isthmus analyses (p > 0.05); however, PTR+PUI was associated with a lesser amount of residual filling material in the canal area analysis (p < 0.05). In evaluating the new filling, the perimeter analysis showed a lesser amount of new endodontic sealer in the PTR group (p < 0.05). Moreover, the PTR+PUI group presented a significantly greater amount of new endodontic sealer in the canal area analysis (p < 0.05). There was no difference among groups in the isthmus analysis (p > 0.05). It can be concluded that PTR associated to PUI yielded better results in removing root canal filling material from the canal area. However, none of the protocols resulted in root walls completely free of remnants.


Assuntos
Materiais Restauradores do Canal Radicular/química , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Instrumentos Odontológicos , Cavidade Pulpar/química , Cavidade Pulpar/efeitos dos fármacos , Humanos , Microscopia Confocal , Reprodutibilidade dos Testes , Retratamento/métodos , Tratamento do Canal Radicular/instrumentação , Estatísticas não Paramétricas , Resultado do Tratamento
19.
PLoS One ; 13(8): e0201129, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30067792

RESUMO

INTRODUCTION: The aim of this study was to compare the shaping ability of four root canal preparation systems in newly developed 3D-printed root canal models. MATERIALS AND METHODS: For this study, 1080 3D-printed acrylic resin blocks with nine different root canal configurations were produced. They were prepared with Reciproc R25 (#25), F6 SkyTaper (#25 and #30) F360 (#25 and #35) and One Shape (#25) (N = 30 per system). Pre- and post-instrumentation images were superimposed for evaluation of the centering ratio of the different systems. Ledges, instrument fractures and preparation times were also recorded. Analysis of variance (ANOVA) and post-hoc Tukey tests were conducted, comparing the mean canal centering ratios and the mean preparation times. RESULTS: There were significant differences between all systems regarding the centering ratios in the different root canal configurations (ANOVA p < 0.001). The root canal configuration had considerable effect on the centering ratio of the instruments. The best overall mean centering ratios were achieved with F6 SkyTaper #25 instruments especially in canal configurations with big curvature angles and radii, while F360 #35 was least centered especially in canals with small curvature angles and radii. Most ledges occurred with OneShape, while it was the significantly (p < 0.001) fastest preparation system (86.7 s (SD 13.53)) and Reciproc the significantly (p < 0.001) slowest (103.0 s (SD 20.67)). CONCLUSION: 3D-printed root canals are suitable to produce challenging canal configurations and to investigate the limitations of root canal instruments. We found that all instruments caused canal transportations. However, F6 SkyTaper #25 files had better overall centering ratios than the other instruments. In canal configurations with small curvature radii, the centering ratio of some instruments is low and the probability for ledges is increased.


Assuntos
Impressão Tridimensional , Tratamento do Canal Radicular/instrumentação , Resinas Acrílicas , Simulação por Computador , Humanos , Modelos Anatômicos , Fatores de Tempo
20.
J Endod ; 44(9): 1422-1424, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30049469

RESUMO

INTRODUCTION: The aim of the present study was to evaluate the cyclic fatigue resistance of the WaveOne Gold Glider (Dentsply Maillefer, Ballaigues, Switzerland), R-Pilot (VDW, Munich, Germany), and ProGlider (Dentsply Maillefer) glide path instruments. METHODS: Ten instruments from each glide path system were included in the study. A stainless steel artificial canal with a 90° angle and a 3-mm radius of curvature was used for the testing process. The working lengths of the instruments were fixed at 19 mm, and the instruments were operated using an endodontic motor (X-Smart Plus, Dentsply Maillefer) at recommended setting for each. A digital camera (Sony HDR-XR260; Sony Corporation, Minato, Tokyo, Japan) was positioned on the top of the cyclic fatigue test device, and the time to fracture was recorded in seconds by means of the video camera. For each instrument, the number of cycles to failure was calculated, and the length of the fractured fragment was measured. The data were analyzed using 1-way analysis of variance followed by the post hoc Tukey test. RESULTS: Statistically significant differences in the number of cycles to failure values were observed across the tested groups; the ranking of the instruments was as follows: WaveOne Gold Glider > R Pilot > ProGlider (P < .05). There was no significant difference in the mean length of the fractured fragment of the instruments (P > .05). CONCLUSIONS: Within the limitations of the present study, it can be concluded that improved alloy properties and reciprocating motion could enhance the cyclic fatigue resistance of glide path instruments.


Assuntos
Ligas , Desenho de Equipamento , Análise de Falha de Equipamento , Falha de Equipamento , Preparo de Canal Radicular/instrumentação , Tratamento do Canal Radicular/instrumentação , Fenômenos Biomecânicos , Movimento (Física)
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