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1.
Niger J Clin Pract ; 23(9): 1188-1193, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913155

RESUMO

Aims: The aim of this study was to investigate the antimicrobial effect of Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser with and without NaOCl solution. A total of 81 extracted human mandibular premolar teeth were used. Materials and Methods: After root canal preparation and sterilization, the samples were inoculated with E. faecalis for 24 hours. The specimens were divided into 4 experimental groups. Group 1 (n = 25) was irradiated with 2 W laser, group 2 (n = 25) was irradiated with 0.75 W laser in combination with 2.5% NaOCl, group 3 (n = 25) was irrigated with 5% NaOCl and group 4 (n = 6) was not treated. Statistical analysis was performed by using Wilcoxon Signed Ranks, Mann-Whitney U and Kruskal-Wallis H tests. Results: The combination of 0.75 W laser with 2.5% NaOCl regime was found to be just as effective at inhibiting the growth of E. faecalis and sterilization of all root canals as 5% NaOCl irrigation (P > 0.001). The 2 W laser had significant bactericidal effect in infected root canals however it did not eradicate all bacteria. The SEM observations were in accordance with the microbiologic findings. Conclusions: Within the limitations of this laboratory study, NaOCl irrigation improved the antimicrobial effect of Er,Cr:YSGG laser irradiation. When the toxic effects of high percentage of NaOCl was considered, the combination of low-powered laser and low concentration of NaOCl can be used as an effective disinfection method in root canal treatment.


Assuntos
Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Lasers de Estado Sólido/uso terapêutico , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Cromo , Érbio , Gálio , Humanos , Preparo de Canal Radicular , Tratamento do Canal Radicular/métodos , Escândio , Ítrio
2.
PLoS One ; 15(9): e0238790, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32903275

RESUMO

The potential mechanical impact of different rotary systems used for root canal preparation has been a matter of debate for long. The aim of this study was to explore the incidence of dentinal cracks after root canal instrumentation with various rotary systems, in vitro. One hundred and eighty intact lower central incisors were selected and randomly divided into fourteen treatment groups (n = 12/group) and a control group (n = 12). After decoronation, the root canals were instrumented with fourteen different rotary systems (E3, E3 azure, NT2, Hyflex CM, Hyflex EDM, 2Shape, OneCurve, ProTaper Next, ProTaper Gold, WaveOne Gold, Mtwo, Reciproc Blue, TF adaptive, K3XF). All roots were horizontally sectioned at 3, 6, and 9 mm from the apex with a low-speed saw under water-cooling. The slices were then examined under stereomicroscope for dentinal cracks. No cracks were found in the control group. Cracks were found in all treatment groups, predominantly in the 3 mm slices. There was no statistically significant difference in the number of cracks when comparing the different systems to each other at any section level. At 3 mm, however, five of the studied systems, namely K3XF (p = 0.004), Protaper Next (p = 0.001), Reciproc Blue (p<0.001), TF adaptive (p = 0.050), and 2Shape (p = 0.009) presented a significantly higher number of cracks than the control group. Within the limitations of this study, instrumented canals presented dentinal cracks, while uninstrumented ones presented no cracks after sectioning. There seems to be no significant difference among the tested systems regarding crack formation in the instrumented root canal wall. Crack formation occurred irrespective of the motion of the rotary system (rotational or reciprocation). Further studies are needed to clarify the factors that contribute to crack formation in the case of each individual rotary system.


Assuntos
Níquel , Preparo de Canal Radicular/instrumentação , Titânio , Ligas Dentárias , Dentina/lesões , Desenho de Equipamento , Humanos , Técnicas In Vitro , Tratamento do Canal Radicular/métodos
3.
Rev. cuba. estomatol ; 57(3): e2945, jul.-set. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126522

RESUMO

RESUMEN Introducción: Los selladores endodónticos desempeñan un papel crucial en la obturación, dado que dichos materiales, no solo actúan en el momento de su aplicación, sino que continúan haciéndolo con posterioridad, protegiendo al periodonto apical contra los organismos microbianos presentes. Precisamente, una de las propiedades deseadas en los selladores endodónticos es que posean acción antimicrobiana, para eliminar las bacterias remanentes después de la irrigación e instrumentación. Objetivo: Realizar una revisión sistemática del efecto antibacteriano de diferentes selladores endodónticos más utilizados en odontología contra Enterococcus faecalis (E. faecalis). Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed y Science Direct. Se revisaron los artículos de estudios antimicrobianos in vitro de selladores endodónticos y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura, así como artículos sobre cementos para otros usos. Desarrollo: Los cementos a base de hidróxido de calcio, resina o biocerámicos son biocompatibles y presentan algún porcentaje de actividad antimicrobiana; sin embargo, se puede apreciar que existe variabilidad en los resultados obtenidos en los estudios incluidos en la revisión, debido al uso de condiciones diferentes para la evaluación antibacteriana, excepto en los selladores endodónticos a base de silicona, los cuales tuvieron, de forma consistente, un efecto antibacterial nulo contra E. faecalis. Conclusión: De acuerdo a la bibliografía revisada, los selladores AH Plus, AH 26, TotalFill, BC Sealer y MTA Fillapex exhibieron efecto antimicrobiano, sin embargo, algunos de ellos mostraron escasa actividad contra E. faecalis(AU)


ABSTRACT Introduction: Endodontic sealers play a crucial role in sealing, for they not only act at the moment of their application, but continue to do so later, protecting the apical periodontium against microbial organisms. One of the properties desired in endodontic sealers is precisely their antimicrobial action against bacteria remaining after irrigation and instrumentation. Objective: Carry out a systematic review about the antibacterial effect of the endodontic sealers most commonly used in dental practice against Enterococcus faecalis (E. faecalis). Methods: The systematic review was based on PRISMA guidelines. The search was conducted in the databases PubMed and Science Direct. Papers were reviewed which dealt with in vitro antimicrobial studies about endodontic sealers, excluding secondary sources such as literature reviews and papers about cements used for other purposes. Discussion: Cements based on calcium hydroxide, resin or bioceramic are biocompatible and display some percentage of antimicrobial activity. However, variability was observed in the results obtained by the studies in the review, due to the use of different conditions for antibacterial evaluation, except for silicone-based endodontic sealers, which consistently displayed no antibacterial activity against E. faecalis. Conclusion: According to the bibliography reviewed, the sealers AH Plus, AH 26, TotalFill, BC Sealer and MTA Fillapex had an antimicrobial effect. However, some of them displayed scant activity against E. faecalis(AU)


Assuntos
Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Tratamento do Canal Radicular/métodos , Cimentos Dentários/uso terapêutico , Antibacterianos/efeitos adversos , Literatura de Revisão como Assunto , Bases de Dados Bibliográficas
4.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e634-e643, sept. 2020. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-196519

RESUMO

BACKGROUND: Hemostasis is of critical importance in endodontic surgery. Studies on bleeding control in maxillary molars are scarce. The present study compares the efficacy of two hemostatic techniques in controlling bleeding in endodontic surgery. MATERIAL AND METHODS: A randomized two-arm pilot study involving 30 patients with peri-radicular lesions in maxillary molars (first and second molars) was carried out including the following hemostatic agents: polytetrafluoroethylene (PTFE) strips as an adjunct to epinephrine impregnated gauze (test group; n = 15) and aluminum chloride (Expasyl(TM)) (control; n = 15). Bleeding control was independently assessed by the surgeon and by two blinded observers before and after application of the hemostatic agent, and was classified as either adequate (complete bleeding control) or inadequate (incomplete bleeding control). RESULTS: Bleeding control was similar in both groups. Simple binary logistic regression analysis failed to identify variables affecting bleeding control. Only the height of the keratinized mucosal band (≥ 2 mm) suggested a decreased risk of inadequate bleeding control of up to 89% (OR = 0.11; p = 0.06). CONCLUSIONS: No difference in the efficacy of bleeding control was observed between PTFE strips as an adjunct to epinephrine impregnated gauze and aluminum chloride in maxillary molars


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hemostasia Cirúrgica/métodos , Raiz Dentária/cirurgia , Cavidade Pulpar/cirurgia , Hemostáticos/uso terapêutico , Dente Molar/cirurgia , Politetrafluoretileno/uso terapêutico , Epinefrina/uso terapêutico , Cloreto de Alumínio/uso terapêutico , Tratamento do Canal Radicular/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Modelos Logísticos , Resultado do Tratamento , Maxila/cirurgia
5.
Niger J Clin Pract ; 23(7): 950-956, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620724

RESUMO

Background: During post restoration, different root structures require several types of posts to increase duration of their clinical use. Several materials have been investigated to enhance their quality and optimize their length according to the available root canal. Aims: The aim of this study was to determine the effect of zirconia, fiber, and ceromer posts with 3- and 6-mm post sizes on the bonding strength of them to root canal dentinal wall with the means of pull-out bond strength test. Methods: Forty-eight single-rooted mandibular human premolar teeth were collected and prepared for this in vitro study. With resin cement, 3- and 6-mm study posts including zirconia, fiber, and ceromer were luted to prepare teeth. For the retention testing, the pull-out force was applied to each specimen parallel to longitudinal axis of both the post and tooth. Results: Both type of materials and size of posts changed the value of bonding strength. In all the post types, 6-mm ones performed better. Overall, the best bonding strength was obtained with fiber posts and the better bonding strength was obtained with zirconia; however, ceromer provided the least bonding strength. Conclusion: Current experiments supported that 6-mm post size can increase the bonding between root canal dentin and studied posts. When considering post materials, fiber provided the best bonding strength in current laboratory setup. Second, zirconia had meaningfully acceptable bonding strength; however, the bonding strength of ceromer posts was not favorable. Further studies optimizing post fabrication techniques of root materials may increase the bonding strength of posts to human dentin to an acceptable clinical degree.


Assuntos
Colagem Dentária , Cavidade Pulpar , Dentina , Técnica para Retentor Intrarradicular , Cimentos de Resina/química , Tratamento do Canal Radicular/métodos , Raiz Dentária/cirurgia , Cerâmica , Resinas Compostas , Vidro/química , Humanos , Teste de Materiais , Zircônio
6.
Pain Res Manag ; 2020: 5853412, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32676136

RESUMO

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


Assuntos
Dor Pós-Operatória/etiologia , Pulpotomia/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Adulto , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Masculino , Dente Molar , Óxidos/uso terapêutico , Dor Pós-Operatória/epidemiologia , Prevalência , Pulpotomia/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Silicatos/uso terapêutico , Resultado do Tratamento
7.
Orv Hetil ; 161(30): 1260-1265, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32653869

RESUMO

Surgical guides and three-dimensional (3D) planning softwares used in everyday dental implantology open new possibilities in other fields of dentistry. While using the operation microscope in endodontic microsurgery provides more precise apicectomy, there is still no consent on the exact localisation and size of the bony window to be prepared for this surgery. Our aim is to describe a new, guided endodontic microsurgery method when osteotomy and apicectomy are planned in a 3D software and performed with a trephine bur. Based on data from Cone Beam Computed Tomography, planning of the surgical guide was performed with a 3D planning software (Smart Guide, dicomLAB, Hungary) in order to define the size of the bony window, the angulation and the depth of the trephine bur during the apicectomy. After preparing a mucoperiosteal flap, with the help of the dentally supported surgical guide, the trephine bur removes the cortical bone and the apex of the root simultaniously. Following the modern microsurgical protocol, after performing the ultrasonic retrograde preparation, mineral trioxide aggregate (ProRoot MTA; Dentsply Maillefer, Ballaigues, Switzerland) is placed as a retrograde filling to close the resected area. After the uneventful healing period, a complete bony regeneration can be seen on the 1-year follow up X-ray. The patient is symptom-free. This technique is considered to be faster and more precise than the non-guided endodontic microsurgery carried out without the utilization of a trephine bur. Orv Hetil. 2020; 161(30): 1260-1265.


Assuntos
Apicectomia/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar/cirurgia , Endodontia/métodos , Microcirurgia/métodos , Osteotomia/métodos , Impressão Tridimensional , Materiais Restauradores do Canal Radicular , Tratamento do Canal Radicular/métodos , Compostos de Alumínio , Compostos de Cálcio , Cavidade Pulpar/diagnóstico por imagem , Combinação de Medicamentos , Humanos , Hungria , Óxidos , Radiografia Dentária , Silicatos , Dente , Resultado do Tratamento , Procedimentos Cirúrgicos Ultrassônicos
8.
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
9.
Medicine (Baltimore) ; 99(22): e20372, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481420

RESUMO

The present study investigated the effectiveness of a Carisolv III + 0.5% sodium hypochlorite (NaOCl)-based root canal irrigant for smear layer removal.Forty maxillary incisors were randomly divided into 4 groups (n = 10 per group). The canals in group A (experimental) were prepared with 0.5% NaOCl, and Carisolv III and 0.5% NaOCl was used for the final washing; groups B and C (positive controls) used 2% and 5.25% NaOCl, respectively; and group D (negative control) used phosphate-buffered saline (PBS). Ethylenediaminetetraacetic acid (EDTA) was used for all of the groups. A 5-point scoring scale and scanning electron microscopy were used to evaluate the effectiveness of the irrigants. The canals were consistently cleaner in the coronal and middle thirds than in the apical thirds (P < .05).For cleaning the root canals, 5.25% NaOCl was more effective than 2% NaOCl, 0.5% NaOCl + Carisolv III, and phosphate-buffered saline , respectively (P < .05). The 2% NaOCl solution showed similar results to 0.5% NaOCl + Carisolv III (P > .05). The combination of 5.25% NaOCl and 17% EDTA remains the most effective irrigant for removal of the root canal smear layer.A combination of Carisolv III + 0.5% NaOCl (with 17% EDTA) showed a cleaning ability similar to that of 2% NaOCl (with 17% EDTA).


Assuntos
Ácido Glutâmico/uso terapêutico , Leucina/uso terapêutico , Lisina/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Adulto , Cavidade Pulpar/cirurgia , Feminino , Humanos , Técnicas In Vitro , Incisivo/cirurgia , Masculino , Pessoa de Meia-Idade
10.
J Appl Oral Sci ; 28: e20190168, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236352

RESUMO

INTRODUCTION: Isthmuses are reported as common anatomic complexities in teeth often associated with failures in endodontic treatment. They should be considered before starting treatment and a preoperative computed tomography scan (CT) may demonstrate these complexities. OBJECTIVE: To assess the diagnostic value of the highest resolution settings of a cone-beam CT (CBCT) system in identifying and measuring apical isthmuses, using micro-CT as reference. METHODOLOGY: After micro-CT scanning, 40 humans' lower first molars with isthmuses in the apical-3 mm of mesial roots were scanned by the highest resolution settings of the New Generation i-Cat ® CBCT equipment. Two blinded observers recorded the detection of isthmuses in CBCT scans. The lengths of isthmuses were compared between micro-CT and CBCT to assess the diagnostic value of CBCT. Quantitative data for sensitivity were represented as percentages (95% confidence interval). The Bland-Altman method was used to assess differences between gold standard lengths (micro-CT) and CBCT lengths. RESULTS: BCT demonstrated 30 positive findings, representing sensitivity for isthmus identification of 75% (95% CI=0.4114-1.1364). Differences between the lengths in micro-CT (1.99±0.40 mm) and CBCT (1.53±0.41 mm) were significant (p<0.0001). CONCLUSION: The CBCT device used presented limited diagnostic value in the identification and measurement of apical isthmuses in the mesial roots of lower molars. In some cases, the actual anatomy of the apical root canal may not be completely delineated in this type of CBCT system, even using the highest resolution settings.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Ápice Dentário/anatomia & histologia , Ápice Dentário/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Análise de Variância , Humanos , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Variações Dependentes do Observador , Tamanho do Órgão , Valores de Referência , Reprodutibilidade dos Testes , Tratamento do Canal Radicular/métodos , Sensibilidade e Especificidade
11.
BMJ Case Rep ; 13(3)2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32169975

RESUMO

Mandibular incisors show variations in their root canal anatomy from regular pattern in some cases. Magnification plays a vital role to identify those unusual canal morphologies. A certain modification in access cavity preparation is required to locate those extra canals. Not only the functional restoration but also aesthetic harmony should be restored while treating anterior teeth. In these cases, post space preparation should be done with extra care to prevent vertical root fracture. This case report illustrates the importance of proper radiograph and magnification in the successful identification and management of complex canal systems in mandibular incisors.


Assuntos
Resinas Acrílicas/uso terapêutico , Resinas Compostas/uso terapêutico , Cavidade Pulpar/diagnóstico por imagem , Incisivo/lesões , Poliuretanos/uso terapêutico , Fraturas dos Dentes/diagnóstico por imagem , Coroas/normas , Cavidade Pulpar/anatomia & histologia , Estética , Humanos , Incisivo/anatomia & histologia , Masculino , Traumatismos Mandibulares/complicações , Radiografia/métodos , Tratamento do Canal Radicular/métodos , Fraturas dos Dentes/terapia , Raiz Dentária/anatomia & histologia , Resultado do Tratamento , Adulto Jovem
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 Pak Med Assoc ; 70(Suppl 1)(2): S125-S128, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31981352

RESUMO

This case report describes dental management of a 15- year-old boy, undergoing treatment for Thalassaemia Major and Acute Myeloid Leukaemia with bone marrow transplant and immuno-suppressants. During the course of his treatment the patient developed a swelling in anterior maxilla and therefore was referred by the primary physician for evaluation. This case report highlights the management of medically compromised patients in a tertiary care hospital in which apexification was carried out in a permanent immature tooth utilizing MTA as an immediate apical plug.


Assuntos
Apexificação/métodos , Compostos de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia , Tratamento do Canal Radicular/métodos , Silicatos/uso terapêutico , Fraturas dos Dentes/terapia , Adolescente , Transplante de Medula Óssea , Necrose da Polpa Dentária/complicações , Humanos , Imunossupressores/uso terapêutico , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Masculino , Fraturas dos Dentes/complicações , Talassemia beta/complicações , Talassemia beta/terapia
14.
Rev. bras. odontol ; 77(1): 1-7, jan. 2020. ilus; tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1102870

RESUMO

Objective: to evaluate the root canal treatment (RCT) and non-surgical root canal retreatment (NSRCR), associated with foraminal enlargement, performed on a singlevisit. Material and Methods: 125 teeth with apical periodontitis and follow-up period ranging from 6 to 12 months were included. The success was considered by the absence of signs and symptoms and complete or incomplete periapical repair. Logistic regression analyses were used to identify factors associated with the repair (p<0.05). Results: RCT showed 71.58% of complete healing and 23.16% of acceptable healing. NSRCR showed 80% of complete healing and 20% of acceptable healing. Age, gender, type of treatment and preoperative pain were not statistically significant for the healing process (p>0.05). Premolars showed the greatest chance of periapical repair. Pulp Canal Sealer showed a greater chance of periapical repair when compared to Sealapex (p<0.05). Conclusion: RCT and NSRCR using a foraminal enlargement protocol provided a favorable prognosis of periapical healing


Objetivo: avaliar o tratamento endodôntico (TE) e o retratamento não cirúrgico do canal radicular (RNCCR), associado a ampliação foraminal, realizado em sessão única. Material e Métodos: foram incluídos 125 dentes com periodontite apical e proservação de 6 a 12 meses. O sucesso foi considerado pela ausência de sinais e sintomas e reparo periapical completo ou incompleto. Análises de regressão logística foram utilizadas para identificar fatores associados ao reparo (p<0,05). Resultados: o TE mostrou 71,58% de cicatrização completa e 23,16% de cicatrização aceitável. O RNCCR mostrou 80% e 20% cicatrização completa e aceitável, respectivamente. Idade, sexo, tipo de tratamento e dor pré-operatória não foram estatisticamente significantes para o processo de cicatrização (p>0,05). Os pré-molares apresentaram a maior chance de reparo periapical. O cimento Pulp Canal Sealer mostrou maior chance de reparo periapical quando comparado ao Sealapex (p<0,05). Conclusão: o TE e RNCCR utilizando um protocolo de alargamento foraminal, proporcionaram um prognóstico favorável da cicatrização periapical


Assuntos
Periodontite Periapical , Tratamento do Canal Radicular/métodos , Preparo de Canal Radicular
15.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e117-e123, ene. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-196203

RESUMO

BACKGROUND: Titanium-prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high con-centration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. MATERIAL AND METHODS: A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. RESULTS: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. CONCLUSION: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions


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Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibrina Rica em Plaquetas , Titânio/uso terapêutico , Regeneração Tecidual Guiada Periodontal/métodos , Doenças Periodontais/terapia , Desbridamento Periodontal/métodos , Tratamento do Canal Radicular/métodos , Resultado do Tratamento , Índice Periodontal , Materiais Biocompatíveis/uso terapêutico
16.
Inflamm Bowel Dis ; 26(2): 273-279, 2020 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-31247107

RESUMO

BACKGROUND: Deep carious lesions cause pulpitis, pulpal necrosis and, finally, apical periodontitis (AP). Root canal treatment (RCT) is the treatment of choice for AP, changing the tooth into a root-filled tooth (RFT). Several studies have linked AP and RFT to systemic diseases. Likewise, previous studies have also found an association among inflammatory bowel disease (IBD) and periodontal disease. This study aims to analyze the frequency of AP and RCT in IBD patients and healthy control subjects. METHODS: An age- and gender-matched case-control study design was used. The study group (SG) included 54 IBD patients (28 with Crohn´s disease, 26 with ulcerative colitis). Another 54 healthy subjects without IBD and age- and gender-matched were included in the control group (CG). The radiographic records were analyzed, and periapical radiolucencies were diagnosed as AP, using the periapical index (PAI). The statistical analysis was carried out using the Student t test, χ 2 test, and multivariate logistic regression. RESULTS: The presence of 1 or more teeth with radiolucent periapical lesions (RPLs) was found in 19 patients (35.2%) in the study group and in 9 subjects (16.7%) in the control group (P = 0.03). No differences were found among the 2 groups neither in the amount of teeth with AP nor in the number of RFTs (P > 0.05). However, multivariate logistic regression analysis adjusting for number of teeth and number of RFTs showed that patients with IBD have RPLs with higher likelihood than control patients (odds ratio, 5.7; confidence interval 95%, 1.7-19.1; P = 0.0048). CONCLUSIONS: Subjects with inflammatory bowel disease have higher prevalence of apical periodontitis. An oral health protocol should be established to address the higher prevalence of inflammatory oral processes.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Saúde Bucal , Periodontite Periapical/epidemiologia , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Doenças Inflamatórias Intestinais/patologia , Masculino , Periodontite Periapical/terapia , Prevalência , Prognóstico , Tratamento do Canal Radicular/métodos , Fatores Sexuais , Espanha/epidemiologia , Adulto Jovem
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.
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
19.
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
20.
J. appl. oral sci ; 28: e20190168, 2020. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1090767

RESUMO

Abstract Isthmuses are reported as common anatomic complexities in teeth often associated with failures in endodontic treatment. They should be considered before starting treatment and a preoperative computed tomography scan (CT) may demonstrate these complexities. Objective To assess the diagnostic value of the highest resolution settings of a cone-beam CT (CBCT) system in identifying and measuring apical isthmuses, using micro-CT as reference. Methodology After micro-CT scanning, 40 humans' lower first molars with isthmuses in the apical-3 mm of mesial roots were scanned by the highest resolution settings of the New Generation i-Cat ® CBCT equipment. Two blinded observers recorded the detection of isthmuses in CBCT scans. The lengths of isthmuses were compared between micro-CT and CBCT to assess the diagnostic value of CBCT. Quantitative data for sensitivity were represented as percentages (95% confidence interval). The Bland-Altman method was used to assess differences between gold standard lengths (micro-CT) and CBCT lengths. Results BCT demonstrated 30 positive findings, representing sensitivity for isthmus identification of 75% (95% CI=0.4114-1.1364). Differences between the lengths in micro-CT (1.99±0.40 mm) and CBCT (1.53±0.41 mm) were significant (p<0.0001). Conclusion The CBCT device used presented limited diagnostic value in the identification and measurement of apical isthmuses in the mesial roots of lower molars. In some cases, the actual anatomy of the apical root canal may not be completely delineated in this type of CBCT system, even using the highest resolution settings.


Assuntos
Humanos , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Ápice Dentário/anatomia & histologia , Ápice Dentário/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Tamanho do Órgão , Valores de Referência , Tratamento do Canal Radicular/métodos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Análise de Variância , Sensibilidade e Especificidade , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem
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