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1.
PLoS One ; 19(7): e0306693, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38976717

RESUMO

BACKGROUND: Endodontic treatment is one of the main dental treatments to manage inflamed or infected root canal systems of teeth. The success of endodontic treatment principally depends on eradicating microorganisms in the root canal by chemo-mechanical debridement with irrigation solutions like sodium hypochlorite (NaOCl). NaOCl has been used in concentrations ranging from 0.5% to 5.25%. This study determined the antimicrobial effectiveness of selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl in endodontic treatment. METHODS: The study sites were the University of Ghana Dental School (UGDS) and Noguchi Memorial Institute for Medical Research (NMIMR). Sixty infected single-rooted single-canal teeth were used. Before (S1) and after (S2), root canal samples during the endodontic treatment with the selected concentrations of NaOCl were examined via anaerobic and aerobic cultures. The isolates were identified using Matrix Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (MALDI-TOF MS). RESULTS: All S1 samples were positive for cultivable bacteria. Fifty-three (53) different microbial species belonging to 20 different microbial genera were isolated. Streptococcus viridans was the most frequently isolated microbe. There were zero isolates in the root canals irrigated with 2.6% and 5.2% NaOCl. Two teeth had isolates in the groups irrigated with the lower concentrations (0.5% and 1.0%) of NaOCl. The persistent bacteria were one species each of Streptococcus mitis and Streptococcus oralis, respectively. CONCLUSION: Root canal treatments using chemo-mechanical preparation with the selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl were effective in significantly reducing the microbial load, and for the 5.2% and 2.6% concentrations, in eliminating all the microorganisms.


Assuntos
Cavidade Pulpar , Tratamento do Canal Radicular , Hipoclorito de Sódio , Hipoclorito de Sódio/farmacologia , Humanos , Tratamento do Canal Radicular/métodos , Cavidade Pulpar/microbiologia , Cavidade Pulpar/efeitos dos fármacos , Irrigantes do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/farmacologia , Masculino , Adulto , Feminino , Resultado do Tratamento , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Pessoa de Meia-Idade
2.
J Contemp Dent Pract ; 25(4): 331-334, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38956847

RESUMO

AIM: The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. MATERIALS AND METHODS: In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of p < 0.05. RESULTS: At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels (p < 0.001). CONCLUSION: In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group. CLINICAL SIGNIFICANCE: With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, et al. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.


Assuntos
Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Camada de Esfregaço , Irrigação Terapêutica , Irrigantes do Canal Radicular/administração & dosagem , Humanos , Irrigação Terapêutica/métodos , Irrigação Terapêutica/instrumentação , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Dente Pré-Molar , Cavidade Pulpar , Técnicas In Vitro
3.
J Contemp Dent Pract ; 25(4): 354-357, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38956851

RESUMO

AIM: The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth. MATERIALS AND METHODS: For the study, 90 extracted primary maxillary incisors without internal or external resorption and with at least two-thirds of complete roots were chosen. Then, based on the kind of instruments used to clean and shape the canals, they were randomly assigned to three experimental groups, each consisting of 30 teeth. Group-I: The canal was instrumented manually with K-files, Group-II: The canal was instrumented with Kedo-S files, Group-III: The canal was instrumented with Kedo-SG Blue files. After the canals were finally instrumented, 2 mL of QMixTM solution was used to irrigate 15 samples from each group. The samples were subsequently allowed to remain in the canals for 90 seconds in order to eliminate the smear layer. After that a stereomicroscope was used to assess the cleaning effectiveness. RESULTS: With irrigant solution, the highest mean value was found in manual K-files (2.86 ± 0.34), followed by Kedo-S files group (1.34 ± 0.26) and Kedo-SG Blue files (1.28 ± 0.18). Without irrigant solution, the highest mean value was found in manual K-files (2.92 ± 0.22) followed by Kedo-S files group (1.44 ± 0.18) and Kedo-SG Blue files (1.36 ± 0.14). There was a statistically significant difference found at all the three levels. CONCLUSION: On conclusion, the current study's findings demonstrated that irrigation solution was significantly more effective in cleaning and removing smear layers from pediatric rotary files than manual K-files. CLINICAL SIGNIFICANCE: The effectiveness of endodontic therapy depends on a successful chemomechanical preparation. The canals are instrumented using either hand files or rotary instruments; there are several irrigation and instrumentation techniques. In order to completely sterilize the canals, chemical agents are utilized for irrigation during instrumentation. Due to their numerous biological, antibacterial, anti-inflammatory, and antioxidant qualities, many natural compounds are also utilized as irrigants. How to cite this article: Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):354-357.


Assuntos
Irrigantes do Canal Radicular , Preparo de Canal Radicular , Camada de Esfregaço , Dente Decíduo , Humanos , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Irrigantes do Canal Radicular/uso terapêutico , Técnicas In Vitro , Instrumentos Odontológicos , Biguanidas , Incisivo , Desenho de Equipamento , Cavidade Pulpar , Polímeros
4.
Gen Dent ; 72(4): 10-14, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38905599

RESUMO

Untreated canals are a primary cause of persistent apical periodontitis, and the inability to identify and adequately treat canals has been considered a major cause of failure of root canal therapy in maxillary molars. The purpose of this retrospective study was to use cone beam computed tomography (CBCT) to quantify the number of missed canals in maxillary first and second molars needing endodontic retreatment after treatment by general dentists. A total of 401 CBCT scans of maxillary first and second molars were examined. A total of 214 scan sets (53.37% [95% CI, 48.48%-58.25%]) showed evidence of an untreated canal, with the highest rate (49.38%; n = 198) observed in the second mesiobuccal canal. Imaging revealed that multiple canals were missed in some patients, for a total of 225 missed canals. The examinations showed untreated first mesiobuccal canals in 2.99% of CBCT scan sets (n = 12), untreated distobuccal canals in 2.99% of CBCT scan sets (n = 12), and untreated palatal canals in 0.75% of CBCT scan sets (n = 3). Preoperative CBCT imaging should be considered prior to initial root canal treatment of maxillary molars. When the risks and limitations of CBCT are taken into consideration, the additional information it provides can improve diagnostic accuracy, increase confidence in decision-making, and positively impact treatment planning.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Maxila , Dente Molar , Tratamento do Canal Radicular , Humanos , Dente Molar/diagnóstico por imagem , Estudos Retrospectivos , Tratamento do Canal Radicular/métodos , Tratamento do Canal Radicular/estatística & dados numéricos , Maxila/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Feminino , Masculino , Retratamento/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Incidência
5.
BMC Oral Health ; 24(1): 656, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38835024

RESUMO

INTRODUCTION: The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY: A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS: Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS: The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.


Assuntos
Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Raiz Dentária , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia
6.
Braz Dent J ; 35: e245771, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38922251

RESUMO

This study aimed to evaluate the antimicrobial activity of calcium hypochlorite (Ca (OCl)2) and sodium hypochlorite (NaOCl) using confocal laser scanning microscopy (CLSM) and dentin organic matrix alteration by picrosirius staining and light microscopy (LM). Samples of human extracted teeth were infected with Enterococcus faecalis by centrifugation of the bacterial suspension and were treated with Ca(OCl)2 or NaOCl at 0.5%, 2.5%, and 6% for 15, 30, and 60 seconds. CLSM and viability staining were used to quantitatively analyze the proportions of dead/live bacteria in the canal lumen and border of the root canal. The data were analyzed by ANOVA and Fisher test. For LM analysis, one hundred bovine teeth were randomly divided into 10 test groups (n=10): G1- Without treatment; G2- 17% EDTA; G3- 6% NaOCl; G4- 6% NaOCl + EDTA; G5- 0.5% Ca(OCl)2; G6- 0.5% Ca(OCl)2 + EDTA; G7- 2.5% Ca(OCl)2; G8- 2.5% Ca(OCl)2 + EDTA; G9- 6% Ca(OCl)2; G10- 6% Ca(OCl)2 + EDTA. The samples were fragmented and stained with Picrosirius. Data were analyzed by Kruskal-Wallis and Dunn (P<0.05). There was a strong correlation between the results of the canal lumen and the border of the root canal (r=0.962). Both hypochlorites at a concentration of 0.5% showed less microbial reduction compared to 2.5% and 6% (P<0.05). There was less antimicrobial activity at 15 seconds compared to 30 and 60 seconds (P<0.05). Ca(OCl)2 and NaOCl showed similar results at the same concentrations (P>0.05). In conclusion, Ca(OCl)2 caused fewer alterations to the dentin organic matrix at concentrations of 0.5% and 2.5%. Ca(OCl)2 presents antimicrobial activity similar to NaOCl, and collagen damage is concentration-dependent.


Assuntos
Compostos de Cálcio , Colágeno , Dentina , Enterococcus faecalis , Hipoclorito de Sódio , Hipoclorito de Sódio/farmacologia , Dentina/efeitos dos fármacos , Dentina/microbiologia , Compostos de Cálcio/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Humanos , Anti-Infecciosos/farmacologia , Irrigantes do Canal Radicular/farmacologia , Bovinos , Microscopia Confocal , Animais , Cavidade Pulpar/microbiologia , Técnicas In Vitro
7.
Braz Oral Res ; 38: e048, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38922208

RESUMO

This review aimed to determine the prevalence of species of yellow, purple and green microbial complexes in root canals (RC) and periodontal pockets (PP) of teeth with endodontic-periodontal lesions. For this purpose, two reviewers searched the literature up to January 2022. Studies reporting the prevalence of species of the yellow, purple and green microbial complexes in teeth diagnosed with endodontic-periodontal lesions were included. The risk of bias of the included studies was assessed using the 14 criteria from the NIH Quality Assessment Tool. Of 1,611 references identified in the initial search, only four studies were eligible and included in the qualitative analysis. The profile and prevalence rates of bacterial species in RC and PP varied among the included studies: levels of Agregatibacter actinomycetemcomitans (12% RC, 58% PP), Capnocytophaga granulosa (10% RC, 35% PP), Capnocytophaga sputigena (15-70% RC, 0-30% PP), Streptococcus mitis (30% RC, 35% PP), Streptococcus sanguinis (30% RC, 35% PP), and Veillonella parvula (70% RC, 50% PP) were identified. The high methodological heterogeneity prevented grouping and quantitative analysis of data. The risk of bias was considered 'moderate' for all studies. The included studies identified the presence of seven bacterial species belonging to the yellow, purple, and green microbial complexes in RC and PP, but with different prevalence rates. Future clinical studies are encouraged to investigate the presence and role of these species in the occurrence and development of endodontic-periodontal lesions.


Assuntos
Cavidade Pulpar , Humanos , Cavidade Pulpar/microbiologia , Prevalência , Bolsa Periodontal/epidemiologia , Bolsa Periodontal/microbiologia
8.
Acta Odontol Latinoam ; 37(1): 25-33, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38920123

RESUMO

Knowledge of root canal internal anatomy and its variations is important forproper endodontic treatment. It is therefore necessary to investigate morphological aspects among different dental groups in the same patient to define the best protocol for the case. AIM: To evaluate the morphology and symmetry of homologous incisors, premolars and mandibular molars using cone beam computed tomography (CBCT). MATERIALS AND METHOD: Descriptive statistical analysis was performed for the frequency of categorical variables, and a chi-square test or Fisher 's exact test was used to test whether gender and side were associated with number of roots, number of canals, and Vertucci's classification. Forty-five CBCT scans were evaluated, and 444 mandibular teeth were analyzed. The number of roots, number of canals, classification of the canals in each root according to Vertucci and presence of a symmetrical relationship between pairs of posterior teeth were analyzed. RESULTS: The resuls showed that 74% of mandibular central incisors had type I root canal, 26% of mandibular lateral incisors had type I and, with a significant difference in the number of canals between males and females (p < 0.05). In mandibular first premolars, 70.5% had type I; and in mandibular second premolars, 98.5% had type I. Mandibular first molars had two roots in 98% of the cases. Second mandibular molars had two roots in 92.5% of the cases, one root in 6%, and three roots in 1.5%. Symmetry between central incisors was higher in females than in males. CONCLUSIÓN: Teeth of the same group can have different morphologies in the same patient.


0 conhecimento da anatomia interna e suas variagoes anatómicas é fator importante para o adequado tratamento endodóntico. Portanto, é necessário investigar esses aspectos morfológicos entre diferentes grupos dentários de um mesmo paciente para definir o melhor protocolo para o caso. OBJETIVO: Avaliar a morfologia e simetria de incisivos, pré-molares e molares inferiores homólogos por meio de tomografia computadorizada de feixe cónico (TCFC). MATERIAIS E MÉTODO: Foi realizada análise estatística descri-tiva para a frequéncia das variáveis categóricas e foi utilizado o teste do qui-quadrado ou teste exato de Fisher para testar a relagao entre sexo e lado em comparagao com número de raízes, número de canais e classificagao de Vertucci. Quarenta e cinco TCFC foram avaliadas e 444 dentes inferiores foram analisados. Foram considerados: o número de raízes, o número de canais, o tipo dos canais acordo com a classificagao de Vertucci e a presenga de relagao simétrica entre pares de dentes posteriores. RESULTADOS: Os resultados mostraram que 74% dos incisivos centrais inferiores tinham um canal radicular tipo 1 e 26% tinham dois canais; 73% dos incisivos laterais inferiores, 26%oeram do tipo I, tinham um canal e 27% tinham dois canais, com diferenga significativa no número de canais entre os grupos masculino e feminino (p < 0,05). Nos primeiros pré-molares inferiores, tipo I, um canal foi detectado em 70,5% e dois canais em 29,5%; nos segundos pré-molares inferiores, tipo I, um único canal foi detectado em 98,5%. O primeiro molar inferior foi observado com duas raízes em 98% e tres raízes em 2%o. O segundo molar inferior tinha duas raízes em 92,5% dos casos, uma raiz em 6% e tres raízes em 1,5%. A simetria foi maior nas mulheres em comparagao aos homens nos incisivos centrais. CONCLUSÃO: Pode-se concluir que dentes de um mesmo grupo podem apresentar morfologias diferentes no mesmo paciente.


Assuntos
Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Incisivo , Mandíbula , Dente Molar , Humanos , Feminino , Masculino , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/anatomia & histologia , Mandíbula/diagnóstico por imagem , Mandíbula/anatomia & histologia , Incisivo/diagnóstico por imagem , Incisivo/anatomia & histologia , Adulto , Adulto Jovem , Adolescente , Pessoa de Meia-Idade
9.
Acta Odontol Latinoam ; 37(1): 59-67, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38920127

RESUMO

A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported. AIM: The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population. MATERIAL AND METHOD: This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher 's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables. RESULTS: Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases. CONCLUSIÓN: There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.


Uma alta prevalência de periodontite apical pós-tratamento associada a variáveis como qualidade do tratamento endodôntico e fracasso do tratamento é relatada na literatura. O objetivo deste estudo foi avaliar a qualidade do tratamento endodôntico e a frequência e fracasso do tratamento associados a dentes com periodontite apical (PA) por meio de tomografia computadorizada de feixe cônico (TCFC) em uma subpopulação colombiana. MATERIAL E MÉTODO: Este foi um estudo transversal que avaliou 318 tomografias computadorizadas de dentes tratados endodonticamente de indivíduos colombianos. Os exames foram realizados utilizando o tomógrafo J Morita X550, com tamanho de voxel de 0,125 a 0,20 mm. Todos os dentes tratados endodonticamente foram avaliados quanto à qualidade do tratamento, presença de canais não localizados e AP. Todas as amostras foram avaliadas por dois especialistas em endodontia e um especialista em radiologia. Foram calculados o teste qui-quadrado ou de Fisher e a razão de chances para identificar associação e relação de risco entre a presença de PA e as variáveis do estudo. RESULTADOS: Foram encontrados canais não localizados em 18,61% (86/462) e 95,3% estavam associados à PA. A frequência de AP foi de 62,34% (288/462) para todos os dentes avaliados. AP foi encontrada em 27,43% (79/288) dos dentes com tratamento endodôntico adequado, em contraste com 72,57% (209/288) dos dentes com tratamento inadequado (P<0,01). A frequência de canais não localizados foi maior nos molares superiores, com 55,23% (58/105), sendo que 96,55% apresentavam PA. O canal mésio-palatino (MB2) apresentou maior frequência de canal não localizado (88,52% - 54/61), com PA em 90,74% (49/54) dos casos. CONCLUSÃO: Houve alta frequência de dentes com canais não localizados e com PA. Mais da metade dos dentes com canais não localizados eram molares superiores, sendo o MB2 é o canal com a maior frequência, comumente apresentando periodontite apical.


Assuntos
Periodontite Periapical , Tratamento do Canal Radicular , Humanos , Estudos Transversais , Periodontite Periapical/diagnóstico por imagem , Periodontite Periapical/terapia , Colômbia , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Tomografia Computadorizada de Feixe Cônico , Dente não Vital/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Adulto Jovem , Qualidade da Assistência à Saúde , Idoso
10.
Niger J Clin Pract ; 27(6): 774-778, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38943303

RESUMO

BACKGROUND: Apically extruded debris can be affected by some features of the file systems such as kinematics or metallurgic properties. AIMS: This in vitro study aimed to evaluate the effect of movement kinematics (reciprocation or rotation) and heat-treated alloys (C.Wire) on the amount of debris extrusion. METHODS: Seventy-two mesiobuccal root canals were assigned into three experimental groups related to the single-file system used (n = 24): two rotational; One Shape (Conventional Ni-Ti), One Curve (C.Wire), and one reciprocating; and One Reci (C.Wire). The file systems were used according to the advisable speed and torque according to the manufacturers' suggestion. The weight of debris was calculated by subtracting the preweights from postweights of Eppendorf tubes. Kruskall-Wallis and Mann-Whitney U tests were used to analyze the data (P = 0.05). RESULTS: One Shape produced the greatest amount of extruded debris compared with One Curve (P < 0.001) and One Reci (P < 0.001), respectively. No statistical difference was found between One Curve and One Reci concerning amount of apical debris extrusion (P = 0.489). CONCLUSION: Metallurgical properties of files may affect apical debris extrusion. Alloy type is an important factor in the amount of debris extrusion. File kinematics does not affect apical debris extrusion.


Assuntos
Ligas , Temperatura Alta , Preparo de Canal Radicular , Humanos , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Temperatura Alta/efeitos adversos , Fenômenos Biomecânicos , Técnicas In Vitro , Teste de Materiais , Desenho de Equipamento , Níquel , Cavidade Pulpar
11.
Clin Oral Investig ; 28(7): 394, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38916762

RESUMO

INTRODUCTION: The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes when the mesiobuccal (MB) and mesiolingual (ML) canals have three distinct phases (unpreparation, preparation and obturation and the removal of the obturation and repreparation). METHODS: Two hundred forty-two extracted human mandibular molars were collected and kept in a physiological saline solution prior to use. 0.2-, 0.28- and 0.35-mm voxel sizes CBCT (n = 242) were performed in three phases (Ph): Ph1, no MB and ML canal preparation or obturation; Ph2, after MB and ML canals preparation and obturation; and Ph3, after the removal of the obturation of MB and ML canals and canals repreparation. Images were analyzed using OnDemand3D® software. After the CBCT acquisition in Ph3, all the samples were clarified to visualize the presence of the MMC directly. A blinded, previously calibrated examiner analyzed all the images. RESULTS: The MMC was detected in 15 of the 242 teeth after the clearing technique. The lowest MMC detection rate was observed at 0.35-mm voxel size regardless of the ML and MB canal condition, while the highest was observed at 0.2-mm voxel size (P < 0.05). There is no statistically significant difference between 0.2-mm and 0.28-mm voxel sizes (P > 0.05). In all voxel sizes, the highest rate of detectability of the MMC was seen in Phase 1, while the lowest was in Phase 2. CONCLUSIONS: It may be appropriate to take a 0.20-mm voxel size CBCT image, especially after the removal of root canal filling. CLINICAL RELEVANCE: An appropriate CBCT voxel size and the absence of root canal filling in the root canal system help to detect the missing MMC.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Mandíbula , Dente Molar , Obturação do Canal Radicular , Preparo de Canal Radicular , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Dente Molar/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Cavidade Pulpar/diagnóstico por imagem , Técnicas In Vitro , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/métodos , Materiais Restauradores do Canal Radicular
12.
PLoS One ; 19(5): e0302810, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38713685

RESUMO

OBJECTIVE: The two commonly used diagnostic methods for taurodontism are susceptible to aging changes, mastication wear and other factors. Therefore, this study proposed an improved diagnostic method for taurodontism, and compared it with the previous two methods as a supplement for taurodontism diagnosis. METHODS: The included patients were aged 10-89 years and admitted to the Department of Stomatology of Hebei Eye Hospital from June 1, 2022 to May 31, 2023. Eighty cone-beam computed tomography images were divided equally into 4 groups: 10-29, 30-49, 50-69, and 70-89 years old. The right mandibular first molars were selected as measurement objects. Firstly, |BD| and taurodontism index (TI)-related parameters were measured using Shifman and Chanannel's method and crown-body(CB) and root (R) lengths was measured by Seow and Lai's method. The improved method used the length from the cementoenamel junction(CEJ) to the root bifurcation point(body, B)and the root length(root, R)as the measurement objects. Finally, TI, CB/R ratios, and B/R ratios were calculated according to the formulas given below. One-way ANOVA analysis was mainly used to compare the differences in the values, indices and ratios of taurodontism among different age groups (p<0.05). RESULTS: With the increase of age, |BD| and TI values decreased significantly (p<0.01). The CB/R ratios of 70-89 years group were significantly lower than those of the other three groups (p<0.01). Ratios derived from the improved method were significantly lower in the 70-89 years than in 10-29 years group (p<0.05). CONCLUSIONS: The |BD| and TI parameters proposed by Shifman and channel are significantly influenced by age. The measurements of Seow and Lai (CB/R ratios) were less affected by age compared with those of the former. The improved method(B/R ratios) was least affected by age, which would reduce error and bias in the measurement of taurodontism and obtain more objective results in older patients.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/anormalidades , Humanos , Idoso , Pessoa de Meia-Idade , Adolescente , Adulto , Idoso de 80 Anos ou mais , Criança , Feminino , Masculino , Adulto Jovem , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Molar/diagnóstico por imagem , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/diagnóstico , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico
13.
BMC Oral Health ; 24(1): 543, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724952

RESUMO

BACKGROUND: In complex teeth like maxillary premolars, endodontic treatment success depends on a complete comprehension of root canal anatomy. The research on mandibular premolars' root canal anatomy has been extensive and well-documented in existing literature. However, there appears to be a notable gap in available data concerning the root canal anatomy of maxillary premolars. This study aimed to explore the root canal morphology of maxillary premolars using cone-beam computed tomography (CBCT) imaging, considering age and gender variations. METHODS: From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10-20, 21-30, 31-40, 41-50, 51-60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology. RESULTS: The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1-2-1 showed significant gender differences. For classifications 1MPM1 and 1MPM1-2-1, age-related changes were seen in the left and right maxillary first premolars. CONCLUSION: This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic.


Assuntos
Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Maxila , Humanos , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/anatomia & histologia , Masculino , Feminino , Adolescente , Maxila/diagnóstico por imagem , Maxila/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Adulto , Arábia Saudita , Pessoa de Meia-Idade , Criança , Estudos Transversais , Adulto Jovem , Fatores Sexuais , Fatores Etários
14.
J Appl Oral Sci ; 32: e20230440, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775557

RESUMO

This study aimed to compare the quality of root canal obturation (ratio of area occupied by gutta-percha (G), sealer (S), and presence of voids (V)) in different anatomical irregularities (intercanal communications, lateral irregularities, and accessory canals) located at different thirds of the root canal system of mandibular molar replicas. Sixty-seven 3D printed replicas of an accessed mandibular molar were prepared using ProGlider and ProTaper Gold rotatory systems. Three specimens were randomly selected to be used as controls and did not receive further treatment. The rest were randomly distributed in 4 experimental groups to be obturated using either cold lateral compaction (LC), continuous wave of condensation (CW), and core-carrier obturation (ThermafilPlus (TH) or GuttaCore (GC)) (n=16 per group). AHPlus® sealer was used in all groups. The three controls and a specimen from each experimental group were scanned using micro-computed tomography. The rest of the replicas were sectioned at the sites of anatomical irregularities and examined at 30× magnification. The G, S, and V ratios were calculated dividing the area occupied with each element by the total root canal area and then compared among groups using the Kruskal-Wallis test. Voids were present in all obturation techniques with ratios from 0.01 to 0.15. CW obtained a significantly higher G ratio in the irregularity located in the coronal third (0.882) than LC (0.681), TH (0.773), and GC (0.801) (p<0.05). TH and GC achieved significantly higher G ratios in those located in the apical third (p<0.05). The worst quality of obturation was observed in the loop accessory canal with all obturation techniques. Whitin the limitations of this study, it can be concluded that CW and core-carrier obturation are respectively the most effective techniques for obturating anatomical irregularities located in the coronal and the apical third.


Assuntos
Cavidade Pulpar , Guta-Percha , Teste de Materiais , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Microtomografia por Raio-X , Obturação do Canal Radicular/métodos , Materiais Restauradores do Canal Radicular/química , Microtomografia por Raio-X/métodos , Guta-Percha/química , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes , Valores de Referência , Dente Molar/anatomia & histologia , Resinas Epóxi/química , Impressão Tridimensional , Propriedades de Superfície , Estatísticas não Paramétricas , Distribuição Aleatória
15.
Colloids Surf B Biointerfaces ; 240: 113978, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38810466

RESUMO

Photodynamic therapy (PDT) is an effective method for bacterial infection control in root canals of teeth with a broad-spectrum antibacterial activity. However, its application in root canal treatment is limited due to its inefficiency under hypoxic conditions and dentin staining. Triton X-100 (TX) shows great potential in enhancing the efficiency of antimicrobial agents through improving bacterial membrane permeability. The present study employed a combination of toluidine blue O (TB)-mediated PDT with TX to target the Enterococcus faecalis (E. faecalis), a bacterium with strong resistance to various antibacterial agents and mostly detected in infected root canals. PDT combined with TX showed enhanced antibacterial efficiency against both planktonic cells and biofilms of E. faecalis. At the same time, TX enhanced the antibacterial effect in dentinal tubules and reduced the incubation time. Mechanism studies revealed that TX improved reactive oxygen species (ROS) production through increasing the proportion of TB monomers. Additionally, increased membrane permeability and wettability were also observed. The findings demonstrated the PDT combined with TX could be used as a highly effective method for the root canal disinfection of teeth.


Assuntos
Antibacterianos , Biofilmes , Enterococcus faecalis , Octoxinol , Fotoquimioterapia , Espécies Reativas de Oxigênio , Enterococcus faecalis/efeitos dos fármacos , Fotoquimioterapia/métodos , Antibacterianos/farmacologia , Antibacterianos/química , Biofilmes/efeitos dos fármacos , Octoxinol/química , Octoxinol/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Cloreto de Tolônio/farmacologia , Cloreto de Tolônio/química , Humanos , Testes de Sensibilidade Microbiana , Cavidade Pulpar/microbiologia , Cavidade Pulpar/efeitos dos fármacos , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/química
16.
Int Endod J ; 57(7): 861-871, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38761098

RESUMO

Microorganisms are the primary aetiological factor of apical periodontitis. The goal of endodontic treatment is to prevent and eliminate the infection by removing the microorganisms. However, microbial biofilms and the complex root canal anatomy impair the disinfection process. Effective and precise endodontic therapy could potentially be achieved using advanced multifunctional technologies that have the ability to access hard-to-reach surfaces and perform simultaneous biofilm killing, removal, and detection of microorganisms. Advances in microrobotics are providing novel therapeutic and diagnostic opportunities with high precision and efficacy to address current biofilm-related challenges in biomedicine. Concurrently, multifunctional magnetic microrobots have been developed to overcome the disinfection challenges of current approaches to disrupt, kill, and retrieve biofilms with the goal of enhancing the efficacy and precision of endodontic therapy. This article reviews the recent advances of microrobotics in healthcare and particularly advances to overcome disinfection challenges in endodontics, and provides perspectives for future research in the field.


Assuntos
Biofilmes , Desinfecção , Humanos , Desinfecção/métodos , Robótica , Endodontia/métodos , Endodontia/instrumentação , Periodontite Periapical/terapia , Periodontite Periapical/microbiologia , Tratamento do Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Cavidade Pulpar/microbiologia
17.
Clin Oral Investig ; 28(6): 311, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38743171

RESUMO

OBJECTIVE: This study used image-based finite element analysis (FEA) to assess the biomechanical changes in mandibular first molars resulting from alterations in the position of the root canal isthmus. METHODS: A healthy mandibular first molar, characterized by two intact root canals and a cavity-free surface, was selected as the subject. A three-dimensional model for the molar was established using scanned images of the patient's mandibular teeth. Subsequently, four distinct finite element models were created, each representing varied root canal morphologies: non-isthmus (Group A), isthmus located at the upper 1/3 of the root (Group B), middle 1/3 of the root (Group C), and lower 1/3 of the root (Group D). A static load of 200 N was applied along the tooth's longitudinal axis on the occlusal surface to simulate regular chewing forces. The biomechanical assessment was conducted regarding the mechanical stress profile within the root dentin. The equivalent stress (Von Mises stress) was used to assess the biomechanical features of mandibular teeth under mechanical loading. RESULTS: In Group A (without an isthmus), the maximum stress was 22.2 MPa, while experimental groups with an isthmus exhibited higher stresses, reaching up to 29.4 MPa. All maximum stresses were concentrated near the apical foramen. The presence of the isthmus modified the stress distribution in the dentin wall of the tooth canal. Notably, dentin stresses at specific locations demonstrated differences: at 8 mm from the root tip, Group B: 13.6 MPa vs. Group A: 11.4 MPa; at 3 mm from the root tip, Group C: 14.2 MPa vs. Group A: 4.5 MPa; at 1 mm from the root tip, Group D: 25.1 MPa vs. Group A: 10.3 MPa. The maximum stress in the root canal dentin within the isthmus region was located either at the top or bottom of the isthmus. CONCLUSION: A root canal isthmus modifies the stress profile within the dentin. The maximum stress occurs near the apical foramen and significantly increases when the isthmus is located closer to the apical foramina.


Assuntos
Cavidade Pulpar , Análise do Estresse Dentário , Análise de Elementos Finitos , Mandíbula , Dente Molar , Humanos , Fenômenos Biomecânicos , Cavidade Pulpar/anatomia & histologia , Análise do Estresse Dentário/métodos , Imageamento Tridimensional/métodos , Estresse Mecânico
18.
Clin Oral Investig ; 28(6): 324, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38761225

RESUMO

OBJECTIVES: To assess the growth of a multispecies biofilm on root canal dentin under different radiotherapy regimens. MATERIALS AND METHODS: Sixty-three human root dentin cylinders were distributed into six groups. In three groups, no biofilm was formed (n = 3): NoRT) non-irradiated dentin; RT55) 55 Gy; and RT70) 70 Gy. In the other three groups (n = 18), a 21-day multispecies biofilm (Enterococcus faecalis, Streptococcus mutans, and Candida albicans) was formed in the canal: NoRT + Bio) non-irradiated + biofilm; RT55 + Bio) 55 Gy + biofilm; and RT70 + Bio) 70 Gy + biofilm. The biofilm was quantified (CFUs/mL). Biofilm microstructure was assessed under SEM. Microbial penetration into dentinal tubules was assessed under CLSM. For the biofilm biomass and dentin microhardness pre- and after biofilm growth assessments, 45 bovine dentin specimens were distributed into three groups (n = 15): NoRT) non-irradiated + biofilm; RT55 + Bio) 55 Gy + biofilm; and RT70 + Bio) 70 Gy + biofilm. RESULTS: Irradiated specimens (70 Gy) had higher quantity of microorganisms than non-irradiated (p = .010). There was gradual increase in biofilm biomass from non-irradiated to 55 Gy and 70 Gy (p < .001). Irradiated specimens had greater reduction in microhardness after biofilm growth. Irradiated dentin led to the growth of a more complex and irregular biofilm. There was microbial penetration into the dentinal tubules, regardless of the radiation regimen. CONCLUSION: Radiotherapy increased the number of microorganisms and biofilm biomass and reduced dentin microhardness. Microbial penetration into dentinal tubules was noticeable. CLINICAL RELEVANCE: Cumulative and potentially irreversible side effects of radiotherapy affect biofilm growth on root dentin. These changes could compromise the success of endodontic treatment in oncological patients undergoing head and neck radiotherapy.


Assuntos
Biofilmes , Candida albicans , Cavidade Pulpar , Dentina , Enterococcus faecalis , Streptococcus mutans , Biofilmes/efeitos da radiação , Dentina/microbiologia , Dentina/efeitos da radiação , Humanos , Cavidade Pulpar/microbiologia , Cavidade Pulpar/efeitos da radiação , Candida albicans/efeitos da radiação , Animais , Enterococcus faecalis/efeitos da radiação , Streptococcus mutans/efeitos da radiação , Bovinos , Microscopia Eletrônica de Varredura , Dureza , Microscopia Confocal , Dosagem Radioterapêutica
19.
Clin Oral Investig ; 28(6): 340, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801642

RESUMO

BACKGROUND: Pediatric rotary file systems were developed to solve manual file limitations. With many systems available, it may be tricky to select the most appropriate one. AIM: to assess & compare Kedo-S Square, Fanta-AF™-Baby rotary files with manual K-file concerning removed dentin amount, canal transportation, centric ability & root canal taper using CBCT in primary anterior teeth. DESIGN: Extracted Seventy-five upper primary anterior teeth with intact 2/3 root length were collected and divided into three groups based on root canal instrumentation, group-I: prepared using K-file, group-II: prepared using Kedo-S Square, and group-III: prepared using Fanta AF™ Baby file. The teeth were imaged with CBCT before & following canal instrumentation. Then, the removed dentin amount was calculated at each root-canal level. The Kruskal-Wallis test was utilized to statistically analyze study data. RESULT: The difference among the three groups was highly statistically significant at cervical & apical thirds concerning dentin thickness changes on both mesial & distal sides following canal preparation with the least removed dentin in the Kedo-S Square group(P < 0.0001). Regarding transportation & centering ability, a non-significant difference between the three groups was found. 80% of the Fanta AF™ Baby group had good-tapered preparation compared to the Kedo-S Square (72%) and K-file (40%) groups(P < 0.05). CONCLUSION: Kedo-S Square was preferable to Fanta-AFTM-Baby & manual K-files in primary root canal preparation.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Desenho de Equipamento , Preparo de Canal Radicular , Dente Decíduo , Humanos , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Técnicas In Vitro , Dente Decíduo/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Instrumentos Odontológicos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/cirurgia
20.
Int Endod J ; 57(8): 1124-1135, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38700876

RESUMO

AIM: To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY: Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS: The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION: The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.


Assuntos
Sequenciamento de Nucleotídeos em Larga Escala , Periodontite Periapical , Hipoclorito de Sódio , Humanos , Periodontite Periapical/microbiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Hipoclorito de Sódio/uso terapêutico , Preparo de Canal Radicular/métodos , Adulto , Desinfecção/métodos , Cavidade Pulpar/microbiologia , Masculino , Feminino , Irrigantes do Canal Radicular/uso terapêutico , DNA Bacteriano/análise , Pessoa de Meia-Idade , Microbiota/efeitos dos fármacos , Tratamento do Canal Radicular/métodos , Bactérias/classificação , Bactérias/efeitos dos fármacos
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