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This study evaluated the feasibility of an automated method to delimit the required area to quantitatively analyze root filling voids and gaps from cross-sectional confocal laser scanning microscopy (CLSM) images. Root canals of maxillary canines were prepared with rotary instruments and filled by lateral compaction technique using gutta-percha and AH Plus sealer. The roots were stored (100% humidity, 37 °C) for a period of 24 h and then transversally sectioned to obtain 2-mm-thick slices from the apical and middle thirds. The areas corresponding to filling materials, gaps, and voids were manually delimited or automatically demarked by ImageJ software after converting the images to the RGB color system. Based on manual and automatic delimitations, the percentages of voids and gaps were calculated. Data of voids and gaps between middle and apical thirds were individually compared by paired t-test. Pearson`s correlation test was used to assess the correlation of data between the methods. Irrespective of the method of area delimitation, no difference was observed between the root thirds for both voids and gaps, while the p-values calculated for each method were similar. Almost perfect correlations between the methods were observed for both outcomes. The proposed method to automatically delimit the areas corresponding to filling material, voids, and gaps appears to be a valid method to facilitate the quantitative analysis of defects in root canal fillings using topographic CSLM images.
Assuntos
Materiais Restauradores do Canal Radicular , Resinas Epóxi , Estudos Transversais , Preparo de Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Teste de Materiais , Guta-Percha , Obturação do Canal Radicular/métodosRESUMO
OBJECTIVES: To compare the root filling quality, the sealer extrusion, and the healing rates of apical lesions addressed via two endodontic treatment approaches. The hypothesis tested was that both techniques present similar apical periodontitis healing results. MATERIALS AND METHODS: This study was a parallel-design, pragmatic, and randomized clinical trial. One hundred twenty anterior teeth with necrotic pulps and apical periodontitis were randomly allocated to be either instrumented with hand files and obturated with the lateral compaction technique or instrumented with a single file in a reciprocating movement and obturated with a single-cone technique. The root canal filling quality, the occurrence of sealer extrusion, and apical periodontitis healing were the outcomes of interest. Data were analyzed through chi-square analysis, and the odds ratio for healing was adjusted using a logistic regression model (α = 0.05). RESULTS: No significant differences were observed between the endodontic techniques regarding the root filling quality or sealer extrusion. Six months after treatment, both endodontic techniques presented equivalent results regarding apical periodontitis healing. The healing rate was affected only by the periapical status at baseline. CONCLUSIONS: The obturation of the root canal of the anterior teeth using reciprocating file-matched single cones presented a similar quality to that obtained with manual instrumentation followed by the lateral condensation technique. Similar healing rates of apical lesions were also observed. CLINICAL RELEVANCE: For treating anterior teeth with apical periodontitis, a reciprocating single-file, single-treatment protocol was as effective as a traditional protocol combining hand instrumentation and the lateral compaction obturation technique.
Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Preparo de Canal Radicular , Humanos , Periodontite Periapical/terapia , Obturação do Canal Radicular , Tratamento do Canal RadicularRESUMO
OBJECTIVE: To quantify Enterococcus faecalis density in root canal dentin after chemomechanical preparation (CMP) using alternated irrigating regimen. METHODOLOGY: Root canals (RC) were contaminated with E. faecalis (ATCC 19433) for 3 weeks and evident biofilms were obtained. After initial sampling (S1), the CMP was aided by irrigants: saline solution (control; n=12), a conventional regimen (CR) (group 1; n=12) using 5.25% NaOCl and a final rinse with 17% EDTA, and an alternating regimen (AR) of intercalated use of NaOCl and EDTA (group 2, n=12), followed by a second sampling (S2). After 2 weeks, S3 was obtained. Two roots were analyzed by scanning electron microscopy. Each root was divided into cervical, mild, and apical segments and sampling of the superficial (n=90) and deep (n=90) dentin layers was obtained using Gates-Glidden burs. The E. faecalis density (CFU/mg) in log10 was categorized as residual (0 > 0.2), moderate (0.2 ≥ 0.5), or elevated (> 0.5). The prevalence of positive samples in BHI and BHI-A was analyzed by Pearson's chi-square test. The data were normalized by a log10 transformation of CFU and were analyzed by one-way ANOVA and Tukey's tests. RESULTS: Biofilms were observed only in the control root canal walls. Topographically, the controls and CR showed similar distributions of E. faecalis in the dentin. Microbiologically positive root canals harbored much E. faecalis in the adjacent dentin (p < 0.05). Irrigating saline provided moderate density of E. faecalis in the dentin while CR and AR resulted in a residual density of microorganisms (p < 0.05). CONCLUSIONS: The Enterococcus faecalis density in dentin was influenced by the irrigating regimen and the microbiological status of the root canal. The CMP aided by the alternating regimen interfered with the recolonization of the root canal and topographic distribution of Enterococcus in root dentin.
Assuntos
Biofilmes/crescimento & desenvolvimento , Dentina/microbiologia , Enterococcus faecalis/crescimento & desenvolvimento , Irrigantes do Canal Radicular/farmacologia , Biofilmes/efeitos dos fármacos , Humanos , Hipoclorito de Sódio/farmacologiaRESUMO
This study was designed to evaluate the effect of a final rinse with 0.2% chitosan solution on the adhesion in roots filled with gutta percha and an epoxy resin based sealer. Thirty extracted human maxillary canines selected to ensure specimen standardization were used in the study. After the coronal portion of each tooth was removed, the roots were instrumented and irrigated with 1% sodium hypochlorite (NaOCl). Roots were distributed into 3 groups according to the final rinsing solution (n = 10): 0.2% chitosan, 17% ethylenediaminetetraacetic acid (EDTA), or 1% NaOCl. The canals were irrigated with 5 mL of each solution for 5 minutes and then filled with gutta percha cones and the resin based sealer. Ten roots in each group were prepared, sectioned, and submitted to push-out testing. Data were analyzed with analysis of variance and Tukey test (P < 0.05). In the push-out test, final irrigation with chitosan (mean, 0.37 [SD, 0.12] MPa) or EDTA (0.38 [0.11] MPa) resulted in significantly greater bond strength of the sealer to the root canal (P < 0.05) than did irrigation with 1% NaOCl (0.13 [0.04] MPa). The cervical third had greater bond strength than the other thirds (P < 0.05). Adhesive failure was the most frequent type in all groups. A final rinse with 0.2% chitosan or 17% EDTA resulted in greater bond strength of root fillings to the root canal than did 1% NaOCl.
Assuntos
Quitosana , Colagem Dentária , Materiais Restauradores do Canal Radicular , Quitosana/química , Cavidade Pulpar , Dentina , Resinas Epóxi , Humanos , Materiais Restauradores do Canal Radicular/química , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de SódioRESUMO
Absence of periapical healing after orthograde retreatment using an apical plug with mineral trioxide aggregate (MTA) can require surgical intervention. A patient with a root-filled maxillary central incisor with chronic apical periodontitis and sinus tract was referred for endodontic retreatment. Excessive apical enlargement was verified, indicating an MTA apical plug placement; however, an unintentional extrusion of MTA occurred during this step. The root canal was filled with gutta-percha and sealer, and periodic recalls were scheduled. The sinus tract was observed after six months and the lesion remained unaltered, although the extruded MTA had resorbed; therefore, an apicoectomy and retrograde root-end filling with MTA were performed. Absence of sinus tract, normal clinical aspect, and complete repair of the lesion were observed at the two-year follow-up.
Assuntos
Compostos de Alumínio/efeitos adversos , Compostos de Cálcio/efeitos adversos , Corpos Estranhos/etiologia , Óxidos/efeitos adversos , Periodontite Periapical/cirurgia , Materiais Restauradores do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Silicatos/efeitos adversos , Ápice Dentário/patologia , Adulto , Compostos de Alumínio/uso terapêutico , Apicectomia/métodos , Bismuto/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Fístula Dentária/cirurgia , Fístula Dentária/terapia , Combinação de Medicamentos , Feminino , Seguimentos , Corpos Estranhos/cirurgia , Guta-Percha/uso terapêutico , Humanos , Incisivo/patologia , Óxidos/uso terapêutico , Periodontite Periapical/terapia , Piezocirurgia/métodos , Retratamento , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Dente não Vital/cirurgia , Dente não Vital/terapia , Falha de TratamentoRESUMO
This study evaluated the antibacterial activity of Rosmarinus officinalis extract and its potential for disinfecting guttapercha (GP) cones. In the first experiment, a hydro-alcoholic extract of Rosmarinus officinalis (leaves) in a dilution ratio of 10% m/v was tested against Enterococcus faecalis by using the disk diffusion method. Positive and negative controls were 70% cereal alcohol and antibiotics, respectively. The procedures were performed in triplicate, and the diameters of the zones of growth inhibition were measured with a caliper after 24 h at 37 degrees C. In the second experiment, the disinfection procedures were evaluated on GP cones artificially contaminated with Enterococcus faecalis. The R. officinalis extract was compared with 2% chlorhexidine digluconate and 2.5% sodium hypochlorite, using a direct exposure test (5 min treatment). Sterilized and non-disinfected cones were used as negative and positive controls, respectively. After 24 h of incubation, bacterial counts were taken. For both experiments, the data were statistically analyzed by Kruskall-Wallis and Tukey's tests (p < 0.05). The plant extract produced zones of inhibition comparable to those of tested antibiotics. Significant GP cone disinfection was verified with all disinfectant solutions, with no significant difference between them. R. officinalis extract showed bactericidal effect on Enterococcus faecalis and capacity to disinfect GP cones contamined with it.
Assuntos
Desinfecção/métodos , Enterococcus faecalis/efeitos dos fármacos , Guta-Percha , Extratos Vegetais/farmacologia , Rosmarinus , Testes de Sensibilidade MicrobianaRESUMO
This study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of mesiobuccal second canal (MB2) in the maxillary first molars and other aspects of its internal anatomy. Sixty-two maxillary first molars were scanned by micro-CT. The presence of the MB2 canal was verified. The distance between the center points of the MB1, MB2, distobuccal (DB), and palatal (P) canal orifices on the pulp floor were measured (MB1-MB2, MB1-DB, MB2-DB, MB1-P, and DB-P). The MB1-P to DB-P ratio was calculated. The distances between the anatomic apex and the MB1 and MB2 apical foramina were measured. The length of the band-shaped isthmus was also measured. Student's t-test was applied to verify the association between the presence of an MB2 canal, the interorifice distances, and the ratio of the MB1-P to DB-P distance (α = 5%). The MB2 canal was present in 43 roots (69.35%). Statistics showed significant differences when MB2 was present for the largest MB1-P distance (p < 0.05) and higher values for the MB1-P to DB-P ratio (p < 0.05). A band-shaped isthmus was detected in 25.8% of MB roots. The mean distance from the apical foramen to the isthmus floor ranged from 1.74 for MB1 canals to 1.42 for MB2 canals. Canal orifice distances on the pulp floor may predict the presence of MB2 canals. There was a high incidence of isthmus, accessory canals, and apical delta in the critical apical zone in MB roots of maxillary first molars.
Assuntos
Maxila , Raiz Dentária , Cavidade Pulpar/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Microtomografia por Raio-XRESUMO
INTRODUCTION: The purpose of this study was to evaluate the impact of conservative endodontic cavities (CECs) on root canal preparation, restoration, and biomechanical behavior of teeth prepared using different shaping systems and restorative materials. METHODS: Ninety upper premolars with a bifurcated root were matched based on morphology and randomly assigned to a control group (n = 10) or 1 of the following experimental groups (n = 40): traditional endodontic cavity and CEC. Teeth were subdivided according to instrumentation (n = 10) as follows: ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), Reciproc (VDW GmbH, Munich, Germany), Reciproc Blue (VDW GmbH), and Hyflex EDM (Coltene/Whaledent, Altstätten, Switzerland). After canal obturation, teeth were restored using temporary material, conventional composite, regular bulk fill composite, or bulk fill flow combined with conventional composite. Before and after preparation and after obturation, the teeth were scanned using micro-computed tomographic imaging. Canal transportation (CT), the percentage of untouched canal surfaces (UCSs), voids in restoration (VRs), and residual filling material in the pulp chamber were evaluated. Finite element analysis, fracture resistance, and the failure pattern were recorded. The data were analyzed using analysis of variance and the Tukey and chi-square tests. RESULTS: CECs had greater CT, percentage of filling material, and VRs compared with traditional endodontic cavities (P < .0001). The highest CT and UCSs were observed in CEC with ProTaper Universal. Bulk fill flow combined with conventional composite showed a lower percentage of VRs compared with other restorative materials (P < .05). Finite element analysis, fracture resistance, and failure pattern revealed similar behaviors in all groups (P > .05) . CONCLUSIONS: CECs had a negative impact on root canal centralization, UCSs, cleaning of the pulp chamber, and percentage of VRs. Controlled memory instruments were the most adequate for the root canal preparation of CECs. The endodontic cavity did not influence the biomechanical behavior of restored teeth.
Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Dente Pré-Molar , Cavidade Pulpar/diagnóstico por imagem , Alemanha , Tratamento do Canal RadicularRESUMO
OBJECTIVES: This study evaluates the bond strength and marginal adaptation of mineral trioxide aggregate (MTA) Repair HP and Biodentine used as apical plugs; MTA was used as reference material for comparison. MATERIALS AND METHODS: A total of 30 single-rooted teeth with standardized, artificially created open apices were randomly divided into 3 groups (n = 10 per group), according to the material used to form 6-mm-thick apical plugs: group 1 (MTA Repair HP); group 2 (Biodentine); and group 3 (white MTA). Subsequently, the specimens were transversely sectioned to obtain 2 (cervical and apical) 2.5-mm-thick slices per root. Epoxy resin replicas were observed under a scanning electron microscope to measure the gap size at the material/dentin interface (the largest and smaller gaps were recorded for each replica). The bond strength of the investigated materials to dentin was determined using the push-out test. The variable bond strengths and gap sizes were evaluated independently at the apical and cervical root dentin slices. Data were analyzed using descriptive and analytic statistics. RESULTS: The comparison between the groups regarding the variables' bond strengths and gap sizes showed no statistical difference (p > 0.05) except for a single difference in the smallest gap at the cervical root dentin slice, which was higher in group 3 than in group 1 (p < 0.05). CONCLUSIONS: The bond strength and marginal adaptation to root canal walls of MTA HP and Biodentine cement were comparable to white MTA.
RESUMO
This study evaluated the sealing ability of gray MTA-Angelus mixed with propyleneglycol in furcal perforations using a bacterial leakage test. Furcal perforations were created in 30 human mandibular molars using a size 3 round bur The samples were divided randomly into 2 experimental groups (n=10) according to the mixing agent. In G1, the MTA powder was mixed with propyleneglycol, while distilled water was used in G2. A 3:1 powder-liquid ratio was used for both groups. The MTA was placed in the perforation with an MTA carrier and condensed with hand pluggers. Non-repaired (n=5) and totally sealed (n=5) perforations served as positive and negative controls, respectively. Bacterial leakage was assessed daily for 30 days in a double-chamber apparatus with Enterococcus faecalis. Data were analyzed using Fisher exact test (p < 0.05) for three leakage periods: 1st to 10th day (P1); 11th to 20th day (P2); and 21st to 30th day (P3). The positive control presented leakage in all specimens within the first 24 hours, while no leakage was observed in the negative control during the experimental period. Leakage was observed in five (50%) of the 10 samples of the propyleneglycol group (G1) and seven (70%) of the distilled water group (G2) by the 20th day, without significant difference between the groups in periods P1 and P2 (p = 0.137). The leakage was significantly lower for G1 than G2 in period P3 (50% versus 100%, respectively, p = 0.016). In this single aerobic bacterial leakage method, the use of propyleneglycol as a vehicle for gray MTA-Angelus increased its sealing ability in furcal perforations at the end of the 30-day experimental period.
Assuntos
Bismuto/farmacologia , Cimentos Dentários/farmacologia , Infiltração Dentária/microbiologia , Óxidos/farmacologia , Selantes de Fossas e Fissuras/farmacologia , Propilenoglicóis/farmacologia , Materiais Restauradores do Canal Radicular/farmacologia , Humanos , Técnicas In Vitro , SilicatosRESUMO
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 , CicatrizaçãoRESUMO
[This corrects the article DOI: 10.1371/journal.pone.0227347.].
RESUMO
The aim of this study was to compare the sealing ability of white mineral trioxide aggregate (MTA) with that of other materials used as a cervical barrier during intracoronal bleaching. Thirty eight extracted teeth were endodontically treated and 3 mm of filling was removed to receive the barrier material: G1-Coltosol; G2 - Vidrion R; G3 - White MTA; G4-No barrier (negative control) and G5- Roots totally protected with three layers of cyanoacrylate (positive control). The 30% hydrogen peroxide associated with the sodium perborate was left in the pulp chamber for 24 h. The specimens were immersed in a test tube containing a solution of potassium chromate (yellow), which turns blue in the presence ofhydrogen peroxide. Two calibrated evaluators scored according to color in the presence of the detecting solution (0 - unaltered color, 1 - light blue and 2 - dark blue). Data were analyzed by the Kruskall-Wallis test (p<0.05). The results showed no statistically significant differences between the experimental group G3 and positive control (G5). No statistically significant difference was observed between G1 and G3. However a statistical difference was verified between G2 and G3. MTA presented higher sealing ability than Vidrion R and did not differ from the positive control. However there was no difference between MTA and Coltosol.
Assuntos
Compostos de Alumínio/farmacologia , Compostos de Cálcio/farmacologia , Cimentos Dentários/farmacologia , Peróxido de Hidrogênio/farmacologia , Oxidantes/farmacologia , Óxidos/farmacologia , Silicatos/farmacologia , Clareamento Dental/métodos , Combinação de Medicamentos , Técnicas In VitroRESUMO
BACKGROUND: The present study evaluated the coronal discoloration induced by different materials or blood as well as the effect of internal bleaching on discoloration. METHODS: After tooth color measurement at baseline with a sphere spectrophotometer (CIE L*a*b*), the root canals of molars were partially filled with white mineral trioxide aggregate (MTA), triple antibiotic paste (TAP), or a cotton pellet with bovine blood (control) was placed into the pulp chamber. The color changes were assessed at 30, 60, and 180 days after the procedure. Following the discoloration, internal bleaching was performed with a mixture of sodium perborate and hydrogen peroxide inserted into the pulp chamber, and this mixture was replaced weekly for 3 weeks. At baseline, after staining and after bleaching, the data of each color parameter were individually analyzed by one-way ANOVA, while differences in pooled color changes (∆E00) were assessed by two-way repeated measures ANOVA (α = 0.05). RESULTS: After the staining period, the TAP-stained specimens were darker and greener than the other specimens, and no difference was observed between the teeth stained with blood and those stained with MTA. The walking bleach technique resulted in an improved tooth color without a difference in the color changes among the different groups. CONCLUSION: The TAP-stained specimens had the greatest tooth discoloration, and the discoloration remained the highest after the walking bleach technique. PRACTICAL IMPLICATIONS: This in vitro study demonstrated that TAP yielded higher tooth discoloration, and this color might hinder a satisfactory tooth color from being obtained with the walking bleach technique.
Assuntos
Clareamento Dental , Descoloração de Dente , Dente , Animais , Bovinos , Endodontia RegenerativaRESUMO
OBJECTIVE: Because the impact of conditioned fear stress on apical bone resorption is unknown, the aim of the current studywas to use a rat model to evaluate the impact of conditioned fear stress on the bone resorption of inflammatory apical periodontitis lesions. METHODS: Twenty-five animals were divided into two groups. They underwent a surgical procedure in the first left lower molar tooth to expose the dental pulp and induce inflammatory apical periodontitis lesions through the retention of contamination (bacterial infection) during a 56-day period. The animals in the case group were stressed daily by using electrical stimuli (1.10 mA), whereas the animals in the control group were absent from the stressful stimuli (shocks). The open field test was performed to validate the stress methodology. The jaws were removed and collected for histological and radiographic analyses. RESULTS: Stressed animals presented increased levels of bone loss and inflammatory cells in the root apex in comparison with the control group (P = 0.0001). However, no radiographic differences were observed between the groups (P > 0.05). CONCLUSIONS: Our results demonstrated that conditioned fear stress could modify a periapical lesion by increasing the size of bone loss there. Conditioned fear stress also increased the total number of inflammatory cells compared with the control group. Studies evaluating the impact of conditioned fear stress on human periapical inflammatory lesions should be encouraged.
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Reabsorção Óssea/fisiopatologia , Reabsorção Óssea/psicologia , Condicionamento Operante , Medo , Periodontite Periapical/fisiopatologia , Periodontite Periapical/psicologia , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Animais , Masculino , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
The localization of partial or completed root canal obliteration is a challenging task in endodontic practice. Recently, guided endodontics has become an alternative solution for those cases. Although this technique has already been used clinically in managing anterior teeth, in this report, we describe 3 complex clinical scenarios of calcified root canals of 1 molar and 2 premolars using guided endodontics. The clinical cases reported here show that technological evolutions should make guided endodontic procedures more widespread because their execution is relatively fast and safe even in the case of the upper molar. Additionally, 12-month clinical follow-up visits showed the effectiveness of the guided endodontic procedures.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Calcificações da Polpa Dentária/diagnóstico por imagem , Calcificações da Polpa Dentária/cirurgia , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/cirurgia , Endodontia/métodos , Maxila , Radiografia Dentária , Tratamento do Canal Radicular/métodos , Cirurgia Assistida por Computador/métodos , Idoso , Dente Pré-Molar , Feminino , Seguimentos , Humanos , Imageamento Tridimensional , Pessoa de Meia-Idade , Dente Molar , Fatores de Tempo , Resultado do TratamentoRESUMO
This article presents non-surgical resolution of an extensive periapical lesion of endodontic origin associated with the maxillary left lateral incisor. Clinical examination revealed an asymptomatic bony hard swelling confined to the palate, while radiographic analysis showed a lesion measuring 22 mm in diameter and nearly 389 mm(2) in area. Through apical patency, 4 ml of intracanal exudate was drained. After thorough biomechanical preparation, a calcium hydroxide/CPMC root canal dressing was applied and periodically renewed for 11 months. The exudate was eliminated at treatment onset and significant bone formation was observed at the periapical region in the following months with concomitant resolution of the cortical expansion. Complete radiographic resolution of the periapical lesion was observed two years after the root canal filling. Thus, non-surgical treatment of this supposedly cystic, extensive periapical lesion provided favorable clinical and radiographic response.
Assuntos
Doenças Maxilares/terapia , Cisto Radicular/terapia , Tratamento do Canal Radicular/métodos , Adulto , Hidróxido de Cálcio/uso terapêutico , Doenças da Polpa Dentária/terapia , Resinas Epóxi/uso terapêutico , Exsudatos e Transudatos , Seguimentos , Guta-Percha/uso terapêutico , Humanos , Incisivo , Materiais Restauradores do Canal Radicular/uso terapêutico , Obturação do Canal Radicular , Preparo de Canal Radicular/métodos , CicatrizaçãoRESUMO
BACKGROUND: The failure of endodontic treatment is linked to the presence of Enterococcus faecalis in the root canals. The scope of this study was to evaluate the influence of the energy dose and frequency of photodynamic therapy (PDT cycles), as well as the volume of bacterial suspensions (BS) in the elimination of Enterococcus faecalis in planktonic form. METHODS: In four successive assays BS of Enterococcus faecalis ATCC 19433 were irradiated with a diode laser (40â¯mW) using the photosensitizer (PS) methylene blue (MB) (0.005⯵g/mL). Group 1 - Effect of energy dose: 100⯵â¯L of BS and 100⯵â¯L of PS were irradiated by 1, 2.5, 5, 7.5 and 10â¯minuteâ¯s. Group 2 - Effect of PDT cycles: The BS received 1, 2, 3 or 4 PDT cycles (in each cycle 100â¯mâ¯L of PS was added and irradiated by 2.5â¯minutes). Group 3 - Effect of energy dose and bacterial suspension volume: 10⯵â¯L of BS and 10⯵â¯L of PS were irradiated similar to group 1. Group 4 - Effect of energy dose, bacterial suspension volume and PDT cycles: 10⯵â¯L of BS and 10⯵L of PS were irradiated according to group 2. The laser source and MB isolated represented the controls. RESULTS: The mean log reduction after separate applying laser light and MB were 0.01 and 0.07, respectively. It was found that wells with 100⯵â¯L of BS irradiated with 2.4 to 24â¯J of energy did not cause significant bacterial elimination (pâ¯>â¯0.05), on the other hand PDT cycles above 12â¯J increased significantly bacterial elimination (pâ¯<â¯0.05). In 10⯵â¯L wells irradiation from 12â¯J of energy provided higher bacterial elimination (pâ¯<â¯0.05) which combined with PDT cycle resulted in the logarithmic elimination of E. faecalis (pâ¯<â¯0.05). CONCLUSIONS: The energy dose, the volume of the bacterial suspension and, especially, the PDT cycles optimized the bacterial elimination of Enterococcus faecalis in planktonic form.
Assuntos
Enterococcus faecalis/efeitos dos fármacos , Azul de Metileno/farmacologia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Plâncton/efeitos dos fármacos , Lasers Semicondutores/uso terapêuticoRESUMO
This study evaluated the effect of mineral trioxide aggregate (MTA) on the retention of fiber posts in repaired root canal perforations. Ten-millimeter post spaces were prepared in 60 endodontically treated bovine incisors. Root perforations were created in half of the root canals in the cervical area prior to being filled with white MTA-Angelus. Fiber posts were luted into the root canals with two self-adhesive (RelyX Unicem or Set) or self-etching (Panavia F) resin cements. The posts were submitted to a pull-out test, and the data were submitted to two-way ANOVA and Tukey's post hoc tests (α = 0.05). The fiber posts exhibited reduced retention in MTA-repaired root canal perforations, regardless of the type of resin cement that was used (p < 0.001). Self-adhesive resin cements provided higher bond strength values than Panavia F, while no difference was observed between RelyX Unicem and Set (p > 0.05). The presence of MTA in repaired root perforations negatively affected post retention. In addition, self-adhesive cements seemed to be the best option to lute fiber posts within a root canal in these cases.
Assuntos
Compostos de Alumínio/química , Compostos de Cálcio/química , Retenção em Prótese Dentária , Cavidade Pulpar/efeitos dos fármacos , Óxidos/química , Técnica para Retentor Intrarradicular , Materiais Restauradores do Canal Radicular/química , Obturação do Canal Radicular/métodos , Silicatos/química , Animais , Bovinos , Cimentação/métodos , Dentina/efeitos dos fármacos , Combinação de Medicamentos , Teste de Materiais , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes , Cimentos de Resina/química , Propriedades de SuperfícieRESUMO
The aim of the present study was to evaluate the bond strength (BS) of root canal fillings to root dentin using the reciprocating file-matched single-cone or lateral compaction techniques with resin-based and calcium-silicate-based sealers. Maxillary canine roots were prepared and filled using one of the following approaches: Reciproc R40 file and R40 single cone, WaveOne Large file and Large single cone, or ProTaper up to F4 file with lateral compaction. The root filling was performed using AH Plus, Epiphany SE or MTA Fillapex (n = 10). Three 1-mm-thick slices were obtained from each third of each root. Two slices were subjected to a push-out test, and the other slices were prepared for scanning electron microscopy (SEM) to examine the dentin-sealer interface. Data (in MPa) from the push-out tests were analyzed using a two-way ANOVA and Tukey's test (p < 0.05). Failure modes (adhesive, cohesive or mixed) were evaluated at ×25 magnification. The single-cone techniques resulted in lower BS values than the lateral compaction technique. For lateral compaction, AH Plus and Epiphany SE showed the highest and lowest BS values, respectively. Slight differences were observed between sealers when the single-cone techniques were used. A tendency to reduce the BS toward the apical third was observed. Adhesive failures were predominant for all experimental conditions. A closer adaption of the filling material on the root dentin was observed for the AH Plus and lateral compaction techniques. The Reciproc and WaveOne techniques were associated with lower BS values than the lateral compaction technique. However, the effect of the root canal filling technique appears to be sealer-dependent.