Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis

SIQUEIRA JR. et al. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., v. 104, n. 1, p. 122-130, 2007.

Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis

SIQUEIRA JR. et al. Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treatment of teeth with apical periodontitis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., v. 104, n. 1, p. 122-130, 2007.

Detecção de bactérias periodontopatogênicas cultiváveis e não cultiváveis em placas ateromatosas

Periodontal infections consist of a group of inflammatory conditions caused by microorganisms that colonize the tooth surface through the formation of dental biofilm. Chronic infections such as periodontitis have been associated to the development and progression of atherosclerosis. AIM: Detect cultivatable and non-cultivatable periodontopathogenic bacteria in atheromatous plaques; search for factors associated to the presence of these bacteria in the atheromatous plaques and characterize the presence of cultivatable and non-cultivatable bacteria in these plaques. METHODOLOGY: A cross-sectional study was performed with a sample of 30 patients diagnosed with atherosclerosis in the carotid, coronary or femoral arteries and surgically treated with angioplasty and stent implant, bypass or endarterectomy. The plaques were collected during surgery and analyzed using the PCR molecular technique for the presence of the DNA of the cultivatable bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Treponema denticola and of the non-cultivatable Synergistes phylotypes. The patients were examined in the infirmary, after the surgery, where they also responded to a questionnaire aimed at determining factors associated to the presence of periodontopathogenic bacteria in the atheromatous plaques. RESULTS: All patients with tooth (66,7%) possessed disease periodontal, being 95% severe and 65% widespread. No periodontopathogenic bacteria were found in the atheromatous plaques. However, four samples (13.3%) were positive for the presence of bacteria. Of these, three participants were dentate, being two carriers of widespread severe chronic periodontite and one of located severe chronic periodontitis. None of them told the accomplishment of procedures associated to possible bacteremia episodes, as treatment endodontic, extraction the last six months or some procedure surgical dental. CONCLUSION: The periodontopathogenic bacteria studied were not found in the atheromatous plaques, making it impossible to establish the prevalence of these pathogens or the factors associated to their presence in plaques, the detection of positive samples for bacteria suggests that other periodontal and non-periodontal pathogens be studied in an attempt at discovering the association or not between periodontal disease and/or others infections and atherosclerosis, from the presence of these bacteria in atheromas

Avaliacão da satisfação do usuário e da qualidade dos tratamentos endodônticos em Centros de Especialidades Odontológicas da Grande Natal-RN

Objective: To evaluate the degree of users satisfaction and technical quality of endodontic treatment in specialized dental clinics (CEO) of Grande Natal / RN between 2006 and 2008. Methodology: evaluated 282 endodontically treated teeth in CEOs through clinical and radiographic examinations. A questionnaire about the clinical condition of the tooth, evaluation of care and satisfaction with treatment was applied. Data on pre-and trans-operative were noted by the patient's clinical record. Endodontically treated teeth were examined by a specialist in endodontics, which compared with previous radiographs and current ones. The collected datas were presented descriptively by absolute numbers, percentages, averages. To determine the association between the independent and dependent variables was carried out through the bivariate association test Chi-square and Fisher exact test. Results: 79.8% presented with radiographic normal and 84.4% without pain symptoms. 8.2% of the teeth were fractured and 3.2% extracted. The persistence of the periapical lesion was associated with initial periapical status (p <0.05). 91.5% of patients are satisfied with the outcome of treatment. Such satisfaction is associated with absence of pain and an adequate esthetic tooth position (p <0.05). Conclusion: endodontic treatment in specialized dental clinics have an adequate technical quality, resulting in the success of endodontic therapy performed in these centers and that users are satisfied with the treatment

Comprovação da real comunicação entre o endodonto e o periodonto através do canal cavo inter-radicular e sua prevalência em molares inferiores humanos

The neurovascular system of the pulp and of the periodontium is interconnected and among the possible intercommunications between these two tissues, there is the cavo inter-radicular canal. It is a small canal that goes through any inter-radicular dentine and arises in the furca region of the multi-radicular teeth. Its predominance has been studied in the literature, by several methodologies, with divergent results. The objective of this work was to establish, in vitro, the predominance of the cavo inter-radicular canal, in human lower molars, through the diaphanization technique and dye leakage. For this research, 140 teeth (100 first and second 40 lower molars) were selected, extracted due to different reasons, belonging to a teeth bank of the Endodontics discipline of the Dentistry College at Federal University of Rio Grande do Norte. The teeth were preserved in formol until the moment of use and immersed in physiological solution. Had the endodontic access fulfilled and the whole external surface, except for the furcation, sealed with two layers of nail enamel. The cleaning of the pulpar chamber floor was carried out with sodium hypochlorite solution 5%, being this solution renewed every 5 minutes, during 1 hour. The teeth were immersed in Indian dye and, after drying of the dye, they had their crowns split up in the amelo-cemental junction. Then, they were examined in a stereomicroscope, where marks of the coloring were observed in the furcation and on the pulpar floor. After this recording, the sample was diaphanized and with the transparent teeth, it was possible to observe in the stereomicroscope, the true inter-radicular canals. As a result of this experiment, the presence of these canals was observed in 13 % of the first and 7, 5 % of the second evaluated molars. The study showed that both the presence of the cavo inter-radicular canal is real and the diaphanization and dye leakage is an efficient method for this type of research

Avaliação da eficiência da técnica de obturação pela compressão hidrùlica vertical após instrumentação automatizada

The purpose of this study was to evaluate through radiographic and microscopic analysis the efficiency of the filling techniques by vertical hidraulic compression after the root canal mechanical instrumentation in vitro as well to evaluate the marginal apical leakage through macroscopic and microscopic analysis. Thirty human mandibular molars were used , they were divided on three groups, these were subdivided on six subgroups with five specimens each, come down to 106 root canals filled. Initially, the teeth were instrumented with Profile system series 29 and filled with two ways: single accessory cone or single cone associated with gutta-percha secundary cone, with Fill Canal sealer or Sealer 26. Completed the filling, the teeth were coated with araldit and finger -nail polish except for the apical 2 mm and dried for 3 hours, thep radiographs were taken of the teeth in orto and disto-radiai directions. Next, the coronal seal was carried out with composite resin photopolymerized and with their process of making impermeable. Teeth of positive controls were used without araldit and finger-nail polish whereas the negative controls were used with total coat of araldit and finger-nail polish. The specimens were placed in 2% Methylene Blue dye for 24 hours and thermocycled for 7 days. Afterwards, sections were made of each tooth at mesial and distal roat, after this the teeth were radiographed at buccolíngual direction for a macroscopic analysis and at buccolingual and mesiodistal directions for assessment of the marginal apical leakage. Cross sections were made 3 mm to 3mm since the tooth apice. The sections obtained for each group were observed with a stereomicroscope to evaluate the quality of the root canal filling and the marginal apical leakage. The results showed that: In the four techniques the marginal dye leakage was present in the apical third; in all groups the quality of the root canal filling in the radiography was better at mesial root canal and the single cone technique showed inefficient when only a single distal root canal was present. In the radiographic evaluation the best quality of the root canal filling was observed in the 1A group (single accessory cone + FiIl Canal), as in the mesial root as in the distal root wich Shcwed twe root canals: when the distaI root had only one canal. the best result was showed by 28 group (single accessory cone associated with secundary cone + Fill Canal) In the macroscopic analysis of longitudinal !eaKage (outside surface). less leakage was showed as In the mesial root as in the distal root in the negative control group (3) followed 2A group (single accessory cone + Sealer 26). When the microscopic analysis of tranversal leakage of both roots (inside surface) was carried out. the groups that showed less dye leakage were the negative control (38) followed the 28 group (single acessory cone associated with secundary cone + Sealer 26). The homogeneity o filling was best noted in the 1 A group (.single accessoty cone + Fill Canal). The groups that showed less dye penetration in the tranversal leakage (total area) were negative control (3B) and 2B