Avaliação in vitro da ação de substâncias químicas auxiliares, clorexidina e medicações intracanais sobre C. albicans, E. faecalis, E. coli e sua endotoxina em canais radiculares: [recurso eletrônico]

The purpose of this study was to evaluate the antimicrobial activity of chlorhexidine gel 2% as auxiliary chemical substance on the biomechanical preparation (BMP) and medication intracanal (ICM) on C. albicans, E. faecalis, E. coli and their endotoxin in root canals. We used 48 single-rooted human teeth divided into four groups according to dressing ICM: 1) Ca(OH)2 + pyrogen-free saline solution; 2) 2% chlorhexidine gel (CLX); 3) Ca(OH)2 + CLX, and; 4) pyrogen-free saline solution (control group). Were collected the contents of root canals to confirm the presence of microorganisms (confirmation), immediately after instrumentation (1st collection), after 7 days of the BMP (2nd collection), after 14 days of the action of ICM (3rd Collection) and 7 days after removal of the ICM (4 th collection). Were performed: the evaluation of antimicrobial activity and the content analysis of endotoxins for all sampling tests. The results were statistically analyzed using Kruskall-Wallis and Dunn tests with a significance of 5%. It was found that the CLX as auxiliary chemical substance has significantly reduced microorganisms confirmation collection when compared. In relation to the neutralization of endotoxin, it was found that the 1st and 2nd collections presented a decrease of 92.03% and 98.10% in mean percentage respectively, when compared to the confirmation collection. In the 3rd and 4th samplings, the Ca (OH)2 + CLX group showed the best results. It was concluded that the BMP and the ICM were able to eliminate the tested microrganisms, however, they were not able to completely eliminate endotoxins root canal

Estudo da anatomia interna dos incisivos laterais superiores pelos métodos radiográficos digital e convencional

The maxillary lateral incisor has a very peculiar and internal morphology that can be influenced by the its external anatomy such as supernumerary roots and ruts deep root, which often hinders an effective endodontic treatment. Generally, this tooth have a single root with one root canal, but teeth with two to four channels can be found. The main canal can present ramifications such as accessory canals, laterals, collaterals, recorrents and apical deltas. All this factors interfere directally on endodonthics treatment. The objective of this work is a study of the internal anatomy of the maxillary lateral incisors by digital and conventional radiographics methods, comparing the results obteined by each method Six hundred upper lateral incisor were used in this study teeth of the collection of the Department of Anatomy ICT – UNESP. All the teeth were radiographed by vestibular face, using a digital radiographic unit(Dabi Atlante). After this step, all the teeth underwent by conventional radiographic technique(Kodak 2200) so that the results obtained were compared. To classify the channel system, it was adopted the classification of Pucci and Reig. All data obtained by digital technique were compared with those obtained in the conventional technique and were subjected to statistical analysis

Monitoramento do perfil microbiológico de dentes com infecção endodôntica primária durante terapia com diferentes medicações intracanal

Pós-graduação em Odontologia Restauradora - ICT

Análise comparativa da ação antimicrobiana dos cimentos endodônticos Acroseal, Sealapex e AH plus pós presa em biofilme de enterococcus faecalis

Pós-graduação em Ciência Odontólogica - FOA

Digital radiography for determination of primary tooth length: in vivo and ex vivo studies

Background. Methods for determining the root canal length of the primary tooth should yield accurate and reproducible results. In vitro studies show some limitations, which do not allow their findings to be directly transferred to a clinical situation. Aim. To compare the accuracy of radiographic tooth length obtained from in vivo digital radiograph with that obtained from ex vivo digital radiograph. Method. Direct digital radiographs of 20 upper primary incisors were performed in teeth (2/3 radicular resorption) that were radiographed by an intraoral sensor, according to the long-cone technique. Teeth were extracted, measured, and mounted in a resin block, and then radiographic template was used to standardise the sensor-target distance (30 cm). The apparent tooth length (APTL) was obtained from the computer screen by means of an electronic ruler accompanying the digital radiography software (CDR 2.0), whereas the actual tooth length (ACTL) was obtained by means of a digital calliper following extraction. Data were compared to the ACTL by variance analysis and Pearson’s correlation test. Results. The values for APTL obtained from in vivo radiography were slightly underestimated, whereas those values obtained from ex vivo were slightly overestimated. No significance was observed between APTL and ACTL. Conclusion. The length of primary teeth estimated by in vivo and ex vivo comparisons using digital radiography was found to be similar to the actual tooth length.

Acurácia das medidas de limas endodônticas em radiografias digital e convencional: estudo in vitro em dentes decíduos

The objective of this study is to evaluate the measurement accuracy of endodontic files obtained by digital and conventional radiographies in primary teeth. Kerr and Hedströen files (# 20), with the reference as the apparent length of tooth, were inserted in the root canal of 18 extracted primary teeth, which were x-rayed by digital and conventional techniques. Measurements from a reference point to the apical end were carried out by an experienced operator twice in a week. An electronic ruler was used for the digital method and a caliper was used for the conventional method. The data were subjected to Pearson correlation test and Student´s t test (p = 0.05). The correlation between the first and the second measurements was r = 0.99, regardless the type of file and method. Comparing the measurements within the methods, the agreement was r = 0.96 for Kerr and r = 0.95 for Hedströen files. The values of length files in the digital radiographies were statistically lower than that obtained in the conventional radiographies (p = 0.02). However, the values obtained by the two methods were statistically similar to real length of teeth for Kerr files (p = 0.29) and for Hedströen files (p = 0.18). The digital radiography was a more trustful method to obtain the lengths of endodontic files.

Cutting Ability of Nickel-titanium rotary systems protaper, mtwo and k3

Nickel-titanium rotatory systems should remove dentin during the root canal preparation to promote the enlargement and tapered shape with continuously narrowing towards the apex. Objective: The aim of this study was to analyze the cutting ability of three NiTi rotatory systems (n = 12): ProTaper (group 1), Mtwo (group 2), and K3 (group 3). Material and methods: Thirty six maxillary molar teeth were weighted on an analytical balance before and after the rotatory preparation of the mesio-buccal root canal. Data was statistically analyzed by ANOVA and Tukey s test with a significance level of 5%. Results: The results revealed the following mass differences (g) before and after the root canal preparation: ProTaper (group 1 – 0.0159 ± 0.004), Mtwo (group 2 – 0.0125 ± 0.002), and K3 (group 3 – 0.007 ± 0.003). Conclusion: ProTaper showed the highest cutting ability among the three tested nickel-titanium rotatory systems followed by Mtwo and K3.

Comparação entre soluções irrigadoras na endodontia: clorexidina x hipoclorito de sodio

The objective of this review was reporting an overview about the properties of two irrigating solutions, solution of sodium hypochlorite and chlorhexidine, used in the treatment of root canals. A solution must submit irrigating antimicrobial action, dissolve waste tissue, promote wetting to facilitate the instrumentation, and present biocompatibility with the adjacent tissues. The sodium hypochlorite used in different concentrations has been the solution of choice among professionals by presenting antimicrobial action and act as a solvent tissue. However, today, chlorhexidine has been widely used as an irrigating solution due to specific properties that enable its use, such as substantivity, antimicrobial effectiveness, and low toxicity. Thus the solution of chlorhexidine with different concentrations is presented as an alternative to irrigating solution for the treatment of root canals.

Effects of coronal leakage on concentration of hydrogen ions and calcium hydroxide release of several calcium hydroxide pastes over different periods of time

Purpose: To evaluate the effects of coronal leakage on concentration of hydrogen ions (pH) and calcium release of several calcium hydroxide pastes, over different periods of time. Material and Methods: Fifty extracted human mandibular central incisors (n=10) were instrumented up to the F2 instrument and assigned to the following intracanal dressing: G1- Calen, G2- Calen with 0.4% chlorhexidine (CHX), G3- Calcium hydroxide with camphorated paramonochlorophenol (CPMC) and glycerin, G4- Calen, but temporary filling material maintained during all test (positive control) and G5- Root canal without intracanal dressing (negative control). All groups were immersed in distilled water for 7 days. In sequence, the temporary filling materials were removed, except in controls groups. All specimens were individually mounted on a specific device and only its root again immersed in distilled water. Concentration of hydrogen ions and calcium release by calcium hydroxide pastes in distilled water were evaluated in 24h, 7, 14 and 28 days. The results were submitted to ANOVA test (p = 0.05). After 28 days, root canals from experimental groups were examined in SEM. Results: G1, G2, G3 and G4 presented similar pH values and calcium release and did not differ from each other (p>0.05), up to 7 days. After this time G1, G2 and G3 presented values lower values than G4 (p<0.05). In SEM analysis, calcium hydroxide residues were observed in all experimental groups. Conclusions: After 7 days, coronal leakage decreased the concentration of hydrogen ions and calcium ion release provided by all calcium hydroxide pastes.

Aspectos atuais do tratamento da infecção endodôntica

Endodontics is a science that embodies etiology, diagnosis, prevention, and treatment of apical periodontitis and its repercussion in the organism. Technological resources in diagnosis and root canal negotiation, and new strategies , associated to mainly cleaning and eliminating the infection of the root canal system, shaping, and filling the endodontic space, according to biological bases, will allow us to reach higher standards of post-treatment success.

Avaliação da eficácia de limpeza de quatro agulhas irrigadoras endodônticas

The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. OBJECTIVE: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. MATERIAL AND METHODS: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file), root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution) and after irrigation (remnant of contrast solution), were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed by using Anova and Tukey's test. The level of significance was set at P < 0.05. RESULTS: For all root canal enlargements, 30G needles (G3 e G4) presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. CONCLUSION: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

Restoration of endodontically treated teeth

The restoration of endodontically treated teeth is one of the most challenging situations of the dentist`s clinical practice, because it involves procedures related to several areas, such as Endodontics, Operative Dentistry, and Prosthetics. These restorations aim to replace the structures lost during endodontic surgery and access to both the pulp chamber and root canal system during the instrumentation, as well as the removal of the carious tissue and temporary restorations. It is also important to remember that the prognosis of endodontically treated teeth depends not only on endodontic treatment success itself, but also on the amount of remnant tooth tissue and the definitive restoration that will be placed onto the dental element.

Evaluación comparativa in vitro de la capacidad de sellado del sistema de conductos radiculares por diferentes técnicas

The aim of this study was to evaluate in vitro the sealing ability of the root canal using different techniques: cold lateral compaction, modified Hybrid Tagger, Thermafil and System B. Material and methods. Were used 116 human single-roots, included in resin blocks, sectioned longitudinally, attached to a device with screws and divided into four groups (n=29). After instrumentation using a bur, depression was made in each third of the root canal in each of the halves. Teeth were filled upon the different techniques. For evaluation of the quality, pictures were taken with a 1.5X magnification, photos and radiographs were utilized. After statistical analysis, were performed both macroscopic and radiographic evaluation, by Chi-square test (χ2). Results. The Thermafil technique showed better results in terms of sealing capacity, failures and homogeneity followed by modified Hybrid Tagger, the System B and cold lateral compaction. Conclusions. Thermafil was the technique that shown to be macroscopic, radiographic and homogeneously best over the other techniques evaluated in regard to the filling of the depressions made (AU)

Resolução por retratamento não cirúrgico de dente com lesão periapical: relato de caso clínico

The development and maintenance of periapical lesion occurs as a result of bacterial infection of the root canal system. Faced with the failure of endodontic treatment, retreatment is the first option with great potential for success, when performed with proper disinfection of the root canal system. Case report: Patient aged 39 years needing dental care show at clinical examination moderate gingival bleeding in the region of tooth 22 and the presence of radiographic periapical bone rarefaction due to unsatisfactory endodontic treatment. It was indicated the endodontic retreatment. We performed procedures to remove the filling material, root canal preparation using manual and mechanical techniques and completion with the use of root canal medication based on calcium hydroxide. After root canal filling, clinical and radiographic success were demonstrated for the case. Conclusion: We conclude that the non-surgical retreatment with disinfection and proper use of medication to the base of calcium hydroxide promoted success after outcome monitoring for 2 years and 8 months (AU)

Residues of different gel formulations on dentinal walls: a SEM/EDS analysis

The aim of this study was to evaluate the presence of residues of sodium hypo-chlorite gel, chlorhexidine gel, and EDTA gel on dentina l walls after canal preparat ion throughchemical SEM- elemental chemical microanal ys is (EDS) analysis. Forty-eight single-rootedteeth were selected. They had their crowns sectioned and were instrumented with a reciprocat-ing system. The canals were irrigated with 5 mL of saline solution during root canal preparation.After instrumentation, the root canals were irrigated with 3 mL 17% EDTA followed by 1 min ofultrasonic passive activation (33 20 sec) to remove the smear layer, and then irrigated with3 mL of saline solution. The specimens were randomized into three groups (n 5 12) accord ing tothe chemical substance that filled the root canal for 30 min: GI: 5.5% sodium hypochlorite gel;GII: 2% chlorhexidine gel; GIII: 24% EDTA gel; Negative c ontrol group: no substance was used.Then, the root canals were irrigated with 6 mL of saline solution followed by 1 min of ultrasonicpassive activation (33 20 sec). After ultrasonic activation , the canals were irrigated with 2 mLsaline. The roots were sect ioned, and the perce ntage of each chemical element present in thesamples was analyzed through chemi cal SEM-EDS microanalysis. All expe rimental groupsshowed a significantly higher percentage of chemical elements (Na and/or Cl) than the controlgroup (P < 0.03). This in vitro study has shown that, regardless of chemical solutions used evenafter the final irrigation protocol, chemical residues of d ifferent substances remained attached tothe r oot c anal wa lls. Microsc. Res. Tech. 78:495–49 9, 2015.