Reparo periapical de dentes tratados endodonticamente submetidos a movimentação ortodôntica

The relationship of Orthodontics and Endodontics is being clarified with the development of evidence-based dentistry. However, few studies have reported the repair of periapical lesions with orthodontic treatment. Therefore, the aim of this study was to evaluate the available evidence on periapical repair of endodontically treated teeth during orthodontic movement. The strategy used was the electronic search with keywords and criteria including studies published up to July 2011. It was also carried out qualitative assessment of the articles methodology. Although a significant number of studies have reported this topic, only two filled the criteria for inclusion in this systematic review. The results obtained in the literature suggest that orthodontic treatment should be interrupted to perform endodontic treatment. During this therapy, the use of root canal dressing based on calcium hydroxide for at least 14 days, and sealer with adequate biological property are indicated. After this phase, orthodontic movement of the endodontically treated teeth can be resumed without waiting period.

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.

Adaptação marginal do agregado de trióxido mineral com e sem cloreto de cálcio em retrocavidades

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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.

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.

Visão contemporânea sobre pinos anatômicos

As an alternative to improve the adaptation of prefabricated posts in flared canals and weakened roots, the option is for relining prefabricated pin, known as a technique of anatomical post. This technique, which can be made with composite resin increases the adjustment post to the walls of the canal and reduces the cementing line, causing the retaining post is less dependent on the mechanical properties of the cementing agent. This article aims to provide an overview of anatomical posts, specifically in the last two decades, based on studies extracted from Scielo, Scopus and Pubmed, referring to the following terms of MeSH Data Base: custom made fiber post, indirect fiber glass posts, root canal therapy and post and core tecnique. According to the literature review in this article, it can be concluded that this technique has been used by several authors and has been shown effective and promising, it creates an individualized retainer with better adaptation and decreased mechanical imbrication cementing line .

Influence of the gutta-percha taper and finger spreader on lateral consensation effectiveness

Introduction: Lateral condensation effectiveness may be influenced by the gutta-percha and finger spreader taper used during root canal obturation. Objective: To evaluate the penetration ability of finger spreader into simulated root canals prepared using MTwo rotary system and filled with different gutta-percha and finger spreader tapers. Material and methods: Resin blocks with curved root canals had the apical diameter enlarged up to #25.06 and distributed into groups (n = 6) according to the gutta-percha taper (#25.02, #25.04, and #25.06) and the finger spreader (#30 and #35 NiTi, and stainless steel B) used to perform cold lateral condensation. After applying a load of 1.5 Kg over the finger spreaders’ head, the distance between the finger spread tip and the apical limit of the root canal preparation were obtained. The data were submitted to Anova and Tukey-Krammer’s test, with 5% of significance. Results: The gutta-percha cones with 0.02 taper enabled higher finger spreader penetration when compared to 0.04 and 0.06 tapers (p < 0.05), which were similar between each other (p > 0.05), regardless of the type and diameter of the finger spreader used. When different finger spreaders were compared among themselves, stainless steel B showed higher penetration ability (p < 0.05). Conclusion: It was concluded that the stainless-steel finger spreaders showed superior penetration ability and gutta-percha with lower tapers enabled a more effective lateral condensation at the apical third.

Capacidade de termoplastificação da guta-percha com diferentes conicidades

jObjective: The objective of this study was to evaluate the thermoplasticity of the gutta-percha cones used for root canal obturation: Dentsply convencional (Dentsply Ind. e Com., Petrópolis, RJ, Brazil), Dentsply 0.04, (Dentsply Ind. e Com., Petrópolis, RJ, Brazil), Antaeos 0.04 (VDW GmbH, Munich, Germany), ProTaper (Dentsply Ind. e Com., Petrópolis, RJ, Brazil) and Alfa 0.06 (VDW GmbH, Munich, Germany). Material and method: Specimens of each material (n = 10) were prepared after heating. After 24 hours were again heated to 70 °C and placed between two glass plates and subjected to a compression of 5 kg for 2 minutes. The scanned image of the groups before and after the compression was analyzed with the software Image Tool (UTHSCSA Image Tool for Windows version 3.0, San Antonio, TX, USA). The flow capacity of the different materials was determined by the difference between the initial and final area of each specimen. The results were submitted to ANOVA and Tukey test with significance level of 5%. Result: Among the material evaluated, the gutta-percha cones Alpha 0.06 and ProTaper presented more thermoplasticity than other groups (p < 0.05). The Dentsply gutta-percha presented thermoplasticity intermediate. The groups Dentsply 0.04 and 0.04 showed lower thermoplasticity after heating (p > 0.05). Conclusion: The gutta-percha present different property of thermoplasticity, which is important to selection of thermoplastic obturation techniques.

Chemical characterization and bioactivity of epoxy resin and Portland cement-based sealers with niobium and zirconium oxide radiopacifiers

The purpose of this study was to characterize and to evaluate the bioactivity potential of experimental root canal sealers (ES) based on Portland cement, epoxy resin with nano- and micro-particles of niobium or zirconium oxide used as radiopacifiers in comparison to AH Plus and MTA Fillapex. Methods Specimens of the sealers (10 mm in diameter × 1 mm thick) were prepared and the radiopacity was evaluated according to ISO 6876 (2012) specifications. Characterization of the sealers was performed under the scanning electron microscope (SEM) immediately after setting and after immersion for 28 days in Hank's balanced salt solution (HBSS). In addition X-ray energy dispersive spectroscopy (EDS), X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy were also performed. The pH and calcium ion release were measured after 1, 7, 14, 21 and 28 days after completion of seating using a digital pH meter and an atomic absorption spectrophotometer, respectively. Results The experimental sealers exhibited an average radiopacity of 2.5 mm thickness of aluminum, which was similar to MTA Fillapex (P > 0.05) and inferior to AH Plus (P < 0.05). AH Plus did not show bioactivity. Although the experimental sealers did not exhibit the formation of hydration product, they encouraged the deposition of crystalline spherical structures of calcium deficient phosphate. The highest pH and calcium release values were observed with the experimental sealers (P < 0.01). ES-Nb-micro was the only sealer to present hexagonal shaped crystal deposition. Significance Novel root canal sealers based on a mixture of Portland cement, epoxy resin and radiopacifier exhibited a degree of bioactivity although no evidence of cement hydration was demonstrated on material characterization. The radiopacifier particle size had limited effect on the sealer microstructure and chemical properties.

Análise físico-química do MTA e do cimento Portland associado a quatro diferentes radiopacificadores

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo da diversidade microbiana e níveis de endotoxinas em lesões endo-periodontais

Pós-graduação em Odontologia Restauradora - ICT

Effects of Ciprofloxacin-containing Scaffolds on Enterococcus faecalis Biofilms

Introduction: Antibiotic-containing polymer-based nanofibers (hereafter referred to as scaffolds) have demonstrated great potential for their use in regenerative endodontics from both an antimicrobial and cytocompatibility perspective. This study sought to evaluate in vitro the effects of ciprofloxacin (CIP)-containing polymer scaffolds against Enterococcus faecalis biofilms. Methods: Human mandibular incisors were longitudinally sectioned to prepare radicular dentin specimens. Sterile dentin specimens were distributed in 24-well plates and inoculated with E. faecalisfor biofilm formation. Infected dentin specimens were exposed to 3 groups of scaffolds, namely polydioxanone (PDS) (control), PDS + 5 wt% CIP, and PDS + 25 wt% CIP for 2 days. Colony-forming units (CFU/mL) (n = 10) and scanning electron microscopy (SEM) (n -= 2) were performed to quantitatively and qualitatively assess the antimicrobial effectiveness, respectively. Results: PDS scaffold containing CIP at 25 wt% showed maximum bacteria elimination with no microbial growth, differing statistically (P < .05) from the control (PDS) and from PDS scaffold containing CIP at 5 wt%. Statistical differences (P < .05) were also seen for the CFU/mL data between pure PDS (5.92-6.02 log CFU/mL) and the PDS scaffold containing CIP at 5 wt% (5.39 5.87 log CFU/mL). SEM images revealed a greater concentration of bacteria on the middle third of the dentin specimen. after 5 days of biofilm formation. On scaffold exposures, SEM images showed similar results when compared with the CFU/mL data. Dentin specimens exposed to PDS + 25 wt% CIP scaffolds displayed a practically bacteria-free surface. Conclusions: On the basis of the data presented, newly developed antibiotic-containing electrospun scaffolds hold promise as an intracanal medicament to eliminate biofilm/infection before regenerative procedures.

Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections

Introduction: This clinical study aimed to determine the microbiological profile resistant to different intracanal medications in primary endodontic infections by using both microbiological culture and the checkerboard DNA-DNA hybridization technique. Methods: Twenty primarily infected root canals were selected and then instrumented before being randomly divided into 2 groups according to the intracanal medications: calcium hydroxide (Ca[OH](2)) or Ca(OH)(2) + chlorhexidine (CHX). Samples were collected before and after root canal procedures, which consisted in submitting them to microbiological culture and processing them for checkerboard DNA-DNA hybridization. Results: No differences were found between the Ca(OH)(2) (99.98%) and Ca(OH)(2) + CHX groups (99.76%) regarding the median percentage values for the reduction of cultivable bacteria. The most frequently detected species were Capnocytophaga ochracea (70%) and Fusobacterium nucleatum ssp. vincentii (70%) in the initial samples. After instrumentation, the most frequently detected species were E. faecium (60%). After root canal treatments using either Ca(OH)(2) or Ca(OH)(2) + CHX as intracanal medications, the most frequently detected species were E nucleatum ssp. vincentii (90%) and Enterococcus faecium (40%), respectively. Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, this reduction was significantly greater in the Ca(OH)(2) + CHX group (P < .05). This difference was also observed when evaluating the total bacterial load (P < .05). Conclusions: The use of Ca(OH)(2) associated with CHX as an intracanal medication showed better results by acting on gram-positive and gram-negative microorganisms although such an action to eradicate enterococci should also be sought.