Influência da agulha irrigadora e da dilatação do canal radicular na eficácia da irrigação endodôntica

Introduction: 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.

Conservative treatment for amelogenesis imperfecta: a case report

Amelogenesis imperfecta is a hereditary condition that can alter the thickness, color, and shape of tooth enamel. Recent adhesive materials and techniques have provided less invasive treatment options. This case report presents the treatment of a patient whose anterior teeth had color alterations, white spots, pits, and shape defects. Using a more conservative technique, the mandibular and maxillary anterior teeth were restored using veneer direct composite restorations. After 6 years, the restorations demonstrated no deterioration, and no pathology was seen in association with the rehabilitation.

A method for retrieving endodontic or atypical non-endodontic separated instruments from the root canal: a report of two cases

Aim: This clinical report presents a new method for retrieving separated instruments from the root canal with minimally invasive procedures. Background: The presence of separated instrument in root canal may interfere in the endodontic treatment prognosis. There are several recommended methods to retrieve separated instruments, but some are difficult in clinically practice. Case report: This study describes two cases of separated instrument removal from the root canal using a stainless-steel prepared needle associated with a K-file. Case 1 presented a fractured gutta-percha condenser within the mandibular second premolar, it was separated during incorrect intracanal medication calcium hydroxide placement. Case 2 had a fractured sewing needle within the upper central incisor that the patient used to remove food debris from the root canal. After cervical preparation, the fractured instruments were fitted inside a prepared needle and then an endodontic instrument (#25 K-file) was adapted with clockwise turning motion between the needle inner wall and the fragment. Conclusion: The endodontic or atypical nonendodontic separated instrument may be easily pull on of the root canal using a single and low cost device. Clinical significance: The methods for retrieving separated instruments from root canal are difficult and destructive procedures. The present case describes a simple method to solve this problem.

Responsabilidade do profissional da saúde no esclarecimento equivocado do paciente para obter o seu consentimento livre e esclarecido

Ao paciente é necessário fornecer esclarecimentos sobre as possibilidades terapêuticas, apresentando os riscos, benefícios, prognóstico e custos de cada alternativa possível e indicada. Esta é uma determinação ética e jurídica. Não obstante, o profissional da saúde detém o conhecimento clínico/técnico/científico, e determina quais informações serão (ou não) fornecidas. O paciente decide submeter-se a um tratamento, fornecendo o seu Consentimento Livre e Esclarecido com base nos dados a ele apresentados. Infelizmente, pode ocorrer de alguns profissionais não fornecerem todas as informações necessárias a uma tomada de decisão esclarecida ou, depois de obtido o consentimento do paciente, apresentarem-lhe informação que cause sua desistência do tratamento inicialmente aceito. Esta última informação, se pertinente, e não se tratando de fato superveniente, deveria ter sido fornecida inicialmente. Porém, a informação pode não ser de todo verdadeira, e levar o paciente a decidir baseado, por exemplo, em riscos apresentados e mensurados de forma equivocada. A reabilitação crânio-facial da Articulação Têmporo-Mandibular (ATM), por meio de prótese de ATM, é indicada em muitas situações. Amiúde, pacientes que necessitam de tais próteses apresentam problemas funcionais e estéticos; a expectativa gerada com a reabilitação é grande. Este trabalho apresenta um caso e discute questões éticas e legais, incluindo a responsabilidade civil, do fornecimento parcial e inadequado de esclarecimentos a um paciente.

Associação de prótese fixa, implantes e estética periodontal para reabilitação de pacientes parcialmente edêntulos

Periodontitis is a chronic inflammatory disease that results in the destruction of teeth and their supporting tissues with subsequent tooth loss. The replacement of missing teeth for implant-supported restorations has proven to be a highly predictable treatment method with good long-term prognosis. However, some consequences of tooth loss prevents dental implant placement in an ideal position, where regenerative procedures are necessary for this type of rehabilitation. Less invasive procedures such as conventional prosthesis emerge as a therapeutic option in cases where there is enough bone structure for implants and patient´s non-acceptance for invasive procedures. Thus, this paper aims to present the resolution of rehabilitation through a noninvasive and multidisciplinary treatment. One female patient referred to the clinic presented maladaptive bilateral mandibular fixed prostheses, endodontic lesions, gingival recession, and root sensitivity. For proper resolution of this case, an association among osseointegrated implants, fixed partial prosthesis, tooth extraction, and aesthetic periodontal procedures with the use of subepithelial connective tissue graft was proposed. After two years, the patient shows excellent aesthetics and chewing. Within the limits of this scenario, this paper discusses the various factors that may affect the choice of a particular treatment modality for the rehabilitation of edentulous single spaces.

Aplicação do enxerto conjuntivo subepitelial para recobrimento de recessões em dentes inferiores

Some regions of the oral cavity present anatomical conditions that seem to hinder the result of gingival recessions coverage. Thus, the aim of this case report was to present two surgeries for gingival recessions coverage in the mandibular teeth performed on the same patient with the follow-up of 24 months. Patient RP, 35 years old, male, Caucasian, nonsmoker, systemically healthy, sought care at the clinic of specialization course in Periodontics from the Araraquara Dental School (Foar-Unesp). His main complaint was the gingival recessions within the lower teeth 33, 34, 35, 43, 44 and 45. Besides the aesthetic nuisance, the patient reported occasional dentin sensitivity. For resolution of the case was referred to the technique of subepithelial connective tissue graft associated with a coronally advanced flap. After 2 years of surgery, it was observed an excellent root guards with significant aesthetic improvement of the case. It can be concluded that the subepithelial connective tissue graft technique was effective in covering of type class I gingival recessions of Miller, even in a region that provides a difficult procedure.

Avaliação tomográfica no tratamento com Herbst em adulto jovem

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influência do diâmetro foraminal do canal radicular, do tipo e da penetração de agulha, e do fluxo da solução irrigadora na limpeza e na extrusão apical

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Correlation of Fractal Dimension with Histomorphometry in Maxillary SinuLifting Using Autogenous Bone Graft

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of a Denture Adhesive on the Satisfaction and Kinesiographic Parameters of Complete Denture Wearers: A Cross-Over Randomized Clinical Trial

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influence of Sealer Placement Technique on the Quality of Root Canal Filling by Lateral Compaction or Single Cone

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Surface Characteristics of Reciprocating Instruments Before and After Use - A SEM Analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)