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)

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.

Push-out bond strength of calcium hydroxide and mineral trioxide aggregate based sealers

The adhesiveness of six root canal sealers: Acroseal, Endo CPM, Epiphany, White MTA, Sealapex and Sealer 26 to dentin, was evaluated in a push-out test design. Methods: Twenty eight roots of freshly extracted teeth were gauged with a size 5 Largo drill. With a cutting machine slices of 2 mm were prepared, rinsed with 5.25% NaOCl and a final rinse with 17% EDTA, dried and filled with one of the sealers. After setting their bond strength was measured in a mechanical testing machine. The data were statistically analyzed by using a One Way ANOVA and post hoc Tukey test. Results: The mean and standard deviation from values of bond strength was: Sealapex 2.2±0.4; Endo CPM 3.8±1.3; White MTA 6.0±1.4; Epiphany 10.9±2.6; Sealer 26 12.3±2.3; and Acroseal 12.2±1.4. Acroseal, Sealer 26 and Epiphany presented a significantly (P<0.01) greater bond strength compared with the other sealers. Also White MTA showed higher adhesiveness compared with Endo CPM and Sealapex (P<0.01). Conclusion: The bond strength between endodontic sealers and root dentin was maximal when Acroseal, Sealer 26 and Epiphany were used; Sealapex e Endo CPM, in turn, presented the lowest bond strength mean values.

Effectiveness of gutta-percha and Resilon in filling lateral root canals using thermomechanical technique

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influence of the rotary and/or oscillatory reciprocating systems in the morphological changes of narrow and curved molar root canals anatomy

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

Citocompatibilidade, propriedades antibiofilme e físicas e cimentos endodônticos associados à amoxilina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da capacidade seladora apical de um adesivo dentinário, acrescido ou não de hidróxido de cálcio, comparada à de um cimento endodôntico à base de hidróxido de cálcio, na obturação de canais radiculares

Pós-graduação em Odontologia Restauradora - ICT

Estudo in vitro da efetividade do hidróxido de cálcio e da polimixina B na eliminação das endotoxinas presentes nos canais radiculares

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

Avaliação do selamento de ápices radiculares retrobturados ou recobertos com diferentes materiais mediante infiltração marginal por corante e análise da interface em microscopia eletrônica de varredura

The purpose of this study was to evaluate the apical sealing ability and the marginal adaptation of five dental materials used in retrofillings or applied to the bevelled root surface. One hundred and forty extracted single rooted human teeth were used, divided into seven groups of twenty each. ln the first, second, third and fourth groups, the teeth were apicoectomized, submitted to cavity preparations and retrofilled with one of the following materiais: zinc free silver amalgam, a dentin bonding system plus composite resin, a glass ionomer cement ora compomer. In the fifth, sixth and seventh groups, the teeth were apicoectomized and capped on the bevelled root surface with one of the following materiais: a dentin bonding system plus composite resin, a glass ionomer cement or a compomer. Two specimens of each experimental group were evaluated for the marginal adaptation using scanning electron microscopy. The remaining 126 specimens were immersed in 2% methylene blue dye, stored for one week at 37ºC and the infiltration was evaluated with a stereomicroscope. The results showed that the glass ionomer cement presented the lowest values of marginal infiltration when used as retrofilling material, with a significant statistical difference when compared with the others tested materials. When used as apical capping, the glass ionomer cement and the compomer were equivalent and significantly better than the dentin bonding system plus composite resin. Using scanning electron microscopy, all the materials showed some slight adjustment problem. ln the retrofilling, the smallest marginal gaps were observed with the compomer and the dentin bonding system plus composite resin, while the largest were observed with the glass ionomer cement and zinc free silver amalgam. ln the apical capping, the smallest marginal gaps were observed with the compomer and the dentin bonding system plus composite resin and ...

Efetividade in vitro de agentes irrigantes na neutralização de endotoxinas em canais radiculares

Pós-graduação em Biopatologia Bucal - ICT

Avaliação e correlação da presença de endotoxinas e MMP-3, -8 e -9 em canais radiculares com necrose pulpar submetidos ao tratamento endodôntico - estudo in vivo

It is know that endotoxin and various matrix metalloproteinases (MMPs) are involved in the development of periapical lesions. The purpose of this study was to evaluate and correlate the presence of endotoxins and MMP- 3, MMP-8 and MMP-9 in root canals of teeth with necrotic pulp and periapical lesion before, during and after the biomechanical preparation (PBM) using a combination of different irrigations solutions and intracanal dressing. Thirty-three single-root teeth with a diagnosis of pulp necrosis and periapical lesion radiographically visible were selected. Immediately after the coronal opening was collected the first sample from the root canal content. Then, all canals were prepared (cervical and middle thirds) by oscillatory instruments (EndoEze) and irrigated by 2.5% NaOCl. After, a manual preparation was made for the apical third and the teeth were divided into three groups according to the irrigation protocol: G1) 2.5% NaOCl (4 manual files); G2) 2.5% NaOCl (2 manual files) + [Ca (OH)2 0.14%] (2 manual files) and G3) 2.5% NaOCl (2 manual files) + polymyxin B (2 manual files). After the PBM, the second sample was collected; then the third collect was performed after using EDTA final flush. The fourth sample was collected 14 days after placing the dressing [2% chlorhexidine gel + Ca(OH)2]. Quantification of endotoxins was performed by a kinetic chromogenic lysate from amoebocytes of Limulus (LAL) and quantification of MMPs by ELISA assay. The results were analyzed statistically by Kruskal-Wallis and Dunn's test (5%) and ordinal Spearman correlation. Presence of endotoxin was observed in 100% of cases and G3 showed the greatest reduction of endotoxins from the 1st to the 2nd samples (97%), being statistically similar to G2 (84.2%) and different from G1 (49.4%) (p<0.05). The intracanal dressing promoted a significant reduction of endotoxin, no difference among the groups. For...

Avaliação dos fatores críticos para a seleção e aplicação clínica dos pinos de fibra: relato de caso cliínico

Teeth that have lost much of their coronal tooth structure need intraradical devices to achieve a desired retention of the restorative material, restoring aesthetics and function to the patient. For this purpose, various types of intracanal posts have been studied, of wich the fiber posts have been highlighted with its increasing use in the dental market. The purpose of this study was to present a clinical case of using fiberglass post. As well as critically analyze the published works and points of controversy described by different authors related to factors such as different protocols cementation, surface treatments pins, fracture toughness and compression, the possibility of microleakage, diameter and length of the pin, and the various materials used in conjunction with the intracanal retainers. Thus, we concluded that fiber posts showed as an excellent alternative for anterior teeth, since have least 2 mm of tooth remaining.

Atividade antimicrobiana de cimentos endodônticos

The antimicrobial activity is a fundamental property of root-canal sealers due to persistence of residual microorganisms in the root canal system, even after the chemo-mechanical preparation and using of intracanal dressing. The aim of this study is to review the literature about the antimicrobial properties of some of the main root-canal sealers. Although there is controversy regarding this property, probably due to differences in the methodologies used in the studies, it was concluded that the sealers with the best antimicrobial activity were (in ascending order): Endofill, Ketac Endo, Sealapex, AH Plus, Endo CPM Sealer, Sealer 26 and Epiphany. Activ GP still needs scientific research to evaluate this property.

Influência do hipoclorito de sódio no processo de reparo de dentes de cães tratados em sessão única

Introdução: a eliminação de bactérias dos canais radiculares é essencial no tratamento endodôntico de dentes com polpas necrosadas, desde que bactérias não só causam, mas também mantêm, as lesões periapicais. Objetivo: analisar in vivo a influência de soluções irrigantes (NaOCl 1%, NaOCl 2,5%, solução salina estéril 0,9%) no tratamento de dentes de cães com lesão periapical crônica em sessão única. Métodos: quarenta canais radiculares de três cães da raça Beagle permaneceram expostos à cavidade bucal para permitir a contaminação e a formação de lesões periapicais crônicas. Em seguida, os canais radiculares foram preparados biomecanicamente. Durante a instrumentação, três soluções irrigantes foram utilizadas: G1 – NaOCl 2,5%; G2 – NaOCl 1%; G3 – solução salina estéril 0,9%. O grupo controle (G4) não recebeu tratamento nem selamento coronário. Os canais radiculares foram obturados com cones de guta-percha e Sealapex. As aberturas coronárias foram seladas com IRM e amálgama. Após 6 meses, os animais foram sacrificados e blocos de tecido processados histologicamente para serem corados com hematoxilina e eosina, ou Brown e Brenn. Resultados: não houve diferença histológica significativa entre a utilização de hipoclorito de sódio a 1% ou 2,5% (p>0,05), mas houve entre eles e a solução salina estéril a 0,9% (p<0,05). Conclusão: concluiu-se que o uso de soluções irrigantes com potencial antibacteriano (hipoclorito de sódio a 1% e 2,5%) proveu condições mais favoráveis ao processo de reparo.