Análise da penetrabilidade de duas substâncias irrigadoras: estudo em canais simulados

O objetivo do estudo foi verificar ex vivo a penetração de duas substâncias irrigantes hipoclorito de sódio 5% e Chlor-Xtra (Vista Dental Products, Racine, WI) através da adição de corante em canais simulados de dentes clarificados. Sessenta caninos inferiores unirradiculares humanos foram utilizados. As raízes foram seccionados em 16mm e instrumentadas com limas rotatórias do sistema Protaper até a F2 no comprimento de trabalho de 15mm. As amostras foram submetidas ao processo de clarificação para ficarem transparentes e durante o processo foram criados os canais simulados no terço apical. As raízes foram divididas aleatoriamente em três grupos ( NaOCl 5%, Chlor-Xtra e água) contendo 20 espécime por grupo. As amostras foram irrigadas com 1,5mL de solução contraste( tinta chinesa junto com a solução irrigante do respectivo grupo). E cada amostra foi fotografada e analisada. Os dados foram analisados estatisticamente pelos testes Kruskal-Wallis e Student-Neuman-Keuls. Não houve diferença estatística entre as substâncias irrigantes testadas (p>0,05). A partir da análise dos dados, foi possível concluir que apesar da presença de agentes surfactantes na solução irrigante de Chlor-Xtra não houve uma melhor penetrabilidade nos canais simulados em comparação ao hipoclorito de sódio(NaOCl).

Avaliação microtomográfica de canais mesiais de molares inferiores preparados com sistemas rotatórios e reciprocantes

O objetivo do presente trabalho foi avaliar, em microtomografia computadorizada (CT), o preparo de canais de molares inferiores com diferentes sistemas acionados a motor. Foram selecionadas 58 raízes mesiais patentes, de diâmetro anatômico correspondente a #10. Para a avaliação em TC, um anel de aço inoxidável foi confeccionado nos moldes do suporte para amostra do microtomógrafo, para que servisse de fôrma para a inclusão das raízes em resina Duralay, a fim de padronizar a posição do espécime no escaneamento inicial e final. Os canais foram preparados com os sistemas Reciproc R25 (n=16); WaveOne Primary File (n=16); Twisted File (n=14), e HyFlex (n=12). Após serem escaneados, foram reconstruídos tridimensionalmente e avaliados quantitativamente quanto à variação de volume (mm3), área de superfície (mm2) e structure model index (SMI). Foi, ainda, realizada a avaliação qualitativa das seções transversais por terço e por quadrante (MV, ML, DV, DL), sendo avaliado o toque de paredes. Os dados paramétricos foram analisados estatisticamente pelos testes ANOVA e t para amostras pareadas (α=5%). Não foi observada diferença estatística nos parâmetros quantitativos avaliados para Reciproc (142,77 76,75; 42,22 19,22; e 14,68 17,69, respectivamente); WaveOne (105,09 64,82; 29,54 19,21; 14,81 9,10, respectivamente); Twisted File (111,83 43,09; 33,31 18,40; 9,16 6,57, respectivamente), e HyFlex (151,74 149,37; 43,08 41,44; 10,80 8,52, respectivamente) (p=0,423). Dentro de cada grupo, foi observada diferença significante entre os resultados pré e pós-operatórios. O teste não paramétrico de Kruskal Wallis foi aplicado para a avaliação relativa ao toque de paredes. Foi observado que o sistema HyFlex apresentou a maior porcentagem de toques (82,3 13,1), seguido por Reciproc (81,3 16,9), Twisted File (78,3 14,4) e, por fim, WaveOne (76,9 21,7) (p>0,05). Em relação aos terços não foi observada diferença significativa (p=0,424). Os resultados da avaliação dos quadrantes intergrupo não demonstraram diferenças, porém indicaram tendência do preparo em direção à parede distal no terço cervical. Ao final, pôde-se concluir que os sistemas testados se equivalem quanto ao preparo de canais mesiais de molares inferiores; porém, nenhuma das técnicas foi capaz de tocar completamente em todas as paredes do canal radicular.

中国北方表沙无机碳储量及次生碳酸盐固碳潜力研究

This paper selected the Taklamakan Desert and the Badain Jaran Desert as the research areas, tested the carbonate content of surface-sand samples of dunes using Eijkelkamp carbonate goniophotometer, and analyzed the spatial-distribution characteristics of carbonate and estimated the carbonate-stock and secondary carbonate-stock in 1m depth of surface sand in the Taklamakan Desert and the Badain Jaran Desert. In addition, the paper test XRD, SEM, TDA, stable carbon isotope and radioactive strontium isotope of lacustrine deposits in the Taklamakan Desert and carbonates, such as kunkar, root canal, lacustrine deposits, sinter and calcrete, in the Badain Jaran Desert. Resting on the achievements by our predecessors, it analyzed the mineral-composition differences of the carbonates, calculated the contents of secondary carbonate and, furthermore, evaluated their potential of sequestration of CO2 in the atmosphere. The overall goal of this study was to increase our understanding of soil carbonate in the context of carbon sequestration in the arid region in China. That is, to advance our understanding about whether or not secondary carbonate in desert is a sink for atmospheric CO2. The following viewpoints were obtained: 1 Carbonate contents of surface-sand samples decend from the south to the north of the Taklamakan Desert. The minimum lies in the south and the maxmum in the mid. Carbonate content of surface-sand of megadunes in the Badain Jaran Desert has low value generally in the dune-crest and the base of slope, and large value in the mid. The average of Carbonate contents of all sorts of collected samples in the same area of the Taklamakan Desert has small diffetences. The average is about 9%. 2 Using carbonate contents as key parameters, calculate the carbon-stock of carbonates in 1m depth of surface sand in the Taklamakan Desert and the Badain Jaran Deser.They are 1.13Pg and 0.19 Pg respectively. There are 0.53Pg and 0.088Pg carbon-stock of secondary-carbonates in 1m depth of surface sand in the Taklamakan Desert and the Badain Jaran Desert. 3 Through testing data from XRD （X-ray diffraction）and TAD ( Thermal Analysis Data), the most significant conclusion derived from is that the main mineral ingredient is calcite in different carbonate substances in arid regions, From the SEM(Scanning electron microscopy ) images, can obtains the information about the micro environment of different carbonate forms in which they can grow. 4 Selected gas by termal cracking and traditional phosphoric acid method, their δ13C show that δ13C is a good parameter to indicate the micro environment in which different secondary carbonate forms. From the δ13C of the same type samples, if the redeposit degree is hard, theδ13C is light, the redeposit degree is weak, the δ13C is heave. and the δ13C of the different type samples, δ13C is mainly controlled by the micro environment in which secondary formed. if the procedure is characterized by redeposit and dissolve of marine facies carbonate, δ13C is heavy, it is characterized by CO2 which produced by plant respiration,δ13C is light. 5 From the δ13C of lacustrine deposit in the different grain size, there exsit certain differences in their micro environment and secondary degree among different grain size in the same grade. 6 The secondary carbonate content of lacustrine deposits in Taklimakan Desert is 47.26%. And those of root canal, sinter, calcrete, kunkar, lacustrine deposit and surface sand in Badain Jaran Desert are 91.74%, 78.46%, 76.26%, 87.87%, 85.37%and 46.49%, respectively. Of different grain size samples, the secondary carbonate contents of coarse fraction (20-63μm), sub-coarse fraction (5-20μm) and fine fraction (<5μm) are 80.10%, 47.2%and 50.07%, respectively. 7 There is no obvious relevance betweenδ13C of secondary carbonate and the content of secondary carbonate,theδ13C of secondary carbonate mainly reflects the parameters of secondary process, the content of secondary carbonate reflects difference of secondary degree.. 8 Silicates potentially supply 3.4 pencent calcium source during forming process of lacustrine deposits in Taklimakan Desert. If calcium source is mainly supplied by goundwater, it can be calculated that about 5.18 %, 6.13%, 5.68%, 5.64 % and 6.82% silicates supply calcium source respectively for root canal, kunkar, lacustrine deposit, calcrete and sinter, during the forming process of different kinds of carbonates in Badain Jaran Desert.

Enterococcus sp. considerações clínicas e microbiológicas em endodontia

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Endodontic 'Solutions'. Part 2:An audit comparing current practice in Belfast with UK and Republic of Ireland Dental Schools

Endodontic lubricants, irrigating solutions and medicaments help reduce the microbial load within root canals. Primary and secondary cases involve different microbes. Each'solution'or combinations thereof could play a significant role but no detailed guidelines exist on their use. An audit was undertaken to compare current practice in Belfast Dental School to the others across the UK and Republic of Ireland (ROI). This audit highlighted three main differences between Belfast and other dental schools. Many other institutions utilized other irrigants besides sodium hypochlorite (NaOCl), different intracanal medicaments, including calcium hydroxide, and higher concentrations of NaOCl. Having gathered this information, we ask, 'Is there sufficient evidence to change the endodontic regime currently used at Belfast Dental School?'. Using the findings from the literature review (Part 1), we introduce new evidence-based protocols for primary and secondary cases for use in Belfast Dental School. Clinical Relevance: In the absence of detailed clinical guidelines on the use of endodontic lubricants, irrigants and medicaments in primary and secondary cases, it is important to be aware of current practice in UK and ROI dental schools where dentists and specialists are trained.

Endodontic 'solutions' part 1:A literature review on the use of endodontic lubricants, irrigants and medicaments

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of 'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic 'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases. The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2.

The Restorability Assessment and Endodontic Access Cavity Interface

Successful root canal treatment requires management of the bacterial infection within the root canal space and protection of residual tooth structure with direct/indirect restorations. Long-term success depends upon prevention of re-infection of the root canal space as well as ensuring favorable distribution of the occlusal forces throughout the residual tooth structure. Appropriate planning and design of the final restoration prior to initiating root canal treatment is paramount in achieving this objective. This article describes simultaneous restorability assessment and access cavity preparation to optimize outcome of both endodontic and prosthodontic treatment of the endodontically involved tooth.

Citotoxicidade do ácido peracético: avaliação metabólica, estrutural e de morte em fibroblastos L929

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

Fatigue life assessment of endodontic instruments subjected to multi planar curvature

This present study aimed to investigate the fatigue life of unused (new) endodontic instruments made of NiTi with control memory by Coltene™ and subjected to the multi curvature of a mandibular first molar root canal. Additionally, the instrument‟s structural behaviour was analysed through non-linear finite element analysis (FEA). The fatigue life of twelve Hyflex™ CM files was assessed while were forced to adopt a stance with multiple radius of curvature, similar to the ones usually found in a mandibular first molar root canal; nine of them were subjected to Pecking motion, a relative movement of axial type. To achieve this, it was designed an experimental setup with the aim of timing the instruments until fracture while worked inside a stainless steel mandibular first molar model with relative axial motion to simulate the pecking motion. Additionally, the model‟s root canal multi-curvature was confirmed by radiography. The non-linear finite element analysis was conducted using the computer aided design software package SolidWorks™ Simulation, in order to define the imposed displacement required by the FEA, it was necessary to model an endodontic instrument with simplified geometry using SolidWorks™ and subsequently analyse the geometry of the root canal CAD model. The experimental results shown that the instruments subjected to pecking motion displayed higher fatigue life values and higher lengths of fractured tips than those with only rotational relative movement. The finite element non-linear analyses shown, for identical conditions, maximum values for the first principal stress lower than the yield strength of the material and those were located in similar positions to the instrument‟s fracture location determined by the experimental testing results.

Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs` teeth with apical periodontitis

Objective. The objective of this study was to evaluate in vivo the revascularization and the apical and periapical repair after endodontic treatment using 2 techniques for root canal disinfection (apical negative pressure irrigation versus apical positive pressure irrigation plus triantibiotic intracanal dressing) in immature dogs` teeth with apical periodontitis. Study design. Two test groups of canals with experimentally induced apical periodontitis were evaluated according to the disinfection technique: Group 1, apical negative pressure irrigation (EndoVac system), and Group 2, apical positive pressure irrigation (conventional irrigation) plus triantibiotic intracanal dressing. In Group 3 (positive control), periapical lesions were induced, but no endodontic treatment was done. Group 4 (negative control) was composed of sound teeth. The animals were killed after 90 days and the maxillas and mandibles were subjected to histological processing. The sections were stained with hematoxylin and eosin and Mallory Trichrome and examined under light microscopy. A description of the apical and periapical features was done and scores were attributed to the following histopathological parameters: newly formed mineralized apical tissue, periapical inflammatory infiltrate, apical periodontal ligament thickness, dentin resorption, and bone tissue resorption. Intergroup comparisons were done by the Kruskal-Wallis and Dunn`s tests (alpha = 0.05). Results. Although statistically significant difference was found only for the inflammatory infiltrate (P < .05), Group 1 presented more exuberant mineralized formations, more structured apical and periapical connective tissue, and a more advanced repair process than Group 2. Conclusion. From the histological observations, sodium hypochlorite irrigation with the EndoVac system can be considered as a promising disinfection protocol in immature teeth with apical periodontitis, suggesting that the use of intracanal antibiotics might not be necessary. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 779-787)

Cone-beam computerized tomographic, radiographic, and histologic evaluation of periapical repair in dogs` post-endodontic treatment

Objective. To evaluate the periapical repair after root canal treatment in the teeth of dogs using CT and conventional radiography and to compare these findings with the gold standard microscopic evaluation. Study design. The animals were divided into three groups according to endodontic treatment performed: Group 1, single-visit endodontic treatment in teeth without apical periodontitis; Group 2, single-visit endodontic treatment in teeth with apical periodontitis; and Group 3, endodontic treatment in teeth with apical periodontitis using calcium hydroxide as a root canal dressing. Group 4 consisted of teeth with apical periodontitis not submitted to root canal treatment and Group 5 consisted of healthy teeth without periapical disease. Radiographic, tomographic, and microscopic evaluations were performed by blind examiners. At 180 days experimental time, CT and radiographic measurements of periapical disease were compared with the gold standard microscopic measurement using intraclass correlation coefficient. Intergroup comparisons considering different methods of periapical lesions measurement or different clinical protocols of root canal treatment were performed by Kruskal Wallis test followed by Dunn. Integrity of lamina dura, presence of radiolucent areas, and presence of root resorption were analyzed by Fisher`s exact test. Results. There was discontinuity of the lamina dura and CPD in all teeth from Groups 2, 3, and 4 evaluated by tomography and radiography 45 days after CPD induction. Radiographically, 180 days after root canal treatment, there was no periapical lesion in teeth from Groups 1 and 3, different from groups 2 and 4 (p < .05). The highest reduction in the CPD size was observed on Group 3 (p < .05). According to the tomographic results, there was decrease of the size of the CPD on Group 3 but not on Groups 2 or 4. However, in all groups the periapical lesions presented larger mesio-distal extension if compared with radiography, both 45 days after CPD induction and 180 days after root canal treatment. At 180 days, CT measurements were closely related to microscopic results (ICC = 0.95) differently from radiographic evaluation (ICC = 0.86). Conclusion. CT Scan evaluation of periapical repair following root canal treatment provided similar information than that obtained by microscopic analysis, whereas radiographic evaluation underestimated the size do periapical lesion. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108:796-805)

High Matrix Metalloproteinase Activity Is a Hallmark of Periapical Granulomas

Introduction: The inability to distinguish periapical cysts from granulomas before performing root canal treatment leads to uncertainty in treatment outcomes because cysts have lower healing rates. Searching for differential expression of molecules within cysts or granulomas could provide information with regard to the identity of the lesion or suggest mechanistic differences that may form the basis for future therapeutic intervention. Thus, we investigated whether granulomas and cysts exhibit differential expression of extracellular matrix (ECM) molecules. Methods: Human periapical granulomas, periapical cysts, and healthy periodontal ligament tissues were used to investigate the differential expression of ECM molecules by microarray analysis. Because matrix metalloproteinases (MMP) showed the highest differential expression in the microarray analysis, MMPs were further examined by in situ zymography and immunohistochemistry. Data were analyzed by using one-way analysis of variance followed by the Tu-key test. Results: We observed that cysts and granulomas differentially expressed several ECM molecules, especially those from the MMP family. Compared with cysts, granulomas exhibited higher MMP enzymatic activity in areas stained for MMP-9. These areas were composed of polymorphonuclear cells (PMNs) in contrast to cysts. Similarly, MMP-13 was expressed by a greater number of cells in granulomas compared with cysts. Conclusion: Our findings indicate that high enzymatic MIMP activity in PMNs together with MMP-9 and MMP-13 stained cells could be a molecular signature of granulomas unlike periapical cysts. (J Endod 2009;35:1234-1242)

Ex Vivo Accuracy of an Apex Locator Using Digital Signal Processing in Primary Teeth

The purpose of this study was to evaluate ex vivo the accuracy an electronic apex locator during root canal length determination in primary molars. Methods: One calibrated examiner determined the root canal length in 15 primary molars (total=34 root canals) with different stages of root resorption. Root canal length was measured both visually, with the placement of a K-file 1 mm short of the apical foramen or the apical resorption bevel, and electronically using an electronic apex locator (Digital Signal Processing). Data were analyzed statistically using the intraclass correlation (ICC) test. Results: Comparing the actual and electronic root canal length measurements in the primary teeth showed a high correlation (ICC=0.95) Conclusions: The Digital Signal Processing apex locator is useful and accurate for apex foramen location during root canal length measurement in primary molars. (Pediatr Dent 200937:320-2) Received April 75, 2008 vertical bar Lost Revision August 21, 2008 vertical bar Revision Accepted August 22, 2008

Electronic working length determination in primary teeth by Propex and Digital Signal Processing

The purpose of this study was to evaluate the accuracy of electronic apex locators Digital Signal Processing (DSP) and ProPex, for root canal length determination in primary teeth. Fifteen primary molars (a total of 34 root canals) were divided into two groups: Group I - without physiological resorption (n = 16); and Group II - with physiological resorption (n = 18). The length of each canal was measured by introducing a file until its tip was visible and then it was retracted 1 mm. For electronic measurement, the devices were set to 1 mm short of the apical resorption. The data were analysed statistically using the intraclass correlation coefficient (ICC). Results showed that the ICC was high for both electronic apex locators in all situations - with (ICC: DSP = 0.82 and Propex = 0.89) or without resorption (ICC: DSP = 0.92 and Propex = 0.90). Both apex locators were extremely accurate in determining the working length in primary teeth, both with or without physiological resorption.

Inhibition of Sodium Hypochlorite Antimicrobial Activity in the Presence of Bovine Serum Albumin

Introduction: This study investigated the inhibition of the antimicrobial activity of sodium hypochlorite (NaOCl) by bovine serum albumin (BSA). The killing of Enterococcus faecalis, Candida albicans, Staphylococcus epidermidis, and Escherichia coil by NaOCl in concentrations from 2% to 0.03% was measured in the presence of BSA in concentrations between 6.7% and 0.1%. Methods: NaOCl, BSA, and microorganism suspensions were mixed, and, after 30 seconds, 6 minutes, and 30 minutes, samples were taken and NaOCl was inactivated by 5% sodium thiosulphate. The microbes were incubated in tryptic soy broth broth for up to 7 days for the detection of growth. Results: All microorganisms were killed within 30 seconds by 0.03% NaOCl when BSA was not present. High concentrations of BSA significantly reduced the antimicrobial activity of NaOCl against the four species. Conclusions: The inhibition of sodium hypochlorite by BSA was directly dependent on their quantitative relationships. The result partly explains the poorer performance in vivo of NaOCl as compared to in vitro experiments. (J Endod 2010;36:268-271)