POSTOPERATIVE PAIN INCIDENCE AND INTENSITY FOLLOWING ROOT CANAL OBTURATION WITH BIOCERAMIC AND OTHER SEALERS: A SYSTEMATIC REVIEW WITH META-ANALYSIS

Aims: To investigate whether bioceramicsealers induce a lower incidence and intensity of postoperative pain compared to other sealers. Materials and Methods: Six electronic databases were searched for studies published up to April 2022, following the PICOS strategy: (P) adult patients undergoing root canal treatment or retreatment; (I) root canal filling using bioceramic sealer; (C) root canal filling using other types of sealers; (O) Primary: postoperative pain incidence and/or intensity; Secondary: number of medication intake; (S) randomizedclinical trials. Risk of bias assessment was performed with the revised Cochrane risk of bias tools for randomized trials (RoB 2). Overall certainty of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Results: Ten studies were included. Eight studies had a low risk of bias, and two had some concerns risk. Meta-analyses showed no differences regarding postoperative pain intensity and incidence between bioceramic sealers and AH Plus. Number of medication intake seemed to be associated to the preoperative diagnosis. Zinc oxide-eugenol sealer demonstrated an intense postoperative pain compared to bioceramic sealers and AH Plus. GRADE analysis showed a low certainty of evidence for all outcomes. Conclusions: There seem to be no differences between bioceramic sealers and AH Plus regarding postoperative pain intensity and incidence. Number of medication intake seem to be associated to the preoperative diagnosis. Zinc oxide-eugenol evoked a more pronounced postoperative pain.

Prognostic factors from squamous cell carcinoma of the hard palate, gingiva and upper alveolar ridge

Abstract: The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.

Evaluation of physicochemical properties of new calcium silicate-based sealer

Abstract This study aimed to evaluate the physicochemical properties of a calcium silicate-based sealer (Sealer Plus BC; MK Life, Porto Alegre, Brazil) compared with an epoxy-resin sealer (AH Plus; Dentsply DeTrey GmbH, Konstanz, Germany). Initial and final setting time was assessed based on ISO 6876:2012 and ASTM C266:03. Calcium ion release and pH were evaluated by filling polyethylene tubes with sealers and then immersing them in 10 mL of deionized water. Following experimental periods of 1, 24, 72 and 168 hours, the samples were measured regarding pH and calcium ion release with a pH meter and a colorimetric spectrophotometer, respectively. The flow was examined based on ISO 6876:2012. Rings of 10 mm in diameter with 1 mm thickness were prepared to analyze the radiopacity (ISO 6876:2012 and ADA n.57) and solubility (ISO 6876:2012). The data were analyzed by variance analysis, Student-T and Tukey tests (p<0.05). The calcium ion release and pH values were significantly higher for the Sealer Plus BC compared with the AH Plus (p<0.05). Lower setting time, flow and radiopacity were observed for the bioceramic sealer than for AH Plus (p<0.05). Sealer Plus BC exhibited higher solubility compared with AH Plus (p<0.05). Sealer Plus BC showed physicochemical properties as setting time, pH, calcium release, flow, and radiopacity following the required standards, but higher solubility than the minimum values required by ISO 6876:2012.

Resumo Este estudo teve por objetivo avaliar as propriedades físico-químicas de um cimento à base de silicato de cálcio (Sealer Plus BC MK Life, Porto Alegre, Brasil) e compará-las a um cimento à base de resina epóxica (AH Plus, Dentsply DeTrey GmbH, Konstanz, Alemanha). Tempo de presa inicial e final foram avaliados com base na ISO 6876:2012 e ASTM C266:03. Liberação de íons cálcio e pH foram avaliados após o preenchimento de tubos de polietileno com os cimentos e imersão em 10 mL de água deionizada. Após os tempos experimentais de 1,24,72 e 168 horas, os valores de pH e liberação de íons cálcio foram mensurados utilizando um medidor de pH e um espectofotômetro colorimétrico, respectivamente. Escoamento foi avaliado com base na ISO 6876:2012. Moldes de 10 mm de diâmetro e 1 mm de espessura foram preparados para análise de radiopacidade (ISO 6876:2012 e ADA n.57), solubilidade (ISO 6876:2012). Os dados foram analisados por análise de variância, teste T de Student e teste de Tukey (p<0,05). A liberação de íons cálcio e os valores de pH foram significativamente maiores para o Sealer Plus BC em comparação com o AH Plus (p<0,05). Menores valores de tempo de presa, escoamento e radiopacidade foram observados para o cimento biocerâmico quando comparados com o AH Plus (p<0,05). Sealer Plus BC apresentou propriedades físico-químicas de tempo de presa, pH, liberação de íons cálcio, escoamento, radiopacidade de acordo com as normas exigidas, porém maior solubilidade que aquelas previstas pela ISO 6876:2012.

Microbiological analysis of absorbent paper points employed by undergraduate students from a dental school in south of Brazil

Aim: The aim of this study was identify contamination on absorbent paper points used by students of Dental Clinic III of the Faculty of Dentistry of Federal University of Rio Grande do Sul in the semester 2015/1, in order to warn students and professionals of the area on the importance to sterilize these materials. Material and Methods: In a clinical environment, 180 absorbent paper points we collected (80 of them from the first series and 80 from the second one), from 40 students. After the collection, each one was singly immersed in a microtube containing 1.5 ml of the BHI (Brain Heart Infusion) culture. Positive control was composed by one paper point contaminated by saliva, and negative control was composed by a closed microtube, only with BHI. The microtubes were incubated at 37ºC in bacteriological incubator during 14 days. The microtubes that presented turbidity were considered positive, and those which did not present turbidity were considered negative. Results: The results were analyzed by the Fisher Exact Test, which demonstrated that paper points from the second series presented higher agreement contamination between the paper points collected from each box, when compared to the analyzed boxes from the first series (p=0.03). All the samples observed presented growth of Bacillus spp in the microorganism identification. Conclusions: It is possible conclude that absorbing paper points, when exposed to clinical environment suffer contamination, and the autoclave sterilization is necessary before the use, regardless the commercial brand, in order to ensure the aseptic chain maintenance.

Evaluation of the in vitro antimicrobial activity of alcoholic solution and aqueous extract of bee propolis against enterococcus faecalis

AIM: The purpose of this study was to analyze the in vitro antimicrobial activity of aqueous and alcoholic extracts of propolis at 1% and 3% concentrations against Enterococcus faecalis (ATCC® 19433). MATERIAL AND METHODS: Initially, the microbial suspension was seeded in a Brain Heart Infusion Agar (BHIA) culture medium, distributed in 20 Petri dishes. Then, 4 soaked filter paper discs were placed on the surface of the inoculated medium of each plate for 1 minute in 1 mL of the following substances: C+ (positive control, n=20): 2% chlorhexidine gel; C- (negative control, n=20): saline solution; S1 (n=10): 1% bee propolis alcoholic solution; S2 (n=10): 3% bee propolis alcoholic solution; E1 (n=10): 1% aqueous propolis extract; E2 (n=10): 3% aqueous propolis extract. One filter paper disc of each (C+, C-, S1 and S2) was placed in a set of 10 Petri dishes, whereas one filter paper disc of each (C+, C-, E1 and E2) was placed in the other set of 10 Petri dishes. RESULTS: The results obtained after incubation at 37°C for 24 hours under microaerobic conditions revealed that S2 showed higher mean levels of microbial growth inhibition as compared to E1, E2 and S1. There were no significantly statically differences between the groups, except for the S2 group and C- group. Mean levels in all other groups were lower than in the C+ group. CONCLUSION: The study concluded that 1% and 3% bee propolis alcoholic solution had lower antibacterial activity against Enterococcus faecalis as compared to 2% chlorhexidine gel.