Improvement on oral health related quality of life after orthosurgical treatment: a mixed methods study

Abstract The aim of this study was to understand the influence of orthosurgical treatment on oral health-related quality of life (OHRQoL) in patients with Class II and III skeletal malocclusion by conducting a mixed method case series study. Nineteen patients submitted to orthosurgical treatment in a private practice in Brazil were included in the sample. Data were collected retrospectively and interviews were held from March 2020 to July 2021. Patients answered to the Oral Health Impact Profile (OHIP-14) in the first part of the interview and subsequently answered the qualitative questions. The overall mean of OHIP-14 after treatment was 4.21 (SD 4.68). The qualitative data were analyzed according to thematic analysis and four themes emerged from the interviews: a) concept of quality of life, b) pre-treatment life, c) post-treatment life, and d) positive and negative aspects of treatment. Quality of Life was reported by the patients as the absence of feeling pain, having emotional and physical health, having a satisfactory esthetic appearance and self-esteem. Before treatment, most Class II patients used to complain about breathing and sleeping problems, while Class III patients complained more intensely about esthetics. Pain was a common problem reported by both Class II and Class III patients. In general, improvement was perceived in self-esteem, esthetics, function and pain. Complaints about negative aspects of the treatment were restricted to the postoperative period. The orthosurgical treatment was important for improving the OHRQoL of patients in terms of esthetic, functional and psychosocial aspects.

Remoção de obturações endodônticas de Endosequence BC/CPoint em canais radiculares curvos usando instrumentos rotatórios ou reciprocantes / Removal of Endosequence BC/CPoint endodontic fillings in curved root canals using rotary or reciprocating instruments

Objetivo: O presente estudo usou micro-CT para avaliar a quantidade de material obturador remanescente em canais radiculares curvos que tinham sido obturados com cimento Endosequence BC/Cpoint ou com cimento AH/ guta-percha, depois do retratamento utilizando instrumentos rotatórios ou reciprocantes. Métodos: Sessenta canais mesiovestibulares de molares superiores foram instrumentados até MTwo #35.04. As amostras foram randomicamente alocadas em quatro grupos (n=15): os canais do G1 e G2 foram obturados com AH/guta-percha, e os canais do G3 e G4 foram obturados com BC/Cpoint. O material obturador foi removido usando instrumentos rotatórios ou reciprocantes ­ G1 e G3: R25 Reciproc + reinstrumentação com R40; e G2 e G4: Sistema ProTaper Universal Retratamento + reinstrumentação com MTwo 40.06. Micro-CTs foram usadas para medir a quantidade de material obturador remanescente (mm3 ) para o canal inteiro e para cada terço, em dois momentos: 1) após a remoção do material obturador; e 2) após a reinstrumentação. Resultados: Após a remoção do material obturador, BC/CPoint permaneceu mais dentro do canal do que AH/guta-percha quando o canal inteiro (29,92% x 19,25%, p=0,0290) e o terço apical foram analisados. Após a reinstrumentação, BC/CPoint permaneceu mais do que AH/guta-percha somente no terço apical. Protocolos de tratamento com instrumentos rotatórios ou reciprocantes removeram material obturador sem diferença para AH/guta-percha (G1 e G2: p> 0,05) e BC/CPoint (G3 e G4: p> 0,05). Conclusões: BC/Cpoint é mais difícil de ser removido de canais radiculares curvos do que AH/guta-percha. Instrumentos rotatórios e reciprocantes têm habilidade similar na remoção de material obturador (AU).

Objective: This study used micro-CT to evaluate the amount of remaining filling material in curved root canals obturated with Endosequence BC Sealer/Cpoint or AH/gutta-percha after a rotary or reciprocating retreatment. Methods: Sixty mesiobuccal canals of maxillary molars were instrumented up to MTwo #35.04. Samples were randomly assigned to four groups (n=15): canals from G1 and G2 were filled with AH/gutta-percha, and canals from G3 and G4 were filled with BC/Cpoint. Filling material was removed using rotary or reciprocating instruments: G1 and G3: R25 Reciproc + re-shaping with R40; and G2 and G4: ProTaper Universal Retreatment system + re-shaping with MTwo 40.06. Micro-CT was used to measure the remaining amount of filling material (mm3 ), for the whole canal, and for each third, in two moments: 1) after filling removal and 2) after canal re-shaping. Results: After filling removal, BC/CPoint remained more into the canal than AH/Gutta-percha when the whole canal (29.92% x 19.25%, p = 0.0290) and the apical third were analyzed. After re-shaping, BC/CPoint remained more than AH/Gutta-percha only in the apical third. Rotary or reciprocating retreatment protocols removed filling material without difference for AH/gutta-percha (G1 and G2: p > 0.05) and BC/CPoint (G3 and G4: p > 0.05). Conclusion: BC/Cpoint is more difficult to be removed from curved root canals than AH/gutta-percha. Reciprocating and rotary instruments have similar ability to remove filling material (AU).

Effect of blood contamination on the push-out bond strength of calcium silicate cements

Abstract This study investigated the effect of blood-contamination on the push-out bond strength of BiodentineTM (BD) and MTA Angelus® (MTA-A) to root dentin over time. Twenty-five teeth were sectioned horizontally to obtain 120 root slices. The lumens were filled with MTA-A or BD: 60 for each cement (30 uncontaminated and 30 blood contaminated). Push out bond strength to dentin was assessed at 24 h (n=10), 7 days (n=10) and 28 days (n=10). Failure modes were classified as: cohesive, adhesive or mixed failure. Two-way ANOVA was used to investigate the interaction between blood contamination vs. hydration period. Mann Whitney test compared different materials in each period, and it also compared the contaminated versus uncontaminated material for each period. Friedman, followed by Dunn`s test, compared periods of hydration for each material, regardless of blood contamination. Failure modes were reported descriptively. The interaction hydration period vs. blood contamination was highly significant for MTA-A (P=0.001) and it was not significant for BD (P=0.474). There were no differences between bond strength of uncontaminated and contaminated BD in any of the periods. Bond strength of uncontaminated MTA-A increased at each time of hydration; but it remained stable over time for blood-contaminated samples. BD had higher bond strength than MTA-A in all periods of hydration. Cohesive failure predominated. Only for MTA-A, the over time bond strength to dentin was affected by blood contamination.

Resumo Este estudo investigou o efeito da contaminação sanguínea na resistência de união do BiodentineTM (BD) e do MTA Angelus® (MTA-A) à dentina, em diferentes períodos. Vinte e cinco dentes foram seccionados para obter 120 fatias de dentina. Os lúmens das fatias foram preenchidos com MTA-A ou BD: 60 para cada cimento (30 não-contaminados e 30 contaminados com sangue). A resistência de união à dentina foi medida por teste push-out em 24 horas (n=10), 7 dias (n=10) e 28 dias (n=10). Os tipos de falha foram classificados como: falha coesiva, adesiva ou mista. Two-way ANOVA foi usado para investigar a interação entre contaminação sanguínea vs. período de hidratação. O teste de Mann Whitney comparou os diferentes materiais em cada período, e comparou as amostras contaminadas e não contaminadas de cada material em cada tempo. O teste de Friedman, seguido pelo teste de Dunn, comparou os períodos de hidratação de cada material, independentemente da contaminação. A análise estatística mostrou a interação entre contaminação sanguínea vs. período de hidratação. Os tipos de falha foram reportados de maneira descritiva. A interação entre contaminação sanguínea vs. período de hidratação foi altamente significativa para o MTA-A (P=0,001), e não foi significativa para o BD (P=0,474). Não houve diferenças entre a resistência de união entre o BD contaminado e não-contaminado independente do período. A resistência de união do MTA-A não-contaminado aumentou a cada tempo de hidratação; mas, permaneceu estável ao longo do tempo para as amostras contaminadas com sangue. BD obteve maior resistência de união que o MTA-A em todos os períodos de hidratação. Falhas coesivas predominaram. A contaminação ao longo do tempo influenciou a resistência de união no grupo MTA-A.