Endodontic treatment during COVID-19 pandemic - Economic perception of dental professionals

Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pandemic on the clinical routine and inspection by the competent authorities, on the flow of patients in the office, as well as on possible changes in Endodontic treatment costs and the amounts charged to patients. Methods: This cross-sectional study was conducted from May 2nd, 2020 to May 6th, 2020, using an online questionnaire with a convenience sample. The inclusion criterion was professionals who perform endodontic treatments in daily clinical practice and who professional setting is private practice. The questionnaire brought questions about the impact on costs and the amount charged to the patient. Results: A total of 1042 questionnaires were answered from all the different states of Brazil, by professional who usually perform Endodontic treatment, and who is working in private practice. A total of 1010 (96.9%) respondents affirm it was necessary to modify the protective equipment in endodontic treatment due to pandemic and longer intervals between appointments was cited by 922 (88.5%), economically affecting the dental practice. There was no association between routine changes and economic impacts with gender, professional experience, area of residence or education level. Conclusion: In conclusion, most dental professionals recognized changes in the routine of endodontic treatment during the COVID-19 pandemic. They have a perception of increase in endodontic costs, and reduction in the volume of patients

Identificação de corpo macerado por meio de fotografias intraorais exigidas por um plano de saúde odontológico: relato de caso pericial / Identification of macerated body by means of intraoral photographs required by a dental health plan: forensic case report

Introdução: Diante de casos de identificação humana, vários são os registros odontológicos que podem ser utilizados a fim de possibilitar a comparação Post-mortem para identificação. Objetivo: Por meio de um relato de caso pericial, demonstrar a possibilidade da identificação odontolegal a partir de registros odontológicos exigidos por plano de saúde. Relato do Caso: Em 2020, um cadáver do sexo masculino, com uma suspeita de identidade, chegou a um Instituto Oficial de Perícias do Nordeste brasileiro, em estado avançado de decomposição, com características do fenômeno de maceração. A família forneceu, após contato com o dentista do indivíduo, imagens do sistema de um plano odontológico no qual era beneficiário e exigia fotografias para auditoria e consequente liberação de tratamentos odontológicos. Após a disponibilização com poucas horas da descoberta do corpo, prosseguiu-se com o confronto dos dados Ante-mortem (AM) e Post-mortem (PM) para identificação odontolegal. Na ausência de pontos divergentes e havendo congruências relativas quanto ao formato da arcada, tratamentos odontológicos, presença e ausências dentárias, forma e posições dentárias, lesões de cárie, foi possível associar a identidade da vítima desaparecida ao corpo examinado. Conclusão: O caso evidencia a confiabilidade, rapidez e baixo custo do processo de identificação odontolegal por meio do confronto de características individualizadoras AM e PM, que só foi possível pela exigência de imagens intraorais pelo plano odontológico da vítima.

Introduction: In cases of human identification, various dental records can be used in order to help in the comparison of postmortem evidence. Objective: The aim of this study was to demonstrate by the forensic report that dental records, which are required by health insurance, could be utilized to obtain a positive identification of an individual. Case report: In 2020, the body of a male individual was referred to the Official Forensic Institute of Northeast Brazil, his body arrived in advanced stage of decomposition and shows signs of maceration. After contact the dentist of the individual, the family provide his teeth images from dental insurance plan that using them to authorize any dental treatment and for audit purposes. Afterwards the identification was made matching ante-mortem (AM) and post-mortem (PM) data. There are no irreconcilable discrepancies and the available data achieve a positive identification then the body examined matched with the missing victim. Conclusion: The case shows the reliability, rapid and cost-effective identification process through comparing AM data to PM evidences. This has only been possible due to the requirement for intraoral images by the victim's dental insurance plan

Estudo ex vivo da elevação do pH em superfície radicular externa após agitação ultrassônica de diferentes pastas de hidróxido de cálcio / Assessment of pH increase in the external root surface after ultrasonic agitation of different calcium hydroxide pastes: Ex vivo study

Objetivo: O presente estudo teve por objetivo avaliar, ex vivo, a capacidade de elevação do pH da superfície radicular externa de diferentes pastas de hidróxido de cálcio (HC) utilizadas como medicação intracanal, além da influência da ativação ultrassônica (AUS) durante aplicação no interior do canal radicular. Métodos: Foram utilizados 100 incisivos humanos superiores unirradiculares, que tiveram os canais radiculares modelados e divididos aleatoriamente em seis grupos experimentais (n=15), de acordo com a pasta de HC, tendo como variáveis as medicações utilizadas e a ativação da pasta com AUS no momento da aplicação, além de um grupo controle (n=10): Pasta Calen; HC+clorexidina 2% gel (CX2%); e HC + água destilada. Os dentes foram mantidos imersos em água deionizada e as medidas do pH, verificadas nos períodos de 7, 14, 21 e 28 dias, com auxílio de pHmetro. Resultados: De acordo com os dados obtidos, verificou-se elevação do pH nos períodos de 7 e 14 dias em todos os grupos. Apenas os grupos em que foi utilizada a associação do HC com CX2% apresentou evolução com aumento significativo do pH ao longo dos períodos analisados (p<0,05). A ativação das pastas com AUS proporcionou incremento significativo dos valores de pH (p<0,05). Conclusão: De acordo com a metodologia empregada, pode-se concluir que todas as pastas utilizadas promovem elevação do pH no tecido dentinário, e a ativação das pastas com AUS influencia significativamente na elevação do pH no tecido dentinário (AU).

Objective: The aim of the present study was to evaluate, ex-vivo, the pH elevation capacity on the external root surface of different calcium hydroxide (HC) pastes, utilized as intracanal medication, it was also evaluated the influence of the ultrasonic activation at the application within the root canal. Methods: 100 human single root superior incisors were used, which had their root canals shaped and randomly divided into 6 experimental groups (n=15) according to the following HC pastes: Calen; HC + Chlorhex- idine 2% gel (CX2%); HC + distilled water, utilizing the medications and the ultrasonic activation of the paste at the time of the application as variables and 1 control group (n=10). The teeth were kept immersed in deionized water and the pH parameters were verified in 7, 14, 21 and 28 days with a pH measurement machine. Results: According to the data obtained, pH was elevated in the first week in all groups. Only the groups which the association of HC with CX2% was made, did show a significant increase in the pH level over the analyzed periods (p < 0,05). The activation of the pastes with US provided a significant increase in pH values (p < 0,05). Conclusion: According to the methodology used, we can conclude that all the HC pastes used, promote pH elevation in dentin tissue. And the acti- vation of the pastes with US significantly influences the pH increase in dentin tissue

Fatores preditivos do sucesso en dodôntico em tratamentos realizados por alunos de graduação§ / Predictive factors of endodontic success in treatments performed by undergraduate / Factores predictivos del éxito endodontico en tratamientos realizados por un estudiante

Resumo Introdução e objetivo: Ainda são escassos os estudos que avaliam com exatidão o sucesso do tratamento e retratamento endodônticos e quais as falhas que realmente impactam no desfecho dos mesmos. Determinar o índice e os fatores preditivos para o sucesso de tratamentos e retratamentos endodônticos, realizados por alunos de graduação com o mesmo nível de aprendizado. Materiais e métodos: Foram verificados os registros de proservação, com pelo menos 12 meses, dos tratamentos endodônticos realizados na Faculdade de Odontologia de Pelotas, analisando o sucesso ou o fracasso endodôntico, de acordo com critérios clínicos e radiográficos. As variáveis preditivas no resultado do sucesso do tratamento foram: dente, número de canais, coroa dentária, sintomas, diagnóstico da polpa e índice periapical radiográfico. As variáveis relacionadas ao tratamento foram: técnica de instrumentação, número de sessões e limite de instrumentação apical. Resultados: 136 tratamentos endodônticos foram realizados com um acompanhamento de, pelo menos, 12 meses. A avaliação mostrou que o sucesso endodôntico foi influenciado pelo número de sessões (P = 0,015), diagnóstico inicial e grupo dentário (P= 0.014). Também foi possível observar que, quanto maior o índice periapical radiográfico inicial, pior o prognóstico endodôntico (P < 0.001). Conclusão: O índice de sucesso do tratamento endodôntico foi de 96.7% para casos de polpa vital, 87.5% para os casos de necrose pulpar e 92.9% em retratamentos. Estes índices foram influenciados pelo dente tratado, diagnóstico inicial, índice periapical radiográfico inicial e pelo número de sessões utilizadas no tratamento.

Abstract Introduction and objective: There are still few studies that accurately address endodontic success and which failures actually impact the endodontic treatment outcome. Determine success rate and predictive factors for successful endodontic treatment and retreatment by undergraduate students of the same learning level. Materials and methods: The preservation records (12 months) of the endodontic treatments performed in the Faculty of Dentistry of Pelotas were verified, indicating the success or failure of the treatment. Predictive variables in the outcome of successful endodontic treatment or retreatment were: tooth, number of channels, dental crown, symptoms, pulp diagnosis, radiographic periapical index. The treatmentrelated variables were: instrumentation technique, number of sessions and apical instrumentation limit. Results: 136 endodontic treatments were performed with a follow-up of at least 12 months. The evaluation showed that endodontic success was influenced by the number of sessions (P = 0.015), initial diagnosis and dental group (P = 0.014). It was also observed that the higher the initial radiographic periapical index, the worse the endodontic prognosis (P < 0.001). Conclusion: The success rate of endodontic treatment was 96.7% for cases of vital pulp, 87.5% for cases of pulp necrosis and 92.9% for retreatments. These indices were influenced by type tooth, initial diagnosis, initial radiographic periapical index and the number of visits used in the treatment.

Resumen Introducción y objetivo: Todavía hay pocos estudios que aborden con precisión el éxito endodóntico y cuáles fracasos realmente impactan el resultado del tratamiento endodóntico. Determinar la tasa de éxito y los factores predictivos para el tratamiento y el retratamiento exitoso de endodoncia por estudiantes universitarios del mismo nivel de aprendizaje. Materiales y métodos: Se verificaron los registros de conservación (12 meses) de los tratamientos de endodoncia realizados en la Facultad de Odontología de Pelotas, lo que indica el éxito o el fracaso del tratamiento. Las variables predictivas en el resultado de un tratamiento o retratamiento endodóntico exitoso fueron: diente, número de canales, corona dental, síntomas, diagnóstico pulpar, índice periapical radiográfico. Las variables relacionadas con el tratamiento fueron: técnica de instrumentación, número de sesiones y límite de instrumentación apical. Resultados: se realizaron 136 tratamientos de endodoncia con un seguimiento de al menos 12 meses. La evaluación mostró que el éxito endodóntico estaba influenciado por el número de sesiones (P = 0.015), el diagnóstico inicial y el grupo dental (P = 0.014). También se observó que cuanto mayor es el índice periapical radiográfico inicial, peor es el pronóstico endodóntico (P <0.001). Conclusión: La tasa de éxito del tratamiento endodóntico fue del 96.7% para casos de pulpa vital, 87.5% para casos de necrosis pulpar y 92.9% para retratamientos. Estos índices fueron influenciados por el tipo de diente, el diagnóstico inicial, el índice periapical radiográfico inicial y el número de visitas utilizadas en el tratamiento.

Fatores etiológicos e prevalência de lesões bucofaciais em surfistas de Fortaleza

RESUMO O estudo investigou fatores etiológicos e prevalência de lesões bucofaciais em surfistas profissionais e amadores em Fortaleza, Ceará. Aplicou-se um questionário em 150 surfistas homens e usaram-se testes estatísticos (qui-quadrado e teste t de Student) com nível de significância p < 0,05. Em 56% encontrou-se alguma lesão bucofacial. Queimaduras de lábio e de face, laceração de mucosa e fratura dentária foram as mais prevalentes. Comparando surfistas competidores com não competidores houve significância entre ocorrência de lesões com fundo de rocha (p = 0,032) e com prancha (p = 0,003) e maior presença de lesões entre os competidores (p = 0,003). Conclui-se que fraturas dentárias e queimaduras facial e labial são prevalentes em surfistas e que há mais chances de ocorrência de lesões quanto maiores forem a idade e o tempo de prática.

ABSTRACT The study investigated etiological factors and the prevalence of orofacial lesions in surfers professionals and amateurs in Fortaleza, Brazil. A questionnaire was applied to 150 male surfers and statistical tests (Chi-square and Student t) were used with significance level p <0.05. In 56%, there was some orofacial lesion. Lip and face burns, mucosal laceration and dental fracture were the most prevalent. Comparing competitive surfers with non-competitors there was significance between the occurrence of rock bottom injuries (p=0.032) and surfboard (p=0.003) and greater presence of injuries among competitors (p=0.003). It is concluded that dental fractures and facial and lip burns are prevalent in surfers and that there is a greater chance of occurrence of injuries the greater the age and the time of practice of them.

RESUMEN El estudio investigó factores etiológicos y prevalencia de lesiones bucofaciales en surfistas profesionales y aficionados en Fortaleza, Ceará. Se aplicó un cuestionario en 150 surfistas de sexo masculino y se utilizaron pruebas estadísticas (chi cuadrada y prueba de la t de Student) con un nivel de relevancia estadística de p <0,05. En el 56% se encontró alguna lesión bucofacial. Las más frecuentes fueron quemaduras del labio y de la cara, laceración de mucosa y fractura dental. Al comparar a surfistas competidores con otros no competidores hubo relevancia entre lesiones producidas por el fondo (p = 0,032) y por la tabla (p = 0,003), y mayor existencia de lesiones entre competidores (p = 0,003). Se concluye que las fracturas dentales y las quemaduras facial y labial son frecuentes en surfistas y hay más probabilidad de que se produzcan lesiones cuanto mayor es la edad y el tiempo de práctica.

Prevalência de dois canais em incisivos inferiores permanentes humanos / Prevalence of two root canal in humans permanent lower incisors

Introdução e objetivo: O sucesso do tratamento endodôntico requer um amplo conhecimento da anatomia do dente e de suas variações. Assim, o presente estudo teve como objetivo avaliar através das imagens radiográficas a prevalência de dois canais em incisivos inferiores permanentes humanos, determinando com isso o local de união desses canais. Material e métodos: Utilizou-se 100 dentes incisivos inferiores permanentes humanos. Inicialmente, em cada dente obteve-se um corte transversal na junção cemento-esmalte, logo após, realizou-se avaliação radiográfica em todos os dentes, visando identificar a presença ou não de dois canais. Posteriormente, identificou-se o local de bifurcação dos dentes com dois canais, através de radiografias. Resultado: Observou-se no exame radiográfico que 28% dos espécimes (28 dentes) examinados possuíam dois canais. Destes, 85,7% dos espécimes (23 dentes) apresentaram canais com união no terço apical, 7,1% dos espécimes (3 dentes) tinham canais independentes, 3,6% dos espécimes (1 dente) possuíam canais com união no terço médio e nenhum apresentava união dos canais no terço cervical. Em um dos dentes estudados (3,6%), não foi possível fazer essa avaliação. Conclusão: Conclui-se que a prevalência de dois canais em incisivos inferiores permanentes humanos foi de 28% dos espécimes, sendo que o principal local de união é o terço apical (85,7%).

Introduction and Objective: The success of endodontic treatment requires a comprehensive knowledge of tooth anatomy and its variations. So, this study aimed to evaluate the prevalence of two root canals in human permanent lower incisors, determining the place of union of these root canals. Materials and methods: A hundred human mandibular incisors were used. First, a cement-enamel cross section was obtained in each tooth, after that radiographic evaluation was performed in all the teeth in order to identify the presence or not of two root canals. Subsequently, the location of the bifurcation of two root canals teeth was identified through radiography. Results: It was observed through radiographic examination that 28% of the specimens (28 teeth) examined had two root canals. 85.7% of these specimens (23 teeth) presented union in the apical third, 7.1% of the specimens (3 teeth) had independent canals, 3.6% of the specimens (1 tooth) had canals with the union in the third medium and none of them presented union in the cervical third. In one of the teeth studied (3.6%), it was not possible to make this assessment. Conclusion: It was concluded that the prevalence of two root canal in human permanent lower incisors was of 28%, and that most unions occurred is the apical third (85.7%).

In vitro effectiveness evaluation of different substances in decontamination of intracanal metallic

Introduction: The intracanal metallic post, for many years, was the most used intracanal retainer and the best choice to restore endodontically treated teeth, showing until today high rates of success scientifically proven, good adaptation at the configuration of the root canal and resistance. Objective: The purpose of this study was to evaluate the effectiveness of some chemical substances in the decontamination of these intracanal metallic posts. Material and methods: Twenty intracanal metallic posts were divided into 6 experimental groups and 1 control group with 3 specimens each. The groups were divided into G1 (apple cider vinegar), G2 (0.12% chlorhexidine liquid), G3 (2% chlorhexidine gel), G4 (70° ethyl alcohol), G5 (2.5% sodium hypochlorite), and G6 (2% glutaraldehyde). For the control group was used saline solution. Each intracanal metallic post was submerged in your respective substance for 3 minutes and subjected to a smear dried sterile gauze. Immediately after this procedure the specimens were individually placed into tubes containing culture medium broth Brain Heart Infusion (BHI). The set of tubes containing the intracanal metallic post submerged in BHI were taken to the dry out machine and kept there at 37ºC for 48 hours. Results: The tubes that showed turbidity of BHI broth were considered positive, or contaminated. Conclusion: The methodology used in this study showed that all the disinfectants substances utilized were effective in decontaminating of the metallic post.

Investigation of medicines with potential xerostomic effect used in institutionalized elderly

Introduction: Several factors affect the salivary flow and cause xerostomia, i.e. aging, diets, radiation, various pathologies and the use of drugs. Objective: This study aimed to investigate drugs with potential xerostomic effect in institutionalized elderly patients. Material and methods: 235 elderly were investigated, of both sexes, of which 123 were women (52.3%) and 112 (47.7%) were men. In addition to the gender and age, the use of medications containing side effects of xerostomia/dry mouth/ hyposalivation or hyposialia was investigated. Such drugs were separated according to their medical area of expertise: Cardiology, Gastroenterology, Allergy, Neurology and pulmonology Results: When investigated the amount of drugs used for female patients, it was observed that 83 (67.5%) used up to five drugs, 35 (28.4%) between 6 and 10 and medicines, and 5 (4.1%) more than 10 drugs. When analyzed the amount of drugs used for male patients, it was observed that 88(78.6%) used up to five drugs, 17 (15.2%) were between 6 and 10 7 medicines, and (6.2%) more than 10 drugs. By analyzing the drugs with xerostomic potential, we found 354 medicines. Among these, 181 (51.1%) were used in Neurology, 45 (12.7%) had been prescribed in Cardiology, 33 (9.2%) were used drugs for allergic conditions, 80 (22.3%) were prescribed in gastroenterology and 15 (4.3%) in pulmonology. Conclusion: It can be concluded that many medications used to treat institutionalized elderly had xerostomic potential effect, notably those used in Neurology. Polypharmacy is also present, especially in the older age group.

Tratamento não-cirúrgico de lesões periapicais extensas / Non-surgical treatment of large periapical lesions

Introdução: lesões periapicais extensas associadas a dentes desvitalizados são tratadas por meio de tratamento endodôntico com posterior complementação cirúrgica. Entretanto, meios mais conservadores estão sendo empregados para resolução desses casos. Relato dos casos: o primeiro caso se refere a uma paciente com 21 anos de idade, que procurou atendimento odontológico por razão ortodôntica. Na radiografia panorâmica, constatou-se a ocorrência de uma grande área radiolúcida na região periapical das unidades 12, 11, 21, 22 e 23. O tratamento realizado limitou-se à terapia endodôntica, que consistiu na pulpectomia, esvaziamento do conteúdo séptico, preparo biomecânico e medicação intracanal; e, em uma segunda sessão, a obturação do sistema de canais dos 5 dentes. O controle radiográfico após dois e cinco anos mostrou reparação completa da área radiolúcida e áreas de neoformação óssea. O segundo caso é de um paciente com 84 anos de idade, diabético, que procurou atendimento odontológico por razões protéticas. No exame intrabucal, foi constatada expansão da cortical vestibular na região anteroinferior. Na tomada radiográfica panorâmica, foi visualizada extensa área radiolúcida nos dentes 32, 31, 41, 42 e 43. O tratamento consistiu em tratamento endodôntico conservador, sem necessidade de cirurgia parendodôntica, semelhante ao primeiro caso. O controle radiográfico de um ano mostrou diminuição da área radiolúcida e cicatrização óssea. Conclusão: a cirurgia parendodôntica nem sempre está recomendada para os casos de lesões periapicais grandes, em que o acompanhamento clínico e radiográfico é de suma importância para o sucesso do tratamento

Efficacy of gutta-percha solvents used in endodontic retreatments

Introduction and Objective: The aim of this study was to evaluate the effectiveness of four different solvents and classify them according to their potential of action. Material and methods: Four solvents were tested: xylene, eucalyptol, orange oil and chloroform. Twelve gutta-percha points (medium-large), sectioned at 10 mm were used and divided into four groups, resulting in three samples for each solvent. The gutta-percha points were weighed on an analytical balance before being subjected to the action of solvents and subsequently put onto watch glasses that were immersed into the solutions for the following times: 1, 2, 3, 4 and 5 minutes. The percentage of mass loss was registered through weighing after every minute of action of the solvent on the points. Results: All solvents showed the first minute of action as the period of greatest power of dissolution because they act only on the gutta-percha itself and not on the other components of the point, suggesting that at the remaining minutes there would be a lower percentage of dissolution because there was a smaller amount of gutta-percha within the points. Conclusion: Chloroform and xylene showed similar results regarding the rate of dissolution of gutta-percha, yet they were statistically significant higher than eucalyptol and orange oil from 1 to 5 minutes.

Filling lateral canals: Influence of calcium hydroxide paste as a root canal dressing.

Context: The use of intracanal medication aims to provide antimicrobial activity in the root canal system, leading to a more satisfactory condition for root canal obturation. However, it is important to evaluate whether such medication would affect the sealing-off from the main root canal of ramifications such as lateral canals. Aim: Evaluate the influence of calcium hydroxide [Ca(OH) 2 ] paste on the filling of lateral canals. Settings and Design: Ex vivo quantitative laboratory study. Materials and Methods: Sixty single-rooted teeth with lateral canals created were used, 10 teeth per group. Group A was described respectively as lateral condensation technique (subgroup 1), thermomechanical compaction (subgroup 2), and continuous wave of condensation (subgroup 3). In Group B, subgroups 4, 5, and 6 were filled with Ca(OH) 2 for 7 days before filling using the techniques applied in subgroups 1, 2, and 3. Radiographic evaluation was performed to count the number of filled lateral canals in each group. The teeth were cross-sectioned over the lateral canals; thus, 180 specimens were obtained. Each specimen was immersed in a polyester resin. Digital images were obtained and specific software (Image Tool; ) was used to evaluate the number of obturated lateral canals and the filling length in each lateral canal of groups. Statistical Analysis Used: Data were statistically analyzed using SPSS 12.0 for Windows (Descriptive statistical analysis and Newman-Keuls test). Results: A greater number of simulated lateral canals were filled in Group A (91.1%). Group B had less filled lateral canals (33.3%). The sealing of lateral canals was statistically different between Group B (26.15%) and Group A (74.43%). Conclusions: According to the radiographic analysis and the linear filling measurement, the use of Ca(OH) 2 decreased the number and the length of sealed lateral canals.

Burnout syndrome: evaluation in dentists in the city of Fortaleza, Brazil

Objective: The objective of this study was to assess the occurrence of burnout syndrome in dentists in the city of Fortaleza. Material and methods: By means of an analytical-descriptive research of quantitative character through the application of a MBI (Maslach Burnout Inventory) and a socio-cultural questionnaire. Results: The sample of 100 respondents was equally divided into female and male (50%), with a mean age of 38.09 years, 60% married, 34% single and 6% divorced. Most of the participants had between one and 20 years of tenure (62%), with a predominance of weekly working hours from 21 to 40 hours (44%). Conclusion: Burnout syndrome was diagnosed in 32% of respondents, without statistical significant differences in the relationship among gender and working hours, marital status and years of tenure (Mann Whiteney p < 0.005).

Endodontic treatment for necrotic immature permanent teeth using MTA and calcium hydroxide: A retrospective study

Introduction: Endodontic treatment of young permanent teeth with incomplete root formation and necrotic pulp has been a challenge for the dentist. It is necessary to induce the formation of apical barrier (apical plug), enabling the complete root canal filling. Objective: This retrospective clinical study compared the protocols for treatment of teeth with incomplete root formation, using calcium hydroxide (CH) or mineral trioxide aggregate (MTA). Material and methods: 28 patients with incomplete root formation have undergone root canal treatments in the period from 2000 to 2009 were selected. The procedures for cleaning, shaping and intracanal medication (CH paste) were performed in a standardized manner. In 13 patients, after using the CH paste (14 days), apical plugs with MTA were made. In the remaining 15 teeth monthly exchanges with CH paste were executed until it was observed radiographically the formation of the apical barrier. In all cases the canals were filled conventionally with gutta-percha and sealer. Initially, follow-ups were made on a quarterly and semiannually at the end of first year. Results: All apical lesions showed apical healing between 4 and 13 months after starting treatment. There was not noted the continuing process of root formation. Conclusion: It was concluded that the treatment of teeth with incomplete root formation and necrotic pulp with the use of MTA as apical plug has the same clinical results compared with the use of CH, with the advantage of less clinical time.

In vitro analysis of the pH alteration of the dentine after using different calcium hydroxide-based pastes

Introduction: To analyze the pH increase at the external root surface after the use of different calcium hydroxide pastes (Calen, calcium hydroxide associated with 2% chlorhexidine gel, calcium hydroxide associated with saline) with and without EDTA as chelating agent before the topical application of the intracanal medication. Material and methods: One-hundred single-rooted extracted teeth were cleaned and shaped. They were randomly divided into six experimental groups (n = 15) and one control group (n = 10), according to the medication to be used. The teeth were kept immersed in saline solution and the pH measurements were weekly verified with the aid of a pH meter. Results: It was verified the pH increasing at the first week in almost all groups. Only the groups in which Ca(OH)2 was associated with 2% chlorhexidine gel exhibited a significant evolution in the pH increasing over time (p = 0.0116). The use of EDTA did not result in higher pH values (p = 0.2278). Conclusion: i) the pH increased in all associations used; ii) 2% chlorhexidine gel allowed the gradual pH increasing over time; iii) the smear layer removal did not influence on the pH increasing.

Análise da prevalência do quarto canal de primeiros e segundos molares superiores permanentes humanos: avaliação clínica versus avaliação microscópica / Analysis of the prevalence of the fourth canal in first and second molars permanent humans: clinical evaluation versus microscopic evaluation

O objetivo deste estudo foi analisar a prevalência do quarto canal em primeiros e segundos molares superiores humanos e identificar onde esses canais uniam-se. Foram avaliados 89 dentes primeiros e segundos molares superiores humanos. Primeiramente, foi realizada uma análise clínica convencional em todos os dentes, procurando identificar o 4O canal, chamado MP. Em seguida, foi realizada uma nova análise desses dentes com o auxílio do Microscópio Operatório (MO), comparando os resultados. A última etapa deste trabalho foi identificar, através de radiografias, onde os canais da raiz mésio vestibular uniam-se. Observou-se que no exame clínico o 4O canal estava presente em 47,2% (42) dos dentes examinados, já no exame microscópico houve um considerável aumento, fazendo com que 65,1% (58) dos dentes examinados apresentassem o canal MP. Em 43,2% dos dentes analisados, os canais da raiz mésio vestibular estavam independentes. O MO é um instrumento muito importante para o domínio da anatomia interna dos dentes, aumentando de forma significante a quantidade de dentes em que o canal MP foi encontrado, em relação à análise clínica

The objective of this study was to analyze the prevalence of the mesiopalatine canal present in first and second maxillary permanent molars humans and identify where the fusion of the mesiobuccal root canals occur. Eighty-nine first and second maxillary permanent human molars were selected and evaluated clinically in order to determine the location of the mesiopalatine canal. After the samples were observed under a light microscope 40X magnification with the same purpose. Finally, X-rays were taken from those teeth to determine the canal pathway. In the clinical examination, the mesiopalatine canal was present in 47.2% (42) of the teeth examined, in the microscopic examination there was a considerable increase, making 65.1% (58) of the teeth examined has the canal orifice. In 43.2% of teeth examined mesiopalatine canals were independent. Operation microscope is a very important arsenal to diagnosis of the internal anatomy of teeth, increasing significantly the number of teeth in the canal orifice was found in relation to clinical analysis

Microbiological evaluation of infected root canals and their correlation with pain

Introduction and Objective: The aim of this study was to evaluate the endodontic microbiota of human teeth without pulp vitality presenting radiographically visible periapical lesions and its correlation with pre- and postoperative pain symptomatology. Material and methods: Sixteen young adult patients, both genders, aging from 18 to 45 years, presenting 21 single-rooted teeth with pulp necrosis and needing endodontic treatment were selected in the multidisciplinary clinic at the University of Fortaleza (UNIFOR). After crown surgical access, the root canals were embedded with 0.9% saline solution and the material from root canals was collected with sterile paper point. The paper points were placed into Stuart transport medium and sent to the microbiology laboratory of the University of Fortaleza. Isolation and identification of bacteria were made by culture technique. The cleaning and shaping of root canals was performed by crown-down technique. Intra-canal medication comprised calcium hydroxide mixed with chlorhexidine and after 14 days the canals were filled. Patients were asked about the occurrence of pain before treatment and 24 hours after cleaning and shaping procedures. Results: The most prevalent microbial group was Streptococcus sp. followed by Fusobacterium nucleatum, although Gram-positive cocci, non-sporulating Gram-positive bacilli, Gram-negative bacilli, pigmented Gram-negative bacilli, Veillonella, Staphylococcus aureus, Pseudomonas sp. were also frequently isolated. Conclusion: According to the results, it can be concluded that Fusobacterium nucleatum and Gram-negative bacilli were more related to pre-operative pain. Regarding to postoperative pain, the most prevalent bacteria were Gram-positive cocci.

Análise da espessura da linha de cimento após o uso de diferentes técnicas de obturação de canais radiculares / Evaluation of the film thickness of a root canal sealer following different filling techniques

Introdução: O objetivo deste estudo foi realizar uma análise quantitativa da espessura da linha de cimento endodôntico formada após o uso de três diferentes técnicas de obturação. Materiais e método: Foram utilizados sessenta pré-molares inferiores. Após os procedimentos de limpeza e modelagem, os dentes foram distribuídos aleatoriamente em três grupos, de acordo com a técnica de obturação a ser empregada: Grupo I - Compressão hidráulica; Grupo II - Condensação lateral; Grupo III - Híbrida de Tagger. Foi utilizado no experimento um cimento a base de óxido de zinco eugenol. Os espécimes foram analisados em quatro cortes: 12 mm, 9 mm, 6 mm e 3 mm aquém do ápice radicular. As imagens dos cortes transversais foram capturadas e a espessura de cimento foi mensurada utilizando-se o programa Image Tool 3.0. A análise estatística foi executada utilizando-se o teste de Wilcoxon (SPSS 12.0). Resultados: A técnica de Tagger foi superior às demais, seguida pela compressão hidráulica e condensação lateral, com os resultados mostrarando-se estatisticamente diferentes entre todos os grupos (p = 0,0109). Conclusões: Em geral, as menores espessuras de cimento foram obtidas para o Grupo III, sendo piores os resultados obtidos para o grupo da condensação lateral.

Análise da capacidade de preenchimento de canais radiculares com guta-percha promovida por três diferentes técnicas de obturação de canais radiculares / Analysis of gutta-percha's root canal filling capacity through three different obturation techniques

Introdução e objetivo: O objetivo deste estudo foi determinar a deste estudo foi determinar a capacidade de preenchimento de canais radiculares com guta-percha por meio de três diferentes técnicas de obturação endodôntica. Material e métodos: Utilizaram-se 60 dentes unirradiculados, os quais foram limpos, modelados e divididos aleatoriamente em três grupos. Recorreuse a três técnicas distintas de obturação para cada grupo de estudo: grupo I ­ condensação lateral; grupo II ­ compressão hidráulica; grupo III ­ híbrida de Tagger. Todos os procedimentos foram executados por dois operadores calibrados em momento anterior. Após os procedimentos de obturação, seccionaram-se os espécimes transversalmente em quatro medidas a partir do ápice radicular (3 mm, 6 mm, 9 mm e 12 mm), com auxílio de disco de diamante montado em IsoMet®, sob intensa refrigeração e baixa rotação. Esses cortes foram incluídos em resina plástica e lixados, e as imagens dos canais radiculares capturadas e analisadas com auxílio do programa Image Tool 3.0. Mensuraram-se as áreas dos canais radiculares e de toda a massa de guta-percha presente no interior do canal radicular, a fim de obter a porcentagem de preenchimento do canal radicular com material guta-percha para cada corte. Resultados: Os resultados foram tabulados e avaliados por intermédio do programa GMC 10.0 (Kruskal-Wallis). A análise dos resultados evidenciou que a técnica híbrida de Tagger (95,1%) foi superior às demais na capacidade de preenchimento do canal radicular com guta-percha, seguida das técnicas da compressão hidráulica (89,1%) e da condensação lateral (70,6%). Os resultados mostraram-se diferentes estatisticamente entre as técnicas empregadas (p < 0,01) para todos os cortes obtidos. Quanto às análises intragrupos, notou-se diferença estatística significante apenas no grupo I (p < 0,01), porém os cortes executados em 6 mm e 9 mm foram iguais (p > 0,05). Conclusão: Das técnicas de obturação de canais radiculares testadas, a híbrida de Tagger possui a maior capacidade de preenchimento do sistema de canais radiculares com guta-percha. Depois vêm as técnicas da compressão hidráulica e da condensação lateral

Introduction and objective: The aim of this study was to determine gutta-percha's root canal filling capacity through three different filling techniques. Material and methods: Sixty single-rooted human teeth were cleaned, shaped and randomly divided according to the filling technique: Group I: Lateral condensation; Group II: Hydraulic compression; Group III: Tagger's hybrid. All procedures were performed by two previously calibrated operators. The teeth were transversely sectioned into four cuts, starting from the root apex (at 3 mm, 6 mm, 9 mm, and 12 mm), by using an Isomet diamond blade (wafering blade, series 15 high concentration, 5 inch blade, Buehler Ltd., Lake Bluff, IL, USA), mounted in an IsoMet® Low Speed Saw (Buehler Ltd., Lake Bluff, IL, USA), and water as a cooling medium. Each group's cut was embedded in acrylic resin and polished. Root canal images were captured and then analysed by Image Tool 3.0 software (Department of Dental Diagnostic Science, University of Texas, Health Science Center, San Antonio, Texas). Measurements of root canal overall area and gutta-percha-filled area were executed, therefore, obtaining the percentage of gutta-percha's root canal filling capacity for each slice. Results: Data were analyzed by GMC software 10.0 and Kruskal-Wallis test. Tagger's hybrid technique (95.1%) was superior to the other two techniques, followed by Hydraulic compression (89.1%) and lateral condensation (70.6%). The results were statistically different among the three techniques, for all cuts (p < 0.01). Intra-group analyses showed statistically significant differences only in Group I (p < 0.01). However, slices obtained at 6 mm and 9 mm were statistically equal (p > 0.05). Conclusion: These results suggest that Tagger's hybrid technique may yield better root canal filling capacity than Hydraulic compression and lateral condensation technique, which showed the worst filling capacity of all the three techniques employed

Avaliação in vitro da adaptação de materiais obturadores às paredes dentinárias de canais radiculares / In vitro evaluation of the adaptation of filling materials to dentin walls of root canals

O objetivo deste estudo foi avaliar a adaptação dos cimentos endodônticos ao terço apical das paredes dos canais radiculares...

The aim of this study was to evaluate the adaptation of root canal sealers to 1/3 of apical root canal walls...