Cleaning of long oval canals with WaveOne Gold system associated with different irrigant agitation protocols

Aim: The aim of the study was to evaluate the cleaning of mandibular incisors with WaveOne Gold® (WO) under different preparation techniques. Methods: A total of 210 human mandibular incisors were selected and divided into seven groups (n = 30), prepared by WO single-files (Small 20/.07 ­ WOS; Primary 25/.07 ­ WOP; Medium 35/.06 ­ WOM; or Large 45/.05 - WOL) and sequential-file techniques (WOS to WOP; WOS to WOM; and WOS to WOL). Further subdivision was made according to irrigation protocol: control group (manual irrigation - CON), E1 Irrisonic® - EIR, and EDDY® - EDD. Debris removal and the smear layer were evaluated by scanning electron microscopy. Data were analyzed by using Spearman's correlation test. The significance level was set at 5%. Results: For debris and smear layer removal, WOS and WOP, EIR differed from CON and EDD (p <0.05). Conclusion: Regardless of the instrumentation used, the agitation of the irrigant solution provided better cleanability. These findings reinforce the need for agitation techniques as adjuvants in cleaning root canal systems in mandibular incisors

Influence of different reciprocating systems on the apical extrusion of debris in flat-oval canals

Aim: To evaluate the apical extrusion of debris in flat-oval canals, using three reciprocating systems at two different working lengths (WL), 0 mm and 1 mm from the apical foramen. Methods: Ninety mandibular incisors were randomly divided into three groups based on the systems: WaveOne Gold #25.07 (WOG), ProDesign R #25.06 (PDR), and X1 Blue #25.06 (X1B). Extruded debris were collected and dried in pre-weighed Eppendorf tubes. Three consecutive weighings were performed for each tube, and the mean was calculated. If the assumptions of normality and homogeneity of variance were not met, the Kruskal-Wallis test was used to analyze the amount of extruded debris between groups with the same WL, and the Mann-Whitney U test was used for comparison within groups for each WL. Results: All groups had extruded debris, with higher median values occurring at 1 mm. No significant difference regarding the amount of debris extrusion was observed at 0 mm (p>0.05) and 1 mm (p>0.05) between groups. However, within the groups, at different WL, there was greater extrusion at 1 mm (p<0.05), with PDR differing significantly from the other systems (p<0.05). Conclusion: The extrusion of debris occurred regardless of the group, with higher values at 1 mm. However, using PDR at 1 mm from the apical foramen showed the highest values of extrusion

Descoloração da coroa após obturação endodôntica com diferentes cimentos: estudo clínico / Crown discoloration after endodontic obturation with different cements: a clinical study

Objetivo: O objetivo do presente estudo foi avaliar clinicamente a descoloração da coroa dentária após obturação do canal radicular com diferentes cimentos endodônticos. Métodos: Trinta e dois dentes foram tratados endodonticamente e obturados com AH Plus (AHP), Endofill (END), MTA Fillapex (MTA) ou Sealer 26 (SEA), divididos em oito pacientes por grupo. O registro das cores foi realizado com um espectrofotômetro antes da intervenção (T0 ), aos 30 (T1 ) e aos 90 dias após a intervenção (T2 ). As avaliações foram feitas no centro da coroa dentária e a variação de cor (ΔE) foi calculada por meio da Commission International de l'Eclai- rage (CIE) L*a*b. Um operador, especialista em Endodontia, realizou os procedimentos clínicos. Os dados foram submetidos a medidas repetidas ANOVA e teste de Tukey (Δ=5%). Resultados: Não houve diferença estatisticamente significativa na variação de cores entre os cimentos (AHP ΔE=4,11; END ΔE = 6,34; SEA ΔE = 8,77 e MTA ΔE = 12,15), p>0,05. Porém, houve diferença entre os períodos analisados (T1ΔE= 5,65; T2 ΔE = 10,02). Conclusões: Dentro das limitações deste estudo, todos os cimentos endodônticos causaram alterações cromáticas clinicamente perceptíveis na coroa dentária. No entanto, o AH Plus promoveu menos alterações cromáticas na coroa dentária (AU).

Introduction: The aim of this study was to evaluate the crown discoloration after root canal filling with different endodontic cements clinically. Methods: Thirty-two teeth were endodontically treated and filled with AH Plus (AHP), Endofill (END), MTA Fillapex (MTA), or Sealer 26 (SEA), divided into eight patients per group. Color recording was performed with a spectrophotometer before the intervention (T0 ) and at 30 (T1 ) and 90 days post-intervention (T2 ). The evaluations were done in the center of the dental crown and color variation (ΔE) was calculated by means of the Commission International de IEclairage (CIE) L*a*b. The data were subjected to repeated measures ANOVA and Tukeys test (alpha=5%). Results: There was no statistically significant difference in color variation between the cements (AHP ΔE=4.11; END ΔE=6.34; SEA ΔE=8.77, and MTA ΔE=12.15), p>0.05. However, there was a difference between the periods tested (T1 ΔE=5.65; T2 ΔE=10.02). Conclusions: All tested endodontic cements altered the color of dental crowns (AU).

Effects of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide on adhesion of posts in teeth obturated with different sealers

Abstract The aim of this study was to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) on bond strength of fiberglass posts in root canals obturated with different endodontic sealers. Seventy-eight mandibular premolars were obturated with three sealers (n=26): Endofill (END), AH Plus (AHP), and Endosequence BC Sealer (EBS). After preparation of the post space, two subgroups were formed according to the cementation of the posts (n=13): with EDC (EDC), and without EDC (control - CON). The specimens were submitted to a pull-out test, failure mode classification, and root canal surface evaluation by scanning electron microscopy after post displacement. Regarding the bond strength, a significant difference between the EDC and CON subgroups occurred only in the END (p=0.001). No difference was detected among the CON subgroups (p=0.339). However, among the EDC subgroups, AHP presented significantly higher values (END versus AHP: p=0.001; AHP versus EBS: p=0.016). Upon classification of failure modes, score 1 (≥ 50% of cement) was the most commonly observed, except for the END + EDC. Remains of endodontic sealers and resin cements were found in the cervical third, but without statistical difference (p=0.269), while in the middle third, difference occurred (p=0.004). In conclusion, EDC decreases bond strength when associated with END sealer, without changing the failure mode between the resin cement and fiberglass post. The best performance was observed when EDC was combined with AHP sealer.

Resumo O objetivo deste estudo foi avaliar o efeito da 1-etil-3- (3-dimetilaminopropil) carbodiimida (EDC) na resistência de união de pinos de fibra de vidro em canais radiculares obturados com diferentes cimentos endodônticos. Setenta e oito pré-molares inferiores foram obturados com três cimentos endodônticos (n=26): Endofill (END), AH Plus (AHP) e Endosequence BC Sealer (EBS). Após o preparo do espaço para pino, dois subgrupos formaram-se conforme a cimentação dos pinos (n=13): com EDC e sem EDC (controle - CON). Os espécimes foram submetidos ao teste pull-out, classificação do modo de falha e avaliação da superfície do canal radicular por microscopia eletrônica de varredura após o deslocamento. Quanto à força de resistência de união, uma diferença estatisticamente significativa ocorreu entre os subgrupos EDC e CON apenas no END (p=0,001). Não foi detectada diferença entre os subgrupos CON (p=0,339). Contudo, no subgrupo EDC, o AHP apresentou maiores valores (END versus AHP: p=0,001; AHP versus EBS: p=0,016). Acerca da classificação dos modos de falha, o escore 1 (≥50% de cimento) foi o mais comumente observado, exceto para END + EDC. Restos de cimentos endodônticos e cimentos resinosos foram encontrados no terço cervical, mas sem diferença estatística (p=0,269), enquanto no terço médio, houve diferença (p=0,004). Em conclusão, o EDC diminui a resistência de união quando associado ao cimento END, sem alterar o modo de falha entre o cimento resinoso e o pino de fibra de vidro. O melhor desempenho foi observado quanto o EDC foi usado com o cimento AHP.

Long-term evaluation of crown and root discoloration induced by different endodontic sealers

Aim: To evaluate crown and root discoloration promoted by different endodontic sealers after root canal filling. Methods: Eighty bovine incisors were prepared and filled with: Endofill, Sealer 26, AH Plus, and MTA Fillapex. Color was recorded using a spectrophotometer before endodontic treatment (T0) and at 24 hours (T1), seven days (T2), 30 days (T3), and 90 days (T4) after treatment. Analyses were performed on the middle and cervical regions of the crown, and on the cervical third of the root, immediately below the cementoenamel junction. The color alterations (ΔE) were calculated using Commission International de I'Eclairage (CIE) L*a*b parameters, and data were analyzed by analysis of variance (ANOVA) and Tukey's test (p<0.05). Results: All sealers induced color alterations. Sealer 26 resulted in the smallest changes in color (E = 5.32). The other materials did not present statistical differences (AH Plus E = 6.98; MTA Fillapex E = 6.88; Endofill E = 6.41). Of the three regions analyzed, the largest discoloration was observed at the cervical third of the root (E=10.67). In terms of time, the largest ΔE values (E=7.72) were observed at T4. Color changes at T1 (E=5.88), T2 (E=6.10), and T3 (E=5.89) were statistically similar. Conclusions: All endodontic sealers promoted discoloration on the tooth crown and root

Thermoplastic endodontic obturation - TC system: case report

Introduction: The TC system, developed in 2002, allows the endodontic filling by means of a non-conventional technique that uses gutta-percha at alpha phase, thermoplasticized in its own oven, placed into canal through a McSpadden compactor, without using a main cone. Objective: The aim of this case report was to show the TC system used for root canal filling. Case report: Three teeth of a patient was indicated for endodontic treatment, so TC system was used for the root filling. Conclusion: This technique showed to be effective for the root canal filling.

Epidemiological data and relevance of care provided in dental emergency service of a private hospital

Introduction and Objective: The aims of this study were to determine the etiology and prevalence of dental emergency visits in a private hospital in the period from July 2009 to July 2011 and the importance of this type of service in private hospitals. Material and methods: During the study period, we analyzed 795 charts from patients seeking emergency services. The emergencies were classified as trauma, odontalgia, prosthesis, periodontal diseases, and traumatic factors. Results: Women and men accounted for 61% and 39% of cases, respectively, and the most prevalent age group was individuals aged 20 to 49 years. The predominant types of dental emergencies observed were odontalgia (52.58%) and dental trauma (22.64%). Pulpitis was the most common pathology (67% of cases) and the most frequent type of trauma was enamel and dentin fracture (54% of cases). Conclusion: A high demand for dental emergency care exists in hospital settings. Most people seek emergency dental services for emergencies related to lack of prevention and dental traumas.

Comparative analysis of four cleaning methods of endodontic files

Introduction: Due to the size and design of endodontic files, these instruments have been considered one of the most difficult to clean among all dental instruments. The debris maintenance within the sulcus prevents the effective sterilization and may compromise the disinfection of root canal systems in endodontic therapy. However, there is neither a method nor technique that standardized the cleaning of these instruments. Objective: To evaluate the cleaning ability of four techniques used in dentistry. Material and methods: For this purpose, 30 new size #40 Flexofile were used for the preparation of the canals of mandibular molars of pigs. After instrumentation, the contamination and the presence of debris in the sulcus was confirmed and the files were randomly divided into four groups: control group (without cleaning), group 1 (enzymatic detergent + manual brushing with nylon bristle brush), group 2 (ultrasound + enzymatic detergent), group 3 (ultrasound + water) and group 4 (gauze embedded in 70% alcohol). Next, all files were photographed and photographs were printed at high quality. The spirals containing debris were counted. Results: Manual cleaning with enzymatic detergent and nylon bristle brush, ultrasound with either water or detergent showed the best cleaning capacity in which respectively 100%, 98.9% and 96.2%, of the spirals were free of debris. Cleaning with alcohol and gauze proved to be ineffective, showing debris in more than 40% of the spirals by visual analysis. In control group, 91% of the spirals presented debris. It can be concluded that the association between manual and ultrasound cleaning may be promising in ensuring a cleaning protocol for endodontic files cleaning.

Bacterial infiltration comparison of two root canal filling techniques

Introduction: Root canal system filling aims to the hermetic sealing of the space formerly occupied by the dental pulp. Objective: The aim of this study was to analyze the bacterial infiltration of Enterococcus faecalis in root canals filled through two techniques: single cone technique (group A) and thermoplasticized gutta-percha technique (group B). Material and methods: A total of 40 single-rooted human premolars were divided into two experimental groups (n = 15) and two control groups: positive (n = 5) and negative (n = 5). The root canals were prepared with ProTaper Universal system up to size F3 file and filled with the corresponding gutta-percha point. Teeth were mounted on a dual-chamber model, where the infiltration of E. faecalis was evaluated for a 30-day period by BHI turbidity indicating bacterial growth. Results: After the trial period all specimens in experimental and positive control groups showed turbidity of the culture medium. The average number of days until culture medium turbidity was 11.42 days for group A, 16.69 days for group B, and 5.5 days for positive control. By applying Anova test, there was no statistically significant difference between groups (p > 0.05). This allowed the observation that no difference between the obturation techniques in the infiltration of E. faecalis could be observed by the methodology used. Conclusion: It can be concluded that regardless of the obturation techniques, bacterial infiltration occurred.

Adhesion and formation of tags from MTA Fillapex compared with AH Plus® cement

Introduction and Objective: The aim of this study was two-fold: 1) to evaluate, in vitro, the shear bond strength of two sealers by push-out test and 2) to assess the failures after displacement. Additionally, the formation of tags was observed by SEM. Material and methods: Forty mandibular premolars were selected and the canals were subjected to biomechanical preparation with rotary instruments. These specimens were divided into two groups according to the sealer (n = 20): GI - MTA Fillapex and GII - AH Plus. All roots were filled with sealer only, without gutta-percha. After a period corresponding to three times the setting time of the sealer, the roots were sectioned transversely into slices of 1 mm thickness, to obtain one slice from the cervical third, to be used in the push-out test. Following, two slices of each group were randomly chosen for ultrastructural analysis by scanning electron microscopy (SEM). The data obtained in shear bond strength test were subjected to statistical analysis. Results: AH Plus cement exhibited higher shear bond strength values (1.332±0.75 MPa) than MTA Fillapex (0.071±0.07 MPa), with statistically significant differences. Conclusion: MTA Fillapex has a low bond strength with less formation of tags than AH Plus.

The relationship of a clinical protocol and emergency treatment success of dental trauma running head: clinical protocol in dental trauma

Introduction and Objective: The aim of this study was to investigate whether the sequelae arising from dental trauma in permanent teeth were influenced by the use or non-use of a clinical protocol, in emergency care treatment facilities in the city of Joinville/SC, Brazil. Material and methods: From 2008 to 2010, a total of 70 dental records were reviewed and evaluated 6 months after the completion of treatment. In addition to the data relating to gender, age, etiology, most affected teeth, and most prevalent traumas, the individuals were divided into 2 groups to compare the sequelae observed following either the use or non-use of a clinical protocol for dental trauma treatment. Results: There was a greater incidence of male patients, particularly in the age-range of 8 to 15 years. Falls were the most frequent cause of trauma. The total success rate of the emergency care was of 78.57%. In the group in which the protocol was used, the success rate reached 88.89% compared to 60.0% in the group in which the protocol was not used. Conclusion: The use of a clinical protocol positively influenced the sequelae arising after treatment for dental trauma.

Microbiological aspects of endoperiodontal lesion

Introduction: The endoperiodontal lesion occurs when a tooth undergoing endodontic disease is united to a periodontal lesion with apical progression. Many times, the differential diagnosis between the endodontic and periodontal disease can be of difficult execution and the correct diagnosis and planing of the treatment is of main importance for a good prognosis. Objective: To identify the main microorganisms within the lesion of endodontic and periodontal origin and correlate them with the endoperiodontal lesion. Literature review: The search strategy comprised the electronic studies of databases such as PubMed and Cochrane on the microbiology of the endodontic and periodontal systems through employing the following keywords: microbiology, endodontics, periodontal pocket. Results: There were similarities in the endodontic and periodontal microflora. However, the number of microorganisms within the cross infection is limited, including Bacteroides, Eubacteria, Fusobacteria, spirochaetes, Wolinella. The bacterias forming the red complex are closely related to the severity of the periodontal disease and can also participate in the pathogenesis of the periradicular abscesses. Conclusion: There are many communication routes between the periodontium and pulpal tissue, therefore the contamination from um tissue to another can occur, existing a microbiological inter-relationship between these tissues.

Apicoectomy after conventional endodontic treatment failure: case report

Introduction: Paraendodontic surgery is a safe and adequate alternative when teeth are not responding to conventional treatment and endodontic re-treatment. It must only be applied in specific situations. Endodontic treatment failures can be related to: extraradicular infections such as periapical actinomycosis; to foreign body reactions that can be caused by endodontic material extrusion; to endogenous cholesterol crystal accumulation in apical tissues; and unresolved cystic lesion. Paraendodontic surgery comprehends a set of procedures recommended in periapical diseases treatment, when traditional endodontic therapy does not obtain favorable outcomes. Objective: To report a clinical case where an apicoectomy was indicated due to failure in conventional endodontic treatment. Case report and Conclusion: Clinical case report of a tooth with unsatisfying conventional endodontic treatment history, due to lack of treatment in fourth root canal and an unsuccessful apicoectomy, since the lesion and the fistula had persisted. It was chosen to retreat tooth #26 and perform a new apicoectomy in the mesiobuccal root. The treatment was successful due to absence of fistula and painful symptoms and due to periapical bone repair.

Etiologia, diagnóstico e tratamento da reabsorção cervical externa: revisão de literatura / Etiology, diagnosis and treatment of external cervical resorption: literature review

Introdução: a reabsorção cervical externa (RCE) é uma forma progressiva e agressiva de destruição da estrutura dental, caracterizada pela localização cervical e pela presença de tecido fibrovascular preenchendo a região reabsorvida. A RCE não apresenta uma etiologia específica, embora existam alguns fatores predisponentes para que ela ocorra. Devido à ausência de sintomas, a reabsorção cervical externa acaba se tornando um achado radiográfico, sendo detectada em exames de rotina. Algumas vezes, pode ocorrer a comunicação da lesão com o canal radicular e surgirem sintomas relacionados à pulpite. Em outros casos, clinicamente, a RCE pode ser identificada apenas como uma mancha rosa na margem gengival da coroa do dente afetado. Para o correto diagnóstico da RCE, além da técnica radiográfica convencional, é indicada a realização da tomografia computadorizada cone beam para avaliar a exata extensão e localização da lesão. O tratamento dependerá do estágio de evolução da reabsorção e, mesmo com a aplicação de materiais como o MTA, aRCE tem um prognóstico duvidoso na maioria dos casos. Objetivo: rever a literatura sobre a etiologia, diagnóstico e o tratamento da reabsorção cervical externa. Conclusão: a reabsorção cervical externa quanto mais cedo detectada melhor será seu prognóstico. Pacientes que apresentem algum fator predisponente devem ser acompanhados por meio de exame radiográfico de rotina e, quando necessário, o clínico pode solicitar tomada tomográfica para avaliar a extensão e localização da reabsorção, bem como, definir o tratamento adequado para cada caso.

Introduction: External cervical resorption (ECR) is a progressive and aggressive destruction of tooth structure, characterized by the cervical location and the presence of fibrovascular tissue filling the reabsorbed region. The ETS does not present a specific etiology, although there are some predisposing factors to occur. Due to the absence of symptoms, the external cervical resorption turns out to be a radiographic finding, being detected in routine tests. Sometimes, may occur the communication of the lesion with the root canal and develop symptoms related to pulpite. In othercases, clinically the ECR can only be identified as a pink spot at the gingival margin of the crown of the affected tooth. Besides the conventional radiographic technique,it is important for the correct diagnosis of ECR perform the cone beam computed tomography to evaluate the exact extent and location of the lesion. The treatment will depend on the evolution stage of resorption, and even with the application of materials such as MTA, the ECR has a dubious prognosis in most cases. Aim: review the literature about the etiology, diagnosis and treatment of external cervical resorption. Conclusion: External cervical resorption detected the sooner the better your prognosis. Patients who have some predisposing factor must be accompanied by routine radiographic examination and, where necessary, the clinician may request tomographic taking to assess the extent and location of resorption, as well as define the appropriate treatment for each case.

The challenges of treating a fused tooth

This paper describes and discusses the multidisciplinary treatment involving a permanent maxillary lateral incisor fused to a supernumerary tooth, both presenting pulp necrosis and periapical lesion. A 15-year-old male patient sought treatment complaining of pain, swelling and mobility on the maxillary right lateral incisor. After clinical and radiographic examination, root canal preparation was performed according to the crown-down technique and a calcium hydroxide dressing was placed for 15 days. The patient returned and the definitive endodontic filling was done with thermomechanical compaction of gutta-percha and sealer. After 18 months, clinical and radiographic examinations were carried out and no pain or swelling was reported. Two years after endodontic treatment, the patient returned for periodontal and cosmetic treatments. Nine months later, a cone-beam computed tomography (CBCT) revealed that the previously detected periodontal defect and periapical lesion were persistent. Apical endodontic surgery was indicated. The supernumerary tooth was removed, the communicating distal surface was filled and the surgical site received bioactive glass and demineralized bovine organic bone. The pathological tissue was submitted to histopathological examination and the diagnosis was periapical cyst. One year after the apical endodontic surgery, CBCT showed bone formation at maxillary lateral incisor apical area. Two years after the surgery, the restoration was replaced due to aesthetic reasons and periapical radiograph showed success after 5 years of treatment. A correct diagnosis and establishment of an adequate treatment plan resulted in a successful management of the case.

Este caso descreve o tratamento multidisciplinar de um incisivo lateral superior permanente fusionado a um dente supranumerário, ambos apresentando necrose pulpar e lesão periapical. Paciente compareceu ao consultório se queixando de dor, edema e mobilidade do incisivo lateral superior. O preparo endodôntico foi realizado no sentido coroa-ápice e foi colocada pasta de hidróxido de cálcio como medicação intra-canal por 15 dias. A seguir, a obturação foi realizada pela termoplastificação da guta-percha. Após 18 meses, foram realizados exames clínicos e radiográficos indicando ausência de dor e edema. Dois anos após o tratamento endodôntico, o paciente retornou para o tratamento periodontal e estético. Nove meses depois, foi realizada tomografia computadorizada e observou-se presença de defeito periodontal e lesão periapical. Foi então indicada e planejada a cirurgia paraendodôntica. O dente supranumerário foi removido e a área de comunicação com o canal radicular do incisivo lateral foi preenchida; a loja cirúrgica foi preenchida com vidro bioativo e osso orgânico bovino desmineralizado. O tecido patológico da lesão periapical foi submetido à análise histopatológica sendo diagnosticado como cisto periapical. Um ano após a cirurgia parendodôntica, uma nova tomografia computadorizada mostrou neoformação óssea na região periapical do dente em questão. Doi anos após a cirurgia, a restauração foi trocada devido à motivos estéticos e uma radiografia periapical mostrou sucesso do tratamento (5 anos após o tratamento inicial). Um correto diagnóstico e plano de tratamento multidisciplinar é essencial para o sucesso do tratamento de dentes fusionados à dentes supranumerários.

Avaliação da capacidade de dissolução tecidual de diferentes soluções de hipoclorito de sódio em tecido conjuntivo e muscular de ratos / Evaluation of capacity of tissue dissolution of various solutions of sodium hypochlorite in connective and muscle tissue of rats

Analisar a capacidade de dissolução tecidual de diferentes soluções de hipoclorito de sódio em tecido conjuntivo e muscular esquelético de ratos.Metodologia: foram obtidos 60 fragmentos de tecido conjuntivo (dorso) e muscular esquelético (língua) de ratos da linhagem Wistar, que foram submetidos à ação solvente das soluções de hipoclorito de sódio comercializadas, prontas para uso, Hipoclor 1%, HW 1% e 2,5%, Limpa Bem 2,5% e soluções manipuladas nas mesmas concentrações. O tempo de dissolução foi cronometrado. O método de titulometria com iodo foi utilizado para confirmação do teor de cloro ativo das soluções utilizadas.Resultados: a análise estatística revelou diferença não significante entre os dois diferentes tecidos (p>0.05) e apresentou diferença significante (p<0.001) entre as concentrações de 1% e 2,5%. O tempo médio de dissolução em minutos no tecido conjuntivo foi: Limpa Bem 2,5% (80,4); Manipulado 2,5% (100,2); Hipoclor 1% (164,2); HW 2,5% (205,6); Manipulado 1% (278,4). No tecido muscular esquelético o tempo médio foi: Limpa Bem 2,5% (111,6); Manipulado 2,5% (171,6); Hipoclor 1% (178,5); HW 2,5% (219); Manipulado 1% (289,6). O HW 1% não foi capaz de dissolver os tecidos. Os resultados da titulometria demonstraram que as soluções testadas apresentavam teor de cloro ativo aceitáveis, com exceção da marca HW nas concentrações de 1% e 2,5%.Conclusão: ambos tecidos podem ser utilizados para a verificação da capacidade de dissolução tecidual do hipoclorito de sódio e que esta obedece uma relação diretamente proporcional a concentração do teor de cloro ativo...

The aim of this study was to analyze the ability of different solutions of sodium hypochlorite to dissolve connective and skeletal-muscle tissue of rats. Methodology: it was obtained 60 pieces of connective tissue (back) and skeletal-muscle (tongue) of Wistar rats that were subjected to solvent action of sodium hypochlorite solutions marketed, ready to use, 1% Hipoclor, 1 and 2, 5% HW, 2.5% Limpa Bem and solutions manipulated at the same concentrations. The dissolution time was recorded. The method of titration with iodine was used to confirm the active chlorine content of solutions used. Results: statistical analysis revealed no significant difference between the two different tissues (p> 0.05) and significantly difference (p <0.001) between concentrations 1% and 2.5%. The average time in minutes to dissolve the connective tissue was: 2.5% Limpa Bem (80.4); 2.5% Manipulated (100.2); 1% Hipoclor (164.2), 2.5% HW ( 205.6); 1% Manipulated (278.4). In skeletal muscle the average time was: 2.5% Limpa Bem (111.6); 2.5% Manipulated (171.6); 1% Hipoclor (178.5), 2.5% HW (219); 1% Manipulated (289.6). The 1% HW was not able to dissolve the tissues. The results of titrations demonstrated that the solutions tested had acceptable levels of chlorine, with the exception of brand HW concentrations of 1% and 2.5%.Conclusion: both tissues can be used for verifying the ability of tissue dissolution of sodium hypochlorite and that obeys a directly proportional to the concentration of active chlorine content...

Estudo da anatomia interna dos pré-molares: revisão de literatura / The root and root canal morphology of the human premolar: a literature review

Com a intenção de reforçar a estreita relação existente entre o conhecimento da anatomia interna e a obtenção do sucesso no tratamento endodôntico, são relatadas aqui características da anatomia interna presentes no grupo dental dos pré-molares.Revisão de literatura: as alterações morfológicas quando desconsideradas podem dificultar a terapia endodôntica. A resolução de casos com anatomia incomum exige consequentemente, mudanças no método de diagnóstico, assim como no tratamento.Conclusão: a identificação, e, portanto, o tratamento satisfatório de raízes e canais diferenciados, diminui a persistência dos sinais e sintomas, reduzindo, assim as possíveis causas de um retratamento...

Intended to illustrate and reinforce the close link between knowledge of internal anatomy and the achievement of success in endodontic treatment, are reported here characteristic of the internal anatomy in the dental group of premolars.Literature review: the morphological changes when discarded can complicate the endodontic therapy. The resolution of cases with unusual anatomy requires, therefore, changes in the method of diagnosis, and treatment.Conclusion: the identification and, therefore, the satisfactory treatment of roots and different canals, reduces the persistence of signs and symptoms, reducing thus, the possible causes of a retreatment...

Opinião de graduandos após 5 anos de experiência com instrumentos endodônticos rotatórios / Undergraduates' opinion after 5-year experience with rotary endodontic instruments

Introdução: A evolução da odontologia nos últimos anos revolucionou a prática diária em algumas especialidades. Uma dessas revoluções ocorreu na Endodontia devido ao avanço das técnicas rotatórias de preparo do canal radicular e sua posterior incorporação ao ensino dos graduandos de Odontologia. Objetivo: O objetivo deste estudo foi relatar uma experiência de 5 anos na graduação laboratorial e clínica do preparo endodôntico rotatório em uma universidade privada. Material e métodos: O levantamento dos dados foi realizado por meio de um questionário composto por nove questões objetivas; o questionário foi respondido pelos graduandos. Resultados: Os resultados mostraram uma aceitação positiva em relação ao ensino da técnica rotatória na graduação (94,7%). As seguintes vantagens foram destacadas: preparo mais rápido do canal radicular (91,6%) e redução do estresse do paciente (80,9%). Conclusão: Pode-se concluir que a experiência com as duas turmas de graduação foi excelente devido ao alto nível de aceitação da nova técnica pelos alunos

Introduction: Dentistry evolution in the past few years has revolutionized daily practice in some specialties. One of these revolutions has occurred in Endodontics due to the advancement of rotary techniques for root canal preparation and its subsequent incorporation into the teaching of Dentistry undergraduates. Objective: The aim of this study was to report a 5-year experience on the undergraduate laboratorial and clinical use of rotary endodontic preparation at a private university. Material and methods: Data survey was performed by using a questionnaire composed of nine objective questions; the questionnaire was answered by the undergraduates. Results: The results showed a positive acceptance regarding the undergraduate teaching of the rotary technique (94.7%). The following advantages were highlighted: faster root canal preparation (91.6%) and reduction of patient's stress (80.9%). Conclusion: It can be concluded that the experience with the two undergraduate groups was excellent due to the high acceptance level of the new technique by the students

A ação do hidróxido de cálcio frente ao enterococcus faecalis nos casos de periodontite apical secundária: [revisão] / The action of calcium hydroxide against enterococcus faecalis in cases of secondary apical periodontitis: [review]

Introdução: a infecção da polpa e dos tecidos periapicais tem a sua etiologia discutida há anos. A periodontite apical é caracterizada por ser de origem polimicrobiana, sendo o Enterococcus faecalis o microorganismo mais comumente encontrado. Em situações clínicas, o objetivo do tratamento endodôntico é eliminar micro-organismos do sistema de canais radiculares. As medicações intracanal são um importante passo no tratamento e devem ser efetivas frente aos micro-organismos que resistem ao preparo do canal radicular. Dentre as medicações empregadas, o hidróxido de cálcio é utilizado rotineiramente como medicação intracanal. Sua ação se deve ao fato de estabelecer um pH altamente alcalino dentro do canal radicular, 12,5 aproximadamente, no qual a maioria dos microorganismos não consegue sobreviver. Objetivo: realizar uma revisão de literatura sobre a relação do Enterococcus faecalis no insucesso endodôntico e a efetividade do hidróxido de cálcio nesta situação clínica. Conclusão: a ação do hidróxido de cálcio frente ao Enterococcus faecalis é limitada.

Introduction: Pulp and periapical tissue infection etiology has been discussed for many years. Apical periodontitis is characterized by multimicrobial flora origin, in which Enterococcus faecalis is the microorganism more frequently found. In clinical situations, the aim of endodontic treatment is to remove microorganisms of the system of root canals. Intra canal medications are an important step in the treatment and they must be effective in microorganisms that resist the preparation of the root canal. Among all used medications, the calcium hydroxide is frequently used. It acts establishing a highly alkaline pH inside the root canal, 12.5 approximately, in which most of the microorganisms do not manage to survive.Aim: to make a review of the literature about the relationship on the Enterococcus faecalis on endodontic failure and calcium hydroxide effectiveness in this clinical situation. Conclusion: Calcium hydroxide has limited action against Enterococcus faecalis.

Análise ex vivo da influência do preparo cervical na determinação do comprimento de trabalho por três diferentes localizadores apicais eletrônicos / Ex vivo analysis of the influence of cervical preparation in determining the working length by three different apex electronic locators

Introdução: Atualmente uma geração nova de localizadores apicaiseletrônicos (electronic apex locators ? EALs) passou a utilizar correntesalternadas com frequências baixas, em que o efeito do potencial de polarização do eletrodo é evitado, dando mais precisão para os valoresmedidos. Objetivo: O objetivo deste estudo foi avaliar ex vivo a influênciado preparo do terço cervical na eficácia de três localizadores apicaisquando comparados com o exame radiográfico. Material e métodos:Foram utilizados 20 pré-molares inferiores de canais únicos e retos. Osespécimes tiveram inicialmente o comprimento de trabalho estabelecidoa 1 mm do ápice radicular pelo método visual. Na sequência os dentesforam submetidos ao método radiográfico e aos localizadores apicaisRoot ZX, Root ZX II e Novapex, definindo dessa forma dados numéricosdo grupo controle, radiográfico e localizadores apicais. A medição foifeita antes e após o preparo do terço cervical, com o instrumento SXdo sistema Protaper. Resultados: Após a obtenção dos dados, estesforam submetidos a análise estatística, e não se encontrou diferençaestatisticamente significante entre os grupos experimentais estudados.Conclusão: Os localizadores apicais pesquisados provaram ser precisospara a realização da odontometria durante a terapia endodôntica.

Introduction: Currently, a new generation of electronic apex locators(EALs) started to use alternating current at low frequencies, where theeffect of polarization potential of the electrode is avoided, giving moreprecision to the measured values. Objective: The aim of this studywas to evaluate ex vivo the influence of the preparation of the cervicalthird in the effectiveness of three apex locators when compared to theradiographic examination. Material and methods: 20 mandibularpremolars with single straight canals were used. At first the specimenshad the working length established at 1 mm from the apex through thevisual method. Then teeth were submitted to the radiographic methodand to the Root ZX, Root ZX II and Novapex apex locators, therebysetting data in the control group, radiographic and apex locators. Themeasurement was performed before and after the preparation of thecervical third, with the SX instrument of the Protaper system. Results:After obtained, data was submitted to statistical analysis, and nostatistically significant difference was found between the experimentalgroups studied. Conclusion: The apex locators studied proved tobe accurate to perform the root canal measuring during endodontictherapy.