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1.
Braz. dent. j ; 33(3): 8-17, July-Sept. 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1384037

ABSTRACT

Abstract This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.


Resumo Este estudo avaliou o efeito da terapia fotodinâmica (PDT) em canais radiculares infectados com E. faecalis. Vinte e um dentes humanos extraídos foram selecionados, e 18 foram infectados por E. faecalis por 60 dias. As estratégias antimicrobianas testadas foram: G1. Preparo do canal radicular (PCR) com instrumentos rotatórios de NiTi, NaOCl 2,5% e irrigação final com EDTA 17%, seguido de PDT com fotossensibilizador azul de metileno e laser diodo de baixa potência; G2. PCR usando limas de aço inoxidável e os mesmos protocolos de irrigação e PDT do G1; G3. Protocolo de PCR similar que G1 sem PDT; G4. Somente irrigação com NaOCl 2,5%; G5. Protocolo similar ao G1, sem PCR; G6. Controle negativo; G7. Controle positivo. Amostras para exames microbiológicos foram coletadas inicialmente (S1), após PCR (S2) e após PDT (S3). Na sequência, as raízes foram seccionadas e preparadas para análise em microscopia eletrônica de varredura (MEV). O crescimento bacteriano foi analisado de acordo com a turbidez do meio de cultura seguida pela densidade óptica espectrofotométrica (nm). O efeito da PDT na estrutura dentinária foi avaliado em aumentos de 1.600X e 5.000X, e descrito qualitativamente. O teste de Wilcoxon foi utilizado para as comparações dos mesmos espécimes e o teste de Mann-Whitney para as comparações entre os grupos ((=5%). Bactérias foram encontradas em todos os grupos experimentais, e em todas as coletas microbiológicas (S1, S2 e S3). A densidade óptica dos meios de cultura foi menor em S2 do que em S1 de G1, 2, 3 e 4 (p>0,05). Após a PDT (S3) em G1 e 2, houve redução adicional na densidade óptica do meio de cultura de 90,0% e 92,0%, respectivamente (p>0,05). No Grupo 5, a análise dos meios de cultura em S2 revelou um aumento de 3,2% na densidade óptica em comparação com S1(p>0,05). Nas imagens de MEV do G1, 2 e 5 foram evidenciadas dentina com áreas de fusão e recristalização. O PDT utilizado após preparo do canal radicular com sistema rotatório ou manual, associado ao NaOCl 2,5%, não foi capaz de eliminar completamente o E. faecalis em biofilme maduro presente no canal radicular.

2.
Braz. dent. j ; 33(4): 21-30, July-Aug. 2022. graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1394092

ABSTRACT

Abstract A contemporary technological revolution has started a new era in the metaverse of Endodontics, a world of virtual operational possibilities that use an exact replica of the natural structures of the maxillofacial complex. This study describes a modeling method for root canal endoscopy using modern cone-beam CT (CBCT) software in a series of clinical cases. The method consists in acquiring thin CBCT slices (0.10mm) in the coronal, sagittal, and axial planes. A specific 3D volume filter, the pulp cavity filter of the e-Vol DX CBCT software, was used to navigate anatomical root canal microstructures, and to scan them using root canal endoscopy. The pulp cavity filter should be set to synchronize CBCT scans from 2D mode - multiplanar reformations (MPR) - to 3D mode - volumetric reconstruction. This filter, when adopting the option of volumetric reconstruction, the developed algorithm leaves the dentin density in transparent mode so that the pulp cavity may be visualized. The algorithm applied performs the suppression (visual) of areas with dentin density. This ensures 3D visualization of the slices and the microanatomy of the root canal, as well as a dynamic navigation throughout the pulp cavity. This computational modeling method adds new resources to Endodontics, which may impact the predictability of root canal treatments positively. The virtual visualization of the internal anatomy of an exact replica of the canal ensures better communications, reliability, and clinical operationalization. Root canal endoscopy using this novel CBCT filter may be used for clinical applications together with innovative digital and virtual-reality resources that will be naturally incorporated into the principles of Endodontics.


Resumo Uma revolução tecnológica contemporânea deu início a uma nova era no metaverso da Endodontia, um mundo de possibilidades operacionais virtuais que utilizam uma réplica exata das estruturas naturais do complexo dentomaxilofacial. Este estudo descreve um método de modelagem computacional para a endoscopia do canal radicular, usando um moderno software de tomografia computadorizada de feixe cônico (TCFC), em uma série de casos clínicos. O método consiste na aquisição de finos slices de TCFC (0,10mm) nos planos coronal, sagital e axial. Um filtro específico de TCFC (filtro cavidade pulpar do software e-Vol DX) foi usado para navegar nas microestruturas anatômicas do canal radicular, e escanear para a aplicação da endoscopia do canal radicular. Este filtro foi configurado para sincronizar as imagens de TCFC em modo 2D - reformações multiplanares (MPR) para o modo 3D - reconstrução volumétrica. O filtro Pulp Cavity ao adotar a opção de reconstrução volumétrica, um algoritmo desenvolvido deixa a densidade dentinária em modo transparente, para que a cavidade pulpar possa ser melhor visualizada. O algoritmo aplicado realiza a supressão (visual) das áreas com densidade dentinária. Este modo de aplicação garante a visualização 3D da microanatomia do canal radicular, bem como permite uma navegação dinâmica por toda a cavidade pulpar. O método de modelagem computacional agrega novos recursos à Endodontia, o que pode impactar positivamente na previsibilidade dos tratamentos endodônticos. A visualização virtual da anatomia interna de uma réplica exata do canal radicular garante melhor comunicação, confiabilidade e operacionalização clínica. O exame de endoscopia do canal radicular com este novo filtro (Pulp cavity) pode ser usada para aplicações clínicas juntamente com recursos digitais e de realidade virtual inovadores que serão naturalmente incorporados aos princípios da Endodontia.

3.
Braz. oral res. (Online) ; 36: e038, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1364592

ABSTRACT

Abstract: This study measured the thickness of cementum/dentin in the danger zone of the mandibular molars after root canal preparation using novel cone-beam computed tomography (CBCT) software. Eighty-four teeth were distributed into four groups: ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold. E-Vol DX® CBCT software was used to measure initial and final remaining cementum-dentin thicknesses after root canal preparation of the mesial root of mandibular molars at 1 and 3 mm from the furcation. The Kolmogorov-Smirnov test was used to test variable symmetry. The variables were described as mean and standard deviations, compared among the groups using analysis of variance (ANOVA), and within the groups using the Student t test. A generalized estimating equation model was used to compare the variation before and after root canal preparation. The level of significance was set at 5%. Differences between mean initial and final thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals were not statistically significant. The mean initial thickness was 3 mm (0.900 mm ± 0.191), considering that a mean lower than 1 mm (1.035 mm ± 0.184) indicates the danger zone. Although cementum/dentin is thinner at 3 mm from the furcation (0.715±0.186) after root canal preparation, the greatest amount of dentin removed was found at 1 mm (0.734 ± 0.191). The cementum-dentin remaining after preparation was thicker than 0.715 mm in root canals prepared using #35 (WaveOne Gold®) and #40 (ProTaper Next®, BioRace® and Reciproc Blue®) instruments. This confirms the safety of canal preparation in the danger zone using these systems.

4.
Dent. press endod ; 11(3): 75-82, Sept-Dec.2021. Ilus
Article in English | LILACS | ID: biblio-1379665

ABSTRACT

Introdução: Perfuração radicular é a comunicação entre as paredes do canal radicular e o espaço periodontal. O tempo, a localização e a dimensão da perfuração são fatores que afetam no prognóstico do dente. Objetivo: Relatar um caso clínico de tratamento de perfuração radicular supraóssea associado a enxertia de tecido conjuntivo em área estética. Relato do caso: Paciente relatou ter sido submetido, há 3 meses, ao tratamento endodôntico do dente #22; porém, esse não foi finalizado. Ao exame clínico, o dente apresentava ausência de dor e presença de fístula na região da gengiva inserida. As imagens radiográficas e tomográficas revelaram imagem sugestiva de perfuração radicular na região vestibular do dente #22, além de área hipodensa/radiolúcida circunscrita ao ápice radicular, conduzindo ao diagnóstico de periodontite apical assintomática associada a perfuração radicular supraóssea. Inicialmente, foi realizado preparo do canal radicular e utilizada medicação intracanal por 21 dias. Posteriormente, foi realizada a obturação do canal radicular e restauração definitiva em resina composta na face palatal. Na mesma sessão, foi realizado o acesso cirúrgico para selamento da perfuração com resina composta, associado a enxertia de tecido conjuntivo no dente #22, para evitar recessão tecidual marginal. Foi observada, após 12 meses, neoformação óssea na região periapical do dente #22, com ausência de dor e preservação da estética na região periodontal. Conclusão: O diagnóstico e o planejamento multidisciplinar são fatores importantes no tratamento de perfurações radiculares, assim como a correta escolha do material selador (AU).


Introduction: Root perforation is the communication between the walls of the root canal and the periodontal space. The time, location and size of the perforation are factors that affect the prognosis of the tooth. Objective: To report a clinical case of treatment of supraosseous root perforation associated with grafting of connective tissue in aesthetic area. Case report: Patient reported that 3 months had started root canal treatment of tooth 22, but was not finalized. At the clinical examination, the tooth presented absence of pain and presence of sinus tract in the region of attached gingiva. Radiographic and tomographic images revealed an image suggestive of root perforation in the buccal region of tooth 22, as well as a hypodense / radiolucent area circumscribed to the root apex, leading to the diagnosis of asymptomatic apical periodontitis associated with supraosseous root perforation. Initially, it were performed root canal preparation and intracanal medication. After 21 days, root canal obturation and composite restoration were performed on the palatal face. In the same session, the surgical access was made to sealing the perforation with composite resin, associated to the grafting of connective tissue in tooth 22, to avoid marginal tissue recession. It was observed after 12 months new bone formation in the periapical region of tooth 22, with absence of pain and preservation of aesthetics in the periodontal region. Conclusion: Multidisciplinary diagnosis and planning are important factors in the treatment of root perforations, as well as the correct selection of materials used to seal root perforations (AU).


Subject(s)
Humans , Tissue Transplantation , Composite Resins , Root Canal Preparation , Esthetics , Periapical Periodontitis , Research Report
5.
Braz. dent. j ; 32(6): 28-35, Nov.-Dec. 2021. graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1355840

ABSTRACT

Abstract This study describes a methodology to identify accessory root canals using the e-Vol DX software in CBCT scans. Accessory root canals are strategic shelters for microorganisms present in root canal infections. The identification of these small canals in periapical radiographic exams has limitations, besides being markedly limited accessibility to the action of endodontic instruments and to the antimicrobial agents. A significant number of accessory canals have sufficient diameters to be visible on cone-beam computed tomography (CBCT) images of high spatial resolution. Therefore, it may go unnoticed or even confused when there is no specific training for this type of diagnosis. The methodology consists in establishing thin slices (0.1mm or smaller) obtained from coronal, sagittal and axial slices. The method consists of the following steps: during navigation along the long axis of a root canal when finding a possible hypodense line of main root canal in a tomographic section (axial, sagittal or coronal), the navigation software lines of the multiplanar reconstruction (MPR) must be adjusted so that they are parallel and perpendicular to the hypodense line (parallax correction). Then, after judiciously adjusted, the accessory canal image will invariably appear as a line on one of the MPR tomographic slices, another line on another slice, and a dot on the third slice. The three sections of the MPR present images with the "line-line-dot" sequence. In this way, it is possible to identify an accessory root canal and also visualize it in volumetric reconstruction in a specific filter. The application of this method is easy to employed and may benefit the diagnosis when you want to visualize accessory root canals and distinguish it from root fracture line.


Resumo Este estudo descreve um método para identificar canais radiculares acessórios usando o software e-Vol DX em imagens de TCFC. Os canais radiculares acessórios constituem abrigos estratégicos aos micro-organismos presentes nas infecções endodônticas. A identificação destes pequenos canais em exames radiográficos periapicais apresenta limitações, além de apresentar baixa acessibilidade natural a ação dos instrumentos endodônticos e dos agentes antimicrobianos. Os canais acessórios apresentam diâmetros suficientes para ficarem visíveis em imagens de tomografia computadorizada de feixe cônico (TCFC) de alta resolução espacial. Porém, podem passar despercebidos ou até confundidos quando não ocorrer treinamento específico para este tipo de diagnóstico. A metodologia consiste em estabelecer finos slices (0,1 mm ou menor) obtidos a partir de cortes coronal, sagital e axial. O método consiste nos seguintes passos: ao encontrar uma linha hipodensa de um canal radicular principal em um corte tomográfico (axial, sagital ou coronal) deve-se ajustar as linhas de navegação da reconstrução multiplanar (MPR) para que fiquem paralelas ao canal principal e perpendiculares a esta linha hipodensa (correção de paralaxe). A seguir, depois de criterioso ajuste da imagem em busca do canal acessório, aparece invariavelmente como uma linha em um dos cortes tomográficos da MPR, outra linha em outro corte e um ponto no terceiro corte. Os três cortes da MPR apresentam imagens com a sequência linha-linha-ponto. Desta maneira, pode-se identificar um canal acessório e visualizá-lo em reconstrução volumétrica em filtro específico. Esta metodologia é fácil de ser aplicada e pode beneficiar o diagnóstico quando se deseja identificar canais radiculares acessórios e distingui-lo de linha de fratura radicular.

6.
Braz. oral res. (Online) ; 35: e065, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1249364

ABSTRACT

Abstract: Maxillary and mandibular incisors have increased risk for severe orthodontically induced inflammatory root resorption. A patient-related risk factor is aberrant root morphology. This study aimed to assess the frequency of detection of different root morphologies in anterior teeth using dental panoramic tomography (DPT) and long cone periapical radiographs (LCPAs). A retrospective cross-sectional design was used to assess a sample of 50 consecutive pre-treatment radiographic records of patients from a specialist orthodontic practice in Adelaide, Australia. A reference guide was developed that included three previously unreported morphologies: pipette and bent, bent and pointed, bent and blunt. Two trained and calibrated assessors examined each record against the inclusion criteria, then independently assessed each anterior tooth from DPTs and LCPAs to detect the type of root morphology present. Data were analysed using the chi-square statistical test. Radiographic records for 48 patients (48 DPTs and 161 LCPAs) were eligible, with 355 and 426 teeth on DPTs and LCPAs, respectively, included for assessment. Normal root morphology (119 teeth) was commonly observed in DPTs, while bent (154 teeth) was frequently observed using LCPAs. Mandibular incisors often had normal morphology in DPTs but bent in LCPAs. Bent was the most common morphology in maxillary lateral incisors using DPT and LCPAs, although maxillary centrals were mostly normal in DPTs but pointed in LCPAs. Differences using the two image acquisition methods were highly significant (p < 0.01). Aberrant root morphologies are more easily detected in anterior teeth using LCPAs compared to DPTs.


Subject(s)
Humans , Root Resorption/diagnostic imaging , Tooth Root/diagnostic imaging , Radiography, Panoramic , Cross-Sectional Studies , Retrospective Studies , Maxilla
7.
Braz. oral res. (Online) ; 35: e024, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1153617

ABSTRACT

Abstract Cone-beam computed tomography (CBCT) is an essential imaging method that increases the accuracy of diagnoses, planning and follow-up of endodontic complex cases. Image postprocessing and subsequent visualization relies on software for three-dimensional navigation, and application of indexation tools to provide clinically useful information according to a set of volumetric data. Image postprocessing has a crucial impact on diagnostic quality and various techniques have been employed on computed tomography (CT) and magnetic resonance imaging (MRI) data sets. These include: multiplanar reformations (MPR), maximum intensity projection (MIP) and volume rendering (VR). A recent advance in 3D data visualization is the new cinematic rendering reconstruction method, a technique that generates photorealistic 3D images from conventional CT and MRI data. This review discusses the importance of CBCT cinematic rendering for clinical decision-making, teaching, and research in Endodontics, and a presents series of cases that illustrate the diagnostic value of 3D cinematic rendering in clinical care.


Subject(s)
Radiographic Image Interpretation, Computer-Assisted , Cone-Beam Computed Tomography , Software , Tomography, X-Ray Computed , Imaging, Three-Dimensional
8.
Dent. press endod ; 10(3): 27-37, Sept-Dec.2020. Ilus
Article in English | LILACS | ID: biblio-1344759

ABSTRACT

Introdução: As obturações dos canais radiculares e os pinos intrarradiculares geralmente produzem artefatos de contraste branco e possíveis alterações volumétricas nas imagens de tomografia computadorizada de feixe cônico (TCFC). Esses artefatos, induzidos pela maior densidade dos materiais obturadores de canais radiculares, cimentos para colocação de coroa e pinos intracanais, podem potencialmente levar a interpretações incorretas, interferindo no diagnóstico de um volume adquirido de TCFC, principalmente na avaliação de potenciais fraturas e perfurações radiculares. Objetivos: Avaliar em seis casos clínicos os efeitos positivos e negativos dos artefatos de contraste branco no diagnóstico de fraturas radiculares, perfurações radiculares e cimentação de restaurações de porcelana. Métodos: O software e-Vol DX, que possui filtros específicos para redução de artefato de contraste (BAR, Blooming Artifact Reduction), foi usado para melhorar o valor diagnóstico dos volumes adquiridos de TCFC. Conclusões: O em- prego do software e-Vol DX para a reconstrução de imagens de TCFC melhorou a visualização das estruturas anatômicas e reduziu os artefatos. A visualização aprimorada de da- dos nas imagens pode auxiliar na identificação de detalhes essenciais que, em conjunto com os achados clínicos, são úteis para uma correta estruturação do diagnóstico (AU).


Introduction: Root canal fillings and intraradicular posts often create white contrast artifacts and possible volumetric changes on CBCT scans known as blooming artifacts. These alterations could lead to the incorrect interpretations reducing the diagnostic of an acquired CBCT volume, particularly when evaluating potential root fractures and root perforations. Methods and Results: In six clinical cases, the positive and negative effects of beam hardening artifacts on the diagnosis of root fractures, root perforations and porcelain restoration cementation were evaluated. These artifacts, induced by the higher density of root canal filling materials, cements for crown placement and intracanal posts, may potentially lead to inaccurate or false interpretations. A novel software, e-Vol DX, which has specific filters for blooming artifact reduction (BAR), was used to improve the diagnostic value of acquired CBCT volumes. Conclusions: The use of the e-Vol DX software package for the reconstruction of CBCT scans improved visualization of anatomical structures and reduced blooming artifacts. Improved data visualization may help reveal essential details that, in conjunction with clinical findings, are useful to achieve a correct diagnosis (AU).


Subject(s)
Software , Filters , Artifacts , Cone-Beam Computed Tomography , Serial Publications
9.
Braz. dent. j ; 31(6): 582-588, Nov.-Dec. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132346

ABSTRACT

Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.


Resumo Este estudo avaliou as dimensões de pinos intrarradiculares usando um novo software de tomografia computadorizada de feixe cônico (TCFC) e um micrômetro digital, e verificou o potencial da redução do artefato de contraste do branco. Sessenta e três dentes humanos unirradiculares foram modelados, obturados, preparados para colocação de pinos e distribuídos em três grupos: G1: pino de fibra de vidro pré-fabricado anatômico; G2: pino metálico de liga de baixa fusão; G3: pino metálico de liga de ouro. Após a confecção e cimentação dos pinos com RelyX U200®, os espécimes foram cortados no sentido axial a 9 mm do ápice radicular, sendo efetuadas marcações em suas superfícies radiculares (eixos X, Y e Z) para orientação das medidas e sincronizações das imagens. Foi utilizado um micrômetro digital para a mensuração das dimensões dos pinos originais (grupo controle) associado ao microscópio operatório. Posteriormente, as imagens em TCFC foram obtidas usando o PreXion 3D Elite®. Para a mensuração dos pinos nas imagens de TCFC utilizou-se o arquivo DICOM e a ferramenta de medida do software e-Vol DX, configurada para medidas milesimais, com o filtro BAR (Blooming Artifact Reduction). Os dados estatísticos foram avaliados com a análise de variância não-paramétrica de Van der Waerden, seguida pelo Teste de Tukey aplicado aos dados normalizados. O nível de significância foi de α = 5%. Os resultados mostraram que as medidas dos diâmetros dos pinos intrarradiculares (fibra de vidro anatômico, metálico liga de baixa fusão, e em liga de ouro) usando o software e-Vol DX e o micrômetro não mostram diferenças significativas entre si. O uso do filtro BAR do software e-Vol DX não induziu diferenças dimensionais nas imagens de TCFC dos pinos quando comparadas às medidas realizadas com o micrômetro sobre os pinos originais. O uso do filtro BAR eliminou artefatos de contraste do branco.


Subject(s)
Humans , Post and Core Technique , Artifacts , Tooth Root , Software , Cone-Beam Computed Tomography
10.
Braz. dent. j ; 31(3): 337-343, May-June 2020. graf
Article in English | LILACS, BBO | ID: biblio-1132295

ABSTRACT

Abstract Lateral luxation injuries are one of the most severe periodontal injuries in dental trauma. The correct diagnosis followed by repositioning of the tooth on the right position is fundamental for the periodontal ligament healing. This study reported a clinical case of lateral luxation of maxillary central incisor involving a new cone beam computed tomography (CBCT) software for reconstruction (e-Vol DX) to confirm the lateral luxation after no conclusive dental trauma injury definition by using conventional exam. The lateral luxation injury was digitally reduced by insertion of tooth back to its alveolus, and at the same session, the tooth was stabilized with a rigid splint and further changed to a semi-rigid nylon splint. During the pulpal status monitoring, the pulp was diagnosed necrotic, then the root canal was treated to prevent root resorption. External office-bleaching and restorative procedure was performed. The 4-years follow up and new imaging exam and digital reconstruction confirmed bone healing and no complication. CBCT images analyzed by eVol DX can be used to determine and to guide lateral luxation treatment.


Resumo Lesões de luxação lateral são uma das lesões periodontais mais graves no traumatismo dental. O diagnóstico seguido do reposicionamento do dente na posição correta é fundamental para o reparo do ligamento periodontal. Este estudo relata um caso clínico de luxação lateral do incisivo central superior envolvendo um novo software de reconstrução (e-Vol DX) por tomografia computadorizada de feixe cônico (TCFC) para confirmar a luxação lateral após nenhuma definição de lesão por trauma dental conclusivo pelo exame convencional. A lesão de luxação lateral foi reduzida digitalmente pela inserção do dente de volta ao seu alvéolo e, na mesma sessão, o dente foi estabilizado com uma contenção rígida e posteriormente trocada para uma contenção de nylon semirrígida. Durante o monitoramento da condição pulpar, foi diagnosticada necrose da polpa e, em seguida, o canal radicular foi tratado para evitar a reabsorção radicular. Procedimento externo de clareamento e restauração foi realizado. O acompanhamento de 4 anos e o novo exame de imagem e reconstrução digital não confirmaram reparo ósseo e nenhuma complicação. Imagens de TCFC analisadas pelo e-Vol DX podem ser utilizadas para determinar e orientar lesão de luxação lateral.


Subject(s)
Humans , Root Resorption , Tooth Avulsion , Root Canal Therapy , Software , Cone-Beam Computed Tomography , Incisor
11.
Dental press j. orthod. (Impr.) ; 25(2): 44-51, Mar.-Apr. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1133656

ABSTRACT

ABSTRACT Objective: To evaluate facial profile changes promoted by polymethyl methacrylate (PMMA) cement graft to reduce excessive gingival display due to hyperactivity of the elevator muscles of the upper lip during smiling. Methods: Eleven patients (all females, age range: 20 to 43 years) presenting gingival smile that were treated with PMMA cement grafts in a private clinic were selected for this retrospective study. Three angular and ten linear cephalometric facial profile measurements were performed preoperatively (baseline, T1) and at least 6 months postoperatively (T2). Differences between T1 and T2 were verified by Wilcoxon test, and the correlation between the thickness of the graft and facial profile changes was statistically evaluated by Spearman's Coefficient test. The significance level was set at p< 0.05. Results: The nasolabial angle (p= 0.03) and the labial component of the nasolabial angle showed statistically significant differences (p= 0.04), with higher values in T2. No correlations were found between the graft thickness and the statistically significant facial profile changes (p> 0.05). Conclusions: The PMMA bone cement graft projected the upper lip forward, thereby increasing the nasolabial angle without affecting the nasal component. No correlations between the graft thickness and the facial profile changes were detected.


RESUMO Objetivo: Avaliar as alterações do perfil facial promovidas pelo enxerto de cimento de polimetilmetacrilato (PMMA) para redução da exposição gengival excessiva devida à hiperatividade dos músculos elevadores do lábio superior durante o sorriso. Métodos: Onze pacientes (todos do sexo feminino, faixa etária de 20 a 43 anos) com sorriso gengival, tratados com enxerto de cimento de PMMA em clínica privada, foram selecionados para este estudo retrospectivo. Três medidas cefalométricas angulares e dez lineares do perfil facial foram realizadas no pré-operatório (T1) e com pelo menos seis meses de pós-operatório (T2). As diferenças entre T1 e T2 foram verificadas pelo teste de Wilcoxon, e a correlação entre a espessura do enxerto e as alterações do perfil facial foi avaliada estatisticamente pelo Coeficiente de Spearman. O nível de significância foi estabelecido em p< 0,05. Resultados: o ângulo nasolabial (p= 0,03) e o componente labial do ângulo nasolabial apresentaram diferenças estatisticamente significativas (p= 0,04), com maiores valores em T2. Não foram encontradas correlações estatisticamente significativas (p> 0,05) entre a espessura do enxerto e as alterações do perfil facial. Conclusões: O enxerto de cimento ósseo de PMMA projetou discretamente o lábio superior, aumentando o ângulo nasolabial sem afetar o componente nasal. Não foram detectadas correlações entre a espessura do enxerto e as alterações do perfil facial.


Subject(s)
Humans , Female , Adult , Young Adult , Smiling , Bone Cements , Cephalometry , Retrospective Studies , Gingiva , Lip
12.
J. appl. oral sci ; 28: e20190148, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056580

ABSTRACT

Abstract The site of the sinus tract depends on the rate of resistance against abscess exudate drainage, bone morphology, and distance from the root apex to the outer cortical bone. Objective To assess apical bone thickness in buccal and palatal/lingual aspects of maxillary and mandibular teeth, using a high-resolution cone-beam computed tomography (CBCT) system. Methodology In total, 422 CBCT examinations were included in the study, resulting in a sample of 1400 teeth. The scans were acquired by PreXion 3D, with a high-resolution protocol. The bone thickness was taken as the distance between the center of the apical foramen and the buccal and lingual/palatal cortical bone. The quantitative variables were expressed as mean values±standard deviation. The independent samples were analyzed using the t-test or the Mann-Whitney test (p<0.05). Results The lowest mean value of bone thickness was observed in the buccal cortical bone of the upper canines (1.49 mm±0.86) and in the upper central incisors (1.59 mm±0.67). In premolar teeth, the lowest values were found in the buccal cortical bone of upper first premolars (1.13 mm±0.68). In the posterior teeth, the lowest values were found in the buccal cortical bone of upper first molars (1.98 mm±1.33). In the lower second molar region, the buccal cortical bone (8.36 mm±1.84) was thicker than the lingual cortical bone (2.95 mm±1.16) (p<0.05). Conclusions The lowest mean values of bone thickness are in the buccal cortical bone of the maxillary teeth. In the mandible, bone thickness is thinner in the buccal bone around the anterior and premolar teeth, and in the lingual aspect of mandibular molars. All these anatomic characteristics could make the occurrence of the sinus tract more susceptible in these specific regions of the maxillary and mandibular alveolar bone.


Subject(s)
Humans , Male , Female , Adult , Tooth/anatomy & histology , Cone-Beam Computed Tomography/methods , Mandible/anatomy & histology , Maxilla/anatomy & histology , Reference Values , Tooth/diagnostic imaging , Statistics, Nonparametric , Mandible/diagnostic imaging , Maxilla/diagnostic imaging , Odontometry/methods
13.
Braz. oral res. (Online) ; 34: e064, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132662

ABSTRACT

Abstract This study evaluated the interference of enamel and coronal dentin thickness and ambient light in pulse oximetry interpretation, using SaO2the human finger as a reference. Forty-two intact human permanent mandibular molars were sectioned mesiodistally in the central portion. Buccal and lingual dentin surfaces were drilled, and 4 mm, 3 mm and 2 mm enamel/dentin thicknesses were interposed between finger and device, after which SaO2 levels were measured by finger pulse oximetry. A reference device was designed to align pulse oximeter light-emitting diode, buccal surface of tooth, little finger, lingual surface of tooth and photodiode. Variables were described as means and standard deviation, and the confidence interval was reported. Repeated measures analysis of variance (ANOVA) was used to compare the groups, followed by Bonferroni correction. Student t test for paired samples was used to determine presence of ambient light (α = 0.05). Mean SaO2 level was lower at 4.0 ± 0.2 mm thickness, regardless of presence or absence of ambient light (92.7% and 89.3%). The other thicknesses yielded values of 95.5% and 94.5% at 3.0 ± 0.2 mm, and 96.4% and 96.0% at 2.0 ± 0.2 mm (p < 0.001). There were significant differences between SaO2 values at 4.0 ± 0.2 mm, 3.0 ± 0.2 mm and 2.0 ± 0.2 mm thicknesses, in the presence of ambient light. Mean SaO2 level in positive control was 96.3%, and mean pulse rate was 69.5 bpm in presence of ambient light; in the absence of light, these values were 96% and 70.5 bpm. Enamel and dentin thickness interfere with SaO2, regardless of presence or absence of ambient light. The lowest SaO2 levels were found for the thickest tooth samples.


Subject(s)
Humans , Oximetry , Dental Enamel , Oxygen , Dentin , Molar
14.
Braz. oral res. (Online) ; 34: e056, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132692

ABSTRACT

Abstract This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods , X-Ray Microtomography/methods , Reference Values , Risk Factors
15.
J. appl. oral sci ; 28: e20190393, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1056585

ABSTRACT

Abstract Objectives This study assessed the incidence and variability features of root canals system (RCS) and their ramifications according to Pucci & Reig (PR) (1944) and the American Association of Endodontists (AAE) (2017) by micro-computed tomography (μCT). Methodology 500 representative extracted human teeth of each tooth group (n=50) (maxillary/mandibular central and lateral incisors, canines, first and second premolars and molars) were scanned by μCT with a resolution of 26.70 μm. The reconstructed cross-sections images and the visualization of the continuous slices in the transversal axis were performed using DataViewer software. RCS were classified according to Pucci & Reig (main canal, collateral canal, lateral canal, secondary canal, accessory canal, intercanal, recurrent canal) and AAE (main canal, accessory canal, lateral canal). The apical deltas were assessed for both classifications. The prevalence of apical deltas was evaluated using the Chi-squared test (p<0.05). Results According to PR, a higher incidence of lateral canals was observed in maxillary canines (10%), central incisors (8%) and first premolars (6%). Using AAE, the highest incidence of lateral canals was observed in the mandibular first premolars (85%), first and second molars (84%), lateral incisors (67%), canines (59%), and in maxillary first premolars (52%). Regarding accessory canals, the PR showed a frequency in 2% of the maxillary lateral incisors and maxillary and mandibular first premolars and 3% of mandibular first and second molars. On the other hand, the AAE showed the highest incidence of accessory canals in 86% of the maxillary first premolars, 71% in mandibular lateral incisors, 69% in mandibular first premolars, 65% in mandibular canines, and 56% in maxillary canines. The PR showed the lowest incidence of apical deltas for all dental groups when compared with AAE (p=0.004). Interestingly, distal canals in maxillary molars showed a significant discrepancy between classifications (p=0.027). Conclusions μCT enabled accurately describing the RC system and related ramifications, adding to the PR and AAE classifications, with some discrepancies reported for maxillary molars. Clinical Relevance This μCT study enabled a thorough description of the variability among root canals and their ramifications, including clinically relevant details on the presence and location of lateral canals and accessories in all human tooth groups, beyond the currently existing classification systems.


Subject(s)
Humans , Dental Pulp Cavity/anatomy & histology , X-Ray Microtomography/methods , Reference Values , Statistics, Nonparametric , Tooth Apex/anatomy & histology , Tooth Apex/diagnostic imaging , Imaging, Three-Dimensional , Dental Pulp Cavity/diagnostic imaging , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imaging
16.
Dent. press endod ; 9(3): 20-28, Sept-Dec.2019.
Article in English | LILACS | ID: biblio-1343623

ABSTRACT

As conquistas incorporadas à Endodontia em decorrência das novas tecnologias de informação permitiram avanços que impactaram no êxito clínico e no prognóstico. Essas novas aquisições influenciaram o mundo contemporâneo, que presencia uma profunda mudança proporcionada pela velocidade e qualidade das informações, economia de investimento e tempo, assim beneficiando a área da saúde. Uma revolução do pensamento e modo de viver contemporâneo que se experimenta nos dias atuais é a biotecnologia. O impacto da tomografia computadorizada de feixe cônico na Endodontia foi capaz de superar várias limitações das radiografias periapicais, como a eliminação das sobreposições, a extraordinária possibilidade de navegação pela imagem, a qualidade das imagens em alta resolução e contraste, entre outras. Esse estudo objetiva apresentar algumas características de um novo software de tomografia computadorizada de feixe cônico chamado de e-Vol DX, capaz de impactar nas tomadas de decisões clínicas em Endodontia. O software de TCFC e-Vol DX se constitui em um recurso imprescindível na obtenção de imagens de alta qualidade. Vários filtros, com diferentes propriedades, foram desenvolvidos e incorporados, como o filtro BAR, que permite a redução de artefatos de contraste do branco, entre outros. Essa ferramenta é efetiva em tomadas de decisões clínicas para a execução do protocolo terapêutico de casos endodônticos complexos.


The achievements incorporated into endodontics, resulting from new information technologies allowed advances that impacted prognosis and clinical success. These new acquisitions have influenced the contemporary world, that is witnessing a profound change brought about by the speed and quality of information, investment savings and time, thus benefiting the health areas. A revolution in contemporary thinking and living that is being experienced today is biotechnology. The impact of cone beam computed tomography on endodontics was able to overcome several limitations of periapical radiography, such as the removal of overlaps, the extraordinary possibility of image navigation, the quality of high resolution and contrast images, among others. This study aims to present some characteristics of a new cone beam computed tomography software named e-Vol DX which may impact the clinical decision-making in endodontics. The e-Vol DX CBCT software is an indispensable resource for high quality images. Various filters with different properties have been developed and incorporated, such as the Blooming Artifact Reduction (BAR) filter that allows the reduction of white contrast artifacts, among others. This tool is effective in clinical decision-making for the implementation of the therapeutic protocol of complex endodontic cases.


Subject(s)
Software , Artifacts , Endodontics , Information Technology , Cone-Beam Computed Tomography , Diagnosis , Investments
17.
Braz. dent. j ; 30(6): 550-554, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1055450

ABSTRACT

Abstract Electronic apex locators (EAL) have been used to establish the working length (WL) in root canal treatment. In teeth diagnosed with apical periodontitis, resorption of tooth apical structures can lead to difficulties to obtain an appropriate WL. The aim was to compare the capacity of three EAL's (Root ZX II, Raypex 6 and Endo-Eze Quill) to locate the tip of the K-file between 0 to -0.5 mm from the apical foramen (AF) on teeth diagnosed with asymptomatic apical periodontitis (AAP). Electronic working length was performed on 60 roots with AAP. A K-file #15 was inserted in the root canal until the apical foramen (AF) was located, and followed was re-adjusted to -0.5 mm through observation in EAL display. The K-file was fixed to the tooth with composite and teeth were extracted. The 4 apical millimeters were worn out until the K-file could be seen and were prepared and measured its distance to AF in a scanning electron microscope. Appropriate WL was when the tip of the K-file was located between 0 to -0.5 mm from AF. Results: Root ZX II showed significant difference (p<0.01) with the other two EALs. Root ZX II presented the better performance than Raypex 6 or Endo-Eze Quill in teeth with AAP.


Resumo Os localizadores eletrônicos apicais têm sido usados ​​para estabelecer o comprimento de trabalho no tratamento do canal radicular. Nos dentes diagnosticados com periodontite apical, a reabsorção das estruturas apicais dos dentes pode levar a dificuldades na obtenção de uma odontometria apropriada. Este estudo comparou três localizadores apicais (Root ZX II, Raypex 6 e Endo-Eze Quill) para localizar a ponta do instrumento K-file entre 0 a -0,5 mm do forame apical em dentes com diagnóstico de periodontite apical assintomática. O comprimento de trabalho eletrônico foi realizado em 60 dentes com periodontite apical assintomática. Uma lima K-file de número 15 foi inserida no canal radicular até a localização do forame apical, e seguida foi reajustada para -0,5 mm por meio de observação no visor do localizador eletrônico apical. A lima K-file foi fixada ao dente usando compósito, e a seguir os dentes foram extraídos. Os 4 milímetros apicais foram desgastados até que a lima K-file pudesse ser visualizada para as medidas de distância no forame apical por meio de microscópio eletrônico de varredura. O comprimento de trabalho apropriado foi determinado quando a ponta do instrumento estivesse localizada entre 0 a -0,5 mm do forame apical. O Root ZX II apresentou o melhor desempenho (p<0,01) que o Raypex 6 ou Endo-Eze Quill em dentes humanos com periodontite apical assintomática.


Subject(s)
Humans , Periapical Periodontitis , Tooth Apex , Root Canal Therapy , Root Canal Preparation , Dental Pulp Cavity , Electronics , Odontometry
18.
ROBRAC ; 28(84): 1-4, jan./mar. 2019. Ilus, Tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1049218

ABSTRACT

Objetivo: Avaliar a acurácia, sensibilidade e especificidade de diferentes filtros do software Cliniview™ (versão 10.1) em radiografias periapicais digitais na detecção de fraturas radiculares verticais em dentes unirradiculares. Material e Métodos: Foram utilizados 31 dentes humanos recém-extraídos divididos em dois grupos: controle (CTL) e fraturado (FTR), constituídos por 15 e 16 dentes, respectivamente. Realizou-se o tratamento endodôntico dos dentes para posterior desobturação de 2/3 da raiz e confecção dos pinos metálicos. Após cimentação dos pinos, as raízes dos dentes grupo FTR foram fraturadas na máquina de ensaio (Instron). As radiografias periapicais digitais foram obtidas em todos os dentes com sistema digital Express™. As radiografias originais e com aplicação dos filtros (inversão na escala de cinza, hot, nitidez 1, vertical e vertical + horizontal) foram salvas e avaliadas por dois especialistas. Após as análises, foram calculados os valores de sensibilidade, especificidade, preditivo positivo, preditivo negativo e acurácia da radiografia periapical digital com e sem a aplicação dos filtros. Resultados: Considerando os dois examinadores, os maiores valores de acuraria, sensibilidade e especificidade para as imagens originais foram de 85,2%, 100% e 95,2% respectivamente. Para as radiografias com aplicação de filtro, os maiores valores de acurácia, sensibilidade e especificidade foram de 82,6%, 71,4% e 87,5%, respectivamente. Conclusão: O uso de filtros não aumentou os valores de acurácia, sensibilidade e especificidade das radiografias periapicais digitais para a detecção das fraturas radiculares verticais. De fato, pelo contrário, em alguns casos, o diagnóstico piorou.


Objective: To evaluate the accuracy, sensitivity, and specificity of different Cliniview™ (version 10.1) software filters in digital periapical radiographs for the detection of vertical root fractures in single-rooted teeth. Materials and Methods: Thirty-one human teeth freshly extracted were divided into two groups: control (CTL) and fractured (FTR), constituted by 15 and 16 teeth respectively. The endodontic treatment of the teeth was performed and followed by desobturation of ⅔ of the root canal and the metallic posts confection. After the cementation of the posts, the fractures were made using the universal test machine (Instron) only in the FTR group. The digital periapical radiographs were performed in all the teeth using the ExpressTM digital system. The original radiographs and the ones with applied filters (gray scale, hot, sharpness 1, vertical and vertical + horizontal) were saved and evaluated by two specialists. After the analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the digital periapical radiographs with and without the application of filters were calculated. Results: Taking into consideration the two examiners, the highest accuracy, sensitivity and specificity values for the original images were 85,2%, 100% and 95,2% respectively. For the radiographs with applied filters, the highest accuracy, sensitivity and specificity values found were of 82,6%, 71,4% and 87,5%, respectively. Conclusion: The use of filters did not increase the accuracy, sensitivity and specificity values of the digital periapical radiographs for the detection of VRF. In fact, on the contrary, for some cases, the diagnosis became worse.

19.
Braz. dent. j ; 30(1): 3-11, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-989432

ABSTRACT

Abstract This study discusses a method to determine the root canal anatomic dimension by using e-Vol DX software. The methodology consists in initially establishes the correct positions which will be measured, define the point on the edge of the anatomical structure, and next adjust the intermediate position in the grayscale of CBCT image. Afterward, thin sections (0.10 mm) are obtained from 3D reconstructed slices in the filter for the measurements, in order to determine the edge of the anatomical surface in the axial plane. A replication of positions in 3D mode is done in multiplanar reconstruction (MPR) of CBCT images, where the correct position is established with the aid of a positioning guide. The 3D density is adjusted so that it is in the same dimension as the 2D image, and a dimension calibration occurs to the point where there is a coincidence between 3D and 2D. This calibration is done only at the beginning of the measurement. Next, the intermediate position of the division between the grayscale is verified in the CBCT scan. Once one side has been completed, it is moved to the other side and follows the same guidelines described above. When setting the position of the courses in the other margin, being that 2D mode is used as reference. Thus, one obtains the required measure, being checked in the two points. The creation of this filter in the e-Vol DX software for measurement, and its appropriate management, allows more effective applications when it is desired to obtain diameters of anatomical structures.


Resumo Este estudo discute um método para determinar a dimensão anatômica do canal radicular usando o software e-Vol DX. A metodologia consiste em inicialmente estabelecer as posições corretas que serão medidas, definir o ponto na borda da estrutura anatômica e ajustar a posição intermediária na escala de cinza na imagem em tomografia computadorizada de feixe cônico (TCFC). A seguir, slices finos (0,10mm) são obtidos a partir de cortes 3D reconstruídos no filtro para as medidas, a fim de determinar a borda da superfície anatômica no plano axial. Uma replicação de posições no modo 3D é feita em reconstrução multiplanar (MPR) em imagens de TCFC, onde a posição correta é estabelecida com o auxílio de um guia de posicionamento. A densidade 3D é ajustada de modo a ficar na mesma dimensão da imagem 2D, e então realiza-se uma calibração de dimensão até o ponto em que há uma coincidência entre o modo 3D e 2D. Essa calibração é feita apenas no início da medição. Posteriormente, a posição intermediária da divisão entre a escala de cinza é verificada na TCFC. Uma vez que um lado tenha sido concluído, o guia é movido para o outro lado, e segue-se as mesmas diretrizes descritas. Define-se a posição do marcador na outra margem, sendo que o modo 2D usado como referência. Assim, obtém-se a medida necessária, sendo verificado nas duas margens do canal radicular. A criação deste filtro no software e-Vol DX para medição e seu uso apropriado permite aplicações eficazes quando se deseja obter diâmetros de estruturas anatômicas.


Subject(s)
Humans , Software Design , Imaging, Three-Dimensional/methods , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography/methods
20.
J. appl. oral sci ; 27: e20180442, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-1002405

ABSTRACT

Abstract Objective To assess pulp oxygen saturation levels (SaO2) in maxillary central incisors after dental bleaching. Materials and Methods 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - In-office bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5th (T2), 8th (T3), 12th (T4), and 16th days of at-home bleaching (T5); and on the 7th (T6) and 30th (T7) days. Mean (SD) pulp SaO2 levels were compared within groups by generalized estimating equations (GEE) and Student's t-test (P<0.05). Results Mean pulp SaO2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P<0.05). During home bleaching, pulp SaO2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P<0.05). Conclusions Pulp SaO2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Oxygen/metabolism , Tooth Bleaching/adverse effects , Dental Pulp/metabolism , Tooth Bleaching Agents/adverse effects , Incisor/metabolism , Reference Values , Time Factors , Tooth Bleaching/methods , Toothpastes/therapeutic use , Oximetry/methods , Treatment Outcome , Dental Pulp/drug effects , Dentin Sensitivity/chemically induced , Dentin Sensitivity/prevention & control , Dentin Desensitizing Agents/therapeutic use , Carbamide Peroxide/adverse effects , Hydrogen Peroxide/adverse effects , Incisor/drug effects
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