Is clindamycin-modified triple antibiotic paste better than iodoform-based medicament for the treatment of non-vital primary molars using LSTR technique – A randomised clinical trial

Objectives: The objectives of this study were to evaluate and compare the success rate of local application of iodoform-based obturating material (Pulpotec – [Produits Dentaires S.A., Switzerland]) and clindamycinmodified triple antibiotic paste (ClinM-TAP) in pulp chamber using minimally invasive endodontic treatment of carious primary molars indicated for pulpectomy, for 12 months, using clinical and radiographic parameters. Materials and Methods: A randomised clinical trial was conducted in 60 children in the age group of 3–8 years reporting carious primary molars with symptoms of irreversible pulpitis and pulpal involvement clinically, allocated into Group 1 (30) and Group 2 (30). In Group 1, Lesion sterilisation and tissue repair (LSTR) was done using Pulpotec (Produits Dentaires S.A., Switzerland) as medicament and in Group 2, ClinM-TAP (Clindamycinmodified triple antibiotic paste) was used as medicament. Clinical follow-up was done at 3, 6 and 12 months; radiographic follow-up was done at 6 and 12 months. Clinical parameters compared were tenderness on percussion, spontaneous pain, intraoral swelling and sinus/fistula. Radiographic comparison was done based on furcation radiolucency, root resorption and bone regeneration. Both intergroup and intragroup statistical analysis was done using Chi-square test or Fisher exact test, Cochran’s Q Test and Mann–Whitney U-Test for the test of significance. All the statistical tests were performed at 5% significance level. Results: The mean age of patients in the study was 5.25 ± 1.3years with 45% males and 55% females. Both groups showed significant improvement in terms of clinical symptoms from baseline to 12 months. On intergroup comparison clinical parameters, TOP was present in 11.2% and 44% of cases at the end of 12 months in Groups 1 and 2, respectively (P < 0 0.05). On intergroup comparison of radiographic parameters, at the end of 12 months, furcation radiolucency was seen in 32% and 73% (P < 0.05) and root resorption was seen in 16% and 30% cases in Group 1 and 2, respectively (P > 0.05). Overall clinical success rate of Group 1 and Group 2 was 88% and 50%, respectively (P < 0.05) and radiographic success rate was 60% and 27%, respectively (P < 0.05). Conclusion: LSTR using Pulpotec as a medicament has shown promising results in the present study. It could be a better alternative to conventional endodontic treatment in primary teeth. In the present study, ClinM-TAP has shown poor radiographic success; hence, it should be used with caution.

Pasta de hidróxido de calcio/yodoformo en pulpectomías de dientes deciduos: Reporte de caso con seguimiento de seis meses / Calcium hydroxide/iodoform paste in primary teeth pulpectomies: a case report with six-month follow-up

Resumen Introducción: Las pastas de obturación a base de hidróxido de calcio/yodoformo han demostrado buenos resultados en pulpectomías de dientes primarios. Objetivos: describir el desempeño de una pasta de hidróxido de calcio/yodoformo (Calplus®) mediante la evaluación clínica y radiográfica en pulpectomias durante 6 meses. Metodología: Un paciente de sexo masculino de 2 años de edad acudió a la Clínica Odontológica de la Universidad Científica del Sur, Lima-Perú. Durante la evaluación clínica se diagnosticó caries de infancia temprana. Tratamientos preventivos y restauradores fueron realizados. Las pulpectomias fueron obturadas con (Calplus®). Para evaluar el desempeño, las pulpectomías fueron acompañadas durante 1, 3 y 6 meses mediante exámenes clínicos y radiográficos examinando dolor, movilidad patológica, alteraciones de tejido blando, rarefacción ósea, y reabsorción radicular patológica. Al tercer mes de seguimiento solo se observó contorno gingival alterado. Conclusiones: La pasta a base de hidróxido de calcio/yodoformo (Calplus®) demostró buen desempeño en pulpectomías de dientes primarios considerando aspectos clínicos y radiográficos después de 6 meses de seguimiento.

Abstract Introduction*: Calcium hydroxide/iodoform is a root canal filling material that have shown good results in pulpectomies of primary teeth. Objective: Describe the performance of a calcium hydroxide/iodoform (Calplus®) root canal filling material considering clinical and radiographic outcomes after 6 months follow-up. Methods: A 2-year-old male patient attended the Dental Clinic of Universidad Científica del Sur, Lima-Perú. Oral clinical examination showed early childhood caries. Preventive and restoration treatments were carried out. Pulpectomies were performed with Calplus®. To evaluate pulpectomies performance it was examined clinical and radiographic outcomes: pain, pathological mobility, soft tissue disorders, bone rarefaction and pathological root resorption. The clinical and radiographic findings at 1, 3, and 6 months were assessed. After three months, it was only observed altered gingival contour. Conclusion: Calcium hydroxide/ iodoform (Calplus®) root canal filling material showed good success rate in primary teeth pulpectomies considering clinical and radiographic outcomes after 6 months follow-up.

Application of different biomaterial capping agents in pulpotomy of deciduous molars / 实用口腔医学杂志

Objective: To investigate the effects of biomaterial capping agents mineral trioxide polymer (MTA), calcium hydroxide iodoform paste (CHI) and calcium hydroxide (CH), in the pulpectomy of deciduous molars. Methods: 96 children undewent deciduous molar pulpectomy were included and divided into MTA, CHI and CH groups (n = 32), MTA, CHI and CH were respectively usd as capping agents for the 3 groups. The patients were regularly examined clinically and by X-ray at 3, 6 and 12 months after surgery. Results: 3 months after treatment the total effective rate of MTA, CHI and CH groups was 100％, 96. 88％ and 96. 88％ respectively (P＞ 0. 05), 6 months after operation 90. 63％, 93. 75％ and 78. 13％ respectively (P＞ 0. 05), 12 months after operation. 87. 50％, 84. 38％ and 59. 38％ respectively (P ＜ 0. 05) . There was no significant difference in root resorption between the 3 groups at 3 months and 6 months after surgery (P＞ 0. 05) . 12 months after operation, the non-root resorption rate of MTA, CHI and CH group was 93.75％, 87. 50％ and 50. 00％ respectively (P ＜ 0. 05) . The mild root resorption rate of group MTA, CHI and CH was 3. 13％, 9. 38％and 21. 88％; the moderat resorption 3. 13％, 3. 13％ and 18. 75％; the severe resorption 0, 0 and 9. 38, respectively. Conclusion:MTA and CHI used as capping agents are effective in pulpotomy, CH is prone to root absorption, which leads to treatment failure.

The Effect Of Accidentally Extruded Calcium Hydroxide With Iodoform Paste Into The Periradicular Lesion: A Case Report

Introduction: Since its introduction in the dentistry calcium hydroxide (Ca(OH)2 has been used for a wide variety of purposes. Its use in root canal treatment as an intracanal medication has been associated with periradicular healing. Aim: To report a case of accidentally extruded Ca(OH)2 paste into the periradicular lesion associated withthe mandibular left central incisor and evaluate the prognosis of periradicular healing. Methods:The canal of mandibular left central incisor was prepared and Ca(OH)2 paste with Iodoform was used as an intracanal medicament. The medicament was accidently extruded into the periradicular tissues. Follow-up was done to determine the effect of extruded medicament on periradicular tissues and healing. Conclusion:The follow-up radiograph after 8 months showed complete resolution of the periapical lesion and resorption of the Ca(OH)2 paste.

Formulation optimization of iodoform paste for root canal filling of deciduous teeth / 中国药学杂志

OBJECTIVE: To optimize the formulation of iodoform paste for root canal filling of deciduous teeth. METHODS: Using multi-indicators comprehensive scoring method, which takes the delicate degree, lubricity, difficulty of root canal filling, and difficulty of removal as performance indicators, the matrix type was screened, and the formulation of paste was optimized by orthogonal experimental design. The content of iodoform in the optimized paste was determined by UV spectrophotometry. RESULTS: Dimethicone was chosen as the paste matrix by comprehensive scoring of indicators. The results of orthogonal test showed that the ratio of iodoform and zinc oxide was the main factor affecting the performance of the paste, and the optimal formulation of paste was as follows: the ratio of iodoformto zinc oxide 3:7, clove oil 0.5%, and the ratio of powder to liquid 70:30.The linear range of the calibration curve for iodoform in the optimal paste was 48.75-146.22 μg·mL-1, A = 6.781 3C-0.051 6(r=0.999 6); and the average recovery rate was 99.83% (n=9). CONCLUSION: The optimal iodoform paste has a simple preparation, fine and smooth for root canal filling of deciduous teeth. The assay method is accurate and reliable for the quality control of iodoform paste.

Pasta de hidróxido de calcio/yodoformo en pulpectomías de dientes deciduos: Reporte de caso con seguimiento de seis meses

Introducción: Las pastas de obturación a base de hidróxido de calcio/yodoformo han demostrado buenos resultados en pulpectomías de dientes primarios. Objetivos: describir el desempeño de una pasta de hidróxido de calcio/yodoformo (Calplus®) mediante la evaluación clínica y radiográfica en pulpectomias durante 6 meses. Metodología: Un paciente de sexo masculino de 2 años de edad acudió a la Clínica Odontológica de la Universidad Científica del Sur, Lima-Perú. Durante la evaluación clínica se diagnosticó caries de infancia temprana. Tratamientos preventivos y restauradores fueron realizados. Las pulpectomias fueron obturadas con (Calplus®). Para evaluar el desempeño, las pulpectomías fueron acompañadas durante 1, 3 y 6 meses mediante exámenes clínicos y radiográficos examinando dolor, movilidad patológica, alteraciones de tejido blando, rarefacción ósea, y reabsorción radicular patológica. Al tercer mes de seguimiento solo se observó contorno gingival alterado. Conclusiones: La pasta a base de hidróxido de calcio/yodoformo (Calplus®) demostró buen desempeño en pulpectomías de dientes primarios considerando aspectos clínicos y radiográficos después de 6 meses de seguimiento.

Introduction*: Calcium hydroxide/iodoform is a root canal filling material that have shown good results in pulpectomies of primary teeth. Objective: Describe the performance of a calcium hydroxide/iodoform (Calplus®) root canal filling material considering clinical and radiographic outcomes after 6 months follow-up. Methods: A 2-year-old male patient attended the Dental Clinic of Universidad Científica del Sur, Lima-Perú. Oral clinical examination showed early childhood caries. Preventive and restoration treatments were carried out. Pulpectomies were performed with Calplus®. To evaluate pulpectomies performance it was examined clinical and radiographic outcomes: pain, pathological mobility, soft tissue disorders, bone rarefaction and pathological root resorption. The clinical and radiographic findings at 1, 3, and 6 months were assessed. After three months, it was only observed altered gingival contour. Conclusion: Calcium hydroxide/ iodoform (Calplus®) root canal filling material showed good success rate in primary teeth pulpectomies considering clinical and radiographic outcomes after 6 months follow-up.

Assessment of intracanal medications cytotoxicity on L929 fibroblast cells / Avaliação da citotoxicidade de medicamentos intracanais em fibroblastos L929

This study aimed to evaluate the cytotoxicity of intracanal medications on L929 fibroblast cells at different periods of observation. The following experimental groups were studied: calcium hydroxide with camphorated paramonochlorophenol and glycerin (CPG); iodoform with glycerin (IG); calcium hydroxide with iodoform and distilled water (CIW); iodoform with distilled water (IW); calcium hydroxide with distilled water (CW); Otosporin ® (OT); and a control group composed of cells and culture medium. Eluates were prepared from each group and placed in contact with 1 x 105 cells/well for periods of 30 minutes, 12, 24, 48 and 72 hours, 5 and 7 days. After each experimental period, a cytotoxicity test was performed using methyltetrazolium (MTT) and a spectrophotometer at an optical density of 570 nm to analyze cell viability. The ANOVA and Tukey test with a significance level of 5% was used to analyze the data. At 30 minutes and at 12 hours, all groups were equal to the control group. At 24 hours, there was greater cytotoxicity in the IG group than in the control group (P<0.001). At 48 hours, only the OT group was cytotoxic (P <0.001). At 72 hours and at 5 days, the most cytotoxic groups were CW and OT. At 7 days, the IW and CPG groups were the least cytotoxic (P <0.001). With respect to experimental time, significant differences between 24 hours and 7 days were observed in all groups. Otosporin® was the most cytotoxic medication, followed by calcium hydroxide with distilled water.

Este estudo teve como objetivo avaliar a citotoxicidade de medicações intracanais em células L929 de fibroblastos em diferentes períodos de observação. Os seguintes grupos experimentais foram estudados: hidróxido de cálcio com paramonoclorofenol canforado e glicerina (CPG); iodofórmio com glicerina (IG); hidróxido de cálcio com iodofórmio e água destilada (CIW); iodofórmio com água destilada (IW); hidróxido de cálcio com água destilada (CW); Otosporin® (OT); e um grupo controle composto por células e meio de cultura. Os eluatos foram preparados a partir de cada grupo e colocados em contato com 1 x 105 células/poço, por períodos de 30 minutos, 12, 24, 48 e 72 horas, 5 e 7 dias. Depois de cada período experimental, um teste de citotoxicidade foi realizado utilizando metiltetrazólio (MTT) e um espectrofotômetro a uma densidade óptica de 570 nm para analisar a viabilidade celular. A análise de variância e o teste de Tukey com nível de significância de 5% foi utilizado para analisar os dados. Em 30 minutos e em 12 horas, todos os grupos foram iguais ao grupo controle. Em 24 horas, houve uma maior citotoxicidade no grupo IG do que no grupo controle (P<0,001). Em 48 horas, apenas o grupo OT foi citotóxico (P<0,001). Em 72 horas e em 5 dias, os grupos mais citotóxicos foram CW e OT. Aos 7 dias, os grupos IW e CPG foram os menos citotóxicos (P<0,001). Com relação ao tempo experimental, foram observadas diferenças significativas entre 24 horas e 7 dias em todos os grupos. Conclusão: Otosporin® foi o medicamento mais citotóxico, seguido de hidróxido de cálcio com água destilada.

Conservative surgical approach to aggressive benign odontogenic neoplasm: a report of three cases

Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often invade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, management (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefits of conservative management. Three patients with different complaints and final histopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.

Evaluación del poder antiséptico del cemento de Grossman combinado con yodoformo sobre distintas cepas bacterianas encontradas en infecciones de origen endodóntico / An evaluation of the antiseptic efficacy of Grossman´s cement combined with iodoformium on different bacterial strains found in infections of endodontic origin

La obturación de los conductos radiculares consiste en el relleno permanente del “espacio endodóntico” y el reemplazo del contenido normalo patológico del conducto por materiales que deben estar bien compactados y adaptados a las paredes del mismo. Al ser imposible la desinfección total de los conductos radiculares, es evidente la necesidad de utilizar un sellador endodóntico con acción bactericida, o al menos bacteriostática, que pueda actuar contra las bacterias que persisten luego de la preparación quirúrgica del conducto radicular. El objetivo de este estudio fue evaluar in vitro el poder antiséptico del cemento de Grossman, un material de obturación muy utilizado en endodoncia, en combinación con 2 proporciones de yodoformo, sobre bacterias comúnmente encontradas en infecciones de origen endodóntico. Resultados: el yodoformo puro no evidenció capacidad antiséptica sobre ninguna de las cepas estudiadas. Sin embargo, al asociarse con CG incrementó su efecto inhibitorio sobre Streptococcus mutans y sobre Enterococcus faecalis, en forma concentración-dependiante.

The sealing of the root canal consists in permanent "endodontic space" filling and the replacement of the normal or pathological conduit content by materials that should be well compacted and adapted to the walls thereof. Due the impossibility of total disinfection of the root canal, it is clear the need for a root canal sealer with bactericide or bacteriostatic effect that can act against bacteria that persist after surgical preparation of the root canal. The aim of this study was to evaluate in vitro the antiseptic power of Grossman cement, (GC) a material widely used in endodontic obturation, in combination with two proportions of iodoform, on bacteria commonly found in infections of endodontic origin. Results: the pure iodoform showed no antiseptic capacity on any of the strains studied. However, in association with GC, it increased its inhibitory effect on Streptococcus mutans and Enterococcus faecalis in concentration dependent-way.

Análise dos níveis das interleucinas tipo 10 e 1β após aplicação da pasta de iodofórmio na região peri-implantar: estudo piloto / Interleukins 10 and 1β levels in peri-implant region after using iodoform paste in periimplant region: a pilot study

O dano tecidual que leva a perda do implante dentário está intimamente relacionado à resposta inflamatória local. A utilização de medicamentos tópicos tem sido estudada como forma de controlar essa resposta inflamatória, evitando assim perda óssea após o período de osseointegração. Objetivo: avaliar os níveis de IL-10 e IL-1β no fluido crevicular peri-implantar após utilização de uma pasta à base de iodofórmio em humanos. Material e métodos: vinte regiões em 3 pacientes foram divididas em dois grupos: grupo A (reabertura dos implantes e instalação do cicatrizador) e grupo B (reabertura do implante e instalação do cicatrizador juntamente com uma pasta de iodofórmio). Quinze dias após a exposição dos implantes, amostras do fluido crevicular peri-implantar (FCPI) foram obtidas, utilizando filtro de papel absorvente inserido ao sulco peri-implantar, durante 30 s, após a remoção do cicatrizador. Os níveis de IL-10 e IL-1β nas amostras foram determinados por ELISA utilizando o kit DuoSet ELISA Development System DY217B. Após o Teste de Shapiro-Wilk, o teste de Tukey foi utilizado para determinar o valor de p na avaliação das diferenças entre os grupos, com nível de significância de 0,05. Resultados: não houve diferença significativa entre as concentrações de IL-10 nos dois grupos (p=0.34). No entanto, diferença significativa foi evidenciada entre os grupos A e B em relação aos níveis de IL-1β (p=0.03). O grupo B mostrou significativa menor concentração de IL-1β comparado ao grupo A. Conclusão: a pasta de iodofórmio é capaz de diminuir a resposta pró-inflamatória orquestrada pela IL-1β em um curto período de tempo

The tissue damage around dental implant is strictly related to inflammatory response. The use of local drugs has been studied as a tempt of controlling this response in order to avoid the bone loss after osseointegration period. Aim: to evaluate the interleukins 10 and 1β levels in peri-implant crevicular fluid after using iodoform paste in humans. Material and methods: twenty regions, in 03 patients, were divided in 2 groups; group A (implant exposure and healing insertion) and group B (implant exposure and healing/ iodoform paste insertion). Fifteen days after exposure, samples from peri-implant crevicular fluid were collected. ELISA technique determined the interleukins 10 and 1β levels by using DuoSet ELISA Development System DY217B kit. Tukey test analysed differences between groups, considering 0.05 significant level. Results: no difference was observed between groups considering interleukin 10 levels (p=0.34). however, significant differente was observed considering the interleukin 1β levels (p=0.03). Group B showed significant smaller IL-1β level than group A. Conclusion: iodoform paste is able to decrease the pro-inflammatory response conduct by interleukin 1β.

Massive keratocystic odontogenic tumor of mandible: A case report and review of literature.

Keratocystic odontogenic tumor (KCOT), also known as odontogenic keratocysts, as defined by World Health Organization (WHO), are known for their peculiar behavior, varied origin, debated development, unique tendency to recur, and disputed treatment modalities. We present a case of KCOT involving symphysis menti, right and left halves of the body of mandible in an 11-year-old girl treated with enucleation and open dressing (bismuth, iodoform, paraffin paste) with long-term follow-up.

Antimicrobial effect of two endodontic medicaments with different exposure times, and the morphologic alterations caused to Enterococcus faecalis / Efeito antimicrobiano de dois medicamentos endodônticos com diferentes exposições, e as alterações morfológicas causadas a Enterococcus faecalis

PURPOSE: The aim of this study was to verify the antimicrobial effect of calcium hydroxide and iodoform on Enterococcus faecalis with different exposure times evaluating the bacterial morphologic alterations. METHODS: The antibacterial action was investigated in culture broth after zero, seven, fourteen and twenty-one days. Five mL samples were analyzed morphologically on the seventh day by transmission electron microscopy. The data of the antibacterial test were analyzed by Fisher's exact test. RESULTS: The results revealed that between the seventh and fourteenth day, there was a decrease in bacterial growth with both medicaments (P=0.098), where they were eliminated between the fourteenth and twenty-first day. Transmission electronic microscopy showed alterations in the morphologic structures. CONCLUSION: It concluded that both medicaments kill Enterococcus faecalis, with an exposure time of 7 to 14 days, where no cell viability is seen after this period due to irreversible alterations in bacterial cell morphology.

OBJETIVO: O presente estudo verificou o efeito antibacteriano do hidróxido de cálcio e do iodofórmio em Enterococcus faecalis com diferentes tempos de exposição, avaliando as alterações morfológicas bacteriana. MÉTODOS: A ação antibacteriana foi investigada através de caldo de cultura após zero, sete, 14 e 21 dias, e assim, 5 mL das amostras do sétimo dia foram analisadas morfologicamente por microscopia eletrônica de transmissão. Os dados da ação antibacteriana em caldo foram analisados pelo teste Exato de Fisher. RESULTADOS: Os resultados revelaram que entre o 7º e o 14º dia houve diminuição do crescimento bacteriano com ambos os medicamentos (P=0,098), onde a eliminação bacteriana ocorreu entre o 14º e 21º dia. A microscopia eletrônica de transmissão apresentou alterações na estutura morfolófica bacteriana. CONCLUSÃO: Pode-se concluir que ambos os medicamentos destroem o Enterococcus faecalis com tempo de exposição de 7 a 14 dias, onde a viabilidade celular não é observada após este período devido alterações irreversíveis na morfologia celular bacteriana.

Avaliação do pH, da solubilidade e da infiltraçãomarginal em retrobturações com o Sealer 26®puro ou acrescido de iodofórmio / Evaluation of pH, solubility and marginalleakage in retrobturation cases using Sealer 26®alone or with iodoform

Introdução: O cimento Sealer 26® contém resina epóxi associada aohidróxido de cálcio, apresentando menor radiopacidade que algunscimentos endodônticos. Com o intuito de melhorar essa propriedade,tem-se agregado iodofórmio ao pó do cimento. Entretanto, aoexecutar tal procedimento, desconhecem-se as possíveis alteraçõesnas propriedades físicas e químicas do material. Objetivo: Avaliar acapacidade de selamento marginal apical, a solubilidade e o pH doSealer 26® puro ou acrescido de iodofórmio em diversas proporções.Material e métodos: Foram manipuladas e submetidas ao teste desolubilidade três associações experimentais de Sealer 26®, puroou acrescido de iodofórmio. Paralelamente, as combinações foraminseridas em tubos de polietileno e imersas em água destilada, e opH das soluções foi avaliado nos períodos de 24 horas e 7 dias. Emseguida, 40 raízes de incisivos inferiores extraídos, subdivididosem quatro grupos de dez espécimes cada, foram retrobturados comuma das misturas anteriormente descritas. Imergiram-se as raízesem Rhodamine B, sob vácuo, por 72 horas. Concluída a imersão,os espécimes foram desgastados longitudinalmente, os fragmentosradiculares fotografados, as imagens digitalizadas e a infiltração apicalmedida pelo programa Image Tool. Os dados obtidos foram submetidosa análise estatística, com nível de significância de 5%. Resultados:Os testes de infiltração e solubilidade não demonstraram diferençasentre os grupos experimentais (p > 0,05). A análise do pH apresentoudiferença apenas no período de 24 horas entre o grupo do Sealer 26®puro e o grupo com 1,1 g de iodofórmio (p < 0,05). Conclusão: Aadição de iodofórmio ao Sealer 26®, nas proporções descritas, nãoalterou as propriedades de selamento marginal apical, a solubilidadenem o pH do cimento original

Introduction: Sealer 26® cement contains bisphenol epoxy resinassociated with calcium hydroxide, presenting smaller radiopacity thanother endodontic cements. Aiming to improve this property, iodoformhas been added in its composition. However, this addition?s possiblechanges in physical and chemical properties still need to be studied.Objective: To evaluate the apical sealing ability, solubility, and pH ofSealer 26® alone or with iodoform, at several proportions. Material andmethods: Three experimental mixtures of Sealer 26®, alone or withiodoform, were prepared and subjected to solubility test. Additionally,these combinations were inserted into polyethylene tubes and immersedin distilled water, and, their pH was evaluated after 24-h and 7-dayperiods. Subsequently, forty roots of extracted lower incisors subdividedinto four groups of 10 specimens each, were retrograde filled with oneof the previously described mixtures and gutta-percha points. The rootswere immersed in Rhodamine B, under vacuum, for 72 hours. Afterthis period, the specimens were longitudinally sectioned, root fragmentsphotographed, these images scanned, and apical infiltration measuredby Image tool software. The obtained data were subjected to statisticalanalysis, at a significance level of 5%. Results: Marginal leakage andsolubility tests did not show any difference among the experimentalgroups (p > 0.05). pH analysis was only statistically different at 24-h period and between Sealer 26® alone and 1.1g iodoform group(p < 0.05). Conclusion: The presence of iodoform in Sealer 26®, at theused proportions, did not alter the solubility, apical marginal leakageand pH properties of the original cement.

Avaliação da capacidade de vedamento e pH do tampão apical com cimento Portland branco acrescido de radiopacificadores convencionais / Evaluation of sealing ability and pH of the apical barrier with Portland white cement added of conventional radiopacifying agents

Introdução: O cimento Portland tem apresentado resultados biológicos similares aos do hidróxido de cálcio, porém sua radiopacidade é precária. Assim, a adiçãção de substâncias que minimizem essa deficiência deve ser analisada. Objetivo: Procurou-se avaliar a capacidade de vedamento apical e pH de um tipo de cimento Portland branco, acrescido de diversos radiopacificadores encontrados no arsenal endodôntico. Material e métodos: Quarenta raízes de dentes bovinos, com ápices incompletos, tiveram as aberturas foraminais padronizadas de modo equivalente ao diâmetro da ponta da broca PM 720G. Após a impermeabilizaçãção externa radicular, um tampão apical intrarradicular, de aproximadamente 10,0 mm de espessura, foi executado com o pó do cimento Portland branco puro ou acrescido de um radiopacificador (iodofórmio, óxido de zinco ou subnitrato de bismuto), agregado a 0,37 mL de água destilada. As raízes foram mantidas por 24 horas em ambiente úmido e, após esse período, imersas em Rhodamine B, sob vácuo, por mais 24 horas. Concluída a imersão, os espécimes foram desgastados longitudinalmente, os fragmentos radiculares fotografados, as imagens digitalizadas e a infiltraçã o apical foi medida por meio do programa Image Tools. Paralelamente, avaliou-se também o pH das associações nos períodos de 24 e 48 horas e 7 e 30 dias. Os dados obtidos foram submetidos ao teste de Anova a um critério. Resultados: A associaçãção com o óxido de zinco proporcionou menor infiltraçãção em relaçãção aos demais grupos (p < 0,05). O comportamento do pH dos materiais apresentou variações ao longo do tempo de análise, e no período de 24 horas sempre foram encontrados os maiores valores (p < 0,05). Conclusão: O tipo de radiopacificador interfere na capacidade de vedaçã o apical, sendo o óxido de zinco o mais benéfico. O pH varia de acordo com o período de análise, e foram obtidos nas primeiras 24 horas os maiores valores (p < 0,05).

Introduction: The Portland cement has shown similar biological properties to calcium hydroxide, but its radiopacity is lower. Therefore, the addition of materials that minimize this deficiency should be considered. Objective: To evaluate the apical sealing ability and pH of a white Portland cement added of several radiopacifying agents. Material and methods: Forty bovine roots with incomplete apices were selected, and the foraminal openings were standardized to PM 720G bur. After the external root sealing, an apical intracanal barrier 10.0 mm thick was executed with the white Portland cement powder, pure or added of a radiopacifying agent (iodoform, zinc oxide or bismuth subnitrate), and distilled water (0.37 mL). The apical roots were immersed 24h in water in humid atmosphere, and after that they were immersed 24h in 2% Rhodamine B, under vacuum. In sequence, the roots were longitudinally sectioned, the root fragments were photographed, the images were digitalized and the apical infiltration was measured by the Image Tool program. The pH solutions were also evaluated, in 24h and 48h and 7 and 30 days. Data were submitted to Anova test. Results: The zinc oxide solution has the lowest apical infiltration in relation to the other groups (p < 0.05). The pH behavior varied during the analysis, and in the period of 24h all groups showed the highest values (p < 0.05). Conclusion: The type of radiopacifying agent used interferes in the sealing ability of the apical barrier, and zinc oxide showed to be the most beneficial one. The pH varies according to the period of analysis, and the highest values were obtained in the first 24h (p < 0.05).

Tissue inflammatory response to implantation of calcium hydroxide and iodoform in the back of rats / Resposta inflamatória tecidual da implantação de hidróxido de cálcio e iodofórmio em dorso de ratos

Purpose: This study evaluated the inflammatory reaction caused by the implantation of iodoform and calcium hydroxide in the back of rats. These drugs may be used as intracanal dressings to eliminate residual bacteria of the root canal system. Methods: Twenty albinic rats (Rattus norvegicus, var Wistar) were divided into four groups: control group 1 (CG1) had normal skin; control group 2 (CG2) had wounded tissue without drugs; in groups 3 and 4, iodoform (IG) and calcium hydroxide (CHG) were inserted into the wounds, respectively. After 3, 5 and 11 days, slices of the implanted areas were macroscopically and microscopically observed regarding to their qualitative and quantitative aspects. Results: In the macroscopical analysis, the CHG showed a large area of necrosis and swelling, which progressively decreased; in the IG the presence of iodoform surrounded by normal tissue was observed. The qualitative and quantitative histological analysis showed that IG promoted a shorter delay in the inflammatory response than the CHG. Conclusion: The inflammatory reaction for iodoform had a peak period five days after the drug insertion. By comparison, calcium hydroxide showed a very large area of necrosis that could only be partially eliminated after eleven days.

Objetivo: O objetivo deste estudo foi avaliar a resposta inflamatória causada pela implantação do iodofórmio ou hidróxido de cálcio em dorso de ratos. Estas drogas podem ser usadas como curativo intracanal para eliminar bactérias residuais do sistema de canal radicular. Metodologia: Foram utilizados 20 ratos albinos (Rattus norvegicus, var Wistar) e divididos em 4 grupos: grupo controle 1 (CG1) representado por tecido normal íntegro; grupo controle 2 (CG2) com ferida e sem medicação; nos grupos 3 e 4, Iodofórmio (IG) e hidróxido de cálcio (CHG) foram, respectivamente, inseridos nas feridas. Após três, cinco e onze dias, cortes microscópicos das áreas implantadas foram observados macroscópica e microscopicamente quanto a seus aspectos qualitativos e quantitativos. Resultados: Na análise macroscópica, o CHG mostrou uma grande área de necrose e edema, o que diminuiu progressivamente, no GI, a presença de iodofórmio rodeada por tecido normal foi observado. A análise qualitativa e quantitativa histológica mostrou que IG promoveu um prazo mais curto na resposta inflamatória do que o CHG. Conclusão: A reação inflamatória de iodofórmio teve um período de pico de cinco dias após a inserção de drogas. Em comparação, o hidróxido de cálcio mostrou uma grande área de necrose que só poderia ser parcialmente eliminada após onze dias.

Comportamiento clínico y radiográfico del formocresol y la pasta iodoformada en el tratamiento de pulpotomías en molares primarios

OBJETIVO: evaluar el comportamiento clínico y radiográfico de tratamientos de pulpotomía realizados con formocresol y con pasta iodoformada en molares primarios. MATERIALES Y MÉTODOS: se seleccionó una muestra no probabilística de 21 niños de ambos sexos con edades comprendidas entre 3 y 8 años, que asistieron al Servicio de Odontopediatría del Instituto Autónomo Hospital Universitario de los Andes (IAHULA), Mérida - Venezuela, a los que se le realizaron tratamientos de pulpotomía en molares primarios vitales con exposición pulpar por caries. Los molares seleccionados fueron divididos aleatoriamente en dos grupos en función al tipo de material (grupo 1: formocresol y grupo 2: pasta iodoformada). La muestra fue observada al mes, a los dos y a los tres meses de realizados los tratamientos, para evaluar la presencia de signos y síntomas clínicos y radiográficos de patología pulpar. RESULTADOS: el Test exacto de Fisher demostró que no existen diferencias estadísticamente significativas entre los materiales empleados (p=0,351 y 0,176). Encontrándose un éxito del 81,8% con la técnica del formocresol y un 90,9 % con la técnica de la pasta iodoformada. Los hallazgos clínicos y radiográficos observados durante el tiempo de evaluación fueron, inflamación, fístula, zonas radiolúcidas perifurcales, reabsorción radicular patológica externa, reabsorción radicular interna, siendo este último hallazgo el más frecuente (técnica del formocresol 3,03%, técnica de la pasta iodoformada 1,51%). CONCLUSIONES: tanto el formocresol como la pasta iodoformada son materiales que pueden ser empleados para la obturación de pulpotomías en molares primarios. Por tanto, se puede considerar a la pasta iodoformada como una alternativa al uso del formocresol en la terapia pulpar de molares primarios vitales.

PURPOSE: evaluate the clinical and radiographic behaviour of pulpotomy treatments performed with formocresol and iodoform paste in primary molars. MATERIALS AND METHODS: a non probabilistic sample was selected which consisted of 21 children of both sexes ranged in age from 3 to 8 years, who attended to the Pediatric Dentistry Service of the Autonomous Institute Andes's University Hospital, Mérida - Venezuela. Pulpotomy treatments were performed in vital primary molars with carious pulpal exposure. The selected molars were randomly separated according to the material (1st group: formocresol and 2nd group: iodoform paste). The sample was observed into 1, 2 and 3 month after the treatment in stead to evaluate the apparition of clinic and radiographic sings and symptoms of pulpal pathology. RESULTS: the Fisher's exact test showed that there were not statistically significant differences between both materials (p=0,351 y 0,176). It were found a success rates of 81,8% with the formocresol technique and 90,9% with the iodoform paste technique. The clinic and radiographic founds observed during the evaluation period were swelling, fistulation, perifurcal radiolucency, external pathologic radicular resorption, internal radicular resorption. The last one was the most frequently found observed (formocresol technique 3,03%, iodoform paste technique 1,51%). CONCLUSIONS: either formocresol or iodoform paste can be used as obturating materials for pulpotomies in primary molars. Therefore, the iodoform paste can be considered as an alternative to the formocresol use in the primary molar pulpal therapy.

Avaliação do pH de substâncias utilizadas como medicação intracanal em diferentes veículos / Evaluation of pH of substances used as intracanal medication in different vehicles

Introdução e objetivo: Este trabalho teve por objetivo avaliar a alteração de pH que a introdução do hidróxido de cálcio e do iodofórmio associados ou não a um veículo - o Carbowax 1000 - promove em três diferentes soluções: água destilada, soro fisiológico ou álcool. Material e métodos: Para a realização deste estudo, 50 mL de uma das soluções foram colocados em um béquer. A essa solução, porções de 1 g da medicação livre ou associada ao Carbowax eram inseridas até atingir 10 g. Para cada inserção de medicação, o pH da solução foi medido. Resultados: Observou-se que o pH do hidróxido de cálcio foi sempre básico (em torno de 12), enquanto o do iodofórmio tendeu a ser neutro. Uma vez que o iodofórmio é solúvel em veículos gordurosos e em álcool, verificaram-se valores menores de pH quando ele foi associado ao Carbowax, e encontraram-se valores de pH ácidos quando ele foi diluído em álcool. Conclusão: Conclui-se que o hidróxido de cálcio promove meios básicos, e o iodofórmio, meios neutros.

Introduction and objective: The aim of this study was to evaluate the pH change promoted by the insertion of calcium hydroxide and iodoform associated or not to a vehicle - Carbowax 1000 - in three different solutions: distilled water, saline or alcohol. Material and methods: For this study, 50 ml of the solution were inserted in a glass beaker. One gram of the drug associated or not to the vehicle was progressively inserted into the solution (up to 10 g). After each insertion of the drugs, the pH of the solution was measured. Results: It was observed that calcium hydroxide promoted a basic pH (around 12), while iodoform promoted a neutral pH. Once iodoform is soluble in fat and in alcohol, pH values were lower when this drug was associated to Carbowax and acid pH values were found when iodoform was diluted in alcohol. Conclusion: It was concluded that calcium hydroxide promoted basic pH values and iodoform neutral pH values.

Efecto antibacteriano de la asociación de hidróxido de cálcio yiodoformo sobre Enterococcusfaecalis y Pseudomonas aeruginosa / Antibacterial effect of the association of calcium hydroxide with iodoform on Enterococcus faecalis and Pseudomonas aeruginosa

El objetivo de este estudio fue evaluar si existe sinergismo antibacteriano sobre Enterococcus faecalis y Pseudomonas aeruginosa, al asociar iodoformo con CaOH2. Para evaluar el efecto antibacteriano de la asociación experimental del hidroxido de calcio (CaOH2) y el iodoformo sobre Enterococcus faecalis (ATCC 1495) y Pseudomonas aeruginosa (ATCC 9027), fue preparada una suspensión padronizada de la bacteria en 108 células/mL, que luego fue sembrada,en placas conteniendo agar Müller Hinton. Después de 10 minutos a 37°C, fueron realizados pozos de 5mm de diámetro en el agar, colocando en ellos CaOH2, iodoformo y la asociación de ambos, utilizando como vehículos solución fisiológica, lidocaína al 2% con epinefrina, polietilenglicol 400 y paramonoclorofenol. Se incubaron las placas petri a 37°C durante 48 horas y después se calcularon los halos de inhibición de crecimiento bacteriano. Utilizando el test de múltiples comparaciones de Tukey, los resultados mostraron que el iodoformo tuvo acción antibacteriana solo cuando fue utilizado el paramonoclorofenol como vehículo, atribuyéndose la acción antibacteriana a este último, siendo esta semejante a la acción antibacteriana mostrada por el hidróxido de calcio puro y en asociación con el iodoformo (p > 0,05). El iodoformo mostró mayor inhibición frente a P. aeruginosa en comparación a la acción mostrada frente a E. faecalis. No hubo diferencia estadísticamente significativa entre la acción antibacteriana del CaOH2 puro y asociado al iodoformo, independientemente del vehículo utilizado. Se concluye que el efecto antibacteriano del CaOH2 sobre E. faecalis y P. aeruginosa prevalece al mostrado por el iodoformo y que la asociación de ambos no altera ese resultado.

The aim of this study was to assess whether there is antibacterial synergism on Enterococcus faecalis and Pseudomonas aeruginosa when iodoform was mixed to calcium hydroxide. A bacterial suspension containing 108 cells.ml of Enterococcus faecalis (ATCC 1495) and Pseudomonas aeruginosa (ATCC 9027), were plated on Müller Hinton agar, in duplicate, witha sterile swab. After 10 minutes at 37°C, 4 holes of 5 mm in diameter were prepared in the agar and filled with CaOH2, iodoform and the association of both, mixed with 4 different vehicles: physiologic solution, 2% lidocaine with epinephrine, polyethylene glycol 400 and paramonochloro-phenol. The plates were incubated at 37°C during 48 hours and then the halos demonstrating inhibition of bacterial growth were measured. Using Tukey's test, the results showed that iodoform had antibacterial effect only when used as a vehicle of paramonochlorophenol, being this action attributed to the vehicle, which was similar to the antibacterial effect shown by calcium hydroxide pure and mixed with iodoform (p> 0.05). Iodoform showed greater inhibition against P. aeruginosa compared to E. faecalis. There was no statistically significant difference between the antibacterial effect of CaOH2 pure and mixed with iodoform, regardless the vehicle used. We conclude that the antibacterial effect shown by CaOH2 on E. faecalis and P. aeruginosa prevails over that of iodoform and their association does not alter this result.

Clinic Efficacy of Calcium Hydroxide Iodoform Glycerin Paste for Root Canal Disinfection / 中国药房

OBJECTIVE:To evaluate the clinical efficacy of Calcium Hydroxide Iodoform Glycerin(CHIG)paste for root canal disinfection.METHODS:145 patients(145 teeth)requiring root canal therapy were divided randomly into CHIG group,formo-cresol solution group(Group B)and camphor phenol group(Group C).After root canal preparation,the corresponding drugs were introduced into root canal and pulp chamber.The endodontic interappointment pain(EIP)and clinical efficacy in the 3 groups were compared.RESULTS:In Group A,the EIP incidence was the lowest(8.16%)while the effective rate was the highest(97.96%),showing significant differences as compared with Group B(31.91% and 68.09%,respectively)or Group C(34.69% and 71.43%,respectively)(P