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1.
Braz. dent. sci ; 25(1): 1-5, 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1354241

ABSTRACT

The aim of this study is to report a clinical case of lesion sterilization and tissue repair in primary molar, with follow-up until the eruption of the permanent successor. A 6-year-old male patient came to the Pediatric Dentistry Clinic at Faculdade Sao Leopoldo Mandic in Campinas-SP, with his mother, complaining of "caries in several teeth". On clinical examination, it was found that tooth 85 had a severe carious lesion with pulp involvement and fistula. Radiographically, radiolucency was observed in the furcation region. It was then decided to perform lesion sterilization and tissue repair of the tooth with CTZ paste. After 6 months of the procedure, the tooth was clinically and radiographically normal and after 3 years it was observed that tooth 85 was in complete root resorption. After extraction, the permanent successor erupted naturally without clinical or radiographic alterations. It can be concluded that the present clinical case demonstrated success in the use of CTZ paste in the lesion sterilization and tissue repair of primary molars, until the complete eruption of the permanent successor. (AU)


O objetivo desse estudo é relatar o caso clínico de esterilização da lesão e reparação de tecidos em molar decíduo com pasta CTZ, com acompanhamento até a erupção do pré-molar sucessor. Paciente do sexo masculino, 6 anos de idade, apresentou-se à Clínica de Odontopediatria da Faculdade São Leopoldo Mandic em Campinas-SP, acompanhado de sua mãe, queixando-se de "cárie em vários dentes". Ao exame clínico, verificou-se que o dente 85 apresentava lesão de cárie severa com envolvimento pulpar e fístula. Radiograficamente, observou-se radiolucidez na região de furca. Optou-se, então, por realizar a esterilização da lesão e reparação de tecidos do dente com pasta CTZ. Após 6 meses da realização do procedimento, o dente apresentava-se clinica e radiograficamente normal e após 3 anos observou-se que o elemento 85 estava em rizólise completa. Feita a extração, o permanente sucessor erupcionou naturalmente sem alterações clínicas ou radiográficas. Pode-se concluir que o presente caso clínico demonstrou sucesso do emprego da pasta CTZ na esterilização da lesão e reparação de tecidos de molar decíduo, até completa erupção do permanente sucessor. (AU)


Subject(s)
Humans , Male , Child , Pulpectomy , Tooth, Deciduous , Pediatric Dentistry , Endodontics
2.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 32-38, set.-dez. 2021. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1284132

ABSTRACT

A manutenção dos dentes decíduos na cavidade bucal até o período de sua esfoliação fisiológica é de extrema importância. A terapia endodôntica é um tratamento indicado quando a saúde do tecido pulpar é comprometida e diversas técnicas e materiais podem ser empregados para realizar a obturação de canais radiculares. O objetivo deste estudo in vitro foi comparar a qualidade do preenchimento dos canais radiculares utilizando diferentes técnicas de obturação e pastas obturadoras em dentes decíduos bovinos submetidos à pulpectomia. Foram selecionados 30 incisivos decíduos bovinos, e preparados através da técnica manual com posterior obturação dos canais radiculares por meio de duas técnicas e três pastas obturadoras. Os dentes foram divididos em 6 grupos (n= 5/ grupo) da seguinte forma: GI ­ Técnica manual e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GII ­ Técnica manual e pasta Guedes-Pinto Modificada; GIII ­ Técnica manual e pasta Feapex®; GIV ­ Técnica com auxílio da lentulo e pasta de Hidróxido de Cálcio PA espessada com Óxido de Zinco; GV ­ Técnica com auxílio da lentulo e pasta Guedes-Pinto Modificada; GVI ­ Técnica com auxílio da lentulo e pasta Feapex®. Foram realizadas as radiografias digitais para verificar a qualidade do preenchimento dos canais radiculares. Os resultados obtidos apresentaram diferenças significativas na qualidade do preenchimento dos canais radiculares entre os grupos de dentes decíduos bovinos obturados. Considerando os resultados obtidos e a metodologia empregada, pode-se concluir que existe diferença entre as técnicas de obturação e pastas obturadoras(AU)


Maintaining primary teeth in the oral cavity until the period of their physiological exfoliation is extremely important. An endodontic therapy is a treatment indicated when the health of the pulp tissue is compromised and several techniques and materials can be used to perform root canal filling. The aim of this in vitro study was to compare the quality of root canal filling using different filling techniques and filling masses in primary bovine teeth implanted under pulpectomy. Thirty bovine primary incisors were selected and prepared using the manual technique with subsequente filling of the root canals using two techniques and three filling materials. The teeth were divided into 6 groups (n= 5 / group) as follows: GI - Technical Manual and Calcium Hydroxide Mass PA thickened with Zinc Oxide; GII - Manual technique and modified Guedes-Pinto pasta; GIII - Manual technique and Feapex® paste; GIV - Technique with the aid of lentulo and mass of Calcium Hydroxide PA thickened with Zinc Oxide; GV ­ Technique with the aid of lentulo and modified Guedes-Pinto mass; GVI - Technique with the aid of lentulo and Feapex® mass. Digital radiographs were taken to check the quality of the filling of the root canals. The resulting results dissipated in the quality of filling the root canals between the groups of primary bovine teeth filled. Know the results obtained and the methodology used, it can be concluded that there is a difference between filling techniques and filling masses(AU)


Subject(s)
Pulpectomy , Root Canal Filling Materials , Root Canal Obturation , Tooth, Deciduous , Root Canal Therapy , Zinc Oxide , Calcium Hydroxide , Dental Pulp Cavity
3.
Braz. dent. sci ; 24(4, suppl 1): 1-12, 2021. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1349366

ABSTRACT

Objective: The aim of this clinical study was to evaluate the survival rate of a new pulpectomy protocol using 2% chlorhexidine digluconate gel and Feapex® paste for endodontic treatment in primary teeth. Material and Methods: A total of 105 pulpectomies were performed in anterior and posterior teeth of 48 infants (1-3 years old) with high caries experience with irreversible pulpitis or pulp necrosis. All treatments were performed by dental surgeons with no specialization in Pediatric Dentistry, under local anesthesia and rubberdam isolation. Manual files were used in conjunction with 2% chlorherixidine gel for root canal instrumentation, and Feapex® paste was used as a obturation material. The clinical and radiographic outcomes were collected by one trained independent evaluator with a follow-up period of 24months. Success was determined by the absence of pain, pathological mobility, pathologic bone rarefaction, pathological root resorption and soft tissue pathology around the affected tooth Survival of the endodontic treatment was evaluated by estimating survival rates through Kaplan-Meier curves. Cox Regression analysis with shared fragility were performed to evaluate the association between the independent variables to endodontic treatment failure (α=5%). Results: After 24 months, the treatment survival was 86% (SE=0.03). Root resorption at baseline was associated with a higher risk of failure (HR=2.81; CI=1.12-7.08; p=0.027). The survival rate of the endodontic treated teeth due to dental trauma was 100%, while teeth with dental caries had lower survival rate (85.05%; p<0.001*). Other variables analyzed included gender, age of the child, tooth position (incisor/molar), restoration type, obturation quality, and caries experience were not associated with treatment failure (p>0.05). Conclusion: The new protocol using 2% chlorhexidine digluconate and Feapex® presented a high survival rate and can be considered as a suitable protocol for pulpectomy in primary teeth.Trial Registration: REBEC (RBR-282s2f) (AU)


Objetivo: Avaliar a sobrevida de um novo protocolo para tratamento endodôntico (pulpectomia) em dentes decíduos utilizando gel de digluconato de clorexidina 2% e pasta Feapex®. Material e Métodos: Um total de 105 pulpectomias foram realizadas em dentes anteriores e posteriores diagnosticados com pulpite irreversível ou necrose pulpar em 48 crianças (1-3 anos de idade) com alta experiência de cárie. Todos os tratamentos foram realizados por cirurgiões-dentistas clínicos gerais, sob anestesia local e isolamento absoluto. Limas manuais foram utilizadas em conjunto com cloroherixidina 2% gel para instrumentação dos canais radiculares e pasta Feapex® foi utilizada como material de obturação. Os resultados clínicos e radiográficos foram coletados por um avaliador independente treinado com um período de acompanhamento de 24 meses. O sucesso foi determinado pela ausência de dor, mobilidade patológica, rarefação óssea patológica, reabsorção radicular patológica e ausência de fístula/abscesso ao redor do dente tratado. A sobrevida do tratamento endodôntico foi estimativa utilizando curvas de Kaplan-Meier. Análise de regressão de Cox com fragilidade compartilhada foi realizada para avaliar a associação entre as variáveis independentes com a falha do tratamento endodôntico (α = 5%). Resultados: Após 24 meses, a sobrevida do tratamento foi de 86% (EP = 0,03). A reabsorção radicular no início do estudo foi associada a um maior risco de falha (HR= 2,81; IC= 1,12-7,08; p= 0,027). Dentes tratados endodonticamente devido ao traumatismo dentário na dentição decídua apresentaram taxa de sobrevida de 100%, enquanto dentes com comprometimento pulpar devido à cárie dentária tiveram menor sobrevida (85,05%; p<0,001 *). Todas as outras variáveis analisadas como sexo, idade da criança, dente (incisivo/molar), tipo de restauração, qualidade da obturação e experiência de cárie não foram associadas à falha do tratamento (p> 0,05). Conclusão: O novo protocolo utilizando digluconato de clorexidina 2% e Feapex® apresentou alta sobrevida e pode ser considerado um protocolo adequado para pulpectomia em dentes decíduos.Registro do estudo clínico: REBEC (RBR-282s2f). (AU)


Subject(s)
Humans , Infant , Child, Preschool , Pulpectomy , Tooth, Deciduous , Endodontics
4.
Braz. oral res. (Online) ; 35: e004, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132741

ABSTRACT

Abstract: There is a lack of evidence about the best approach for cavitated caries lesions with the possibility of pulpal involvement in primary teeth. Thus, the present authors aimed to verify the best treatment for deep caries lesions with or without pulp involvement in primary teeth. The search was conducted in MEDLINE/Pubmed and Web of Science databases until May 2020. Studies that compared techniques to manage deep caries lesions with at least 12 months of follow-up were included. The risk of bias was evaluated using the RoB tool. Network meta-analysis and pairwise meta-analyses were conducted considering the treatment clinical success as an outcome, according to the pulp health condition. From 491 potentially eligible studies, 9 were included. For deep caries lesions with pulp vitality, the Hall Technique presented the highest probability of success (78%). In the event of accidental pulp exposure, pulpectomy presented a 76% chance of providing the best clinical results. For pulp necrosis, no difference was observed between a pulpectomy and non-instrumented endodontic treatment (RR = 0.69; 95%CI: 0.21-2.33) Thus, it was concluded that the Hall Technique may be a better option for deep caries lesions with pulp vitality. In cases of accidental pulp exposure of vital teeth during caries removal, a pulpectomy may be considered the best option. However, there are insufficient studies to build up evidence about the best treatment option when irreversible pulpitis or pulp necrosis is present.


Subject(s)
Humans , Tooth, Deciduous , Dental Caries/therapy , Pulpectomy , Dental Pulp , Network Meta-Analysis
5.
Braz. dent. sci ; 24(1): 1-6, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1145564

ABSTRACT

Objective: To investigate if video modelling is an effective technique in behaviour modelling of a child in a dental set up. Material and Methods: Fifty children aged 4-6 years indicated for pulpectomy were enrolled in this study. They were selected based on their behaviour using Frankl behaviour rating scale. Children with Frankl behaviour rating 1 and 2 were selected for this study. The video of a child who was cooperative while undergoing pulpectomy was shown to these children. The behaviour was assessed using Frankl behaviour rating scale after the video was shown to the children included in the study. Results: There was a statistically significant difference in the behaviour rating score of the children before after the video of the cooperative child was shown to them. Conclusion: It was observed that video modelling is an effective technique in managing the behaviour of an uncooperative child in a dental set up. (AU)


Objetivo: Investigar se a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de crianças no consultório odontológico. Material e Métodos: Cinquenta crianças, de 4 a 6 anos, indicadas para pulpectomia foram incluídas neste estudo. Elas foram selecionadas com base em seu comportamento utilizando a Escala de Classificação de Comportamento de Frankl. Crianças com classificação de comportamento Frankl 1 e 2 foram selecionadas para este estudo. O vídeo de uma criança que cooperou durante o procedimento de pulpectomia foi mostrado a essas crianças. Posteriormente, o comportamento das mesmas foi avaliado usando a Escala de Classificação de Comportamento de Frankl. Resultados: Houve uma diferença estatisticamente significativa na pontuação da classificação do comportamento das crianças antes e depois do vídeo da criança cooperativa ter sido mostrado a elas. Conclusão: Observou-se que a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de uma criança não cooperativa em um ambiente odontológico (AU)


Subject(s)
Humans , Child, Preschool , Child , Anxiety , Pulpectomy , Child , Pediatric Dentistry , Fear
6.
Rev. Cient. CRO-RJ (Online) ; 5(2): 69-77, May-Aug. 2020.
Article in English | LILACS, BBO | ID: biblio-1254137

ABSTRACT

Introduction: Description of the bacterial community before and after chemomechanical preparation (CP) with the removal of a smear layer (SL) in pulpectomized primary teeth has been little reported. Objective: These case reports describe the presence of total microorganisms and Enterococcus faecalis in root canals of primary incisors before and after CP with SL removal. Case Reports: Microbiological samples were collected from the root canals of three children (3.66±0.58 years old) with necrosis (n=2) and irreversible pulpal inflammation (n=1) in maxillary primary incisors. After teeth isolation with a rubber dam and antisepsis of the operative field, the sample collections were performed with sterile absorbent paper cones before and after the CP, which included irrigation with 2.5% sodium hypochlorite followed by 6% citric acid to remove the SL. The collected samples were analysed immediately at the end of the clinical procedures. The plates were incubated anaerobically for 48 hours at 37°C. The results were expressed as colony forming units (CFU)/mL. Results: Two of the three teeth showed total microorganisms before the CP. One incisor had no microorganisms in the initial collection. No CFU was counted in the samples collected after CP. Moreover, E. faecalis was not observed any time, either before or after the CP. Conclusions: E. faecalis was not detected in any sample, yet two of the three root canals had microorganisms before CP. In cases where microorganisms were initially found, 100% elimination was observed after the applied protocol.


Introdução: A descrição da comunidade bacteriana antes e após o preparo químico-mecânico (PQM) com remoção da smear layer (SL) em dentes decíduos pulpectomizados tem sido pouco relatada. Objetivo: Esses relatos de casos descrevem a presença de microrganismos totais e Enterococcus faecalis em canais radiculares de incisivos decíduos antes e após PQM com remoção de SL. Relatos dos Casos: Amostras microbiológicas foram coletadas do canal radicular de três crianças (3,66 ± 0,58 anos) com necrose (n = 2) e inflamação pulpar irreversível (n= 1) em incisivos decíduos superiores. Após o isolamento dos dentes com dique de borracha e antissepsia do campo operatório, as coletas das amostras foram realizadas com cones de papel absorvente estéril antes e após o PQM, que incluiu irrigação com hipoclorito de sódio 2,5% seguido de ácido cítrico 6% para retirada do SL. As amostras coletadas foram analisadas imediatamente ao final dos procedimentos clínicos. As placas foram incubadas em anaerobiose durante 48 horas a 37°C. Os resultados foram expressos em unidades formadoras de colônias (UFC)/mL. Resultados: Dois dos três dentes apresentaram microrganismos totais antes do PQM. Um incisivo não apresentava microrganismos na coleta inicial. Nenhuma UFC foi contada nas amostras coletadas após o PQM. Além disso, o E. faecalis não foi observado nenhum momento, nem antes, nem depois do PQM. Conclusão: Não foi detectado E. faecalis em nenhuma amostra, porém dois dos três canais radiculares apresentavam microrganismos antes do PQM. Nos casos em que foram encontrados microrganismos inicialmente, observou-se 100% de eliminação após o protocolo aplicado.


Subject(s)
Humans , Male , Female , Child, Preschool , Pulpectomy/methods , Smear Layer/microbiology , Dental Pulp Necrosis/microbiology , Dental Pulp Cavity/microbiology
7.
Braz. dent. sci ; 23(1): 1-10, 2020. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1049185

ABSTRACT

Objective: The aim of this study was to evaluate the impact on the isolation and characterization of stem cells from pulp tissues obtained through rotary instrumentation techniques compared to the manual technique. Material and Methods: Thirty permanent teeth were included, 15 of which were instrumented with rotational technique (Protaper SX) and other 15 with manual technique. Cells obtained were characterized by flow cytometry and proliferation was evaluated by the MTT assay. The plasticity was evaluated for adipogenic, osteogenic and odontogenic differentiations. Results: Cells isolated from the pulp of permanent teeth, by manual techniques, presented fibroblast morphology and were able to differentiate successfully. All lineages expressed CD29, CD73, CD90, CD105, CD146, CD166 and were negative for CD31, CD34 and CD45. MTT assay showing significantly increased proliferation of hDPSCs in 5 and 7 days of the culture. Conclusions: The present study demonstrated that manual instrumentation technique is one of the best candidates to harvest dental pulp tissue as the dental stem cell source due to ability effective expanded with less tissue invasion. The technique of rotational instrumentation proved to be very harmful to the tissues of the dental pulp, and we can't obtain cells using this technique. (AU)


Objetivo: O objetivo deste estudo foi avaliar o impacto no isolamento e caracterização de células-tronco de tecidos pulpares obtidos por meio de técnicas de instrumentação rotatória em comparação à técnica manual. Material e Métodos: Trinta dentes permanentes foram incluídos, 15 dos quais foram instrumentados com técnica mecanizada (Protaper SX) e outros 15 com técnica manual. As células obtidas foram caracterizadas por citometria de fluxo e a proliferação foi avaliada pelo ensaio MTT. A plasticidade foi avaliada quanto às diferenciações adipogênica, osteogênica e odontogênica. Resultados: células isoladas da polpa de dentes permanentes, por técnicas manuais, apresentaram morfologia de fibroblastos e foram capazes de se diferenciar com sucesso. Todas as linhagens expressaram CD29, CD73, CD90, CD105, CD146, CD166 e foram negativas para CD31, CD34 e CD45. O teste de MTT mostrou proliferação significativamente aumentada de hDPSCs em 5 e 7 dias da cultura. Conclusões: O presente estudo demonstrou que a técnica de instrumentação manual é um dos melhores candidatos para a colheita de tecido pulpar como fonte de células tronco dentárias devido à boa capacidade de proliferação celular com menor invasão tecidual. A técnica de instrumentação rotatória provou ser muito prejudicial para os tecidos da polpa dentária, e não possibilitou obter células. (AU)


Subject(s)
Humans , Adolescent , Middle Aged , Pulpectomy , Endodontics , Adult Stem Cells
8.
Braz. dent. sci ; 23(1): 1-8, 2020. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1049266

ABSTRACT

Background: Zinc oxide eugenol(ZOE) has long been the material of choice for obturating primary teeth,but it is resistant to resorption, might result in a deflected successor and has limited antibacterial efficacy. Curcuminpossessesanti-inflammatory and antimicrobialproperties which can be implied by its use as obturating material in primary teeth. Objective: To evaluate and compare the efficacy of Curcumin Gel mixed Endoflas powderand Zinc oxide eugenol as obturating materials in primary molars. Material and methods: A total of 30 primary molars indicated for pulpectomy were selected from 4-9-yearold children and divided into two equal groups based on the obturating material used. Group 1- Curcumin Gel mixed Endoflas powder(CGE) and Group 2- Zinc oxide eugenol(ZOE). The efficacy of these obturation materials was evaluatedboth clinically and radiographically. Follow-up was done after 1, 3 and 6months to evaluate clinical and radiographical success rates. The results were subjected to statistical analysis using SPSS software version 21 using chisquare test. Results: At the end of the 6th month follow-up,there was 93.3% clinical success in Group 1 compared with 86.6% success in Group 2. Whereas, radiographically success reported was 100% with Group 1 and 93.3% with Group 2. The difference in the radiographic success rate between the two Groups was statistically significant (P < 0.05). Conclusion: Based on the present study results, Curcumin Gel mixed Endoflas powder can be considered as an alternative obturation material for treating deciduous molars with extensive involvement of pulp and periradicular tissues.(AU)


Fundamentação: O óxido de zinco eugenol (OZE) há muito tempo é o material de escolha para a obturação de dentes decíduos, mas é resistente à reabsorção, podendo resultar em um dente permanente desviado e tem eficácia antibacteriana limitada. A curcumina possui propriedades anti-inflamatórias e antimicrobianas que podem indicar seu emprego como material obturador em dentes decíduos. Objetivo: Avaliar e comparar a eficácia da pasta de curcumina Endoflas e do óxido de zinco eugenol como materiais obturadores em molares decíduos. Material e métodos: Um total de 30 molares decíduos indicados para pulpectomia foram selecionados entre crianças de 4 a 9 anos e divididos em dois grupos iguais, com base no material obturador utilizado. Grupo 1 - pasta de curcumina Endoflas (CGE) e Grupo 2- óxido de zinco eugenol (ZOE). A eficácia desses materiais de obturação foi avaliada clinicamente e radiograficamente. O acompanhamento foi realizado após 1, 3 e 6 meses para avaliar as taxas de sucesso clínico e radiográfico. Os resultados foram submetidos à análise estatística no software SPSS versão 21, utilizando o teste quiquadrado. Resultados: No final do sexto mês de acompanhamento, houve 93,3% de sucesso clínico no Grupo 1 em comparação com 86,6% de sucesso no Grupo 2. Considerando que, o sucesso radiográfico relatado foi de 100% no Grupo 1 e 93,3% no Grupo 2. A diferença na taxa de sucesso radiográfico entre os dois grupos foi estatisticamente significante (P < 0,05). Conclusão: Com base nos resultados do presente estudo, a pasta de curcumina Endoflas pode ser considerada como um material de obturação alternativo para o tratamento de molares decíduos com amplo envolvimento de polpa e tecidos perirradiculares (AU)


Subject(s)
Humans , Male , Female , Child , Palatal Obturators , Pulpectomy , Zinc Oxide-Eugenol Cement , Curcuma , Anti-Infective Agents
9.
Braz. dent. sci ; 23(1): 1-7, 2020. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1049511

ABSTRACT

Objective: Pulpectomy is the conservative treatment approach that retains and preserves the primary tooth in the dental arch in its normal function and non-pathologic state until its exfoliation. Over the years, pulpectomy has been performed using various instrumentation techniques. The aim of this study was to compare the quality of root filing and instrumentation time using Kedo-S files, Reciprocating files and K-files in primary teeth. Material And Methods: A randomized clinical trial was performed on 45 primary molars equally distributed for instrumentation with Kedo-S files, reciprocating files and K-Files. Immediate post-operative digital radiographs were taken to evaluate the quality of root filing and root canal instrumentation time was also recorded. Results: Mean instrumentation time with Kedo-S was 75.6 seconds, reciprocating file was 190.6 seconds and K-file was 95.4 seconds. Highest optimal fill was obtained with Kedo-S file group, highest overfill was obtained with Kedo-S group and highest under fill was obtained with reciprocating file group. Conclusion: Kedo-S rotary system provides better quality of root canal filling in minimum instrumentation time. (AU)


Objetivo: A pulpectomia é o tratamento conservador que retém e preserva o dente decíduo na arcada dentária em sua função normal e estado não patológico até sua esfoliação. Ao longo dos anos, a pulpectomia foi realizada usando várias técnicas de instrumentação. O objetivo deste estudo foi comparar a qualidade da obturação do canal radicular e do tempo de instrumentação usando limas Kedo-S, limas reciprocantes e limas K em dentes decíduos. Material e Métodos: Foi realizado um ensaio clínico randomizado em 45 molares decíduos distribuídos igualmente para instrumentação com limas Kedo-S, limas reciprocantes e limas K. Radiografias digitais pós-operatórias imediatas foram realizadas para avaliar a qualidade da obturação e também foi registrado o tempo de instrumentação do canal radicular. Resultados: O tempo médio de instrumentação com Kedo-S foi de 75,6 segundos, com limas reciprocantes foi de 190,6 segundos e com limas K foi de 95,4 segundos. O maior índice de obturação ideal foi obtido com o grupo de limas Kedo-S, o maior índice de sobreobturação foi obtido com o grupo Kedo-S e o maior índice de infraobturação foi obtido com o grupo de limas reciprocantes. Conclusão: O sistema rotatório Kedo-S fornece melhor qualidade de obturação do canal radicular em tempo mínimo de instrumentação.(AU)


Subject(s)
Pulpectomy , Root Canal Obturation , Tooth, Deciduous
10.
Article in English | LILACS, BBO | ID: biblio-1101289

ABSTRACT

Abstract Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 records of children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation. Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively). Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pulpectomy , Pulpotomy , Tooth, Deciduous , Survival Analysis , Dental Pulp Necrosis , Dental Pulp , Brazil/epidemiology , Multivariate Analysis , Survival Rate , Regression Analysis
11.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 3902, 01 Fevereiro 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-997921

ABSTRACT

Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.


Subject(s)
Humans , Child , Adolescent , Pulpectomy/methods , Root Canal Obturation/methods , Root Canal Therapy/instrumentation , Tooth, Deciduous , Medical Records , Dental Health Services , Brazil , Survival Analysis , Retrospective Studies , Statistics, Nonparametric
12.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4067, 01 Fevereiro 2019. ilus, tab
Article in English | LILACS, BBO | ID: biblio-997984

ABSTRACT

Objective: To compare the teaching of the pulpectomy in primary teeth among graduate and undergraduate Brazilian dental schools. Material and Methods: From August 2015 to July 2016, an 11-question survey was sent to 44 graduate and 207 undergraduate dental schools. Data obtained were summarized using descriptive statistics. Results: The response rate was higher from graduate (56.8%) than undergraduate (41.1%) courses. Pulpectomy was taught by all participating schools. More than 90% of the undergraduate and graduate courses recommend the use of hand instruments for canals debridement, but the widening of root canals was advised in 69.4% of undergraduate and in 84% of graduate schools. Regarding the irrigatings, 1% sodium hypochlorite as a single irrigating solution was the most taught for both biopulpectomy and necropulpectomy. The iodoform-based Guedes-Pinto paste as the single indication was the preferred root canal filling material in undergraduate schools (30.6%), while the zinc oxidethickened calcium hydroxide paste as the single option was the most recommended in graduate courses (36%). Endodontic hand file associated with lentulo drill for filling root canals was recommended by most courses. Overall, biopulpectomy was performed in one session, while necropulpectomy led two sessions. Periapical radiograph for diagnosis and final obturation was the most adopted conduct by undergraduate (68.2%) and graduate (72%) schools. Gutta-percha and glass ionomer cement were preferred materials to seal the entrance of the pulp chamber. Conclusion: There was variability in the techniques and materials taught to perform pulpectomy in primary teeth among Brazilian graduate and undergraduate dental schools. Calcium hydroxide paste has been used in similar proportion to iodoform-based paste.


Subject(s)
Pulpectomy/methods , Tooth, Deciduous/diagnostic imaging , Brazil , Calcium Hydroxide/analysis , Education, Dental , Surveys and Questionnaires
13.
Article in Korean | WPRIM | ID: wpr-787383

ABSTRACT

Endodontic treatment of primary molars is a great challenge to the dentists because of their complex morphology. However, there have been limited controlled in vivo studies about filling materials for primary teeth. Hence, the aim of this study is to evaluate and compare histologic responses of different calcium hydroxide canal filling materials that are used in daily clinical practice.Pulpectomies were performed in 132 teeth of the dogs. The root canals were randomly filled with either Vitapex® (n = 44), Metapex® (n = 44), or Metapaste® (n = 44). After 4 or 13 weeks, respectively after operation, the dogs were sacrificed, and teeth were processed for histologic examinations. Inflammatory reaction was evaluated and scored in a blind manner. The Fisher's exact test and Kruskal-Wallis test were used to compare the tested groups.In 4-week-group, all inflammatory responses were in normal range except for fibrosis. In 13-week-group, increased response to various inflammation reaction was shown compared to the 4-week-group. However, there were no statically significant differences between the tested groups in all inflammatory reaction.Overall, there were no significant differences among three materials in responses of apical tissues and all of them showed favorable tissue responses.


Subject(s)
Animals , Calcium Hydroxide , Dental Pulp Cavity , Dentists , Dogs , Fibrosis , Humans , Inflammation , Molar , Pulpectomy , Reference Values , Tooth , Tooth, Deciduous
14.
Article in Korean | WPRIM | ID: wpr-787375

ABSTRACT

The purpose of this study is to analyze the changes in patient distribution and practice pattern resulted from changes of socioeconomic circumstances. From January 2008 to December 2017, information about patient distribution and practice pattern was collected and reviewed.Both the number of new patients and revisiting patients increased. The average age of new patients showed a declining trend. Children aged between 0 and 6 had the majority. In case of restorative treatment, the use of composite resin decreased, whereas resin modified glass ionomer increased. As to pulp treatment of primary tooth, the proportion of pulpectomy increased significantly, but decreased in pulpotomy. The results showed an increase in the treatments under sedation and general anesthesia and with the use of midazolam and nitric oxide increased after 2014.


Subject(s)
Anesthesia, General , Child , Glass , Humans , Midazolam , Nitric Oxide , Pediatric Dentistry , Pulpectomy , Pulpotomy , Tooth, Deciduous
15.
Article in English | WPRIM | ID: wpr-764394

ABSTRACT

BACKGROUND: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. METHODS: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7–11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. RESULTS: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. CONCLUSIONS: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.


Subject(s)
Anesthesia, Local , Anxiety , Child , Dental Anxiety , Eyeglasses , Glass , Heart Rate , Humans , Needles , Pain Perception , Prospective Studies , Pulpectomy , Tooth Extraction , Visual Analog Scale
16.
Article in English | LILACS, BBO | ID: biblio-1056829

ABSTRACT

Abstract Objective: To evaluate the antimicrobial action of the CTZ paste in three different proportions by diffusion in agar with the microorganisms: Enterococcus faecalis,Escherichia coli, and Candida albicans. Material and Methods: Three different proportions of antibiotics were tested: GROUP A - CTZ paste in the ratio of 33.33% chloramphenicol + 33.33% tetracycline + 33.33% zinc oxide, mixed with 2 drops of eugenol (1:1:1 ratio); GROUP B - CTZ paste in the proportion of 25% chloramphenicol + 25% tetracycline + 50% zinc oxide, mixed with 2 drops of eugenol (1: 1: 2 ratio); GROUP C - CTZ paste with 13% chloramphenicol + 13% tetracycline + 74% Zinc Oxide, mixed with 2 drops of eugenol (1:1:6 ratio); PC GROUP - Positive Control (0.12% Chlorhexidine); and NC GROUP - Negative Control (0.9% Saline solution). Data were analyzed through descriptive statistics (means and standard deviation). The one-way ANOVA and Tukey's test were used, with a significance level of 5% Results: No statistical differences for Enterococcus faecalis between groups A, B, and C (p = 0.1986) were found. There were statistical differences for Escherichia coli between groups B and C (p = 0.029), and for Candida albicans between groups A and C (p = 0.006). Groups A, B, and C had significant differences with both Positive and Negative Controls for all the microorganisms Conclusion: The three different ratios of CTZ paste showed antimicrobial efficacy against Enterococcus faecalis,Escherichia coli, and Candida albicans microorganisms.


Subject(s)
Pulpectomy/instrumentation , Tooth, Deciduous/microbiology , In Vitro Techniques , Endodontics , Anti-Bacterial Agents , Brazil/epidemiology , Efficacy , Analysis of Variance , Statistics, Nonparametric , Agar
17.
Braz. oral res. (Online) ; 33: e002, 2019. tab, graf
Article in English | LILACS | ID: biblio-989476

ABSTRACT

Abstract This study evaluated clinical and radiographic twelve-month outcomes of root canal treatments (CT) with smear layer removal, performed in primary teeth, using two different root canal filling materials. Pulpectomy was performed on 27 primary teeth with necrosis or irreversible pulpitis, caused by dental caries or trauma, in 23 children (2-7 years old). A single trained operator performed the CT in a single visit in cases without periapical or interradicular radiolucency (PIR) or in multiple visits in cases with PIR. Participants were selected based on specific inclusion and exclusion criteria, and randomly allocated into two groups: Group 1 (G1) - iodoform paste (iodoform + camphorated parachlorophenol + ointment comprising prednisolone acetate 5.0 mg and rifamycin 1.5 mg); Group 2 (G2) - Calen®/ZO paste. Treated teeth were restored with composite resin immediately after the root canal filling. The outcomes were evaluated clinically and radiographically according to specific criteria. Two blinded and standardized evaluators assessed the radiographic outcomes. We used descriptive analyses due to the small sample size. CTs were performed due to caries lesions in 70.4% of the cases and due to trauma in 29.6%. Only one tooth of G1 was unsuccessful; hence, pulpectomy performance in both groups was not influenced by the filling material, nor by any other analyzed variable. The level of the root canal filling was better in the Calen®/ZO group. The clinical and radiographic twelve-month outcomes indicated successful treatment, independently of the root filling material used.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pulpectomy/methods , Root Canal Filling Materials/therapeutic use , Root Canal Therapy/methods , Zinc Oxide/therapeutic use , Calcium Hydroxide/therapeutic use , Hydrocarbons, Iodinated/therapeutic use , Ointments , Pulpitis/therapy , Pulpitis/diagnostic imaging , Tooth, Deciduous , Radiography, Dental , Reproducibility of Results , Treatment Outcome , Smear Layer/surgery , Tooth Injuries/therapy , Tooth Injuries/diagnostic imaging , Dental Caries/therapy , Dental Caries/diagnostic imaging
18.
Braz. dent. sci ; 22(1): 63-69, 2019. tab
Article in English | LILACS, BBO | ID: biblio-986800

ABSTRACT

Pulpectomy is the treatment alternative in rescuing the pulpally involved carious primary teeth. Various obturating materials are being used to conserve an infected deciduous dentition. The present study documents the use of a novel obturating material in primary molars due to the disadvantages associated with of the currently used materials. Objective: To evaluate clinically and radiographically the success rate of the mixture of zinc oxide powder and nanohydroxyapatite with saline as an obturating material in primary molars and also to compare its efficiency with Endoflas. Material and Methods: Thirty pulpectomy indicated primary molars were randomly divided into two equal groups; Group I (mixture of zinc oxide powder and nanohydroxyapatite with saline) and Group II (Endoflas FS). The teeth were evaluated using various clinical and radiographic criteria at 3, 6 and 9-month intervals. The obtained results were statistically analyzed (P <0.05). Results: The overall present study findings revealed 100% clinical success in both the groups. Whereas radiographically, success reported was 66% for Group I and 100% for Group II at the end of 9 months followup. The difference in the radiographic success rate between the two groups was statistically significant (P <0.05). Conclusion: Endoflas FS had demonstrated high success rate both clinically and radiographically when compared to the novel combination of a mixture of zinc oxide powder and nanohydroxyapatite with saline as obturating material. (AU)


Pulpectomia é uma alternativa de tratamento que visa resgatar polpas envolvidas em processos cariosos de dentes decíduos. Vários materiais obturadores estão sendo usados para conservar a dentição decídua infectada. O presente estudo relata o uso de um novo material obturador em molares decíduos devido às desvantagens dos materiais atualmente utilizados. Objectivo: Avaliar clínica e radiograficamente a taxa de sucesso da mistura de pó de óxido de zinco e nanoidroxiapatita como material obturador em molares decíduos e também comparar sua eficiência com Endoflash. Material e Métodos: Trinta molares decíduos que foram indicados para pulpectomias foram divididos aleatoriamente em dois grupos iguais; Grupo I (mistura de pó de óxido de zinco e nanoidroxiapatita) e Grupo II (Endoflash). Os dentes foram avaliados utilizando vários critérios clínicos e radiográficos em intervalos de 3, 6 e 9 meses. Os resultados obtidos foram analisados estatisticamente (P <0,05). Resultados: Os achados gerais do presente estudo revelaram sucesso clínico de 100% em ambos os grupos. Enquanto que radiograficamente, o sucesso relatado foi de 66% para o Grupo I e 100% para o Grupo II ao final de 9 meses de acompanhamento. A diferença na taxa de sucesso radiográfico entre os dois grupos foi estatisticamente significante (P <0,05). Conclusão: O Endoflas demonstrou alta taxa de sucesso tanto clínica como radiograficamente quando comparado à nova combinação de pó de óxido de zinco e nanoidroxiapatita como material obturador (AU)


Subject(s)
Pulpectomy , Zinc Oxide , Molar
19.
Braz. dent. sci ; 22(2): 197-202, 2019. ilus, tab
Article in English | LILACS, BBO | ID: biblio-996503

ABSTRACT

Objective: To evaluate the efficacy of rotary Kedo-S and hand K-files in shaping ability in primary canines using cone beam computed tomography. Material and Methods: Thirty extracted primary maxillary and mandibular canines were selected. Using cone beam computed tomography the teeth were scanned before instrumentation. In Group I, the teeth were prepared using stainless steel K file up to the size of 40. In the Group II teeth, U1 size Kedo-S rotary file was used in crown down technique. The instrumented teeth were scanned again with cone beam computed tomography and the images were compared. Results: The canal taper was more conical for rotary Kedo-S files as compared to K-files, which was statistically significant. Conclusion: Canal preparation with Rotary files resulted in more conical canals when compared to manual instrumentation in primary teeth that contributes to more uniform obturation. (AU)


Objetivo: Avaliar a eficácia da instrumentação rotatória com limas Kedo-S e instrumentação manual com limas Kerr na modelagem de caninos decíduos utilizando tomografia computadorizada de feixe cônico (TCFC). Material e Métodos: Foram selecionados 30 caninos decíduos superiores e inferiores extraídos. Usando a TCFC, os dentes foram escaneados previamente a instrumentação. No Grupo I, os dentes foram confeccionados com limas de aço inoxidável até o tamanho 40. Nos dentes do Grupo II, utilizou-se a lima rotatória Kedo-S tamanho U1 na técnica coroaápice. Os dentes instrumentados foram novamente escaneados por TCFC e as imagens foram comparadas. Resultados: A conicidade do canal foi maior no grupo com instrumentação rotatória em comparação com a instrumentação manual, com diferença estatística significante entre eles. Conclusão: O preparo do canal com o Rotary resulta em canais mais cônicos em comparação com a instrumentação manual em dentes decíduos, o que contribui para uma obturação mais uniforme.(AU)


Subject(s)
Pulpectomy , Tooth, Deciduous , Cuspid , Cone-Beam Computed Tomography
20.
Acta odontol. latinoam ; 32(1): 22-28, 2019. ilus, tab, graf
Article in English | LILACS | ID: biblio-1010413

ABSTRACT

Pulpectomies in primary molars are often hindered by several factors, including anatomical and physiological characteristics of posterior primary teeth and young patients' lack of cooperation with laborious treatments. This study was undertaken in search of easier but equally effective therapies that could eliminate infection, preserve the teeth and avoid extractions. The aim of the study was to estimate and compare clinical and radiographic success between pulp treatment with 3MixMP and pulpectomy with MaistoCapurro paste in primary necrotic molars. A longitudinal prospective study was conducted at the Department of Comprehensive Pediatric Dentistry of the Faculty of Dentistry of the University of Buenos Aires (20152017). The study included 46 primary molars with necrotic pulp of children without immune or metabolic compromise. Children and their legal guardians provided assent and informed consent. Selected molars were randomly divided into 2 groups: G1: Pulpectomy treatment with MaistoCapurro paste; and G2: Treatment with 3MixMP paste. Treatments were evaluated at 1, 3, 6, 12 and 18 months (intra and interrater agreement 0.92 and 0.84). Clinical success was considered to be the absence of any of the following: pain, sensitivity to percussion or palpation, swelling, fistula and nonphysiological mobility, while radiographic success was considered to be: absence of internal or external nonphysiological resorption, no progression or reduction of radiolucent periapical/interradicular lesion and evidence of bone regeneration. Percentages, 95% C.I., and CHI2 were calculated for the comparison between groups. Overall clinical success was 91.5% and 87.5% (p=0.48) and overall radiographic success was 88.3% and 82.3% (p=0.31) for G1 and G2 respectively. No significant clinical or radiographic difference was found between groups. Both treatments showed similar clinical and radiographic behavior during the study period (AU)


Las pulpectomías en molares primarios se ven dificultadas frecuentemente por las características anatómicas y fisiológicas de éstos y por la escasa colaboración que brindan los pacientes de corta edad ante tratamientos tan laboriosos. En búsqueda de terapéuticas más sencillas, pero igualmente eficaces, que consigan eliminar la infección para conservar las piezas y evitar las exodoncias, se ha planteado como objetivo de este estudio: estimar y comparar la proporción de éxito clínico y radiográfico entre el tratamiento pulpar con 3MixMP y la pulpectomía con pasta de MaistoCapurro en molares primarios con necrosis. Se realizó un estudio longitudinal y prospectivo en la Cátedra de Odontología Integral Niños de la Facultad de Odontología de la Universidad de Buenos Aires (2015 2017). Formaron parte del estudio 46 molares primarios con diagnóstico de necrosis pulpar, de niños sin compromiso inmunológico ni metabólico y que junto con sus responsables legales brindaron el asentimiento y el consentimiento informado. Los molares seleccionados fueron divididos aleatoriamente en 2 grupos: G1: Tratamiento de pulpectomía con pasta de MaistoCapurro y G2: Tratamiento con pasta 3MixMP. Los tratamientos fueron evaluados al mes, 3, 6, 12 y 18 meses (concordancia intraexaminador 0,92 e interexaminador 0,84), considerando como éxito clínico la ausencia de dolor, sensibilidad a la percusión y palpación, edema, fístula y movilidad no fisiológica; y como éxito radiográfico, ausencia de reabsorción interna o externa no fisiológica, no progresión o reducción de la lesión radiolúcida interradicular/periapical y evidencia de regeneración ósea. Se calcularon porcentajes, I.C 95% y CHI2 para la comparación. El éxito clínico global fue de 91,5% y 87,5% (p=0.48) y el éxito radiográfico global de 88,3% y 82,3% (p=0.31) para G1 y G2 respectivamente, sin diferencias significativas entre ambos grupos. En los periodos estudiados ambos tratamientos mostraron comportamientos clínico y radiográfico semejantes (AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Pulpectomy , Root Canal Filling Materials , Tooth, Deciduous , Dental Care for Children , Tooth, Nonvital , Molar , Argentina , Schools, Dental , Statistical Analysis , Prospective Studies , Longitudinal Studies
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