Effect of two methods of irrigant agitation on the temperature and cleanliness of sodium hypochlorite associated or not with a chelator: irrigant agitation and influence in temperature

Aim: This study investigated the influence in vitro of different sodium hypochlorite (NaOCl) agitation protocols associated or not with DualRinse (HEDP) on the temperature of the solution. Methods: Forty-eight premolars were instrumented and their apical third sealed to allow a closed irrigation system. The teeth remained immersed in a basin of warm water (37°C). The teeth were divided into the groups: G1 (NaOCl+Passive Ultrasonic Irrigation (PUI)), G2 (NaOCl/HEDP + PUI), G3 (NaOCl + EasyClean (EC)) and G4 (NaOCl/HEDP + EC). The canals were filled with the respective solutions and after 180 seconds the first temperature measurement was taken (T0). Then, the solutions were agitated, following the different protocols, for 60 seconds and a new measurement was performed (T60). The temperature was measured using a digital thermometer for type "K" sensors that was inserted into the middle third of the teeth. At the end of the measurements, the teeth were sectioned and prepared for scanning electron microscopy. The dentinal wall of middle third was graded according to the amount of debris and smear layer remaining on the walls. The results were analyzed using ANOVA test and Tukey's multiple comparisons (p<0.05). Results: G1 and G2 had an average increase in temperature of 1.1°C and 1.65°C, respectively (p>0.05). EasyClean caused a decrease in the temperature of the solutions in both groups, without a significant statistical difference with T0 (p>0.05). Regarding cleaning, it was only possible to observe clean dentinal tubules in the groups with the chelator. PUI discretely increased the temperature of the solution, regardless of the solution. The opposite effect was observed after activation with EasyClean. Conclusion: The association of NaOCl with a chelating agent promoted the cleaning of the dentinal tubules

Physicochemical properties and antimicrobial activity of calcium hydroxide pastes in association with other compounds

Aim: This study aimed to evaluate the pH, Ca2+ release, solubility, and antimicrobial activity of calcium hydroxide (Ca(OH)2) pastes in association with different substances. Methods: Sixty acrylic teeth (n=10) were filled with pastes that associated Ca(OH)2 with the following substances: benzalkonium chloride 5% (G1) and 50% (G2) both in propylene glycol, arnica glycolic extract (G3), green tea glycolic extract (G4), Calen/PMCC™ (G5), and Calen™ (G6). In the group G1 to G4 were used 1g of Ca(OH)2 powder with 0,8g of vehicle. pH and Ca2+ release was measured after 7, 15, and 30 days. For solubility, micro-CT was used immediately and at the periods of 7, 15, and 30 days. For the antimicrobial analysis, a biofilm of E. faecalis was induced in vitro on bovine dentin discs. Live/dead viability dye and confocal scanning microscopy were used. Results: The highest pH values occurred on the first 7 days, and the G6, G1, G3, and G5 presented the highest pH values at this period (P <0.05). Ca2+ release was higher in all groups at 7 days, with the highest values observed in G1, G5, and G6. The volume of all pastes showed no significant difference in the intragroup analysis at 7 and 15 days (P <0.05). G1 and G2 showed the highest antimicrobial action (P <0.05). For the biovolume, there was difference between the G6 and the other groups (P >0.05) with G1 presenting the lowest values. Conclusion: Benzalkonium chloride 5% increases the antimicrobial action of the Ca(OH2), without impairs physicochemical properties

Comparação de diferentes métodos de inserção da pasta de hidróxido de cálcio para preenchimento de canais laterais simulados: estudo in vitro / Comparison of different methods for insertion of calcium hydroxide paste in the filling of simulated lateral canals: in vitro evaluation

Avaliar, em micro-CT, diferentes métodos de inserção da pasta de hidróxido de cálcio para preenchimento de canais laterais simulados em blocos de acrílico. Métodos: Foram utilizados 72 blocos de acrílico com canais laterais simuladas nas porções cervical, média e apical, os quais foram preenchidos com a pasta de hidróxido de cálcio de acordo com os seguintes métodos (n=12): Grupo 1 - lima tipo K #30; Grupo 2 - espiral de Lentulo; Grupo 3 - agitação ultrassônica; Grupo 4 - agitação sônica com EndoActivator; Grupo 5 - seringa + Capillari TIPS; e Grupo 6 - agitação com EasyClean em baixa rotação. Para os grupos que receberam agitação, o canal principal foi preenchido com a pasta utilizando seringa e Capillari Tips. Antes e após o preenchimento, os dentes foram escaneados em micro-CT (SkyScan 1174) e as imagens obtidas foram comparadas utilizando-se o software CTan. O volume de medicação intracanal no interior dos canais simulados foi mensurado e, em seguida, obtida a porcentagem de penetração. Os dados foram submetidos à comparação estatística (p<0,05). Resultados: Os grupos EndoActivator e ultrassom apresentaram resultados significativamente melhores do que a lima #30 nos três níveis analisados, assim como o EasyClean nos terços cervical e médio, e a Lentulo no terço apical, em relação ao Grupo 1 (p <0,05). Nas demais comparações e na análise intragrupos, não houve diferenças significativas (p>0,05). Conclusão: Os métodos de agitação da medicação intracanal, especialmente o ultrassom, proporcionaram uma maior porcentagem de penetração dela em canais laterais simulados (AU).

Objective: The objective of this study was to analyze, in micro-CT, the capacity of different methods for insertion of calcium hydroxide paste in the filling of lateral canals simulated in blocks of acrylic. Methods: A total of 72 acrylic blocks with lateral canals simulated in the coronal, middle and apical portions, were used and filled with calcium hydroxide paste, according to the following methods (n = 12): Group 1 - #30 K-file; Group 2 - Lentulo spiral; Group 3 - Ultrasonic agitation; Group 4 - Sonic agitation with EndoActivator; Group 5 - Syringe + Capillary Tips; Group 6 - Agitation with Easy Clean at low speed. For the groups that received agitation, the blocks were filled with the aid of a syringe and Capillary Tips. Each sample was scanned with SkyScan 1174, before and after the filling procedures, and the volume of calcium hydroxide was measured using CTAN software. The percentage of penetration of intracanal medication inside the simulated canals was calculated. Data were statistically compared (p < 0.05). Results: The agitation with EndoActivator and ultrasonic insert promoted a greater penetration of paste with significant statistical differences in relation to the #30 K-file group in the 3 levels analyzed (p < 0.05). Other statistical differences occurred in the comparison between the Easy Clean group and #30 K-file group in the coronal and middle thirds and in the comparison between Lentulo spiral group and #30 K-file group in the apical (p < 0.05). Conclusion: Methods which use agitation devices , such as ultrasonic insert, promoted higher filling of calcium hydroxide in simulated lateral canals (AU).

Tratamento não cirúrgico para remoção de instrumento fraturado e guta-percha extravasada, com o uso do Masserann EndoKit / Non-surgical treatment for removing fractured instrument and extravasated gutta-percha, by using the Masserann EndoKit

Objetivo: o objetivo deste artigo é relatar um caso clínico em que um instrumento fraturado e a guta-percha extravasada foram removidos via canal. Relato de caso: paciente do sexo masculino, com 38 anos de idade, foi encaminhado para avaliação do incisivo lateral superior direito (dente #12). O paciente apresentava dor à palpação na região apical e ausência de sintomatologia espontânea. O exame radiográfico revelou a presença de cone de guta-percha extravasado, uma espiral de Lentulo fraturada, além de lesão periapical no dente #12. O retratamento endodôntico foi o procedimento de escolha, na tentativa de remover os dois materiais. A espiral de Lentulo foi removida com Masserann Endokit; e o cone de guta-percha, utilizando limas Hedstroen. Após realizar a instrumentação e o preenchimento do conduto com pasta de hidróxido de cálcio com iodofórmio, constatou- se a presença de reabsorção no terço apical. Depois de dois meses, observou-se redução da lesão; utilizou-se, então, MTA na região da reabsorção, e o conduto foi obturado com cone de guta-percha e cimento endodôntico Sealer 26. Conclusão: controles clínicos e radiográficos foram realizados após dois, quatro e oito anos, demonstrando reparo na região apical e ausência de sintomatologia (AU).

The objective of this article was to report a clinical case of finding a fractured instrument and over-extended guttapercha of a tooth, which were removed via the canal. The patient, a 38-year-old man, was referred for treatment of the right maxillary lateral incisor (tooth 7). The patient presented pain on palpation at the apical level and absence of spontaneous symptomatology. Radiographic examination revealed the presence of a over-extended gutta-percha cone, a fractured Lentulo spiral and periapical lesion in tooth 7. Endodontic retreatment was the chosen procedure in an attempt to remove both materials. The Lentulo spiral was removed by means of the Masserann Endokit, and the gutta-percha cone by using Hedstroen files. While performing instrumentation, and filling the canal with calcium hydroxide with iodoform, the presence of resorption in the apical third was verified. After 2 months, reduction of the lesion was observed, thus MTA was placed in the area of resorption and the remainder of the canal was filled with a gutta-percha cone and Sealer 26 cement. Clinical and radiographic controls performed after 2, 5 and 7 years showed repair of the area and absence of symptomatology (AU).

Avaliação longitudinal do comportamento dos bebês durante o atendimento odontológico preventivo / Assessment of longitudinal behavior of babies during preventive dental appointments

Introdução: com o aumento do atendimento odontológico direcionado aos bebês, gerou a necessidade de ampliar o conhecimento quanto ao comportamento destes no ambiente odontológico. Objetivo: avaliar o comportamento de bebês durante a assistência odontológica preventiva por três sessões. Material e Método: foram selecionados bebês, entre três e 18 meses, que nunca haviam recebido atendimento odontológico e o comportamento foi avaliado de acordo com a Ohio State University Behavioral Profile (OSUBRS), e classificados em: A= comportamento quieto; B = choro, mas sem movimento de interrupção; C = movimento de interrupção, mas sem choro e D = choro com movimentos de interrupção. O comportamento foi avaliado nos seguintes momentos: durante o posicionamento da criança, exame clínico e higiene bucal em três sessões, com intervalos trimestrais. Resultados: na primeira consulta foram atendidos 45 bebês, sendo que 44,44%, 6,67%, 13,33% e 35,56% dos bebês apresentaram comportamento A, B, C e D, respectivamente. Para a segunda consulta, compareceram 26 bebês, e o comportamento A, B, C e D foi observado em 23,08%, 11,54%, 34,62% e 30,76% dos bebês, respectivamente. Na terceira consulta, retornaram 13 bebês e o comportamento A foi observado em 28,57% e D em 71,43% dos bebês. Houve diferença estatisticamente significante do comportamento durante a limpeza bucal em relação ao posicionamento e exame clínico (p = 0,032) e na primeira consulta, nos bebês acima de 8 meses em todos os momentos (p<0,05). Conclusão: com o decorrer das consultas, o comportamento quieto diminuiu e o comportamento com choro e movimentos de interrupção aumentou.

Introduction: with the increase of the dental care directed to the babies, it generated a need to increase the knowledge about their behavior in the dental environment. Objective: to evaluate the behavior of babies during a preventive dental care for three sessions. Material and Methods: three to 18-month-old infants were selected who never received dental care and the behavior was assessed according to a behavioral profile of Ohio State University (OSUBRS), and classified into: A = quiet behavior; B = cry, but no interruption movement; C = interruption movement, but no crying and D = crying with interruption movements. The behavior was evaluated by moments, during the positioning of the child, clinical examination and oral hygiene in three sessions, with quarterly intervals. Results: at the first visit, 45 babies were attended, with 44.44%, 6.67%, 13.33% and 35.56% of the babies presenting behavior A, B, C and D, respectively. For a second visit, 26 babies attended, and behavior A, B, C and D were observed in 23.08%, 11.54%, 34.62% and 30.76% of the babies, respectively. In the third dental visit, return 13 babies and behavior A observed in 28.57% and D in 71.43% of the babies. There was a statistically significant difference in behavior during oral cleaning in relation to positioning and clinical examination (p = 0.032) and in the first visit, infants over 8 months at all times (p>0.05). Conclusion: during the course of the visits, the quiet behavior decreased and the behavior with crying and interruption movements increased.

Uso do endoactivator no tratamento endodôntico / Use of the endoactivator in endodontic treatment

Introdução: a irrigação é uma das etapas essenciais no preparo biomecânico e, buscando aumentar a eficiência desta, novos métodos vem sendo empregados no intuito de melhorar a ação e o alcance das soluções irrigadoras. Objetivo: analisar a eficácia do sistema EndoActivator em várias etapas do tratamento endodôntico. Resultados e discussão: apesar de diferenças de metodologias na literatura, o EndoActivator apresentou bons resultados em comparação com a irrigação convencional quando empregado em diferentes fases do tratamento endodôntico. Conclusão: o sistema EndoActivator é seguro e eficaz durante o preparo biomecânico, porém, assim como outros dispositivos de agitação mecânica da solução irrigante, não é capaz de promover completa limpeza dos canais radiculares.

Introduction: the irrigation is an essential part of biomechanical preparation and seeking increase the efficiency of this, new methods have been used in order to expand the effect of irrigating solutions, and promote the reach for areas with difficult access. Objective: the objective of this literature review was to analyze the effectiveness of the EndoActivator system in several stages of endodontic treatment. Results and Discussion: despite differences in methodologies in the literature, the EndoActivator presented good results in comparison to conventional irrigation when used in different phases of endodontic treatment. Conclusion: the EndoActivator system is safe and effective during biomechanical preparation, but, like other mechanical agitation devices of the irrigating solution, it is not able to promote complete cleaning to root canals.