RESUMEN
Abstract This study aimed to compare the quality of root canal obturation (ratio of area occupied by gutta-percha (G), sealer (S), and presence of voids (V)) in different anatomical irregularities (intercanal communications, lateral irregularities, and accessory canals) located at different thirds of the root canal system of mandibular molar replicas. Sixty-seven 3D printed replicas of an accessed mandibular molar were prepared using ProGlider and ProTaper Gold rotatory systems. Three specimens were randomly selected to be used as controls and did not receive further treatment. The rest were randomly distributed in 4 experimental groups to be obturated using either cold lateral compaction (LC), continuous wave of condensation (CW), and core-carrier obturation (ThermafilPlus (TH) or GuttaCore (GC)) (n=16 per group). AHPlus® sealer was used in all groups. The three controls and a specimen from each experimental group were scanned using micro-computed tomography. The rest of the replicas were sectioned at the sites of anatomical irregularities and examined at 30× magnification. The G, S, and V ratios were calculated dividing the area occupied with each element by the total root canal area and then compared among groups using the Kruskal-Wallis test. Voids were present in all obturation techniques with ratios from 0.01 to 0.15. CW obtained a significantly higher G ratio in the irregularity located in the coronal third (0.882) than LC (0.681), TH (0.773), and GC (0.801) (p<0.05). TH and GC achieved significantly higher G ratios in those located in the apical third (p<0.05). The worst quality of obturation was observed in the loop accessory canal with all obturation techniques. Whitin the limitations of this study, it can be concluded that CW and core-carrier obturation are respectively the most effective techniques for obturating anatomical irregularities located in the coronal and the apical third.
RESUMEN
A Odontologia Legal é a especialidade responsável por esclarecer demandas administrativas ou judiciais provenientes de diferentes esferas. Na esfera criminal, o processo de identificação humana engloba um conjunto de procedimentos que visam individualizar uma pessoa e, em diversas situações, a Odontologia Legal se destaca como um importante método de identificação humana. O objetivo desse trabalho foi apresentar um relato de caso em que a presença de um remanescente de guta-percha foi decisiva no processo de identificação humana. Após exame necroscópico em um cadáver e com a entrega do prontuário odontológico, foi realizada a comparação das informações recebidas do suspeito com aquelas coletadas no exame post mortem. Por meio dessa comparação, verificou-se que havia pontos coincidentes que permitiram que a identificação positiva da vítima fosse estabelecida, especialmente a presença, tanto no exame ante mortem quanto no post mortem, de um remanescente de guta-percha envolto por tecido cicatricial ósseo na região do dente 21. Os materiais dentários utilizados em procedimentos odontológicos, tais como o remanescente de guta-percha neste relato de caso pericial, são extremamente valiosos no processo de identificação humana
Forensic Dentistry is the specialty responsible for clarifying administrative or judicial demands from different spheres. In the criminal sphere, the human identification process encompasses a set of procedures that aim to individualize a person and, in several situations, and Forensic Dentistry stands out as an important method in human identification. The objective was to present a case report in which the presence of a gutta-percha remnant was important in the human identification process. After necroscopic examination and delivery of the dental records, the information received from the suspect was compared with that collected in the post mortem examination. Through this comparison, it was verified that there were coincident points that allowed the positive identification of the victim, especially the presence, both in the ante-mortem and in the post-mortem examination, of a gutta-percha remnant surrounded by bone scar tissue in the tooth region 21. Materials used in dental procedures, such as the gutta-percha remnant in this forensic case report, are extremely valuable in the human identification process
RESUMEN
ABSTRACT The aim of this study was to compare the capacity of two reciprocating NiTi instruments in removing gutta-percha/sealer material from simulated curved root canals (SCRC). The time required for filling material removal was also recorded. Twenty SCRCs were divided into two groups of 10 (n=10) samples each. In Group 1, the SCRC were prepared to a R25 Reciproc Blue instrument (RCPB; VDW, Munich, Germany). In Group 2 the SCRC were prepared to a Primary WaveOne Gold instrument (PWOG; Dentsply, Ballaigues, Switzerland). In both groups, the canals were filled with matched-taper single gutta-percha cones and AH Plus sealer. Filling materials were removed with R25 RCPB (Group 1) and PWOG (Group 2). The amount of remaining gutta-percha/sealer was calculated at three predetermined levels of evaluation located at 2, 6 and 10 mm from the WL and expressed in percentages. Canals re-treated with RCPB contained significantly less remaining gutta-percha/sealer compared to canals prepared with PWOG (P=0.02). The RCPB instruments required significantly less time to complete the retreatment procedures (P<0.01). No unwinding or instrument separation was noted. RCPB instruments removed significantly more gutta-percha/sealer from simulated curved root canals than PWOG. However, neither of the tested instruments completely removed all filling materials.
RESUMEN El propósito del presente estudio fue comparar la capacidad de dos instrumentos de NiTi de movimiento reciproco para remover la obturación de gutapercha/sellador durante el retratamiento de conductos curvos simulados (SCRC). El tiempo requerido para la remoción del material fue también registrado. Se utilizaron veinte (n=20) SCRC divididos en dos grupos de diez especimenes (n=10) cada uno. En el Grupo 1 los SCRC se prepararon hasta un instrumento Reciproc Blue R25 (RCPB; VDW, Munich, Germany). En el Grupo 2, los SCRC se prepararon hasta un instrumento WaveOne Gold Primary (PWOG; Dentsply, Ballaigues, Switzerland). En ambos grupos los conductos se obturaron con cono único de gutapercha de conicidad creciente y el sellador AH Plus. La remoción de los materiales de obturación se realizó mediante los instrumentos RCPB R25 (Grupo 1) o PWOG (Grupo 2). La cantidad de gutapercha/sellador remanente se calculó en tres niveles de evaluación predeterminados ubicados a 2, 6 y 10 mm de la LT, y finalmente fue expresada en porcentajes. La cantidad de gutapercha/ sellador remanente en los SCRC retratados con RCPB fue significativamente menor en comparación con los que fueron retratados con PWOG (P=0.02). Los instrumentos RCPB requirieron un tiempo significativamente menor para completar el retratamiento (P<0.01). No se observaron deformaciones o separación de los instrumentos. Los instrumentos RCPB removieron una cantidad significativamente mayor de gutapercha/sellador que los instrumentos PWOG en conductos curvos simulados. Sin embargo, ninguno de los instrumentos ensayados removió completamente los materiales de obturación.
RESUMEN
Aim:To demonstrate the effectiveness of disinfecting substances with 2% and 5% Sodium Hypochlorite and 2% Chlorhexidine Gluconate at each of the pre-established times of 0:15 and 0:30 seconds, and 1, 2, 5, and 10 minutes. Methods: This study selected 96 gutta-percha cones that were contaminated with Enterococcus Faecalis, dried and treated with the aforementioned substances and applied at pre-established times. Subsequently, these were transferred to sterile Brain Heart Infusion broth and placed in a bacteriological incubator at 37°C for 24 hours to evaluate microbial growth, as well as in a nutrient agar medium in Petri dishes. Half of the cone was transferred to individual filter paper packages and exposed to the environment in a dental clinic at Universidade José do Rosário Velano, for 7 days, with subsequent evaluation for microbial growth. The bacterial phenotype test was performed using Gram stain and growth in 6.5% saline solution. The results were submitted to statistical analysis using the Kruskal Wallis H test, with a significance level of 5%. Results:The substances were effective at all times tested and individual storage supported disinfection. In the statistics test, the p-value was greater than 0.05, as there was no variability in the data configurations. Conclusion: The disinfection of gutta-percha cones and individual storage was an effective protocol to be adopted with 2% and 5% Sodium Hypochlorite and 2% Chlorhexidine.
Objetivo: Demonstrar a eficácia de substâncias desinfetantes, Hipoclorito de Sódio a 2% e 5% e Gluconato de Clorexidina 2% em cada um dos tempos pré-estabelecidos de 15 e 30 segundos, e 1,2, 5 e 10 minutos.Métodos: Este estudo selecionou 96 cones de guta-percha,contaminados com Enterococcus Faecalis, secos e tratados com as substâncias citadas e aplicadas em tempos pré-estabelecidos. Posteriormente, estes foram transferidos para tubos contendo caldo Infusão Cérebro Coração estéril e colocados estufa bacteriológica a 37°C por 24 horas para avaliar o crescimento microbiano, também verificado em meio ágar nutriente em Placas de Petri. Metade dos cones foram transferidos para embalagens individuais de papel de filtro, e expostas ao ambiente da clínica odontológica da Universidade José do Rosário Velano por 7 dias, com posterior avaliação do crescimento microbiano. O teste do fenótipo bacteriano foi realizado pela coloração de Gram e crescimento em solução salina a 6,5%. Os resultados foram submetidos à análise estatística por meio do Teste H de Kruskal Wallis, com nível de significância de 5%.Resultados: As substâncias foram eficazes em todos os tempos testados e o armazenamento individual favoreceu a desinfecção. No teste estatístico, o valor de p foi maior que 0,05, pois não houve variabilidade nas configurações dos dados.Conclusão: A desinfecção dos cones com Hipoclorito de Sódio 2% e 5% e Clorexidina 2% a partir de 15 segundos, e o armazenamento individual foram protocolos eficazes para serem adotados.
Asunto(s)
Obturación del Conducto Radicular , Desinfección , Endodoncia , GutaperchaRESUMEN
OBJECTIVE@#To evaluate the clinical effect of root canal obturation therapy using cold flowable gutta-percha on young permanent teeth after apexification.@*METHODS@#Ninety cases of young permanent teeth with pulp necrosis or periapical periodontitis treated by apexification were randomly divided into two groups. The cases in each group were divided into single root canal and multiple root canal according to the number of the root canal, and divided into classifications Ⅰ, and Ⅱ/Ⅲ/Ⅳ according to Frank's classification of root development after apexification. Cold flowable gutta-percha and warm gutta-percha obturation techniques were used for root canal obturation of the two groups. The operation time was recorded, and the patients' therapy pain degree was evaluated by visual analog scale (VAS) immediately after operation. Periapical X-ray was performed after operation to evaluate the effect of the root canal filling. The total length of the root was divided into equal three parts on the X-ray film, and three-dimensional tightness of the apical, middle, and coronal region of the root canals were statistically analyzed respectively. Clinical examinations and X-ray examination were performed 6 and 12 months after the operation to evaluate the treatment success rate.@*RESULTS@#The operation time of cold flowable gutta-percha group was significantly lower than that of the control group, which were 51 s and 74 s (P < 0.05); The percentages of pain and discomfort in the two groups were 26.67% and 40.00%, respectively. There were two cases of underfilling and no overfilling in both groups. The percentages of proper filling and tight three-dimensional obturation in the experimental and control groups were 71.11% and 60.00% respectively; and the percentages of tight three-dimensional obturation in the apical third areas were 86.67% and 66.67%, the difference was significant (P < 0.05). There was no significant difference in the three-dimensional tightness between the two groups in the middle and coronal third areas. The percentages of tight three-dimensional obturation in classification Ⅰ groups were 86.67%, 83.33%, 93.33% and 76.67%, 90.00%, 96.67% in experimental and control group, respectively; The percentages of classification Ⅱ/Ⅲ/Ⅳ groups were 86.67%, 86.67%, 100.00% and 46.67%, 86.67%, 100.00%, respectively, and the difference was significant (P < 0.05). There were no apical lesions that occurred in either group during the one-year review period.@*CONCLUSION@#The application of cold flowable gutta-percha on young permanent teeth root canal obturation after apexification can achieve good obturation effect. The root obturation effect in the apical third area is significantly better than that of warm gutta-percha obturation techniques. Cold flowable gutta-percha can shorten the clinical treatment time and ameliorate the patients' therapy comfort.
Asunto(s)
Humanos , Apexificación , Cavidad Pulpar , Gutapercha , Radiografía , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Preparación del Conducto RadicularRESUMEN
Introdução: Os cones de guta percha são utilizados para obturação de canais radiculares, entretanto a desinfecção desses cones deve ser realizada previamente à obturação, evitando uma contaminação, uma vez que com o manuseio diário na clínica, pode ocorrer a proliferação de microrganismos. Objetivo: Relatar através de uma revisão de literatura a importância da desinfecção de cones de guta percha previamente á obturação dos canais radiculares, com diferentes soluções desinfetantes utilizadas na odontologia. Metodologia: Foi realizada uma busca em artigos de revisão de literatura nas bases de dados Pubmed, Scielo, Lilacs com diferentes anos de publicação, mas todos com enfoque principal no tema de desinfecção de cones de guta percha com diferentes soluções químicas. Foram utilizados os descritores guta percha, desinfecção, soluções químicas. Conclusão: Medidas de prevenção devem ser empregadas durante o atendimento odontológico, em especial durante a obturação dos canais radiculares, sendo a desinfecção dos cones de guta percha essencial(AU)
Introduction: Gutta percha points are used to fill root canals, however its disinfection must be performed prior to filling, avoiding contamination, since with daily handling in the proliferation of microorganisms can occur. Objective: To report through a literature review the importance of disinfecting gutta percha points prior to root canal filling, with different disinfectant solutions used in dentistry. Methodology: A search for literature review articles was carried out in the Pubmed, Scielo, Lilacs databases with different years of publications, but all with a main focus on the topic of disinfection of gutta-percha points with different chemical solutions. The keywords gutta percha, disinfection, chemical solutions were used. Conclusion: Preventive measures must be used during dental care, especially during root canal filling, with the disinfection of gutta percha points being an essential(AU)
Asunto(s)
Irrigantes del Conducto Radicular , Obturación del Conducto Radicular , Gutapercha , Materiales de Obturación del Conducto Radicular , Cavidad PulparRESUMEN
ABSTRACT: Foreign bodies in the ethmoid sinus are uncommon, and endodontic gutta percha displacement is even more rare. We present and discuss a case of displacement of gutta percha into the ethmoid sinus following root canal intervention of a maxillary first molar which presumably migrated through the maxillary sinus. There have been reports on the displacement of tooth roots or implants into the maxillary sinus. However, we know of only one such report on the migration of a gutta-percha point into the ethmoid sinus.
RESUMEN: Los cuerpos extraños en el seno etmoidal son infrecuentes y el desplazamiento de la gutapercha endodóntica es aún más raro. Presentamos y analizamos un caso de desplazamiento de la gutapercha hacia el seno etmoidal después de la intervención del conducto radicular de un primer molar superior que se presume migró a través del seno maxilar. A pesar de que existen informes sobre el desplazamiento de raíces dentales o implantes hacia el seno maxilar, solo conocemos un informe de este tipo sobre la migración de un punto de gutapercha hacia el seno etmoidal.
RESUMEN
Objetivo: O objetivo do presente estudo é revisar a literatura sobre os tipos de guta-percha para obturação, as suas formas de apresentação e as características físico-químicas e biológicas do material. Métodos: Artigos publicados entre 1973 e 2016 foram selecionados nas bases de dados PubMed e Science Direct. Foram utilizados como descritores na língua inglesa "gutta-percha and obturation"; "cones of gutta-percha" e "obturation cones and endodontic". Revisão: A guta-percha é um material de origem orgânica que pode ser encontrado em duas formas cristalinas. Encontra-se, geralmente, na forma de cones compostos de guta-percha associada a outras substâncias. A guta-percha é considerada inerte e biocompatível, porque causa pouca reação alérgica e possui biodegradação lenta. Pode sofrer alterações físico-químicas quando utilizada em técnicas de termo-obturação, nas quais as altas temperaturas aceleram a sua degradação, comprometendo a sua função. Além disso, a sua degrada- ção precoce é também afetada pela presença ou ausência de lesões periapicais. Conclusão: Os cones de guta-percha ainda são considerados o material mais adequado e acessível para o preenchimento de canais radiculares (AU).
Objective: The objective of this study was to identify the types of gutta-percha for obturation and their forms of presentation, as well as physical-chemical and biological characteristics of the material. Materials and Methods: Articles were selected from the PubMed and Science Direct databases, published between 1973 and 2016. Were used as descriptors: "gutta-percha and obturation"; "cones of gutta-percha" and "obturation cones and endodontic". Review: Gutta-percha is a material of organic origin, which can be found in two crystalline forms. It is usually found in the form of cones composed of gutta-percha associated with other substances. Gutta-percha is considered inert and biocompatible, because it causes little allergic reaction and slow biodegradation. It can suffer physical-chemical changes when used in thermo-obturation techniques, where the high temperatures accelerate its degradation, compromising its function. In addition, its early degradation is also affected by the presence or absence of periapical lesions. Conclusion: Gutta-percha Cones are still considered the most suitable and accessible material for root canal filling
Asunto(s)
Obturación del Conducto Radicular , Productos Biológicos , Gutapercha , Hipersensibilidad , Cavidad Pulpar , MétodosRESUMEN
Objetivo: Estimar y comparar la eficacia de diferentes técnicas de obturación para impedir el flujo de colorante a través de los conductos laterales. Materiales y métodos: Se emplearon 50 premolares inferiores extraídos y conservados en formol neutro al 5% hasta el momento de su uso, a los cuales se les realizaron conductos laterales artificiales. Una vez instrumentados los conductos principales, los dientes fueron divididos al azar en 5 grupos (n=10) para ser obturados con cuatro técnicas distintas: A) System B + inyección de gutapercha termoplástica del sistema Elements, Extruder; B) obturadores de Thermafil, ProTaper Universal; C) técnica híbrida y D) obturación con inyección de gutapercha termoplástica del sistema Elements, Extruder. Inmersos en tinta china y diafanizadas las raíces, se evaluó la longitud de penetración de la tinta en los conductos laterales. Se empleó el análisis de la varianza para detectar diferencias significativas (P<0,05) entre los niveles medios de penetración del colorante según las técnicas de obturación y las zonas del diente, y se efectuaron pruebas de rango múltiple (HSD de Tukey) para realizar comparaciones dos a dos, manteniendo fija la tasa de error por familia. Resultados: A la técnica B le correspondió el valor medio más bajo (30,63%) de penetración de tinta china. Los valores medios más elevados (54,52% y 51,74%) correspondieron a las técnicas A y C, respectivamente. Conclusión: Ninguna de las técnicas de obturación del conducto radicular empleadas ha sido capaz de impedir la filtración del colorante en los conductos laterales (AU)
Aim: To estimate and compare the different obturation techniques to avoid the flow of colorant through lateral canals. Materials and methods: 50 extracted lower premolars preserved in 5% neutral formol until the moment of use, had artificial lateral canals made. Once canals were instrumented, the teeth were randomly divided into 5 groups (n=10) to be filled with four different techniques: A) System B + injection of thermoplastic gutta-percha, Elements system, Extruder; B) Thermafil, ProTaper Universal obturators; C) hybrid technique, and D) injection of thermoplastic gutta-percha, Elements system, Extruder. Having immersed the premolars in India ink and diaphanized the roots, the penetration length of the India ink inside the canals was assessed. Analysis of variance was used to detect significant differences (P<0.05) between the mean levels of dye penetration according to the filling techniques and tooth areas, and multiple range tests (Tukey's HSD) were performed for two-to-two comparisons, keeping the error rate per family fixed. Results: Technique B had the lowest mean value (30.63%) of penetration. The highest mean values (54.52% and 51.74%) corresponded to techniques A and C, respectively. Conclusion: No obturation technique of the root canal used was able to avoid filtration of colourant in the lateral canals (AU)
Asunto(s)
Humanos , Obturación del Conducto Radicular , Filtración Dental/diagnóstico , Gutapercha , Materiales de Obturación del Conducto Radicular/química , Diente Premolar/anatomía & histología , Transiluminación/métodos , Cavidad Pulpar/anatomía & histologíaRESUMEN
Objetivo: Evaluar ex vivo, mediante reconstrucción tridimensional con tomografía computarizada de haz cónico, la presencia de vacíos, el volumen y la adaptación de la obturación a las paredes de conductos con reabsorciones dentinarias internas simuladas empleando gutapercha inyectable o cono único de gutapercha más sellador biocerámico. Materiales y métodos: Se utilizaron 10 incisivos centrales superiores humanos extraídos, en cada uno de los cuales se talló una reabsorción artificial para su obturación. La muestra fue sometida, de manera sucesiva, a dos condiciones experimentales diferentes: grupo 1, gutapercha inyectable con sistema EQ-V Master; grupo 2, cono de gutapercha más sellador biocerámico BioRoot RCS. Luego, se realizaron tomografías computarizadas de haz cónico y se hizo el estudio tridimensional. A continuación, se utilizó un programa para identificar los vacíos en la obturación y analizar cuantitativamente el volumen y la superficie cubierta por la obturación en los tercios coronario, medio (ampolla) y apical. Los datos fueron evaluados con la prueba de Wilcoxon (P<0,05). Resultados: El volumen de obturación y la superficie dentinaria en contacto con la obturación fueron similares para las dos técnicas empleadas. Las diferencias entre ambos grupos no fueron estadísticamente significativas (P>0,05). Conclusión: Aunque se observaron vacíos con ambas técnicas (en contacto con la superficie dentinaria cuando se empleó gutapercha inyectable, y en el interior de la obturación cuando se usó cono único de gutapercha más sellador BioRoot RCS), las dos rellenaron adecuadamente las reabsorciones simuladas (AU)
Aim: Ex vivo, tridimensional evaluation with cone beam computed tomography (CBCT), of the presence of voids, the obturation volume and adaption to the root canal walls with simulated internal root resorption, using injected gutta-percha or bioceramic sealer with single gutta-percha cone. Materials and methods: Ten maxillary extracted central human incisors were used and artificial internal root resorption was created in each one. For the root canal obturation, each tooth was subjected to two different experimental conditions successively, conforming two matched groups: Group I: EQ-V Master injected thermo plasticized gutta-percha system. Group II: gutta- percha point plus BioRoot RCS bioceramic sealer. First, the root canals were filled with injected gutta-percha and then, with the bioceramic sealer. Then the teeth were scanned with CBCT and subsequently a digital three-dimensional reconstruction was performed. The presence of voids, obturation volumne and the dentin wall surface covered by the filling material was quantitative analyzed through a software; at the coronal, middle (blister) and apical thirds. The data was analyzed by using Wilcoxon test (P<0.05). Results: The filling material volume and the dentin wall surface covered by it, was similar in both root canal obturation techniques. There was no significant difference between both groups (P>0.05). Conclusion: Although voids were observed in both groups (when the injected thermo plasticized gutta-percha system was used the voids were at the external surface and when BioRoot RCS + gutta-percha cone was used the voids were into the filling material), the obturation of simulated root canal resorption cavities was similar with both obturation techniques (AU)
Asunto(s)
Humanos , Materiales de Obturación del Conducto Radicular , Materiales Biocompatibles , Cerámicas Modificadas Orgánicamente , Gutapercha , Resorción Radicular , Ensayo de Materiales , Imagenología Tridimensional , Tomografía Computarizada de Haz CónicoRESUMEN
Se realizó una investigación analítica realizada in vitro en el laboratorio general del Hospital "Carlos Andrade Marín". La población estuvo compuesta por 20 barras de gutapercha marca Meta®Biomed (Korea), distribuidas en cuatro grupos compuestos por 5 barras atendiendo a características preestablecidas en cuanto a realización de termoplastificación y manipulación. Solo el 15% de las muestras se registró indicios de crecimiento bacteriano, de las que el 66,67% pertenecieron al grupo de barras sólidas de gutapercha que fueron manipuladas, estableciéndose diferencias significativas con respecto al resto de los grupos (p≤0.01), según la prueba de T-stu-dents. La mayoría de las muestras no mostró indicios de crecimiento bacteriano. Sin embargo, dos de las tres muestras que manifestaron esa actividad microbiológica pertenecieron al grupo de las barras sólidas de gutapercha que fueron manipuladas.
An in vitro analytical research was carried out in the general laboratory of the "Carlos Andrade Marín" Hospital. The population consisted of 20 bars of Meta®Biomed brand gutta-percha (Korea) distributed in four groups made up of 5 bars according to the pre-established characteristics in terms of thermoplasticization and handling. Only 15% of the selected samples showed signs of bacterial growth, of which 66.67% belonged to the group of solid gutta-percha bars that were manipulated, establishing specific differences with respect to the rest of the groups (p≤0.01), according to the T-students test. Most of the samples have no evidence of bacterial growth. However, two of the three samples that showed this microbiological activity belonged to the group of solid gutta-percha bars that were manipulated
Asunto(s)
Humanos , Masculino , Femenino , Crecimiento Bacteriano , Control de Infección Dental , Gutapercha , Técnicas In Vitro , Carrera de Maratón , HospitalesRESUMEN
O objetivo deste estudo foi avaliar a capacidade de remoção do material obturador de canais radiculares simulados retos através da radiografia digital, comparando a técnica manual com o uso de solvente, técnica manual com o uso da broca largo e o sistema ProTaper. Para este estudo foram utilizados 15 canais radiculares retos simulados já obturados e divididos em três grupos que foram analisados através do sensor programa VistaScan Mini Easy (Durr, Biertigheim- Bissingen, Germany). Os dados foram submetidos ao teste qui-quadrado com nível de significância de 95%. O terço apical mostrou melhores resultados com o sistema ProTaper (G3), o terço médio teve melhores resultados com o (G2) e (G3) sistema manual com uso de solvente e uso de broca largo e o sistema ProTaper. O terço cervical não mostrou diferença estatística entre os três grupos testados. Conclui-se que os desobturadores de modo geral não apresentaram grandes variações, sendo que após as análises nenhum dos três grupos de estudo foram capazes de remover completamente o material obturador presente no conduto radicular(AU)
The aim of this study was to evaluate the removal capability of the obturator material from straight simulated root canals by comparing the manual technique associated with solvent, the manual technique with the usage of wide drill No. 2 associated with solvent and, the ProTaper retreatment system. For this study we used 15 already filled simulated straight root canals and divided them into three groups that were analyzed by digital radiography. Data were submitted to Pearson's Chi-square test with 95% of significance level. After the analysis, the results showed that the apical third presented better results of unblocking with the ProTaper (G3) system, the middle third showed better results between the G2 and G3 manual system with the usage of solvent, wide drill and the ProTaper system. The cervical third didn't show any significant statistically difference among the three tested groups. The conclusion was that the unblockers in general did not present great variations. And in this study none of the three groups were able to completely remove the obturator material present in the root canal(AU)
Asunto(s)
Materiales de Obturación del Conducto Radicular , Preparación del Conducto Radicular , GutaperchaRESUMEN
Objective: The influence of four root canal filling techniques on the penetration of an endodontic sealer into dentinal tubules and the gutta percha/ sealer ratio (GP/SR) in root canals was evaluated using confocal laser scanning microscopy (CLSM). Material and Methods: Roots of the maxillary central incisors (n=40) were prepared with ProTaper Universal files up to file F5 and assigned to five groups: continuous wave condensation, lateral condensation, single cone, Thermafill®, and negative control group. After root canal filling with gutta-percha and AH26, along with the addition of 0.01% fluorescein, the roots were cut into 2-mm slices. Using CLSM, the specimens were transversely sectioned at 3, 6, and 10 mm from the apex. Results: Sealer penetration was deeper and more frequent at 10 mm than at the 6mm and 3mm for all obturation technique. Penetration was not significantly affected by obturation techniques except single master cone tecnique. Single cone technique demonstrated the lowest sealer penetration at all levels. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone. Conclusion: In conclusion, the single cone technique resulted in lower sealer penetration than the other techniques, which did not differ significantly from each other. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone. (AU)
Objetivo: A influência de quatro técnicas de obturação do canal radicular na penetração de um cimento endodôntico nos túbulos dentinários e a relação gutapercha / cimento (GP / CIM) em canais radiculares foram avaliadas por microscopia de varredura confocal a laser (MVCL). Material e Métodos: As raízes de incisivos centrais superiores (n = 40) foram preparadas com limas ProTaper Universal até a lima F5 e distribuídas em cinco grupos: condensação de onda contínua, condensação lateral, cone único, Thermafill® e grupo de controle negativo. Após o preenchimento do canal radicular com guta-percha e AH26, juntamente com a adição de 0,01% de fluoresceína, as raízes foram cortadas em fatias de 2 mm. Usando MVCL, as amostras foram seccionadas transversalmente a 3, 6 e 10 mm do ápice. Resultados: A penetração do cimento foi mais profunda e mais frequente em 10 mm do que nos 6 mm e 3 mm para todas as técnicas de obturação. A penetração não foi significativamente afetada pelas técnicas de obturação, exceto pela técnica de cone mestre único. A técnica de cone único demonstrou a menor penetração do cimento em todos os níveis. No entanto, a espessura do cimento foi fortemente dependente da técnica de obturação. O Termafill® demonstrou uma relação superior de GP, seguida por condensação de onda contínua, condensação lateral e cone único. Conclusão: Em conclusão, a técnica de cone único resultou em menor penetração do cimento do que as outras técnicas, que não diferiram significativamente uma da outra. No entanto, a espessura do cimento foi fortemente dependente da técnica de obturação. O Termafill® demonstrou uma relação superior de GP, seguida por condensação contínua das ondas, condensação lateral e cone único. (AU)
Asunto(s)
Obturación del Conducto Radicular , Microscopía Confocal , Cementos Dentales , GutaperchaRESUMEN
Objetivo: o presente estudo teve como objetivo caracterizar as dimensões dos instrumentos Reciproc R25 e X1 Blue File, e dos cones de guta-percha da Mk Life R25, Reciproc R25 e DiaDent R25, para verificar qual cone de guta-percha se adapta melhor no preparo dos instrumentos. Métodos: dez instrumentos Reciproc R25 25/0,08v e X1Blue File 25/0,06; e dez cones de guta-percha Dia- Dent R25, Mk Life R25 e Reciproc R25 foram utilizados. As imagens foram obtidas através de uma lupa estereoscópica com uma câmera digital acoplada. As medidas foram obtidas através do programa TS View. Os diâmetros dos instrumentos e dos cones de guta-percha foram determinados em D0 até D9, com intervalos de medidas de 1,0 mm; e a conicidade foi calculada adotando-se os diâmetros D8 e D1. Os resultados obtidos foram submetidos à análise estatística utilizando o programa Primer of biostatistics versão 6.0. Resultados: apesar da maior conicidade dos instrumentos X1Blue file (0,07mm/mm), não houve diferença estatisticamente significativa entre os instrumentos nos três primeiros milímetros (p > 0,05), o mesmo ocorreu para a conicidade dos cones (p > 0,05). Os cones de guta-percha apresentaram diferença estatisticamente significativa em todos os diâmetros aferidos (p < 0,05). Conclusão: os instrumentos e os cones de guta-percha atenderam à recomendação das respectivas normas ANSI/ADA. O cone de guta-percha que apresentou maior compatibilidade dimensional com os diâmetros dos instrumentos foi o MK life, e VDW foi o que apresentou maior desajuste (AU).
Objective: The aim of this study was to characterize the dimensions of the Reciproc R25 and X1 Blue File instruments and the gutta-percha points of Mk Life R25, Reciproc R25 and DiaDent R25 to verify which gutta-percha point better fits to the instruments preparation. Material and methods: Ten Reciproc R25 25/0.08v and X1Blue File 25/0.06 instruments; and ten DiaDent R25, Mk Life R25 and Reciproc R25 gutta-percha points were used. The images were obtained through a stereomicroscopic with a digital camera coupled. The measurements were obtained through the TS View program. The diameters of instruments and gutta-percha points were determined in D0 through D9 at 1.0 mm intervals, and the taper was calculated by adopting diameters D8 and D1. The results were submitted to statistical analysis using the program Primer of biostatistics version 6.0. Results: Despite the greater taper of the X1Blue file instruments (0.07mm /mm), there was no statistically significant difference between the instruments in the first 3 millimeters (p> 0.05), the same was observed for the tapers of the guta-percha points (p> 0.05). The gutta-percha points presented a statistically significant difference in all measured diameters (p <0.05). Conclusion: Gutta-percha points and instruments have met the recommendations of their respective ANSI/ADA standards. The gutta-percha point that presented greater dimensional compatibility with the diameters of the instruments was the MK life, and VDW presented the greatest mismatch (AU).
Asunto(s)
Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Instrumentos Dentales , GutaperchaRESUMEN
La gutapercha es químicamente un polímero a base de isopreno, impermeable, no poroso y radiopaco entre otras características, empleado desde el siglo XIX; sin embargo manifiesta algunos inconvenientes propios del material, lo cual ha dado lugar al nacimiento de otros materiales para mejorar sus propiedades. Recientemente se ha desarrollado y caracterizado un material novedoso a base de fibra óptica recubierta por nano partículas de plata (FONP), propuesto como un material alternativo para la obturación de conductos radiculares. En el presente estudio se seleccionaron 24 dientes para conformar cuatro grupos experimentales comparativos entre la obturación con fibra óptica y con gutapercha, ambos con el sellador AH Plus. Las raíces fueron obturadas en grupos de diez y almacenadas en solución salina a 37 oC. La filtración apical se midió desde el extremo apical de la interfaz del material hasta la extensión más coronal del tinte observado microscópicamente. Se empleó la herramienta de LAS EZ V3.0 (Leica Microsystems, Switzerland), los datos se tabularon y se analizaron. Resultados: Las mediciones de microfiltración a nivel apical e intraconductos manifestaron diferencias en favor de la gutapercha, donde los grupos experimentales manifestaron una filtración promedio correspondiente a 0.872 mm en el grupo de Gutapercha/AH-PLUS y de 2.390 mm con técnica lateral utilizando FONP/AH-PLUS, aun así se evidenció que las propiedades de sellado de la fibra óptica con nanopartículas fueron suficientes para considerarlo como un material de obturación de conductos radiculares dentales como posible sustituto de la gutapercha (AU)
Gutta-percha is chemically an Isoprene-based polymer, impervious, non-porous and radiopaque, among other characteristics, used since the 19th century, it manifests some disadvantages inherent to the material, which has led to the birth of new materials with improved properties. Recently, a novel material based on optical fiber covered by silver nanoparticles (FONP) has been developed, characterized and proposed as an alternative material for root canal obturation. In the present study, 24 teeth were selected and divided into four comparative experimental groups for obturation with fiber optics and gutta-percha, both with the AH Plus sealer. The roots were sealed in groups of ten and stored in saline at 37 oC. Apical filtration test was performed from the apical end of the material interface to the most coronal extension of the dye observed microscopically. The LAS EZ V3.0 tool was used to make the measurements and the data was tabulated and analyzed. Results: Measurements of microfiltration at the apical and intracanal level showed differences in favor of gutta-percha, where the experimental groups showed an average filtration of 0.872 mm in the Gutapercha/AH-PLUS group and 2.390 mm using FONP/AH-PLUS, even so, it was evidenced that the sealing properties of the optical fiber with nanoparticles are sufficient to consider this material as a proper filling material for dental root canals as a substitute for gutta-percha (AU)
Asunto(s)
Materiales de Obturación del Conducto Radicular , Fibras Ópticas , Gutapercha , Técnicas In Vitro , Proyectos Piloto , Compuestos de Plata , Filtración Dental , Nanopartículas del MetalRESUMEN
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).
Asunto(s)
Humanos , Masculino , Adulto , Periodontitis Periapical , Materiales de Obturación del Conducto Radicular , Preparación del Conducto Radicular , Gutapercha , Hidróxido de Calcio , Retratamiento , Pins DentalesRESUMEN
Radiographic imaging is an important criteria in diagnosis, treatment planning, and follow-up of an endodontic treatment. When clinicians encounter with diagnostic difficulties and persistent symptoms, the need for advanced diagnostic aids, especially imaging methods, become imperative and essential. This paper reports a case, in which primary endodontic therapy having failed, the patient had persisting symptoms such as pain, swelling, and draining sinus along with signs and symptoms of maxillary sinusitis. Advanced diagnostic aids such as Cone Beam Computed Tomography was useful in accurate identification of the etiology, which was a fractured mesiobuccal root tip of maxillary molar. This is the first reported case, in which the fractured root tip has migrated to the maxillary sinus, during primary endodontic treatment, through the perforated antral floor causing odontogenic sinusitis. The operating microscope helped in the successful completion of endodontic retreatment along with fractured root fragment retrieval.
RESUMEN
Taurodontism is a morphoanatomical anomaly of teeth characterised by enlarged pulp chamber with apically displaced pulp chamber floor and furcation.Endodontic treatment of a taurodont is challenging and requires special handling because of proximity and apical displacement of roots. In performing root canal treatment on such teeth, one should appreciate the complexity of the root canal system, canal obliteration and configuration, and the potential for additional root canal systems. Careful exploration of the grooves between all orifices particularly with magnification, use of ultrasonic irrigation; and a modified filling technique are of particular use. This paper presents three case reports on diagnosis and successful endodontic management of hypertaurodontic teeth, in non-syndromic patients
RESUMEN
Objetivo: Evaluar el ajuste y la adaptación apical de los conos de gutapercha de cuatro diferentes sistemas de instrumentación y obturación endodóntica en conductos curvos simulados. Materiales y métodos: Se emplearon 4 Endo Training Blocks (Dentsply Sirona) con conductos curvos simulados, instrumentados hasta el límite de trabajo, fijado en el orificio de salida del conducto. Con ese propósito se empleó un tope metálico confeccionado ad hoc, ajustado en la concavidad de la salida del conducto, a fin de asegurar el límite de la instrumentación en todos los bloques de trabajo. El tope metálico se mantuvo en la posición por medio de una morsa de mesa. Los conductos fueron permeabilizados con una lima tipo K #10 (Dentsply Sirona). A continuación, se procedió con los protocolos de instrumentación de los sistemas por evaluar en cada Endo Training Block. Se emplearon los sistemas ProTaper Next (Dentsply Sirona), ProTaper Gold (Dentsply Sirona), WaveOne Gold (Dentsply Sirona) y Reciproc Blue (VDW) de acuerdo con las especificaciones del fabricante (grupos 1, 2, 3 y 4 respectivamente). Los conductos fueron irrigados con agua destilada a cada cambio de instrumento y al finalizar la preparación, y secados con conos de papel. Luego se evaluaron, en el respectivo Endo Training Block, el ajuste y la adaptación apical a la longitud de trabajo de 10 conos de gutapercha del sistema correspondiente. Para la evaluación del ajuste, se introdujeron los conos de gutapercha en el conducto simulado respectivo y se elevaron ambos hasta 10 cm de altura, manteniéndolos durante 10 segundos. Cuando se conservaban en esa situación, se consideraba que el cono ajustaba; si se desprendían antes de ese lapso, se establecía la falta de ajuste. Así mismo, se constató en cada caso su adaptación apical a la longitud de trabajo con un microscopio clínico operativo a 8,5X. Para la evaluación total se consideraron las siguientes categorías: 1, el cono de gutapercha llegaba a la longitud de trabajo y ajustaba; 2, el cono de gutapercha llegaba a la longitud de trabajo, pero no ajustaba; 3, el cono de gutapercha no llegaba a la longitud de trabajo; y 4, el cono de gutapercha sobrepasaba la longitud de trabajo. Resultados: Entre los grupos 1, 3 y 4 no se observaron variables intrasistemas de ajuste y adaptación apical a la longitud de trabajo. En el grupo 2 sí las hubo, pero la diferencia entre grupos no fue significativa (P>0,05). Conclusiones: De los cuatro sistemas utilizados, en tres de ellos el empleo de un cono único de gutapercha garantizó, en todas las pruebas, la adaptación y el ajuste a la longitud de trabajo (AU)
Aim: To evaluate in the tugback and apical adaptation at the working length of four different mechanized systems gutta-percha cones in simulated curved canals. Materials and methods: Four Endo Training Blocks (Dentsply Sirona) with simulated curved canals were instrumented up to the working length established at the orifice located in the canal exit. A metal stop was adjusted in the concavity present at the exit of the canal to ensure the working length during instrumentation in all blocks. The metal stop was maintained using a table walrus. Canal patency was achieved with a #10 K file (Dentsply Sirona). Then the instrumentation protocols for the different systems were performed in each Endo Training Block. ProTaper Next (Dentsply Sirona), ProTaper Gold (Dentsply Sirona), WaveOne Gold (Dentsply Sirona) and Reciproc Blue (VDW) were used according to the manufacturers' instructions (groups 1, 2, 3 and 4 respectively). The canals were irrigated with distilled water between instruments and at the end of the preparation and dried with paper points. Then, the tugback and the apical adaptation at the working length of 10 gutta-percha cones of each system were evaluated in the corresponding Endo Training Block. For the tugback analysis, the gutta-percha cones were introduced in the respective simulated canal and both were raised up to 10 cm in height, holding them for 10 seconds. If the cones remained intact in their position, it was considered that the cone tugback was appropriate, if the cones were detached, a lack of tugback was considered. Likewise, a clinical operating microscope at 8.5X was used to confirm the apical adaptation to the working length in each case. For the overall evaluation the following categories were considered: 1, the gutta-percha cone reached the working length with tugback; 2, the gutta-percha cone reached the working length without tugback; 3, the gutta-percha cone did not reach the working length; 4, the gutta-percha cone exceeded the working length. Results: In three groups 1, 3 and 4 they were not found intra-systems variables in the tugback at the working length. In one group there were observed intra-systems variables but the differences between groups were not statistically significant (P>0.05) (AU)
Asunto(s)
Cavidad Pulpar , Gutapercha , Obturación del Conducto Radicular , Preparación del Conducto Radicular , Ápice del Diente , Equipo Dental de Alta Velocidad , Modelos Dentales , Interpretación Estadística de DatosRESUMEN
This study was done to evaluate the tensile strength of gutta–percha using 5% sodium hypochlorite(SH), 2% chlorhexidine(CH) and 1% peracetic acid disinfectant solutions. 40 guttapercha cones of size 30(6% taper) were obtained from sealed packs as 4 different groups. Experimental groups were disinfected using 5% sodium hypochlorite, 2% chlorhexidine, 1% peracetic acid respectively except the control group. Then tensile strength of gutta–percha cones were measured using the universal testing machine. The mean tensile strength values for group I, II, III, IV are 7.003MPa, 8.49 MPa, 6.60MPa and 9.45MPa respectively. Results were subjected to statistical analysis one–way analysis of varience test and unpaired ‘t’ test. 1% peracetic acid decreased tensile strength significantly as compared to 5% sodium hypochlorite and 2% chlorhexidine. The result concluded that the least decreased in tensile strength is for chlorhexidine followed by sodium hypochlorite and peracetic acid.