Pulpectomies with Iodoform Versus Calcium Hydroxide-Based Paste: A Preliminary Randomised Controlled Clinical Trial

ABSTRACT Objective: To compare clinical and radiographical pulpectomy outcomes in primary teeth filled with different pastes. Material and Methods: The sample included thirty-eight teeth indicated for pulpectomy due to irreversible pulp inflammation or necrosis from thirty patients (2 to 9 years old). The first appointment comprised chemomechanical preparation (2.5% sodium hypochlorite), smear layer removal (6% citric acid), intracanal dressing and temporary restoration. Seven days later, teeth were randomly assigned to filling with iodoform (IP) or calcium hydroxide with zinc oxide (CHZO) based pastes and temporarily restored. Final restoration (composite resin) occurred at the 3rd appointment. Data from baseline, 6 and 12 months were analysed using descriptive and inferential statistics (p≤0.05). Results: The overall frequency of success was 63.6% (n=21), with no significant difference between groups (IP=62.5% n=10; CHZO=64.7% n=11, p=0.59). Multiradicular teeth, overfilled canals and teeth whose coronal restoration have been lost were significantly associated with failure (p=0.01, p=0.04 and p<0.001, respectively). Conclusion: After 12 months, both pastes showed similar outcomes and can be used as good options for pulpectomies in primary teeth. Moreover, tooth location, extent of the root canal filling, and integrity of final restoration during the follow-up influenced the outcome of pulpectomies.

Do Different Proportions of Antibiotics in the CTZ Paste Interfere with the Antimicrobial Action? In Vitro Study

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.

Influence of cervical preflaring on determinationof apical file size in mandibular molars: SEM analysis

This study investigated the influence of cervical preflaring with different rotary instruments on determination of the initial apical file (IAF) in mesiobuccal roots of mandibular molars. Fifty human mandibular molars whose mesial roots presented two clearly separated apical foramens (mesiobuccal and mesiolingual) were used. After standard access opening and removal of pulp tissue, the working length (WL) was determined at 1 mm short of the root apex. Five groups (n=10) were formed at random, according to the type of instrument used for cervical preflaring. In group 1, the size of the IAF was determined without preflaring of the cervical and middle root canal thirds. In groups 2 to 5, preflaring was performed with Gates-Glidden drills, ProTaper instruments, EndoFlare instruments and LA Axxes burs, respectively. Canals were sized manually with K-files, starting with size 08 K-files, inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the file was recorded. The instrument corresponding to the IAF was fixed into the canal at the WL with methylcyanoacrylate. The teeth were then sectioned transversally 1 mm short of the apex, with the IAF in position. Cross-sections of the WL region were examined under scanning electron microscopy and the discrepancies between canal diameter and the diameter of IAF were calculated using the tool "rule" (FEG) of the microscope's proprietary software. The measurements (µm) were analyzed statistically by Kruskal-Wallis and Dunn's tests at 5 percent significance level. There were statistically significant differences among the groups (p<0.05). The non-flared group had the greatest discrepancy (125.30 ± 51.54) and differed significantly from all flared groups (p<0.05). Cervical preflaring with LA Axxess burs produced the least discrepancies (55.10 ± 48.31), followed by EndoFlare instruments (68.20 ± 42.44), Gattes Glidden drills (68.90 ± 42.46)...

Este estudo investigou a influência do alargamento cervical feito com diferentes instrumentos rotatórios na determinação do instrumento apical inicial (IAI) das raizes mésio-vestibulares de molares inferiores. Foram utilizados 50 molares inferiores cujas raízes mesiais apresentavam dois forames apicais nitidamente separados (mésio-vestibular e mésio-lingual). Após o acesso à câmara pulpar de forma convencional e remoção do tecido pulpar, o comprimento de trabalho foi definido a 1 mm do ápice radicular. Os dentes foram divididos aleatoriamente em cinco grupos (n= 10) de acordo com o tipo de instrumento utilizado no alargamento cervical. No grupo 1, o IAI foi definido sem o prévio alargamento dos terços médio e cervical das raízes. Nos grupos 2 a 5, o terço cervical e médio do canal radicular foi alargado com as brocas de Gates-Glidden, instrumentos Pro Taper, Endo Flare e brocas LA Axxes, respectivamente. A determinação do IAI foi realizada manualmente com limas tipo K em ordem crescente de diâmetro a partir da lima 08 até se chegar ao instrumento que permitisse ao operador ter a sensação tátil do mesmo estar firmemente ajustado ao CRT. O instrumento que correspondeu ao IAI foi fixado no interior do canal radicular com cianocrilato de metila. Com o IAI posicionado, os dentes foram seccionados transversalmente até 1 mm do ápice. As seções transversais do CRT foram observadas através da microscopia eletrônica de varredura e os desajustes entre o diâmetro do canal e o diâmetro do IAI foram calculados com a função "régua" (FEG) do software do próprio microscópio. Os resultados foram avaliados estatisticamente pelo testes de Kruskal-Wallis e Dunn ao nível de significância de 5 por cento. Houve diferenças estatisticamente significantes entre os grupos (p<0,05). O grupo sem alargamento apresentou o maior desajuste (125,30 ±51,54) e diferiu significativamente dos demais grupos (p<0,05). O alargamento cervical com as brocas LA Axxess apresentou...

Calcium hydroxide as a root canal filling material in primary teeth--a pilot study.

A pilot study was carried out in five mandibular primary molars using calcium hydroxide (Ca(OH)2) Paste as root canal filling material to find out an alternative to the routinely used zinc oxide eugenol (ZnOE), which is non-resorbable and causes deflection of succedaneous teeth. The six month clinical and radiographic follow-up carried out at 2 months interval, revealed that the treated teeth with Ca(OH)2 as root canal filling material were successful, showing no pain and tenderness to percussion. A tendency for decrease in size of radiolucency was seen. Two teeth showed complete healing of the periradicular radiolucency. Depletion of Ca(OH)2 paste was seen from the root canals even prior to physiological resorption of roots in 2 out of 5 treated teeth.

Comportamiento clínico de un cemento biocompatible en la técnica endodóntica convencional con base en hidróxido de calcio / Clinical behavior of a biocompatible root canal sealer in the conventional endodontic technique based on calcium hydroxide

Existe una gran cantidad de referencias en la literatura odontológica acerca de los usos y efectos del hidróxido de calcio, sobre todo, aplicado a las técnicas endodónticas. En el estudio que presentamos, se usó en 105 casos clínicos, con base en el supuesto demostrado por otros acerca de su efecto biocompatible en el tratamiento de algunas patologías de origen endodóntico. Leonardo M.R., preconizó su uso como tapón apical previo a la endodoncia definitiva, en los casos llamados por él como "biopulpectomía". En esta investigación se generalizó su uso para todos los casos de dientes maduros que requerían endodoncia, en los cuales independientemente del diagnóstico, se obtuvo un éxito significativo (93,4 por ciento), mejorando las características del cemento, lo cual permite recomendarlo en la técnica endodóntica rutinaria agregado como elemento sellador

A eficiência de três diferentes técnicas de remoçäo da polpa viva / Effectiveness comparison of three different pulpectomy techniques

O presente estudo tratou de avaliar a eficiência dos métodos de remoçäo do tecido pulpar vivo do interior do canal radicular, de três formas distintas: a simples penetraçäo com lima tipo K ou H; a pulpectomia completa executada, segundo Paiva & Antoniazzi, por exérese em canais amplos e esmagamento em canais estreitos; e com brocas tipo Gattes. As três técnicas foram utilizadas em dentes anteriores e posteriores, que, após extraídos, foram fixados, descalcificados pelo ácido fórmico e processados histologicamente, para a obtençäo de cortes seriados dos níveis apical, médio e cervical, e corados pela hematoxilina-eosina. Após a análise sob o microscópio óptico, pôde-se observar que nenhuma das técnicas foi capaz de remover todo o conteúdo pulpar dos canais radiculares, sendo, porém a exérese e o esmagamento os mais eficientes, seguidos da técnica que utiliza a broca de Gattes