Efecto de los extractos fitoquímicos en la eliminación del barro dentinario en el tratamiento de conductos radiculares / Effects of phytochemical extracts on smear layer removal in root canal treatment

Introduction: Studies suggested that phytochemical products are considered potential solutions to smear layer removal due to their biological safety in cleaning root canal systems, lower toxicity, lower irritant effect and antimicrobial effect. Objective: The aim of the present study was to perform a systematic review to evaluate smear layer removal of root canal systems by different natural product solutions. Methods: systematic review. Search of the literature was performed on Pubmed, Scopus, Cochrane, Web of Science, Scielo and Google Scholar according the PRISMA protocol. Studies were included if they performed the experiments of smear layer removal on extracted permanent human teeth. Articles published in any language without restriction of year of publication were included in this review. The risk of bias assessment in the included studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. The search strategy resulted in the retrieval of 6221 publications. After the eligibility criteria application, 8 articles were selected for analysis. Results: It was observed that some natural products solutions showed effects on smear layer removal, especially on coronal third. The phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract demonstrated good potential of smear layer removal, however, its effectiveness and clinical applicability are still unclear. Conclusions: Although the limitations of this study, it is possible to highlight those phytochemical products such as Salvadora persica, chamomile alcohol extract and grape seed extract that demonstrated good potential on SL removal(AU)

Introducción: Los productos fitoquímicos se consideran soluciones potenciales para la eliminación del barro dentinario debido a su seguridad biológica en la limpieza del sistema de conductos radiculares, menor toxicidad, menor efecto irritante y efecto antimicrobiano. Objetivo: Evaluar la eliminación del barro dentinario de los sistemas de conductos radiculares mediante diferentes soluciones de productos naturales. Métodos: La búsqueda de la literatura se realizó en Pubmed, Scopus, Cochrane, Web of Science, SciELO y Google Scholar, según el protocolo PRISMA. Los estudios se incluyeron si realizaron los experimentos de eliminación del barro dentinario en dientes humanos permanentes extraídos. En esta revisión se incluyeron artículos publicados en cualquier idioma, sin restricción de año de publicación. La evaluación del riesgo de sesgo en los estudios incluidos se evaluó mediante la lista de verificación de evaluación crítica del Instituto Joanna Briggs para estudios cuasiexperimentales. La estrategia de búsqueda resultó en la recuperación de 6221 publicaciones. Después de la aplicación de los criterios de elegibilidad, se seleccionaron 8 artículos para su análisis. Resultados: Se observó que algunas soluciones de productos naturales mostraron efectos sobre la eliminación del barro dentinario, especialmente en el tercio coronal. Los productos fitoquímicos como salvadora pérsica, extracto de alcohol de manzanilla y extracto de semilla de uva demostraron un buen potencial de eliminación del barro dentinario; sin embargo, su efectividad y aplicabilidad clínica aún no están claras. Conclusiones: A pesar de las limitaciones de este estudio, es posible destacar aquellos productos fitoquímicos como salvadora pérsica, extracto de alcohol de manzanilla y extracto de semilla de uva demostraron buen potencial de eliminación del barro dentinario(AU)

Effect of nitric oxide inhibitor and donor substances on the infammatory process caused by endodontic irrigants

Nitric oxide (NO) has been considered a key molecule in infammation. OBJECTIVE: The aim of this study was to evaluate the effect of treatment with L-NAME and sodium nitroprussiate, substances that inhibit and release NO, respectively, on tissue tolerance to endodontic irrigants. MATERIAL AND METHODS: The vital dye exudation method was used in a rat subcutaneous tissue model. Injections of 2 percent Evans blue were administered intravenously into the dorsal penial vein of 14 male rats (200-300 g). The NO inhibitor and donor substances were injected into the subcutaneous tissue in the dorsal region, forming two groups of animals: G1 was inoculated with L-NAME and G2 with sodium nitroprussiate. Both groups received injections of the test endodontic irrigants: acetic acid, 15 percent citric acid, 17 percent EDTA-T and saline (control). After 30 min, analysis of the extravasated dye was performed by light absorption spectrophotometry (620 nm). RESULTS: There was statistically signifcant difference (p<0.05) between groups 1 and 2 for all irrigants. L-NAME produced a less intense infammatory reaction and nitroprussiate intensifed this process. CONCLUSIONS: Independently of the administration of NO inhibitors and donors, EDTA-T produced the highest irritating potential in vital tissue among the tested irrigating solutions.

Relationship between the size of patency file and apical extrusion of sodium hypochlorite.

Background: Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant because of its excellent antimicrobial, organic tissue dissolving, and lubricating properties. However, it is highly cytotoxic to the periapical tissues. Aim: This study evaluated in vitro the extrusion of 5.25% NaOCl through the apical foramina of mesiobuccal (MB) root canals of maxillary first molars in two experimental conditions: Before apical debridement and after apical debridement with different instrument sizes to ensure direct access to the apical foramen (apical patency). Materials and Methods: Coronal accesses were prepared in 17 teeth and the apical foramina of the distobuccal and palatal root canals were sealed. The teeth were held in acrylic receptacles with the roots turned upwards to reproduce their position in the maxillary dental arch. The receptacles were filled with a starch/KI solution (a reagent that changes its color to blue after contacting NaOCl) covering the roots. The experiment had two phases: P1: Irrigation of the MB canals with 5.25% NaOCl without previous establishment of apical patency; P2: Canal irrigation after use of size 10 K-file and size 15 Flexofile as patency files. Only specimens with no NaOCl extrusion in P1 were assigned to P2. NaOCl was delivered pressureless at the canal entrance. The moment that the starch/KI solution contacted NaOCl was captured on digital photographs. Results and Conclusions: There was no NaOCl extrusion in nine specimens in P1, but all of these teeth had irrigant extrusion in P2. The 5.25% NaOCl used as an endodontic irrigant showed great capacity to extrude beyond both intact and small-sized apical foramina of MB root canals of maxillary first molars.

Avaliação da infiltração marginal de quatro seladores provisórios após a utilização de substâncias químicas auxiliares da instrumentação endodôntica / Evaluation of marginal leakage of four temporary materials after using irrigating solutions in endodontic treatment

O selamento coronário, juntamente com a obturação do canal radicular, possibilita um ambiente propício ao reparo dos tecidos periapicais, epílogo do tratamento endodôntico. Além disso, um bom selamento temporário impede que haja recontaminação entre as possíveis sessões do tratamento endodôntico, resguardando também a medicação intracanal. Muitos estudos têm sido realizados para investigar o vedamento marginal das restaurações temporárias. Este trabalho se propõe a avaliar a infiltração marginal na porção coronária de dentes que sofreram ação das substâncias químicas usadas no tratamento endodôntico, selados com quatro diferentes materiais provisórios. Para tanto, foram utilizados 60 pré-molares humanos hígidos, divididos em 5 grupos experimentais, conforme o material selador provisório empregado (Bioplic , Coltosol , XTempLC, IRM, Coltosol + Ação das substâncias químicas) , e 2 grupos-controle. Os resultados obtidos indicaram que todos os materiais restauradores temporários avaliados permitiram certo grau de infiltração, sendo o Grupo II (Coltosol) aquele que apresentou o menor índice. Constatou-se também que as substâncias químicas auxiliares empregadas durante o preparo químico mecânico podem influenciar no selamento marginal, aspecto observado no Grupo V que apresentou infiltração coronária estatisticamente mais significante.

The coronary sealing, next to root canal obturation, permits an appropriate environment to the periapical tissues repair, which is the major endodontic treatment’s outcome. Furthermore, good temporary sealing prevents new contamination between sessions of the endodontic treatment, also protecting the intracanal dressing. Many studies have been achieved for examining the marginal sealing of temporary restorations. This study intended to evaluate the marginal leakage in the coronary portion of teeth which suffered action of irrigating solutions used in endodontics, sealed with four different temporary materials. Sixty entire human premolars were divided into 5 experimental and 2 control groups according to each temporary restorative material used (Bioplic, Coltosol, XTempLC, IRM, Coltosol + instrumentation). The results indicated that all temporary materials used allowed a certain degree of infiltration, however, Group II (Coltosol) showed the least index. It was also observed that irrigating solutions used during biomechanical preparation can influence the marginal sealing, such as that observed in Group V which presented the greatest significant marginal leakage.

Accidental injection of sodium hypochlorite beyond the root apex

Sodium hypochlorite is one of the most commonly used antimicrobial irrigating solution in endodontic therapy. It should Ideally be confined to the root canal system but incidences of injection into the periradicular area have been reported. Such an Incidence is reported in this case. Extreme pain, edema and hematoma usually occur after this accidental injection. Careful management and proper palliative treatment will restore these complications

Scientific rationale and cost effectiveness of routine use of rubber dam in clinical practice.

The rubber dam was first developed and put to use in the 19th century by S.C. Barnum. Since then, the use of the rubber dam in dentistry has become mandatory especially during root canal treatment. Various irrigation solutions which are used during root canal treatment have toxic effects on the soft tissues around the teeth. This can be prevented or minimized when rubber dam is put to use. Similarly for esthetic dentistry, optimum results are obtained if the working area is protected from contamination by saliva.

Iatrogenia en endodoncia / Iatrogenia in endodontics

Ya sea por descuido, falta de atención o prisa, el profesional puede ocasionar alguna iatrogenia que irá a dificultar la limpieza de los conductos así como la correcta obturación

Efeitos da soluçäo de iodo-iodeto de potássio a 2 por cento sobre o tecido conjuntivo subcutâneo de rato / The effects of 2 per cent iodine-potassium iodide solution on rat subcutaneous connective tissue

O presente trabalho, constitui em verificar os efeitos da soluçäo de iodo-iodeto de potássio a 2 por cento sobre o tecido conjuntivo subcutäneo, colocada em tubos de polietileno implantados em ratos. A verificaçäo celular, bem como o infiltrado linfocitário e outras alteraçöes do tecido foram empregado para testar a compatibilidade e valor biológico do medicamento, comumente usado como curativo intracanal. A avaliaçäo histológica mostrou ausência ou escassa irritaçäo do tecido no primeiro e segundo dias de observaçäo, desaparecendo gradativamente a partir do quarto dia