Effects of various irrigation/aspiration protocols on cleaning of flattened root canals

This study aimed to evaluate, by means of scanning electron microscopy (SEM), the cleaning of flattened root canals, varying irrigation/aspiration protocols during biomechanical preparation. Thirdy human mandibular incisors were distributed into three groups (n = 10) according to the aspiration/irrigation protocols: conventional, conventional + brush, and apical negative pressure irrigation. Irrigation procedure was performed with 5 mL of 1% NaOCl at each change of instrument; final irrigation was conducted with 17% EDTA for 5 min. After biomechanical preparation, the roots were sectioned and prepared for SEM analysis. The images obtained were evaluated under 35× and 1,000× magnification by three calibrated examiners, following a double-blind design. All data were analyzed using Kruskal–Wallis and Dunn’s post hoctests (α = 0.05). Canals wherein the conventional method and apical negative pressure irrigation were employed revealed less debris, statistically different from the conventional + brush group (p < 0.05). Regarding the presence of smears, apical negative pressure irrigation was more effective in cleaning, showing lowest scores (p < 0.05), compared with the other tested protocols. Comparing each root canal third revealed that the apical portion was difficult to clean as all the tested protocols showed similar high scores (p > 0.05), both for the presence of debris and smear layer. In conclusion, although none of the studied irrigation/aspiration protocols have completely cleaned flattened root canals, apical negative pressure irrigation was more effective in smear layer removal, whereas the conventional + brush protocol was the least effective in removing the debris and smear layer.

Functional-aesthetic treatment of crown fracture in anterior teeth with severe crowding

Introduction: Traumatic injuries are usually the result of impacts whose aggressive strength exceeds the resistance found in bone, muscle and tooth tissues. With the advent of the etching technique and considering the improvement of composite resins, simpler and more conservative alternatives are indicated in the aesthetic and functional rehabilitation of fractured anterior teeth. Report and Objective: This study aimed to report the treatment of a 13 year-old patient that fractured his central incisor due to a trauma. After clinical and radiographic examination, an oblique crown fracture with extensive involvement of the incisal angle, without pulp exposure or injury to the biological space of the left maxillary central incisor (tooth #21) was observed. Because the fractured tooth fragment was lost, it was not possible to process a fragment bonding. Thus, it was proposed to treat the tooth through direct technique restoration with composite resin. Conclusion: It can be concluded that the aesthetic and functional rehabilitation with direct composite resin is a viable option for the conservative treatment of fractured anterior teeth.