Do alternative scaffolds used in regenerative endodontics promote better root development than that achieved with blood clots?

Abstract The aim of this integrative review was to identify whether alternative scaffolds used in regenerative endodontics contribute to better root development, in relation to the increase in root length and thickness of dentin walls, compared with blood clot (BC) scaffolds. The literature search was conducted in PubMed, SciELO and Lilacs databases, using descriptors related to the topic. After applying the eligibility criteria, 11 articles were selected and analyzed according to the proposed aim. Five clinical and six in vivo studies, conducted in animals, compared different types of alternative scaffolds with BCs, with emphasis on platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). All scaffolds, alternative or BC, promoted an increase in root length and dentin wall thickness, with varying percentages of increase between studies. In general, there was a significant increase in root length and dentin thickness promoted by PRF and PRP scaffolds, compared with BC. It was concluded that the majority of the scaffolds tested contributed to the increase in root length and thickness of dentin walls, with emphasis on PRF and PRP.

Resumo O objetivo desta revisão integrativa foi identificar se os scaffolds alternativos utilizados em endodontia regenerativa contribuem para um melhor desenvolvimento radicular, em relação ao aumento do comprimento e espessura das paredes da dentina, em comparação com os scaffolds de coágulo sanguíneo (BC). A pesquisa bibliográfica foi realizada nas bases de dados PubMed, SciELO e Lilacs, utilizando descritores relacionados ao tema. Após a aplicação dos critérios de elegibilidade, 11 artigos foram selecionados e analisados de acordo com o objetivo proposto. Cinco estudos clínicos e seis in vivo, realizados em animais, compararam diferentes tipos de scaffolds alternativos com BCs, com ênfase no plasma rico em plaquetas (PRP) e fibrina rica em plaquetas (PRF). Todos os scaffolds, alternativos ou BC, promoveram um aumento no comprimento da raiz e na espessura da parede dentinária, com percentuais variáveis de aumento entre os estudos. Em geral, houve um aumento significativo do comprimento da raiz e da espessura da dentina promovido pelos scaffolds PRF e PRP, em comparação com a BC. Concluiu-se que a maioria dos scaffolds testados contribuiu para o aumento do comprimento das raízes e da espessura das paredes dentinárias, com ênfase em PRF e PRP.

Effects of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide on adhesion of posts in teeth obturated with different sealers

Abstract The aim of this study was to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) on bond strength of fiberglass posts in root canals obturated with different endodontic sealers. Seventy-eight mandibular premolars were obturated with three sealers (n=26): Endofill (END), AH Plus (AHP), and Endosequence BC Sealer (EBS). After preparation of the post space, two subgroups were formed according to the cementation of the posts (n=13): with EDC (EDC), and without EDC (control - CON). The specimens were submitted to a pull-out test, failure mode classification, and root canal surface evaluation by scanning electron microscopy after post displacement. Regarding the bond strength, a significant difference between the EDC and CON subgroups occurred only in the END (p=0.001). No difference was detected among the CON subgroups (p=0.339). However, among the EDC subgroups, AHP presented significantly higher values (END versus AHP: p=0.001; AHP versus EBS: p=0.016). Upon classification of failure modes, score 1 (≥ 50% of cement) was the most commonly observed, except for the END + EDC. Remains of endodontic sealers and resin cements were found in the cervical third, but without statistical difference (p=0.269), while in the middle third, difference occurred (p=0.004). In conclusion, EDC decreases bond strength when associated with END sealer, without changing the failure mode between the resin cement and fiberglass post. The best performance was observed when EDC was combined with AHP sealer.

Resumo O objetivo deste estudo foi avaliar o efeito da 1-etil-3- (3-dimetilaminopropil) carbodiimida (EDC) na resistência de união de pinos de fibra de vidro em canais radiculares obturados com diferentes cimentos endodônticos. Setenta e oito pré-molares inferiores foram obturados com três cimentos endodônticos (n=26): Endofill (END), AH Plus (AHP) e Endosequence BC Sealer (EBS). Após o preparo do espaço para pino, dois subgrupos formaram-se conforme a cimentação dos pinos (n=13): com EDC e sem EDC (controle - CON). Os espécimes foram submetidos ao teste pull-out, classificação do modo de falha e avaliação da superfície do canal radicular por microscopia eletrônica de varredura após o deslocamento. Quanto à força de resistência de união, uma diferença estatisticamente significativa ocorreu entre os subgrupos EDC e CON apenas no END (p=0,001). Não foi detectada diferença entre os subgrupos CON (p=0,339). Contudo, no subgrupo EDC, o AHP apresentou maiores valores (END versus AHP: p=0,001; AHP versus EBS: p=0,016). Acerca da classificação dos modos de falha, o escore 1 (≥50% de cimento) foi o mais comumente observado, exceto para END + EDC. Restos de cimentos endodônticos e cimentos resinosos foram encontrados no terço cervical, mas sem diferença estatística (p=0,269), enquanto no terço médio, houve diferença (p=0,004). Em conclusão, o EDC diminui a resistência de união quando associado ao cimento END, sem alterar o modo de falha entre o cimento resinoso e o pino de fibra de vidro. O melhor desempenho foi observado quanto o EDC foi usado com o cimento AHP.

Success rate of endodontic treatments performed by undergraduate students of the university of southern santa catarina

Introduction: Apical periodontitis is an inflammatory disease of the periradicular tissues caused by microbial (re)contamination of the root canal system. Due to its direct relationship to the quality of endodontic treatment, it is extremely important to carry out longitudinal and cross-sectional studies, following-up treatments carried out in universities. Aim: To evaluate the success rate of endodontic treatments performed by undergraduate students of the University of Southern Santa Catarina - UNISUL, Pedra Branca, between August 2015 and July 2017. Materials and Methods: One hundred twenty-four patients with endodontic treatment were contacted. Of these, only 27 attended for treatment follow-up, adding up to a total of 32 treatments analyzed. All teeth were clinically and radiographically evaluated, and the potential indicators related to endodontic treatment success or failure were analyzed. The frequencies of each criterion were calculated, and the data analyzed using the Chi-Square test (α = 5%). Results: 9 cases (28.13%) were considered failure, either because they were associated with symptoms or because there was a periapical alteration. In addition, 88.88% of the failure cases had temporary restorative material. Association was observed only between the number of root canals and symptoms (P = 0.049). Two of the 3 treated teeth with multiple root canals showed symptoms at the follow-up. The endodontic success rate was 71.87%. Conclusion: The success rate of the 32 endodontic treatments performed by undergraduate students from UNISUL was 71.87%.

Long-term evaluation of crown and root discoloration induced by different endodontic sealers

Aim: To evaluate crown and root discoloration promoted by different endodontic sealers after root canal filling. Methods: Eighty bovine incisors were prepared and filled with: Endofill, Sealer 26, AH Plus, and MTA Fillapex. Color was recorded using a spectrophotometer before endodontic treatment (T0) and at 24 hours (T1), seven days (T2), 30 days (T3), and 90 days (T4) after treatment. Analyses were performed on the middle and cervical regions of the crown, and on the cervical third of the root, immediately below the cementoenamel junction. The color alterations (ΔE) were calculated using Commission International de I'Eclairage (CIE) L*a*b parameters, and data were analyzed by analysis of variance (ANOVA) and Tukey's test (p<0.05). Results: All sealers induced color alterations. Sealer 26 resulted in the smallest changes in color (E = 5.32). The other materials did not present statistical differences (AH Plus E = 6.98; MTA Fillapex E = 6.88; Endofill E = 6.41). Of the three regions analyzed, the largest discoloration was observed at the cervical third of the root (E=10.67). In terms of time, the largest ΔE values (E=7.72) were observed at T4. Color changes at T1 (E=5.88), T2 (E=6.10), and T3 (E=5.89) were statistically similar. Conclusions: All endodontic sealers promoted discoloration on the tooth crown and root

Calcium hydroxide induces mineralized tissue neoformation: a case report

Trauma in the anterior teeth is a relatively common occurrence during childhood, having as main consequence teeth with incomplete root development and open apices. Patient, male, leucoderma, 10 years old, attended the Dental Clinic of the Southern University of the State of Santa Catarina, reporting as main complaint fracture in the crown of element 11. After clinical and radiographic examination, it was possible to identify the incomplete apexogenesis of this tooth and the presence of necrotic pulp. Aiming to stimulate neoformation of mineralized tissue at the dental apex, the calcium hydroxide based dressing was used. He remained for eight months, always with radiographic control. Apexification was observed radiographically and proved through the use of an instrument introduced inside the canal. The use of calcium hydroxide as intracanal medication for eight months stimulated mineralized tissue neoformation in the apical region of element 11 and allowed endodontic treatment.

Performance of Three Single Instrument Systems in the Preparation of Long Oval Canals

Abstract This study aimed to evaluate the performance of the Wave One, Easy ProDesign Logic and One Shape systems in the preparation of long oval root canals. Forty-two mandibular incisors were randomized into three groups: Group I, Wave One Primary (WO) (#25.08); Group II, Easy ProDesign Logic (EPL) (#25.06) and Group III, One Shape (OS) (#25.06). Micro-computed tomography scans were obtained pre- and post-preparation of the samples. Instrument fractures or loss of working length did not occur in any of the groups. There was a statistically significant difference in total root canal volume between the WO and EPL (p<0.05) and OS systems (p<0.05) The mean percentages of instrumented canal area in the middle thirds were 76.9% in the WO, 62.3% in the EPL and 71.8% in the OS (p>0.05). The OS system had the strongest correlation between volume increase and instrumented area (R=0.63). The WO, EPL and OS systems presented mean preparation times of 2.13 min, 0.54 min, and 2.21 min (p<0.05), respectively. All three systems enabled the safe preparation of long oval root canals. The WO system most effectively increased root canal volume, but it did not affect the instrumented areas. The OS system had the strongest correlation between volume increase and instrumented area, while the EPL system was the fastest.

Resumo Este estudo teve como objetivo avaliar o desempenho dos sistemas Wave One, Easy ProDesign Logic e One Shape no preparo de canais radiculares ovais. Quarenta e dois incisivos inferiores foram randomizados em três grupos: Grupo I, Wave One primary (WO) (#25.08); Grupo II, Easy ProDesign Logic (EPL) (#25.06) e Grupo III, One Shape (OS) (#25.06). As amostras foram submetidas a microtomografia computadorizada antes e após o preparo. Não ocorreram fraturas de instrumento ou perda de comprimento de trabalho em qualquer dos três grupos. Houve diferença estatisticamente significante no volume total do canal radicular entre o WO e EPL. A média do percentual de área instrumentada do canal no terço médio foi 76,9% no grupo WO, 62,3% no grupo EPL e 71,8% no grupo OS (p>0,05). O sistema OS teve a correlação mais forte entre o aumento de volume e área instrumentada (R=0,63). Os sistemas WO, EPL e OS apresentaram tempos de preparo médios de 2,13 min, 0,54 min e 2,21 min (p<0,05). Todos os três sistemas foram seguros no preparo canais radiculares ovais. O sistema WO foi mais eficaz no aumento do volume de canal, entretanto, isso não afetou as áreas instrumentadas. O sistema OS teve a correlação mais forte entre o aumento de volume e área instrumentada, enquanto o sistema EPL foi o mais rápido.

Thermoplastic endodontic obturation - TC system: case report

Introduction: The TC system, developed in 2002, allows the endodontic filling by means of a non-conventional technique that uses gutta-percha at alpha phase, thermoplasticized in its own oven, placed into canal through a McSpadden compactor, without using a main cone. Objective: The aim of this case report was to show the TC system used for root canal filling. Case report: Three teeth of a patient was indicated for endodontic treatment, so TC system was used for the root filling. Conclusion: This technique showed to be effective for the root canal filling.

Epidemiological data and relevance of care provided in dental emergency service of a private hospital

Introduction and Objective: The aims of this study were to determine the etiology and prevalence of dental emergency visits in a private hospital in the period from July 2009 to July 2011 and the importance of this type of service in private hospitals. Material and methods: During the study period, we analyzed 795 charts from patients seeking emergency services. The emergencies were classified as trauma, odontalgia, prosthesis, periodontal diseases, and traumatic factors. Results: Women and men accounted for 61% and 39% of cases, respectively, and the most prevalent age group was individuals aged 20 to 49 years. The predominant types of dental emergencies observed were odontalgia (52.58%) and dental trauma (22.64%). Pulpitis was the most common pathology (67% of cases) and the most frequent type of trauma was enamel and dentin fracture (54% of cases). Conclusion: A high demand for dental emergency care exists in hospital settings. Most people seek emergency dental services for emergencies related to lack of prevention and dental traumas.

The relationship of a clinical protocol and emergency treatment success of dental trauma running head: clinical protocol in dental trauma

Introduction and Objective: The aim of this study was to investigate whether the sequelae arising from dental trauma in permanent teeth were influenced by the use or non-use of a clinical protocol, in emergency care treatment facilities in the city of Joinville/SC, Brazil. Material and methods: From 2008 to 2010, a total of 70 dental records were reviewed and evaluated 6 months after the completion of treatment. In addition to the data relating to gender, age, etiology, most affected teeth, and most prevalent traumas, the individuals were divided into 2 groups to compare the sequelae observed following either the use or non-use of a clinical protocol for dental trauma treatment. Results: There was a greater incidence of male patients, particularly in the age-range of 8 to 15 years. Falls were the most frequent cause of trauma. The total success rate of the emergency care was of 78.57%. In the group in which the protocol was used, the success rate reached 88.89% compared to 60.0% in the group in which the protocol was not used. Conclusion: The use of a clinical protocol positively influenced the sequelae arising after treatment for dental trauma.

Microbiological aspects of endoperiodontal lesion

Introduction: The endoperiodontal lesion occurs when a tooth undergoing endodontic disease is united to a periodontal lesion with apical progression. Many times, the differential diagnosis between the endodontic and periodontal disease can be of difficult execution and the correct diagnosis and planing of the treatment is of main importance for a good prognosis. Objective: To identify the main microorganisms within the lesion of endodontic and periodontal origin and correlate them with the endoperiodontal lesion. Literature review: The search strategy comprised the electronic studies of databases such as PubMed and Cochrane on the microbiology of the endodontic and periodontal systems through employing the following keywords: microbiology, endodontics, periodontal pocket. Results: There were similarities in the endodontic and periodontal microflora. However, the number of microorganisms within the cross infection is limited, including Bacteroides, Eubacteria, Fusobacteria, spirochaetes, Wolinella. The bacterias forming the red complex are closely related to the severity of the periodontal disease and can also participate in the pathogenesis of the periradicular abscesses. Conclusion: There are many communication routes between the periodontium and pulpal tissue, therefore the contamination from um tissue to another can occur, existing a microbiological inter-relationship between these tissues.