Optimization of automated preparation of long oval-shaped root canals using supplementary instrumentation

Abstract This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation.

Resumo Este estudo comparou o preparo de canais radiculares ovais longos usando os sistemas WaveOne Gold e XP-endo Shaper, ambos complementados ou não com instrumentação manual. Vinte e quatro canais longos e ovais de incisivos inferiores foram distribuídos em dois grupos de acordo com a instrumentação: sistemas WaveOne Gold Primary ou XP-endo Shaper. Todos os canais foram instrumentados manualmente com uma lima K tamanho 25 após preparo automatizado. Os espécimes foram escaneados usando um dispositivo de micro-CT (17,42 µm) antes e após o preparo automatizado e instrumentação manual. O aumento de superfície do canal radicular e a porcentagem de áreas intocadas foram avaliadas. Ambos os sistemas WaveOne Gold e XP-endo Shaper aumentaram a superfície do canal radicular e apresentaram áreas intocadas semelhantes (p>0,05). A instrumentação complementar aumentou a superfície do canal radicular e diminuiu o percentual de áreas intocadas (p <0,05). Os sistemas WaveOne Gold e XP-endo Shaper tiveram o preparo de canais ovais longos semelhantes, e a instrumentação manual melhorou o preparo.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable

Resumo O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

Abstract The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

A pilot study on the functional outcome using markerless motion analysis tool and surface emg of nerve transfers for upper trunk brachial plexus injuries

INTRODUCTION@#Brachial plexus injuries (BPI) have devastating functional effects. Clinical outcomes of BPI reconstruction have been documented in literature; however, these do not use EMG and quantitative kinematic studies.@*OBJECTIVE@#This study aims to use a markerless motion analysis tool (KINECT) and surface EMG to assess the functional outcomes of adult patients with traumatic upper trunk BPI who have undergone nerve transfers for the shoulder and elbow in comparison to the normal contralateral limb.@*METHODS@#This is an exploratory study which evaluated three participants with BPI after nerve reconstruction. KINECT was used to evaluate the kinematics (range of motion, velocity, and acceleration) and the surface EMG for muscle electrical signals (root mean square, peak EMG signal, and peak activation time) of the extremities. The means of each parameter were computed and compared using t-test or Mann-Whitney U test.@*RESULTS@#Participant C, with the best clinical recovery, showed mostly higher KINECT and EMG values for the BPI extremity. There was a significant difference between the KINECT data of Participants A and B, with lower mean values for the BPI extremity. Most of the EMG results showed lower signals for the BPI extremity, with statistical significance.@*CONCLUSION@#The KINECT and surface EMG provide simple, cost-effective, quick, and objective assessment tools. These can be used for monitoring and as basis for formulating individualized interventions. A specific algorithm should be developed for the KINECT sensors to address errors in data collection. A fine needle EMG may be more useful in evaluating the muscles involved in shoulder external rotation.

Outcomes of Corrective Surgery in Children with Foot Deformities Using Quantitative Gait Analysis

@#OBJECTIVE: This study aimed to quantitatively define outcomes of corrective surgery in children with various foot deformities. METHODS: We used a retrospective, nonrandomized design. All pediatric patients who underwent pre and post-operative gait analysis and corrective surgery were included. Outcome measures included quantitative gait analysis with temporospatial and kinematic parameters, the Gait Deviation Index, Gillette FAQ, and Hoffer’s criteria. RESULTS:. Five patients with neurogenic and idiopathic deformities underwent corrective surgery at the Philippine General Hospital from 2015 to 2017. Comparison of gait pre and postoperatively show promising outcomes, with improvement in GDI and FAQ levels, despite some of the patients’ need for braces. CONCLUSIONS: Quantitative gait analysis is a suitable method for evaluating surgical outcomes for foot deformity correction. It can be used in combination with functional outcome measures and clinical examination to give an overall picture of a patient’s walking ability.

Results of Ponseti Casting for Clubfoot in a Tertiary Public Hospital

@#INTRODUCTION: Congenital talipes equinovarus (CTEV), also called clubfoot, is one of the most common orthopedic congenital anomalies. However, there is no formal study of the condition here in the Philippines, and data is sparse regarding the epidemiology, treatment, and outcomes in similar third-world countries. METHODS: Retrospective review of data of clubfoot patients seen at the Philippine General Hospital (PGH) Clubfoot Clinic from 2006 up to the present. RESULTS: Records from 75 patients treated at the PGH Clubfoot Clinic from 2010-2016 were reviewed. Idiopathic clubfoot comprised 76% of the patients, while syndromic clubfoot comprised 24%. A good outcome of the Ponseti method was seen in 82% and 88% of the idiopathic and syndromic clubfoot patients, respectively. Idiopathic clubfoot cases that had good outcomes required an average of 11.84 casts to tenotomy or bracing, which was not statistically significant compared to 9.55 average sessions for syndromic clubfoot (p=0.21). The initial Pirani scores for both cases were not significantly different (p=0.95). Idiopathic cases with poor outcomes needed less casting sessions (4.45) because the decision to operate was made early. Age was not found to significantly affect the outcome of treatment for idiopathic clubfoot (p=0.20) and syndromic clubfoot (p=0.64). CONCLUSION: Ponseti casting was found to be effective in treating both idiopathic and syndromic clubfoot patients. The number of sessions did not differ significantly between the two.

Volume and/or time of naocl influences the fracture strength of endodontically treated bovine teeth

Abstract The aim of this study was to evaluate whether amplifying the volume and/or time of contact of NaOCl affects the fracture strength of endodontically treated bovine teeth. Four bovine incisors from 10 animals were allocated into 4 groups using a split-mouth design. Root canals were instrumented using a sequence of 4 manual stainless steel files and irrigated with a 5.25% alkalized NaOCl solution. The total volume and time of irrigation, per sample, varied among the groups as following: standard volume and time of contact - 15 mL/11.5 min; volume raise - 30 mL/11.5 min; time of contact raise - 15 mL/19 min; and volume and time of contact raise - 30 mL/19 min. Samples were subjected to a fracture resistance assay. At p=0.05, two-way ANOVA statistically scrutinized the results. Effect size of NaOCl time of contact and volume were also calculated (η2). The variation in time (p=0.000), volume of irrigation (p=0.000) and the combination of both (p=0.038) negatively influenced the fracture resistance. Standard volume and time of irrigation showed the highest fracture strength while isolated increase in volume or time reduced in 25% and 37%, respectively, the fracture resistance; the simultaneous increase in volume and time of irrigation promoted a reduction of 47%. Effect size of NaOCl time of contact was superior (0.746) than the volume (0.564). Raising the volume and/or time of a 5.25% alkalized NaOCl solution reduces the fracture resistance of endodontically treated bovine teeth.

Resumo O objetivo desse estudo foi o de avaliar se o aumento de volume e/ou tempo de contato do NaOCl afeta a resistência à fratura de dentes bovinos tratados endodonticamente. Quatro incisivos bovinos de 10 animais foram alocados em 4 grupos usando um desenho experimental de boca dividida. Os canais radiculares foram instrumentados usando uma sequência de 4 limas manuais de aço inoxidável e irrigados com uma solução de NaOCl alcalinizada a 5,25%. O volume total e o tempo de irrigação, por amostra, variaram entre os grupos da seguinte forma: volume e tempo de contato padrão (grupo controle) - 15 mL/11,5 min; aumento de volume - 30 mL/11,5 min; aumento no tempo de contato - 15 mL/19 min; e aumento no volume e no tempo de contato - 30 mL/19 min. As amostras foram submetidas a um ensaio de resistência à fratura. Com p=0.05, o teste two-way ANOVA analisou estatisticamente os resultados. O tamanho do efeito do tempo de contato e volume de NaOCl também foi calculado (h2). A variação no tempo (p=0,000), no volume de irrigação (p=0,000) e a interação entre ambos (p=0.038) influenciaram negativamente a resistência à fratura. O volume e o tempo padrão de irrigação apresentaram a maior resistência à fratura, enquanto o aumento isolado no volume ou no tempo de contato reduziram 25% e 37%, respectivamente, a resistência à fratura; o aumento simultâneo do volume e tempo de irrigação promoveu uma redução de 47%. O tamanho do efeito do tempo de contato com o NaOCl foi superior (0,746) ao volume (0,564). Aumentando o volume e/ou o tempo de uma solução de NaOCl alcalinizada a 5,25% reduz a resistência à fratura de dentes bovinos tratados endodonticamente.

Evaluation of apically extruded debris using positive and negative pressure irrigation systems in association with different irrigants

Abstract This study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) using positive and negative pressure irrigation systems [Conventional irrigation (CI) and EndoVac (EV)] in association with different irrigants [6% Sodium Hypochlorite (NaOCl), 2% Chlorhexidine gel + saline solution (CHXg + SS), 2% Chlorhexidine solution (CHXs) or Saline solution (SS)]. Eighty mandibular premolars with single root canals were selected and randomly assigned into 8 groups (n = 10) according to the irrigation system and the irrigant used during CMP: G1 (EV + NaOCl), G2 (EV + CHXg + SS), G3 (EV + CHXs), G4 (EV + SS), G5 (CI + NaOCl), G6 (CI + CHXg + SS), G7 (CI + CHXs) and G8 (CI + SS). Reciproc® R25 files (25/.08) were used during the CMP and the extruded debris from each tooth was collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed using a microbalance, and the data were statistically analyzed using ANOVA and the post hoc Tukey's test (a = 0.05). All groups were associated with debris extrusion. EV was the irrigation system with less extruded debris (p < 0.05). No differences were observed regarding the irrigant when EV was used. When CI was used, CHXg + SS were associated with lower debris extrusion (p < 0.05). It was concluded that no irrigation protocol succeeded in preventing debris extrusion. EV resulted in lower levels of debris extrusion than CI. The use of CHXg + SS resulted in lower debris extrusion.

Resumo Este estudo avaliou a quantidade de debris extruídos apicalmente após o preparo químico-mecânico (PQM) utilizando sistemas de irrigação com pressão positiva e negativa [irrigação convencional (IC) e EndoVac (EV)] em associação com diferentes irrigantes [hipoclorito de sódio 6% (NaOCl), clorexidina gel + solução salina (CLXg + SS), solução de clorexidina 2% (CLXs) ou solução salina (SS)]. Oitenta pré-molares inferiores com único canal radicular foram selecionados e aleatoriamente alocados em 8 grupos (n=10) de acordo com o sistema de irrigação e irrigante utilizado durante o PQM: G1 (EV + NaOCl), G2 (EV + CLXg + SS), G3 (EV + CLXs), G4 (EV + SS), G5 (IC + NaOCl), G6 (IC + CLXg + SS), G7 (IC + CLXs) e G8 (IC + SS). Limas Reciproc® R25 foram utilizadas durante o PQM e os debris extruídos de cada dente foi coletado em tubos pré-pesados e secos. O peso médio de debris foi avaliado por meio de microbalança, e os dados foram analisados estatisticamente utilizando ANOVA e teste de Tukey (a = 0.05). Todos os grupos foram associados com extrusão de debris. EV foi o sistema de irrigação com menos debris extruídos (p<0.05). Não foram observadas diferenças entre os irrigantes quando o EV foi utilizado. Quando foi utilizada IC, CLXg + SS foram associados a menor extrusão de debris (p<0.05). Concluiu-se que nenhum protocolo de irrigação conseguiu prevenir extrusão de debris. EV resultou em menores níveis de extrusão de debris que a IC. A utilização da CLXg + SS resultou em menor extrusão de debris.

Upper extremity temporospatial parameters and kinematics of Filipino track and field paralympians during wheelchair Propulsion: An analysis using a Kinect-based markerless motion analysis system

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The potential of a low-cost, novel Kinect?-based markerless motion analysis system as a tool to measure temporospatial parameters, joint and muscle kinematics, and hand trajectory patterns during the propulsion and recovery phase of wheelchair propulsion (WCP) was determined.</p><p style="text-align: justify;"><strong>METHODS:</strong>Twenty (20) adult male track and field paralympians,(mean age = 36 ± 8.47) propelled themselves on a wheelchair ergometer system while their upper extremity motion was recorded by two Kinect? cameras and processed.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The temporospatial parameters, joint kinematics, and hand trajectory patterns during the propulsion and recovery phase of each participant's WCP cycle were determined and averaged. Average cycle time was 1.45s ± 0.19, average cadence was 0.70 cycles/s ± 0.09, and average speed was 0.76m/s ± 0.32. Average shoulder flexion was 30.99° ± 28.38, average elbow flexion was 24.23° ± 12.25, and average wrist flexion was 12.82° ± 26.78. Eighty five percent (85%) of the participants used a semicircular hand trajectory pattern.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The low-cost, novel Kinect?-based markerless motion analysis system had the potential to obtain measurable values during independent wheelchair propu

Mycobacterium ulcerans disease in the middle belt of Ghana: An eight-year review from six endemic districts

Mycobacterium ulcerans [MU] produces mycolactone toxin when infected with a plasmid. Toxin is cytotoxic and immunosuppressive, causing extensive destruction of tissues, leading to large ulcers on exposed parts of the body. Spontaneous healing by secondary intention leads to contractures, subluxation of joints, disuse atrophy, distal lymphedema and other complications. The disease is endemic in some communities within the middle belt of Ghana. To document the clinical and epidemiological features of MU disease in the middle belt of Ghana and the outcome of treatment. Patients with lesions suspected to MU disease were screened by community workers. Lesions were confirmed by any of the following: direct smear examination, culture, polymerase chain reaction [PCR], or histopathology. Patients were treated with rifampicin [10 mg/kg orally] and streptomycin [15 mg/kg IM] combination for eight weeks. Patients selected for surgical treatment included cases where medical treatment had failed, cases where medical treatment is contraindicated, cases presenting late with complications and recurrent cases. 258 patients were seen in the Ahafo Ano, Amansie Central, Amansie West, Asunafo, Asutifi, and Upper Denkyira districts of Ghana between 2005 and 2012. Their ages ranged from 1 year 3 months to 98 years, with a mean age of 29.8 [SD 20.4]. The clinical forms of MU disease seen were: papule [0.5%], nodule [1.5%], chronic osteomyelitis [1.5%], contracture [1.5%], edematous lesion [3%], and ulcer [92%]. Uncommon complications include subluxation of knee joint, salivary gland fistula and Marjolin's ulcer. The lesions were distributed as follows: head and neck [6.8%], upper limb [20.3%], trunk [1.7%], and lower limb [71.2%]. MU disease in the middle belt of Ghana can be controlled by early case detection and adequate curative treatment

Evaluation of photodynamic therapy using a diode laser and different photosensitizers against Enterococcus faecalis

Photodynamic therapy (PDT) has been proven to be effectivein disinfecting root canals. The aim of this present study wasto evaluate the effects of PDT on the viability of Enterococcusfaecalis using methylene blue (MB) and malachite green(MG) as photosensitizers. Solutions containing E. faecalis(ATCC 29212) were prepared and harvested by centrifugationto obtain cell suspensions, which were mixed with MBand MG. Samples were individually irradiated by the diodelaser at a distance of 1mm for 30, 60, or 120 seconds. Colonyformingunits (CFU) were determined for each treatment.PDT for 60 and 120 seconds with MG reduced E. faecalis viabilitysignificantly. Similar results were obtained when MBwas used as photosensitizer. PDT using MB and MG haveantibacterial effect against E. faecalis, showing potential tobe used as an adjunctive antimicrobial procedure in endodontictherapy...

Clinical and Therapeutic Features of Neurofibromatosis in Ghana

Introduction. Neurofibromatosis (NF) is a generalized form of benign tumors of the peripheral nerves involving the skin; subcutaneous tissue; and bone. It comprises neurofibromatosis type 1 (NF-1); neurofibromatosis type 2 (NF-2); and schwannomatosis. Objective. To document the clinical and epidemiological features of patients with NF presenting at Komfo Anokye Teaching Hospital (KATH) in Kumasi; Ghana; from January 2009 to December 2013; and the outcome of management. Patients and methods. This is a retrospective study. Data on all patients managed within the study period were retrieved from the records of the surgical outpatient department (SOPD) of KATH and theater records and analyzed. Results. Fifteen patients underwent surgery for function impairing and disfiguring lesions; comprising five males and 10 females. Their ages ranged from three years to 55 years; with a mean age of 27.3 years. Seventeen lesions were found on the 15 patients that required surgery: 10 on the head and neck; three on the trunk; two on the upper limbs; and two on the lower limbs. Three of the lesions were neurofibromas; 14 were plexiform lesions. Fourteen patients had NF-1; only one patient had NF-2; there were no cases of schwannomatosis. Debulking was done for 12 patients; this was combined with suspension in two cases and enucleation in one case. Excision was done for five patients. Eight of the lesions recurred and the patients underwent a second debulking procedure. Conclusion. NF causes disfigurement and functional deficits in affected patients. Surgery can achieve symptomatic relief. Early presentation is recommended for optimal results

Morphological changes related to age in mesial root canals of permanent mandibular first molars

The aim of this study was to evaluate age-related morphologicalcanal changes in mesial root canals of mandibular first molars ofknown ages. Fifty-six specimens were selected for this study anddistributed into the following four age groups (n. 14): a) Groupof children under 13 years, b) Group of adolescents (from 14 to19 years), c) Group of young adults (from 20 to 39 years) and d)Group of older adults (over 40 years). The specimens were in perfectcondition because after extraction they were carefullycleaned, sterilized, identified and stored in water. In order toimprove the cleaning, they were placed in 1% sodium hypochloritesolution for four hours and rinsed in 10 vol. hydrogenperoxide for 8 hours. After that, a clearing technique was performedto illustrate root canal anatomy. Digitalized images of allsamples were obtained by use of a stereomicroscope. Canals werenoticeably simpler in older adults: they were sharply defined andnarrow, sometimes too narrow. Calcification nuclei were notfound and there were only a few remains of internuclear spaces.The canal system appeared cleaner, clearer and more sharplydefined than in the other age groups. It may be concluded thatthere is a correlation between aging and morphological changesin the mesial root canals of mandibular first molars...

O objetivo do presente estudo foi avaliar as alterações morfológicasrelacionadas com a idade em canais radiculares mesial deprimeiros molares inferiores. Cinqüenta e seis espécimes foramselecionados para este estudo. Os espécimes foram distribuídosem quatro grupos etários (n. 14): a) Grupo de crianças menoresde 13 anos, b) grupo de adolescentes (de 14 a 19 anos), c) Grupode jovens adultos (de 20 a 39 anos ) e d) Grupo de adultos (acimade 40 anos). Após as extrações os elementos foram cuidadosamentelimpos, esterilizados, identificadas e armazenadas emágua. A fim de melhorar a limpeza, foram colocados numasolução de hipoclorito de sódio a 1%, durante quatro horas eenxaguados em 10 vol. peróxido de hidrogénio durante 8 horas.Depois, uma técnica de diafanização foi realizada para ilustrar aanatomia do canal radicular. As imagens digitalizadas de todasas amostras foram obtidas através da utilização de um estereoscópio.Os canais foram visivelmente mais simples em adultosmais velhos: eles foram bem definidas e estreito, por vezes,demasiado estreito. Núcleo de calcificação não foi encontrado ehavia apenas alguns restos de espaços internucleares. O sistemade canal apareceu mais limpa, mais clara e mais bem definidado que nas outras faixas etárias. Pode-se concluir que há umacorrelação entre as alterações do envelhecimento e morfológicasnos canais radiculares mesial de primeiros molares inferiores...

Estudo epidemiológico das fraturas coronárias em pacientes atendidos em um projeto de trauma dental em um período de 6 anos / Epidemiological study of coronal fractures in patients treated in a dental trauma project in a 6 years periods

O presente estudo teve como objetivo realizar um levantamento epidemiológico sobre os casos de fratura coronária em pacientes que foram atendidos no Projeto Trauma Dental da Escola de Odontologia da Unigranrio, no período de 2005 a 2011. O estudo foi baseado nos dados coletados dos prontuários e as informações obtidas estão relacionadas ao gênero, idade, etiologia da fratura, local do pronto atendimento, tempo decorrido até o pronto atendimento, dentes acometidos, situação clínica e a necessidade de tratamento endodôntico. Foi observada uma maior incidência em pacientes do gênero masculino, com a idade mais afetada entre 6 e 10 anos. Os resultados mostram a distribuição etiológica, clínica e demográfica das fraturas coronárias em um projeto de trauma dentário na cidade de Duque de Caxias.

The aim of the present study was to conduct an epidemiological survey on coronal fracture cases in patients treated at the Dental Trauma Project at Unigranrio School of Dentistry, from 2005 to 2011. This study was based on data collected from records and information related to gender, age, fracture cause, prompt service, elapsed time from the accident, affected teeth, clinical condition of the teeth and the need of endodontic treatment. It was observed a higher incidence in male patients, with the most affected age between 6 to 10 years. The results show the etiological, clinical and demographic distribution of coronal fractures in a project of dental trauma in Duque de Caxias city.

Management of complications of Mycobacterium ulcerans disease: a three-year review

Infection with Mycobacterium ulcerans [MU] causes extensive destruction of tissues with the formation of large ulcers on exposed parts of the body. Healing leads to extensive scarring and other complications which may impair function. To document the complications of MU disease and the reconstructive surgery performed to correct them. Prospective from January 2010 to December 2012. Ahafo Ano, Amansie West, Asunafo, and Upper Denkyira districts of Ghana. Patients with unhealed lesions after completing 8 weeks of rifampicin and streptomycin treatment, and patients with complications of MU disease were selected and prepared for surgical treatment. 61 patients were treated successfully with rifampicin and streptomycin without complications. 65 patients presented with complications; they comprised 34 males and 31 females. Their ages ranged from 1 year 3 months to 80 years with mean age of 29.7 [S.D. 20.1]. The types of lesions seen were ulcers [54], contractures [7], chronic osteomyelitis [one], subluxation of knee joint [one], salivary gland fistula [one] and Marjolin's ulcer [one]. The lesions were distributed as follows: 69.2% on the lower, and 23.1% on the upper limbs, 6.2% on the head and neck and 1.5% on the trunk. Wound excision with or without skin grafting was done in 84.6% of patients, surgery for contractures in10.8%, and sequestrectomy, exploration and ligation of fistula, groin dissection and above knee amputation in 4.6%. Whilst ulcers, the commonest MU lesions, are being controlled with antibiotics, rare complications of the disease are also emerging

Infuence of irrigation and obturation techniques on artificial lateral root canal filling capacity

The aim of this study was to evaluate the influence of two dif-ferent irrigation protocols on artificial lateral root canalfilling capacity using different obturation techniques. Sixtysingle-root human teeth were used. Two artificial lateralcanals were created in the apical third. Root canals wereinstrumented up to a 45 K-file to the working length. Beforeeach file, root canals were irrigated either with 2 mL of 2.5%NaOCl or 2% chlorhexidine gel with further irrigation withsaline solution and 3 mL of 17% EDTA. Specimens were ran-domly divided into three groups according to the obturationtechnique: (1) lateral compaction technique; (2) Taggerhybrid technique; and (3) thermoplasticized technique usingBeeFill 2 in 1. All groups used AH Plus as the root canal seal-er. The specimens were decalcified and cleared in methylsalicylate. The total length of lateral canals was observedunder X30 magnification with a stereomicroscope and meas-ured on the buccal and lingual root surfaces using Leica IM50software. The data were submitted to ANOVA and Tukey test(p<0.05). Among the obturation techniques, BeeFill 2 in 1showed deeper penetration into all lateral canals than the lat-eral compaction or Tagger hybrid techniques (p<0.05). Thelateral compaction group showed the worst results (p<0.05).Irrigants did not affect the outcome; there was no differencebetween NaOCl and chlorhexidine when the same obturationtechnique was used (p>0.05). Regardless of the irrigant usedduring endodontic procedures, the thermoplasticized tech-niques showed higher penetration behavior for filling artificiallateral canals than the lateral compaction technique.

O objetivo do presente estudo foi avaliar a influência de doisdiferentes protocolos de irrigação na capacidade de penetraçãode canais artificiais, utilizando diferente técnicas de obturação.Sessenta dentes humanos unirradiculares foram utilizados. Doiscanais laterais artificiais foram confeccionados no terço apicaldo dente. Os canais foram instrumentados até uma lima K 45 nocomprimento de trabalho. Antes do uso de cada lima, os canaisradiculares foram irrigados com 2 mL de NaOCl 2.5% ou comClorexidina gel 2% seguido de solução salina. Ambos os gruposreceberam no final da instrumentação 3 mL de EDTA 17%. Osespecimes foram randomicamente separados em 3 subgrupos deacordo com a técnica de obturação utilizada: (1) técnica de com-pactação lateral; (2) técnica híbrida de Tagger; e (3) técnicatermoplástica utilizando o BeeFill 2 em 1. Em todos os grupos ocimento utilizado foi o AH Plus. Depois, os elementos foramdiafanizados utilizando metil salicilato. As extensões de pe -netração dos cimentos nos canais laterais foram realizadas uti-lizando estereomicroscópio (X30). Os dados de cada grupoforam analizados utilizando ANOVA e o teste de Tukey (p<0.05).Dentre as técnicas de obturação, a técnica termoplástica uti-lizando o BeeFill 2 em 1 mostrou a maior penetração em canaislaterais (p<0.05). A técnica de compactação lateral apresentouos piores resultados dentes os grupos testados (p<0.05). Os irri-gantes não afetaram a penetração dos canais laterais; não foramobservados diferenças entre NaOCl e clorexidina, quando amesma técnica de obturação foi utilizada (p>0.05). Pode-se con-cluir que independente da substância química auxiliar utilizada,as técnicas termoplásticas de obturação demonstraram maiorpenetração de canais laterais do que a técnica de compactação lateral.

Avaliação antimicrobiana dos vapores de para monoclorofenol e tricresol formalina utilizando uma nova metodologia / Antimicrobial evaluation of vapors of paramonochlorophenol and tricresol formalin using a new methodology

O objetivo do presente estudo foi avaliar o efeito antimicrobiano do Paramonoclorofenol Canforado (PMCFC) e do Tricresol Formalina (TF) frente ao Enterococcus faecalis utilizando uma nova metodologia para simular a volatilização dos compostos. Enterococcus faecalis foram inoculados em placas de Petri com BHI, na qual foram fincados escalpes contendo algodão embebido em PMCFC e TF. Bolinhas de algodão sem medicação foram utilizadas como controle negativo. Após 48 horas de cultivo, foi avaliada a formação de halos de inibição de crescimento bacteriano. Pode-se constatar que o grupo com TF produziu halos de inibição em 100% dos escalpes, enquanto o PMCFC e o controle negativo não produziram halo de inibição. Conclui-se que somente o TF apresentou atividade antimicrobiana por volatilização.

The aim of the present study was to evaluate the antimicrobial effects of paramonochlorophenol and tricresol formalin using a new methodology to simulate the volatilization of these substances. Enterococcus faecalis were inoculated em petri dishes with BHI and mm scalps containing cotton balls soaked with the tested substances were stucked in the petri dishes. Cotton balls without medication were used as negative control. After 48 hours the inhibition halo formation was evaluated. The results showed that tricresol formalin group presented inhinition zones in 100% of scalps, while paramochlorophenol and control group produced no inhibition zone. The results suggested that the vapor of formalin tricresol has antibacterial activity; however paramonochlorophenol was unable to exert antibacterial activity from the volatilization of its gases.

Movimento reciprocante em Endodontia: revisão de literatura / Reciprocating movement in endodontics: literature review

A instrumentação dos canais radiculares através do uso de lima única em movimento recíproco vem se popularizando devido à redução do tempo de trabalho e menor tendência de fraturas dos instrumentos. Antes de escolher o sistema que vai utilizar, o cirurgião- -dentista deve conhecer as capacidades e limitações de cada sistema baseado em evidências científicas. Esse artigo realizou uma revisão de literatura sobre o movimento recíproco para instrumentação do sistema de canais radiculares apontando as vantagens e desvantagens da utilização dessa cinemática de instrumentação.

The canal’s instrumentation by using single file in reciprocation movement is gaining popularity due to the reduction of working time and less prone to fractures of the instruments. Before choosing which system will use, the dentist must know the capabilities and limitations of each system based on scientific evidence. This article reviews the literature on the reciprocation movement pointing out the advantages and disadvantages of this different kinematic instrumentation.

Pino anatômico com resina composta: relato de caso / Anatomic fiber post with composite resin: case report

O protocolo restaurador de dentes tratados endodonticamente é um desafio na odontologia adesiva atual, já que existem vários tipos de retentores intrarradiculares à disposição no mercado, com características ópticas e mecânicas que promovem um tratamento satisfatório. Dessa forma, a técnica de pino de fibra anatômico reembasado com resina composta direta torna-se eficiente para uso na clínica odontológica, especialmente em casos de condutos largos e tamanho reduzido de férula. Para tanto, o pino é limpo, aplica-se o silano e adesivo, além da resina composta não polimerizada para moldar o conduto radicular. Após, o pino é tratado novamente e cimentado com uma pequena espessura de linha de cimentação. Nesse artigo, o caso clinico abordará as etapas necessárias para a confecção do pino anatômico, além das estratégias de cimentação adesiva e a restauração com resina composta, trabalhando os conceitos da manutenção de uma delgada linha de cimentação para uma adequada reabilitação dental mantendo biomecânica e retenção do pino de fibra no interior do conduto radicular.

The restorative protocol for endodontically treated teeth is a challenge in adhesive dentistry, since there are several available types of intracanal posts with optical and mechanical characteristics that promotea satisfactory treatment. Thus, the anatomical fiber post technique is efficient for the use in dental practice, especially in cases of large root canals and small dental ferrules. So, the post is cleaned and then the silaneagent and adhesive system are applied, followed by the placement of the non-polymerized composite for root canal modeling. After this, the anatomical fiber post is treated again and followed by the luting procedure, showing a small cementation thickness. In this paper, the case report will address the necessary steps to realize the anatomical fiber post technique using strategies and adhesive cementation with composite resin restoration, working the concepts of maintaining a thin cement line and an adequate dental rehabilitation.