Endodontic techniques with Nickel Titanium instruments: analysis of quality and efficiency of instrumentation in primary molars / Técnicas endodônticas com instrumentos de Níquel Titânio: análise da qualidade e eficiência da instrumentação em molares decíduos

ABSTRACT Objective: The purpose of the present in vitro study was to evaluate the efficiency of three different instruments in the root canals of artificial primary molars as well as the quality of the fillings. Methods: Sixty artificial primary molars were divided into three groups of 20 teeth. Each group was submitted to a different technique: Group 1 - conventional manual technique using Kerr files; Group 2 - manual technique with nickel-titanium files; Group 3 - NiTi rotary technique. The root canals were filled with calcium hydroxide paste. Aspects such as homogeneity of the fillings, taper and flowability of the preparations were considered comparatively to assess the quality of the instrumentations. The non-parametric Kruskal-Wallis and Mann-Whitney tests were used to compare the efficiency of the preparation of the root canal considering the preparation times of them. Results: All three techniques were equally effective at shaping the root canals of primary teeth. The working time was shorter with the rotary instrument (p=0.000). In the pairwise comparisons, working time was shorter with the rotary instrument compared to the manual techniques with steel files (p=0.000) and NiTi files (p=0.000). Comparing the manual techniques, the working time was shorter with NiTi files compared to steel files (p=0.011). Moreover, less variability in the preparation time was found when the rotary instrument was used. Conclusions: The mechanized rotary method led to a shorter operating time in comparison to the manual techniques and is therefore a preferable option for the preparation of the root canals of primary teeth.

RESUMO Objetivo: Avaliar a eficiência de três instrumentos diferentes nos canais radiculares de molares decíduos artificiais, bem como a qualidade das obturações. Métodos: Sessenta molares decíduos artificiais foram divididos em três grupos de 20 dentes. Cada grupo foi submetido a uma técnica diferente: Grupo 1 - técnica manual convencional com limas Kerr; Grupo 2 - técnica manual com limas de níquel-titânio; Grupo 3 - Técnica rotatória de níquel-titânio. Os canais radiculares foram preenchidos com pasta de hidróxido de cálcio. Aspectos como homogeneidade das obturações, conicidade e fluidez das preparações foram considerados comparativamente para avaliar a qualidade das instrumentações. Os testes não paramétricos de Kruskal-Wallis e Mann-Whitney foram utilizados para comparar a eficiência do preparo do canal radicular considerando os tempos de preparo dos mesmos. Resultados: Todas as três técnicas foram igualmente eficazes na modelagem dos canais radiculares. O tempo de trabalho foi menor com o instrumento rotatório (p=0,000). Nas comparações pareadas, o tempo de trabalho foi menor com o instrumento rotatório em comparação com as técnicas manuais com limas de aço (p=0,000) e limas de NiTi (p=0,000). Comparando as técnicas manuais, o tempo de trabalho foi menor com as limas de NiTi em comparação com as limas de aço (p=0,011). Além disso, foi encontrada menor variabilidade no tempo de preparo quando o instrumento rotatório foi utilizado. Conclusão: O método rotatório levou um menor tempo operatório em comparação com as técnicas manuais e, portanto, é uma opção preferível para o preparo dos canais radiculares de dentes decíduos.

Associação entre doença periodontal e obesidade: uma revisão de literatura / Association between periodontal disease and obesity: a literature review

Objetivo: Este estudo teve o objetivo de avaliar a associação entre doença periodontal e obesidade. Métodos: Foi realizada uma busca nas bases PubMed, SciELO e Bireme, sendo incluídos estudos relevantes relacionados ao tema para síntese deste trabalho. Resultados: Foram selecionados treze artigos para serem incluídos nessa revisão, sendo um ensaio clínico, uma meta-análise, dois estudos de coorte, dois caso-controle, cinco estudos transversais e duas revisões sistemáticas. Conclusão: Existe uma plausibilidade biológica entre a obesidade e a doença periodontal, porém não há um consenso na literatura sobre essa associação. Desta forma, são necessários mais estudos prospectivos, laboratoriais, de coorte e meta-análises que avaliem tal associação entre as doenças.

Aim: This study aimed to assess the association between periodontal disease and obesity. Methods: A search was performed in the PubMed, SciELO, and Bireme databases, including relevant studies related to the theme for the synthesis of this work. Results: Thirteen articles were selected to be included in this review, one clinical trial, one meta-analysis, two cohort studies, two case-control studies, five cross-sectional studies and two systematic reviews. Conclusion: There is a biological plausibility between obesity and periodontitis, but there is no consensus in the literature about this association. Thus, further prospective, laboratory, cohort, and meta-analysis studies are needed to assess such an association between diseases.

Antimicrobial Photodynamic Therapy in the Endodontic Treatment of Deciduous Teeth: In Vivo Pilot Study

Abstract Objective: To evaluate the Antimicrobial Photodynamic Therapy (aPDT) in infected deciduous teeth by quantifying the viable bacteria in root canal treatment. Material and Methods: Radicular canal cultures were collected (n= 10). Four intra-canal samples were collected at four different times in each of the sampled teeth, as follows: Time 1 (T1), baseline: After opening the pulp-chamber; Time 2 (T2): After application of aPDT; Time 3 (T3): After mechanical, chemical manipulation; Time 4 (T4): After a second application of aPDT. The aPDT was performed with a 4J/cm energy low-intensity diode, together with 0.005% methylene blue as a photosensitizer. The clinical specimens were taken to the laboratory for a bacteria count (colony forming units) and the results were statistically analyzed using the Friedman and Wilcoxon tests, with a significance level of α=0.05. Results: Statistical differences were seen between the numbers of bacteria at times T1-T2, T1-T3 and T1-T4 on the cultivated plates. However, no significant statistical differences were observed between the number of bacteria in samples T2-T3, T2-T4 and T3-T4. Conclusion: Antimicrobial photodynamic therapy can be a good co-adjuvant in root canal decontamination of necrotic primary teeth.

Perceptions of the Use of the Diode Laser in Dental Surgery: A Qualitative Study

Abstract Objective: To discover the perceptions of pediatric patients, their parents and undergraduate Dentistry students of the use of the diode laser in frenectomy surgeries. Material and Methods: A qualitative study was conducted through semi-structured interviews, recorded and transcribed with subsequent content analysis. Twelve healthy children (5-8 years old) who needed a frenectomy were selected and invited, together with their parents, to undergo laser diode surgery. In addition, 28 undergraduate dentistry students were invited to attend the procedures. One week after performing the surgical procedures, the children (Group 1), their parents (Group 2) and the students who attended the procedures (Group 3) were individually interviewed for the thematic analysis. Results: The analysis of the conversations identified three emerging contents: positive thoughts on the use of diode laser; frustrations from the use of diode laser; and aspects related to professional training. Conclusion: The results pointed to the acceptance of surgical laser use in pediatric dentistry; however, the feelings of frustration indicate that its use requires guidance from the child and his/her parents, in addition to careful handling and specific training.

Recobrimento radicular com enxerto de tecido conjuntivo e fibrina rica em plaquetas: uma revisão crítica / Root coverage with connective tissue graft and platelet-rich fibrin: a critical review

Objetivo:O objetivo desta revisão foi realizar uma análise crítica da literatura quanto à utilização do procedimento enxerto de tecido conjuntivo e da membrana de fibrina rica em plaquetas para recobrimento da raiz exposta, frisando os benefícios e previsibilidade de sucesso de cada uma. Métodos:Foi realizada uma busca nas bases PubMed, SciELO e BIREME em março de 2019, sendo incluídos estudos relevantes relacionados ao tema para síntese deste trabalho. Resultados: Foram selecionados 5 artigos para serem incluídos nessa revisão crítica, sendo 3 ensaios clínicos controlados randomizados, 1 ensaio clínico e 1 um relato de caso. Conclusão:O recobrimento radicular com uso de enxerto de tecido conjuntivo e fibrina rica em plaquetas apresentou resultados satisfatórios, devolvendo estética, saúde e regeneração dos tecidos gengivais e periodontais. Em relação à fibrina rica em plaquetas, há poucos casos na literatura quanto aos resultados clínicos a longo prazo.

Aim: This review sought to perform a critical analysis of the literature regarding the use of the graft procedure of connective tissue and Platelet-rich fibrin to cover the exposed root, emphasizing the benefits and predictability of success of each. Methods: This study performed a search on the PubMed, SciELO, and BIREME databases, and included relevant studies related to the topic for the synthesis of this work. Results:Five articles were selected to be included in this critical review, three randomized controlled clinical trials, one clinical trial, and one case report. Conclusion:The root covering using a subepithelial connective tissue graft and platelet-rich fibrin presents satisfactory results, restoring esthetics and health, and regenerating the gingival and periodontal tissues. Regarding platelet-rich fibrin, there are few cases in the literature regarding long-term clinical outcomes.