Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation.

OBJECTIVES: The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. MATERIALS AND METHODS: Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. RESULTS: Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). CONCLUSIONS: Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). CLINICAL RELEVANCE: None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.

Successful nonsurgical treatment of type II dens invaginatus with 5 root canals using a self-adjusting file: a case report.

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

The connection between brain abscess and odontogenic infections: A systematic review.

OBJECTIVE: The study performed a systematic review to understand better the pathogenesis, microbiology, and predisposing factors related to the association between cerebral abscess and odontogenic infections. DESIGN: The review was performed according to the PRISMA guidelines and registered on PROSPERO. The search was carried out in PubMed electronic database for articles published until March 2020. Eligibility criteria were: case reports, case series, and retrospective studies. After the selection, independent evaluations of the studies' methodological quality were performed using two Joanna Briggs Institute Critical Appraisal Checklists. RESULTS: A total of 648 articles were obtained, and later 81 articles were selected and had data extracted. The number of individual cases was 135. Cerebral abscesses were similarly distributed by both right and left sides. However, 26 (19.3%) affected both sides simultaneously. In 42 cases (31.1%), the brain-affected side coincided with the odontogenic infection side. Cerebral and odontogenic sites shared the same microorganism in 23 cases (17%). Although in most cases, only brain samples were microbiologically analyzed (88, 65%). Upper molars were the most associated teeth (n = 53, 23.7%). The majority of patients recovered their health without sequels after medical-dental intervention 96 (71.1%). However, 9 (6.6%) individuals died. CONCLUSIONS: The association between brain abscess and odontogenic infection was confirmed by numerous articles reporting oral bacteria in samples collected directly from brain abscesses. Upper molars were the teeth most often associated with brain abscesses.

Paecilomyces variotti in deep dental caries.

Paecilomyces variotti (P. variotti) is a fungal species found in soil, wood and some foods, and has been associated with some severe systemic infections. P. variotti has not been previously identified in carious tissue, and the aim of the present study is to report the presence of P. variotti in a deep carious lesion discussing its possible local and systemic associations. A 28 year-old male was submitted to extraction of the upper left second premolar (tooth #25) presenting a deep carious lesion. After extraction the tooth was cleaved in its long axis, and the infected dentinal tissue was curetted and submitted to microbiological analysis using CHROMagar® Candida medium and Malt Extract Agar. Macroscopic and microscopic analysis confirmed the presence of P. variotti in the carious tissue. Post-operatory period was uneventful, healing of the dental socket was complete, and the patient remained well during the follow-up period. P. variotti, a fungus not considered saprophyte in the oral cavity, was encountered in a deep caries lesion, and its potential association with local and systemic infections should be considered. Key words:Paecilomyces variotti, dental caries.

Canal transportation using Mani GPR or HyFlex NT during the retreatment of curved root canals: A micro-computed tomographic study.

This study assessed the apical transportation using Mani GPR or HyFlex NT during the retreatment of curved root canals. Thirty-eight roots were analysed using micro-CT for the comparison of apical transportation produced by two retreatment systems. Longitudinal transportation, horizontal transportation, variation in the canal angle of curvature and variation in the canal/root width ratio were analysed. Longitudinal transportation was frequently observed, regardless of the system used. The canals retreated with Mani GPR showed a significantly higher horizontal transportation at 1 mm from the root apex (P < 0.01) and greater variation of the canal curvature angle (P < 0.01). The canal/root width ratio was similar between groups (P > 0.05). In conclusion, longitudinal transportation occurred more frequently in the mesial canal walls. Mani GPR showed greater horizontal transportation at 1 mm short of the apex, and higher variation of the canal curvature angle compared with HyFlex NT.

Comparação do alargamento apical do canal radicular através dos sistemas de instrumentação SAF e Reciproc / Comparison of apical enlargement of the root canal through SAF and Reciproc instrumentation systems

Objetivo: Comparar o aumento percentual da área da secção reta transversal de canais radiculares, no nível de 3 mm aquém do ápice radicular, após instrumentação com dois sistemas de instrumento único. Métodos: Dezenove primeiros molares inferiores extraídos tiveram as raízes mesiais seccionadas no nível de 3 mm aquém do ápice radicular, sendo os 2 milímetros finais de cada raiz removidos e descartados, para proceder a mensuração da área pré-operatória, através de estereomicroscopia. As raízes foram instrumentadas com os sistemas SAF e Reciproc R25.08 e procedeu-se nova mensuração para comparação do aumento percentual da área. O aumento percentual da área da secção reta transversal foi comparado e analisado estatisticamente pelo teste t de Student. O nível de significância foi estabelecido em 5% (p < 0,05). Resultados: O aumento percentual da área dos canais foi significativamente maior para o grupo Reciproc (p = 0,001) em comparação com o grupo SAF. Os canais instrumentados com o sistema SAF tiveram sua área aumentada em média 53,5%, enquanto que nos instrumentados com o sistema Reciproc a média foi 154,5%. Conclusão: O sistema Reciproc proporcionou um aumento percentual da área da secção reta transversal dos canais radiculares, no nível dos 3 mm apicais, 3 vezes maior que o sistema SAF.

Aim: To compare the percentage increase in the cross-sectional area of root canals, at the level of 3 mm from the root apex after instrumentation with two single instrument systems. Methods: The roots of 19 extracted mandibular first molars were sectioned 3 mm short of the apex level, with the final 2 millimeters of each root removed and discarded in order to enable the preoperative area to be measured by stereomicroscopy. Subsequently, the roots were instrumented with the SAF and Reciproc 25/.08 systems, alternating the technique used per canal from root to root, and a new measurement was performed. After, the percentage increase in area was calculated considering the values of the original and the final area. The Student'st-test was applied to the results, with a level of significance set at 5%. Results: The percentage increase in area of the root canals was significantly higher for the Reciproc (p = 0.001) when compared to the SAF group. In the canals instrumented with the SAF system, the mean increase in area was 53.5%, while in those using the Reciproc system, it was 154.5%. Conclusion:The Reciproc system produced a 3-fold higher percentage increase in the cross-sectional area of the root canals at the level of 3 mm from the root apex than did the SAF system.

Mucosal Fenestration After 2% Chlorhexidine Extrusion Used in Substitution of Sodium Hypochlorite: A Case Report.

This report describes a case of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) extrusion through the apical foramen, causing acute pain, swelling and mucosal fenestration. A 62-year-old woman was referred for endodontic treatment in the first left maxillary premolar with a diagnosis of necrotic pulp. After the root canal irrigation with 2.5% NaOCl, the patient felt a burning sensation and pain. Discrete swelling and redness were noted in the patient's face at the end of the session. Antibiotic and corticosteroids were prescribed. In the next appointment, 2% CHX was used, but another episode of extrusion occurred, with a sudden acute pain and intense swelling within a few minutes after the injection. After 2 weeks, the patient exhibited a left-side facial swelling extending anterior and inferior to the left zygomatic arch and superior to the body of the mandible. Oral antibiotic and anti-inflammatory drugs were administered. After 10 days, the swelling had completely diminished, but a mucosal fenestration and tooth mobility were verified. A cone beam CT was requested and showed a periapical lesion involving both buccal and palatal roots. After a prosthetic evaluation, the tooth extraction was indicated. One week after tooth removal, the mucosa was completely healed.

OTIMIZAÇÃO DA DESINFECÇÃO PÓS PREPARO QUÍMICO-MECÂNICO / OPTIMIZATION OF DISINFECTION AFTER CHEMICAL MECHANICAL PREPARATION

Os microrganismos têm um papel essencial na etiopatogenia das principais alterações pulpares e periapicais. O resultado da terapia endodôntica em dentes contendo polpa necrosada e infectada depende da desinfecção bem-sucedida e obturação adequada do sistema de canais radiculares. A eliminação de microrganismos pode ocorrer pela ação mecânica, associado à irrigação dos canais radiculares. No entanto, apesar dos recentes avanços em termos de técnicas e instrumentos de preparo, diversas áreas do canal ainda permanecem com detritos dentinários e micro-organismos mesmo após a instrumentação. Isto ocorre em grande parte devido à complexidade anatômica. Assim, o objetivo desta revisão de literatura é apresentar diferentes abordagens para suplementar a desinfecção dos canais radiculares, incluindo a irrigação ultrassônica passiva (IUP), a irrigação final com clorexidina, Endovac®, o sistema Self-Adjusting File (SAF®), XP- Endo Finisher® e a terapia fotodinâmica (TF).

Microorganisms have an essential role in the etiopathogenesis of the pulp and periapical changes. The outcome of endodontic therapy in teeth with necrotic and infected pulp depends on successful disinfection and adequate filling of the root canal system. The elimination of microorganisms can occur by mechanical action, associated with irrigation of the root canals. However, despite recent advances in terms of techniques and tools of preparation, several areas of the canal remain with dentinal debris and microorganisms even after instrumentation. This occurs mainly due to anatomical complexity. Thus, the objective of this literature review is to present different approaches to supplement the disinfection of root canals, including passive ultrasonic irrigation (PUI), final irrigation with chlorhexidine, Endovac®, Self-Adjusting File system (SAF®), XP- Endo Finisher ® and Photodynamic Therapy (PDT).

Protocolos de irrigação final em Endodontia: revisão sistemática / Final irrigation protocols in Endodontics: systematic review

Introdução: a ação mecânica dos instrumentos no sistema de canais limita-se ao canal principal, o que valoriza a necessidade de um irrigante com propriedades ótimas para melhorar a limpeza e desinfecção. Objetivos: revisar os diferentes protocolos de irrigação final adotados em Endodontia. Métodos: foram selecionados estudos in vitro e in vivo, para apontar as soluções químicas empregadas, suas possíveis associações e os métodos de agitação. Resultados: ficou evidente a necessidade de mais de uma substância durante a preparação e, também, a associação com um agente quelante, sob agitação, como forma de potenciar a desinfecção dos canais. Conclusão: observou-se que o uso de NaOCl 2,5% associado a EDTA 17%, MTAD ou CHX 2%, sob agitação, parece ser a combinação considerada mais efetiva na literatura, podendo, portanto, ser indicada como irrigantes finais em Endodontia. (AU)

Apical surgery as cystic lesion treatment for barodontalgia prevention: a case report / Cirugía apical como tratamiento de lesión quística para prevenir la barodontalgia: informe de caso

ABSTRACT Barodontalgia is not a pathology but a symptom of a subclinical oral problem that, although rare, may affect patients subjected to atmospheric pressure changes and have an influence on flights. This paper aims to discuss the clinical characteristics of pathologies related to the etiology of barodontalgia, as well as differential diagnoses, treatments, and prevention. This paper reports a case of a Brazilian air force officer who went to the Santos Dumont Air Force Dental Clinic reporting pain in the anterior maxillary during a flight. An endodontic treatment followed by periradicular surgery was performed, in order to quickly seal the bone lesion and to avoid new cases of barodontalgia. This work demonstrated a successful approach of a periradicular lesion solved by surgical treatment in order to avoid new cases of barodontalgia during flights. In addition, this paper highlights the importance of deepening knowledge on this event and the need for periodic oral and dental assessment, as well as conclusive treatment in aircrew members in order to prevent aircraft accidents.

ABSTRACT La barodontalgia no es una patología en sí misma, sino un síntoma de un problema oral subclínico que, si bien es poco frecuente, puede afectar a pacientes sometidos a cambios en la presión atmosférica y afectar la seguridad de los vuelos. Este artículo pretende analizar las características clínicas de las patologías relacionadas con la etiología de la barodontalgia, así como los diagnósticos diferenciales, los tratamientos y la prevención. Se presenta el caso de un agente de la fuerza aérea brasileña que acudió a la Clínica Dental de la Fuerza Aérea Santos-Dumont reportando dolor en el maxilar anterior durante un vuelo. Se realizó un tratamiento de endodoncia seguido de cirugía perirradicular, con el fin de sellar rápidamente la lesión del hueso y evitar nuevos casos de barodontalgia. Este trabajo describe un procedimiento acertado para una lesión perirradicular resuelta por tratamiento quirúrgico para evitar nuevos casos de barodontalgia durante los vuelos. Además, destaca la importancia de profundizar en el conocimiento sobre este evento y la necesidad de llevar a cabo no solo una evaluación bucodental periódica de los miembros de las tripulaciones, además de ofrecerles tratamientos definitivos, con el fin de prevenir los accidentes aéreos.

Efficacy of a new Activation Device in Irrigant Penetration Into Simulated Lateral Canals.

OBJECTIVE: The aim of the present study was to compare the effects of EasyClean (EC) on irrigant delivery into simulated lateral canals using an artificial closed canal system. Passive ultrasonic irrigation (PUI) was used as a reference technique for comparison. METHODS: Forty simulated curved root canals manufactured in transparent resin and with simulated lateral canals were instrumented with Reciproc R40 files and randomly assigned to four groups (n=10) according to the irrigant activation technique: PUI group, ECrec group (EC used in reciprocating motion), ECrot group (EC used in rotary motion), and control group (no activation performed). After activation, stereomicroscope images from each block were taken, and irrigant penetration into lateral canals was measured using Adobe Photoshop software. Data were analysed using ANOVA and Tukey's post hoc test (α=0.05). RESULTS: No penetration was observed in the control group. The ECrec group showed lower penetration than the other group (P<0.05). No differences were observed between the ECrot group and the PUI group (P>0.05). CONCLUSION: EC used in rotary motion was effective in increasing the penetration of the irrigating solution into simulated lateral canals.

Micro-Computed Tomography Analysis of the Root Canal Morphology of Palatal Roots of Maxillary First Molars.

INTRODUCTION: A thorough knowledge of root canal anatomy is critical for successful root canal treatments. This study evaluated the internal anatomy of the palatal roots of maxillary first molars with micro-computed tomography (microCT). METHODS: The palatal roots of extracted maxillary first molars (n = 169) were scanned with microCT to determine several anatomic parameters, including main canal classification, lateral canal occurrence and location, degree of curvature, main foramen position, apical constriction presence, diameters 1 and 2 mm from the apex and 1 mm from the foramen, minor dentin thickness in those regions, canal volume, surface area, and convexity. RESULTS: All canals were classified as Vertucci type I. The cross sections were oval in 61% of the canals. Lateral canals were found in 25% of the samples. The main foramen did not coincide with the root apex in 95% of the cases. Only 8% of the canals were classified as straight. Apical constriction was identified in 38% of the roots. The minor and major canal diameters and minor dentin thickness were decreased near the apex. The minor dentin thickness 1 mm from the foramen was 0.82 mm. The palatal canals exhibited a volume of 6.91 mm(3) and surface area of 55.31 mm(2) and were rod-shaped. CONCLUSIONS: The root canals of the palatal roots were classified as type I. However, some factors need to be considered during the treatment of these roots, including the frequent ocurrence of moderate/severe curvatures, oval-shaped cross-sections, and lateral canals, noncoincidence of the apical foramen with the root apex, and absence of apical constriction in most cases.

Parestesia, por que o endodontista deve se preocupar? / Paresthesia, why should the endodontist worry?

Parestesia é um distúrbio neurossensitivo causado por lesão no tecido nervoso. É caracterizada por sensação de queimação, pontada ou perda parcial da sensibilidade local. Quando relacionada à Endodontia pode decorrer de tratamentos nos quais houve extravasamento de material obturador ou de medicação intracanal, como consequência e cirurgia endodôntica ou de infecções perirradiculares. O presente trabalho teve por objetivo a realização de uma revisão de literatura acerca dos aspectos relacionados à parestesia pós-tratamento endodôntico, de forma a elucidar os nervos mais comumente afetados, o diagnóstico e as condutas de tratamento mais acertadas. De acordo com a literatura consultada, pode-se concluir que os nervos mais acometidos são os que percorrem a mandíbula, como o nervo alveolar inferior, mentual e o lingual. Para o diagnóstico há a necessidade de anamnese precisa, testes mecanoceptivos e nociceptivos, bem como de exames de diagnóstico por imagem. Em relação à conduta, a literatura aponta que ainda não há um padrão para parestesia relacionada a procedimentos endodônticos, uma vez que várias são as causas relacionadas. Nesse sentido, é imperativa a anamnese criteriosa e diagnóstico preciso para minimizar a injúria ao tecido nervoso e restabelecer o bem-estar do paciente (AU).

Paresthesia is a neuro-sensitive disorder caused by a damage to nervous tissue. It is characterized by a burning, tickling sensation or partial loss of local sensitivity. When related to Endodontics, it may result from treatments in which there has been overflow of filling material or intracanal medication as a result of the paraendodontic surgery or periradicular infections. This study aimed at performing a literature review on the aspects related to post-endodontic treatment paresthesia, in order to identify the most commonly affected nerves, the diagnosis, as well as the proper treatment procedures. According to the consulted literature, it can be concluded that the most affected nerves is that runs through the jawbone, such as the inferior alveolar nerve, the mentual nerve, and the lingual nerve. For the diagnosis, accurate medical history, mecanoception and nociception tests, as well as diagnostic imaging exams are required. As regards the clinical conduct, the literature indicates that there is still no standard for paresthesia related to endodontic procedures, since the related causes are diverse. In this sense, careful medical history and accurate diagnosis are fundamental to proper treatment in order to minimize injury to the nervous tissue and to restore the wellness of the patient (AU).

Flexibilidade e fadiga cíclica de instrumentos fabricados com métodos diferentes / Flexibility and resistance to cyclic fatigue of instruments manufactured by different methods

Objetivo: o presente estudo comparou o comportamento mecânico de instrumentos de níquel-titânio que apresentavam forma geométrica semelhante, porem, produzidos por métodos de fabricação diferentes. Métodos: foram usados, para o teste de flexibilidade e de flexão rotativa, vinte instrumentos 25/0,06 RaCe (FKG Dentaire, La Chaux-de-Fonds, Suíça), com 25 mm de comprimento, produzidos por fio de NiTi convencional (usinados); 20 instrumentos endodônticos especiais 25/0,06 Twisted File (TF) (SybronEndo, Orange, EUA), com 27 mm de comprimento, fabricados por torção; e 20 instrumentos endodonticos 25/0,06 ProFile Vortex (Dentsply Tulsa Dental, Tulsa, EUA), com 25mm de comprimento, feitos com liga M-Wire. Cada grupo dos respectivos ensaios teve 10 instrumentos de cada fabricante. Resultados: o teste paramétrico ANOVA mostrou que houve diferença significativa entre os valores de carga máxima, na seguinte ordem decrescente: ProFile Vortex > RaCe > TF (p < 0,01). Com o ensaio de flexão rotativa, o teste paramétrico ANOVA, com nível de significância de 1%, mostrou que os instrumentos RaCe tiveram uma diferença significativa menor para a fratura do que os instrumentos Pro-File Vortex, que foram significativamente inferiores aos instrumentos TF, com relação ao tempo e ao numero de ciclos (p < 0,01). Conclusão: os instrumentos TF foram mais flexiveis do que os instrumentos RaCe, que foram menos resistentes a flexão do que os instrumentos ProFile Vortex. Considerando-se o ensaio de flexão rotativa, os instrumentos TF apresentaram um desempenho significativamente superior com relação ao tempo e ao numero de ciclos para a fratura (NCF) do que os outros instrumentos testados.

Comparison of the efficacy of nickel-titanium rotary systems with or without the retreatment instruments in the removal of gutta-percha in the apical third.

BACKGROUND: The purpose of this study was to compare the efficacy of nickel-titanium rotary systems with or without the retreatment instruments in the removal of gutta-percha from the apical third. METHODS: The systems compared were as follows: ProTaper Universal (PT), ProTaper Universal Retreatment (PTr), Mtwo (M2) and Mtwo Retreatment (M2r). Sixty extracted mandibular incisors were treated with a crown-down technique and filled with gutta-percha and sealer. The apical diameter was standardized in 0.30 mm, 1 mm from the apex. The teeth were distributed into 4 experimental groups: PT, PTr, M2 and M2r. In PTr and M2r groups, filling materials were removed by PTr/M2r followed by root canals preparation up to a PT F4/M2 40; in groups PT/M2, the filling materials were removed and the root canals were prepared by PT up to a PT F4/M2 up to a M2 40. The roots were split and photomicrographing. The percentage of clean area in the apical 5 mm was calculated using software. Data were analyzed with the Kruskal-Wallis test. RESULTS: Remaining material was found in all hemisections and there was no statistically significant difference between the groups (p = 0.09). Considering the surface of the canal walls of all teeth, the mean of the percentage of clean area was 54%. CONCLUSIONS: Considering the applied methodology, remaining filling material was found in all hemisections, regardless of the retreatment technique and PT or M2 were as effective as PTr/PT or M2r/M2.

Antimicrobial activity of three temporary endodontic coronal sealers / Atividade antimicrobiana de três seladores coronários temporários em Endodontia

Objective: The object of the present study is to analyze, in vitro, the antimicrobial activity of three temporary endodontic coronal sealers.Methods: The materials tested were Tempo® (Vigodent, Rio de Janeiro, Brazil), IRM® (Dentsply, Petrópolis, Brazil) and Coltosol® (Vigodent, Rio de Janeiro, Brazil). The agar diffusion method was used for this analysis. Nine plates containing the agar blood culture medium were inoculated withhuman saliva and in each plate three equidistant cavities were made and filled with one of the materials tested. Two plates were not inoculatedand served as the negative control of the culture medium. All the plates were incubated in bacteriological incubators, in aerobiosis, for 48 hours, at 37oC. The inhibition halos of bacterial growth were measured in millimeters. Results: Tempo® (Vigodent, Rio de Janeiro, Brazil) did not show a inhibition halo of bacterial growth in any of the nine plates. Coltosol® (Vigodent, Rio de Janeiro, Brazil) produced halos in all plates, and IRM® (Dentsply, Petrópolis, Brazil) in 4 out of 9 plates. In all the tests, the halos produced by Coltosol® (Vigodent, Rio de Janeiro, Brazil) were more pronounced than the ones produced by IRM® (Dentsply, Petrópolis, Brazil) (p<0.05). The temporary coronal sealer Coltosol® (Vigodent, Rio de Janeiro, Brazil) presented the most prominent antimicrobial activity, followed by the temporary coronal sealer IRM® (Dentsply, Petrópolis, Brazil). Conclusion: Among the materials tested, it was concluded that the Coltosol® (Vigodent, Rio de Janeiro, Brazil) presented the highest antimicrobial activity.

Objetivo: Avaliar, in vitro, a atividade antimicrobiana de três seladores coronários temporários utilizados em Endodontia. Métodos: Os materiais testados foram o Tempo® (Vigodent, Rio de Janeiro, Brasil), IRM® (Dentsply, Petrópolis, Brasil) e Coltosol® (Vigodent, Rio de Janeiro, Brasil). O método utilizado para a avaliação foi o teste de difusão em ágar. Nove placas contendo o meio de cultura ágar-sangue foram inoculadas com saliva humana e em cada uma foram confeccionados 3 furos eqüidistantes sendo cada um preenchido com um dos materiais testados. Duas placas foram inoculadas e serviram como controle negativo do meio de cultura. Todas as placas foram incubadas em estufa bacteriológica, em aerobiose, por 48 horas, à temperatura de 37ºC. Os halos de inibição do crescimento bacteriano foram medidos em milímetros.Resultados: O selador temporário Tempo® (Vigodent, Rio de Janeiro, Brasil) não apresentou halo de inibição do crescimento bacteriano nas nove placas. Coltosol® (Vigodent, Rio de Janeiro, Brasil) produziu halo de inibição em todas as placas enquanto que o IRM® (Dentsply, Petrópolis, Brasil) produziu halo em 4 das 9 placas. Em todos os testes, os halos produzidos pelo Coltosol® (Vigodent, Rio de Janeiro, Brasil) foram maispronunciados que os do IRM® (Dentsply, Petrópolis, Brasil) (p<0.05). O selador coronário temporário Coltosol® (Vigodent, Rio de Janeiro,Brasil) apresentou a atividade antimicrobiana mais pronunciada, seguido pelo IRM® (Dentsply, Petrópolis, Brasil). O selador temporário Tempo®(Vigodent, Rio de Janeiro, Brasil) não apresentou qualquer atividade antimicrobiana. Conclusão: Dentre os materiais testados, podemos concluir que o Coltosol® (Vigodent, Rio de Janeiro, Brasil) é o que apresenta maior atividade antimicrobiana.

Seladores coronários temporários: determinação da atividade antimicrobiana in vitro / Temporary coronary dental sealers: determination of in vitro antimicrobial activity

O objetivo do trabalho foi comparar a atividade antimicrobiana in vitro de 6 seladores coronários temporários. Foram testados: Vitro Molar®, IRM®, Coltosol®, Citodur, Maxxion R® e Cavit®. O método utilizado foi o teste de determinação da ação antimicrobiana de difusão em ágar inoculado com amostras de saliva humana de 30 indivíduos. Os testes ANOVA e Mann-Whitney foram utilizados para a análise estatística da medida dos halos de inibição do crescimento bacteriano. A correção de Bonferroni foi aplicada para as comparações múltiplas. Coltosol® foi selador coronário que apresentou a maior média de halo de inibição do crescimento microbiano in vitro, sendo estatisticamente superior ao IRM® (p<0,001) e Citodur® (p<0,001). As demais comparações dos pares dos outros seladores não demonstraram significância.

The purpose of this study was to compare the in vitro antimicrobial activity of six temperary coronary sealers. The materiais tested were: Vitro Molar®, IRM®, Coltosol®, Citodur®, Maxxion R® and Cavit®. The method used for determining antimicrobial activity was the agar diffusion test with human saliva samples from 30 individuals. The ANOVA and Mann-Whitney test were used for statistical analysis of measurements of the halos of bacterial growth inhibition. The Bouferroni correction was applied for multiple comparisons. Coltoso® was the sealer with the highest average of bacterial growth inhibition, statistically superior to IRM® (p<0.001) and Citodu® (p<0.001). The comparisons of pairs of other sealers showed no significant differences concerning to bacterial growth inhibition.

Biofilm biomass disruption by natural substances with potential for endodontic use

This study evaluated the in vitro effects of four natural substances on the biomass of bacterial biofilms to assess their potential use as root canal irrigants. The following substances and their combinations were tested: 0.2% farnesol; 5% xylitol; 20% xylitol; 0.2% farnesol and 5% xylitol; 0.2% farnesol, 5% xylitol, and 0.1% lactoferrin; 5% xylitol and 0.1% lactoferrin; and 20 mM salicylic acid. The crystal violet assay was used to evaluate the effects of these substances on the biomass of biofilms formed by Enterococcus faecalis and Staphylococcus epidermidis. All substances except for 20 mM salicylic acid and 20% xylitol reduced biofilm mass when compared to controls. The combination of farnesol and xylitol was the most effective agent against E. faecalis ATCC 29212 (p < 0.05). Farnesol combined with xylitol and lactoferrin was the most effective against biofilms of the endodontic strain of E. faecalis MB35 (p < 0.05). Similarly, combinations involving farnesol, xylitol, and lactoferrin reduced the biomass of S. epidermidis biofilms. In general, farnesol, xylitol, and lactoferrin or farnesol and xylitol reduced biofilm biomass most effectively. Therefore, it was concluded that combinations of antibiofilm substances have potential use in endodontic treatment to combat biofilms.

Biofilm biomass disruption by natural substances with potential for endodontic use.

This study evaluated the in vitro effects of four natural substances on the biomass of bacterial biofilms to assess their potential use as root canal irrigants. The following substances and their combinations were tested: 0.2% farnesol; 5% xylitol; 20% xylitol; 0.2% farnesol and 5% xylitol; 0.2% farnesol, 5% xylitol, and 0.1% lactoferrin; 5% xylitol and 0.1% lactoferrin; and 20 mM salicylic acid. The crystal violet assay was used to evaluate the effects of these substances on the biomass of biofilms formed by Enterococcus faecalis and Staphylococcus epidermidis. All substances except for 20 mM salicylic acid and 20% xylitol reduced biofilm mass when compared to controls. The combination of farnesol and xylitol was the most effective agent against E. faecalis ATCC 29212 (p < 0.05). Farnesol combined with xylitol and lactoferrin was the most effective against biofilms of the endodontic strain of E. faecalis MB35 (p < 0.05). Similarly, combinations involving farnesol, xylitol, and lactoferrin reduced the biomass of S. epidermidis biofilms. In general, farnesol, xylitol, and lactoferrin or farnesol and xylitol reduced biofilm biomass most effectively. Therefore, it was concluded that combinations of antibiofilm substances have potential use in endodontic treatment to combat biofilms.

Localizadores apicais na determinação do comprimento de trabalho: a evolução através das gerações / Apex locators in determining the working lenght: the evolution through the generations

O objetivo do presente trabalho foi realizar uma revisãoda literatura a respeito da evolução dos localizadores apicais, desde a primeira até a quarta geração, principalmente quanto aos seus mecanismos de funcionamento. Existem informações contraditórias em relação a qual estrutura anatômica os localizadores apicaisde quarta geração detectam com maior acurácia. Conclui-se que a combinação dos métodos eletrônico e radiográfico é indispensável para a odontometria.