Tip and taper compatibility of accessory gutta-percha points with rotary and reciprocating instruments.

Objectives: This study was conducted to evaluate and compare the tip and taper compatibility of accessory gutta-percha points (AGPs) with various rotary and reciprocating instruments. Materials and Methods: Using a profile analyzer, tip and taper measurements were taken of 10 AGPs of each of the 14 models available from Odous de Deus and the 4 models available from Dentsply-Maillefer. Diameter measurements were taken at 1-mm intervals, from 3 mm from the tip (D3) to 16 mm. Results: Based on the mean values obtained, 3-dimensional (3D) models of the AGPs were drawn in Autodesk Fusion 360 and superimposed on 3D models of each instrument selected (Mtwo, Reciproc, RaCe, K3, and ProDesign Logic) to determine the compatibility between the instrument and the AGP. Data corresponding to the tips and tapers of the various AGPs, as well as the tip and taper differences between the AGPs and the instruments, were analyzed using descriptive statistics. The tapers of the AGPs were subject to the American National Standards Institute/American Dental Association No. 57 standard. The Odous de Deus extra-long medium and extra-long extra-medium AGPs were shown to be compatible with Mtwo, K3, and ProDesign Logic instruments with taper 0.06 and tip sizes 25 and 30, while the Dentsply fine and fine medium cones were compatible with Mtwo, RaCe, and K3 instruments with conicity of 0.04 and tip sizes 35 and 40. Conclusions: Both the Odous de Deus and Dentsply commercial brands included 2 AGP models with tip (D3) and taper compatibility with Mtwo, RaCe, K3, and/or Prodesign Logic instruments.

Impact of Particle Size on the Setting Behavior of Tricalcium Silicate: A Comparative Study Using ISO 6876 Indentation Testing and Isothermal Induction Calorimetry.

This study examines the impact of particle size on the setting behavior of tricalcium silicate powders. The setting behavior was evaluated using ISO 6876 indentation testing and isothermal induction calorimetry techniques. The objective was to compare the outcomes obtained from these methods and establish a correlation between particle size and setting characteristics. The cement pastes were manually mixed with a water-to-solid ratio of 0.66 for conducting indentation tests according to ISO 6876, while calorimetry measurements were performed using isothermal (conduction) calorimetry at room temperature. The findings demonstrate a significant influence of smaller particle sizes on accelerating the hydration process of cement pastes, resulting in a reduction of setting time by up to 24%. Moreover, the final setting times obtained through the indentation method closely approximate the inflection points of the acceleration curves acquired by calorimetry, with time deviations of less than 12% regardless of particle size.

Periodontite apical assintomática com rompimento de cortical óssea em paciente sob tratamento contínuo com isotretinoína: relato de caso / Asymptomatic apical periodontitis with cortical bone disruption in patient under continuous treatment with Isotretinoin: case report

Introdução: A periodontite apical assintomática (PAA) é caracterizada pela inflamação e destruição dos tecidos periapicais, e sua progressão promove reabsorção óssea, podendo ser agravada pelo uso contínuo de isotretinoína. Objetivo: O objetivo do presente estudo foi relatar a resolução de uma PAA com rompimento de cortical óssea mandibular em um paciente sob tratamento contínuo com isotretinoína (Roacutan®), por meio de procedimentos químicos-mecânicos convencionais e controle com tomografia computadorizada de feixe cônico (TCFC). Descrição: Um paciente com 21 anos de idade, ASA I, em tratamento contínuo com isotretinoína, procurou atendimento odontológico com moderada dor na região do elemento dental #38. Após exames clínicos, radiográficos e tomográficos, verificou-se a necessidade de tratamento endodôntico do dente #36. A TCFC mostrou uma imagem apical extensa e hipodensa entre os dentes #36 e #37, compatível com lesão cística óssea, com dimensões de 25,59 mm (largura) x 14,37 mm (altura) x 8,40 mm (profundidade). Também foram observados reabsorção apical da raiz distal, halo hipodenso sob a restauração coronal do #36 e ruptura da cortical externa vestibular e lingual. O tratamento endodôntico foi realizado em três sessões, com auxílio de um microscópio operatório e protocolos químicos-mecânicos, como Easy Clean e terapia fotodinâmica. Resultado: A resolução da PAA foi observada após acompanhamento por três anos. Conclusão: O tratamento endodôntico permitiu o reparo de uma lesão periapical extensa, evitando a cirurgia parendodôntica imediata, e o uso contínuo de isotretinoína não afetou a resolução da PAA(AU).

Introduction: Asymptomatic apical periodontitis (AAP) is characterized by inflammation and destruction of the periapical tissues and its progression leads to bone resorption, which may be aggravated by continuous use of Isotretinoin. The objective of this study was to report the resolution of AAP with mandibular cortical disruption in a patient under continuous treatment with isotretinoin (Roacutan®) and kickboxing practitioner, by conventional chemical-mechanical procedures and cone-bean computed tomography (CBCT) follow-up. Description: A 21-year-old Caucasoid individual, ASA I, under continuous use of isotretinoin and kickboxing practitioner sought dental care with moderate pain at the region of tooth #38. After clinical, radiographic and tomographic examination, the need for endodontic treatment of tooth #36 was verified. The CBCT showed an extensive and hypodense apical image between teeth #36 and #37, compatible with cystic bone lesion, with dimensions of 25.59 mm wide x 14.37 mm high x 8.40 mm deep. Apical resorption of the distal root, hypodense halo under a coronal restoration at #36, and rupture of the external buccal and lingual cortical bone were also observed. The endodontic treatment was performed in three sessions with the aid of a microscope and chemical-mechanical protocols, such as Easy Clean and photodynamic therapy. Result: Resolution of AAP was observed after follow-up for three years. Conclusion: Endodontic treatment allowed healing of an extensive periapical lesion, avoiding immediate parendodontic surgery and the continuous use of isotretinoin did not affect the AAP resolution. (AU).

Effect of the addition of nanoparticles of CaCO3 and different water-to-powder ratios on the physicochemical properties of white Portland cement.

The addition of calcium carbonate nanoparticles (nano-CaCO3 ) accelerates the hydration of Portland cement improving its mechanical properties. Conversely, nano-CaCO3 addition leads to reduction in the water required during initial PC hydration. Therefore, the use of a correct water-to-powder ratio is fundamental for manipulating this hydraulic cement. This study evaluated the effect of nano-CaCO3 addition and different water-to-powder ratios on the physicochemical properties of white Portland cement (WPC). WPC was associated to different concentrations of nano-CaCO3 , and the following experimental groups were created: G1a (no nano-CaCO3 ); G2a (0.5% nano-CaCO3 ), G3a (1% nano-CaCO3 ), G4a (2% nano-CaCO3 ), and G5a (5% nano-CaCO3 ). The setting-time (ST), compressive strength (CS), dimensional change (DC), solubility (S), and pH were assessed (24 hr and 30 days). Next, WPC + 5% nano-CaCO3 was manipulated varying the water-to-powder ratio: G1b (WPC/0.33 ml); G2b (WPC/nano-CaCO3 /0.33 ml); G3b (WPC/0.29 ml); G4b (WPC/nano-CaCO3 /0.29 ml); G5b (WPC/0.26 ml); and G6b (WPC/nano-CaCO3 /0.26 ml). The tests were repeated. The data analysis (2-way ANOVA and Tukey test, α = 5%) demonstrated that ST was shorter for samples containing nano-CaCO3 (p < .05). Reduction in CS was observed for all groups at 30 days, except G5a, G2b, and G6b (p < .05). DC and S had no statistical difference among groups (p > .05) independently of nano-CaCO3 water-to-powder ratio. After 30 days, there was significant reduction in pH for G3a and G6b (p < .05). The different concentrations of nano-CaCO3 and water-to-powder ratios affected the physicochemical properties of WPC, especially the setting-time and compressive strength.

Effectiveness of nanoparticles solutions and conventional endodontic irrigants against Enterococcus faecalis biofilm.

CONTEXT: To overcome the challenge imposed by the presence of biofilm and reach significant bacterial reduction of the root canals, many irrigants have been indicated during endodontic treatment, among them nanoparticles solutions. AIMS: This study aims to evaluate the effectiveness of experimental solutions containing silver and zinc oxide nanoparticles (ZnO Np) and conventional endodontic irrigants against Enterococcus faecalis biofilm, in root canals. METHODS: Seventy-six extracted human teeth were biomechanically prepared and sterilized. The root canal surface was exposed to E. faecalis suspension to form a 7-day-old biofilm. Four teeth were analyzed by scanning electron microscopy (SEM) to confirm the presence of biofilm. The remaining teeth were randomly divided into 6 groups (n = 12) and treated with passive ultrasonic irrigation and different solutions: G1 - 0.85% saline (control); G2 - 2% chlorhexidine gluconate (CHX); G3 - 5% sodium hypochlorite (NaOCl); G4 - 1% NaOCl; G5 - 1% silver nanoparticles (Ag Np) solution; and G6 - 26% ZnO Np solution. The susceptibility of E. faecalis biofilms to disinfecting solutions (n = 10) was determined by quantification of colony-forming units. SEM analysis was also carried out to examine the biofilm structure after treatments (n = 2). Data were analyzed by Kruskal-Wallis and Dunn post hoc tests (P < 0.05). RESULTS: All tested solutions showed superior effectiveness compared to 0.85% saline (P < 0.05). Overall, 2% CHX presented the most effective action against E. faecalis biofilm, followed by 5% NaOCl, 1% Ag Np, 26% ZnO Np, and 1% NaOCl. CONCLUSIONS:: 1% Ag Np and 26% ZnO Np were effective against E. faecalis biofilm similarly to conventional endodontic irrigants.

A atuação do odontolegista do Instituto Médico Legal de Florianópolis (SC) no processo de identificação Post Mortem / The forensic dentistry action in the Legal Medical Institute Of Florianópolis (SC) in the process of Post Mortem indentification

O objetivo deste estudo foi avaliar a atuação do odontolegista no processo de identificação post mortem do Instituto Médico Legal da cidade de Florianópolis, SC. Para tanto, foi realizada uma análise retrospectiva dos casos de identificação post mortem registrados no Instituto Médico Legal no período de 2005 a 2014. Destes, foram selecionados apenas os laudos periciais de identificação post mortem odontológicos. Foram avaliados 6.511 laudos: os quais 26 foram laudos de identificação post mortem realizados pelo odontolegista. Dentre os 26 laudos, 13 casos foram identificados, sendo que 7 (53,84%) por meio do prontuário odontológico da vítima, 4 (30,76%) por prontuário e exame radiográfico, 1 (7,1%) por prontuário/registro de mordida e placa de acrílico e 1 (7,1%) por foto extrabucal. Os outros 13 casos resultaram em não identificação, pois 12 (46,2%) casos não apresentaram prontuário e em 1 (3,8%) caso houve o incompleto preenchimento do prontuário odontológico, resultando na impossibilidade de identificação dos cadáveres. Conclui-se que a atuação do odontolegista no processo de identificação post mortem no IML Florianópolis forneceu informações eficazes para a identificação de 13 casos em 9 anos e que o método de comparação de prontuário odontológico ante e post mortem foi o mais utilizado nas identificações

The purpose of this study is to evaluate the acting of the forensic dentist in the process of the post mortem iden-tification in the National Legal Medicine Institute of Florianópolis, SC. For this matter, a retrospective analysis of post mortem cases identification registered in the National Legal Medicine Institute of Florianópolis, in the period of 2005 to 2014, was done. From these, were selected only the expert reports of odontological post mortem identification. 6.511 expert report were evaluated, though 26 was post mortem identification reports made by the forensic dentist. Among the 26 reports, 13 cases were identified of which 7 (53,84%) through dental records of the victim, 4 (30,76%) mecial record and radiographic examination, 1 (7,1%) record/bite registration material and acrylic plate, and 1 (7,1%) by extraoral photo. The other 13 cases were resulted in no identification, for 12 (46,2%) cases did not present records and in 1 (3,8%) case there was the incomplete filling of the odontological record, resulting in the impossibility of the identification of the corpses. In conclu¬sion, the acting of the forensic dentist in the process of the post mortem identification in the National Legal Medicine Institute of Florianópolis provided effective informations to an identification of 13 cases in 9 years that the method of comparison of the ondontological record ante mortem and post mortem was the most used in the identifications

Florid Cemento-osseous Dysplasia: A Case of Misdiagnosis.

Florid cemento-osseous dysplasia (FCOD) belongs to the group of fibro-osseous lesions in which normal bone is replaced by fibrous connective tissue and calcified cementum tissue of the avascular type. Among the various types of fibro-osseous lesions, FCOD is one of the most commonly encountered diseases in clinical practice and may involve 3 or 4 of the quadrants. FCOD is located in the periapical regions of teeth, and the lesions are predominantly radiolucent (osteolytic phase), become mixed over time (cementoblast phase), and ultimately become radiopaque (osteogenic phase) with a thin radiolucent peripheral halo. The characteristics of FCOD in the initial stages are similar to those of periapical lesions of inflammatory origin, which may lead to misdiagnosis. A 38-year-old woman sought dental care because of complaints of pain on the right side of her face. A clinical examination revealed no marked alterations; a panoramic radiograph was therefore requested and revealed the presence of radiolucent lesions associated with the periapical regions of some of the lower teeth. Thus, the professional referred the patient for endodontic treatment of the associated teeth with the justification that the lesions were of endodontic origin. However, the endodontist found that the teeth responded positively to a sensitivity test. The initial diagnosis could have resulted in unnecessary root canal treatment, but after careful clinical, radiographic, and tomographic assessments by different professionals, FCOD was diagnosed, conservatively treated, and regularly monitored. It is important that dentists have a basic knowledge of the various injuries that affect the jaw bones to prevent errors in diagnosis and treatment and to promote oral health.

The properties of chlorhexidine and undesired effects of its use in endodontics.

OBJECTIVE: The purpose of this article was to review the literature on the properties of chlorhexidine (CHX) and the adverse effects that may occur from its use in endodontics. In addition, adverse effects that may result from its use, such as dark staining of teeth, chemical interaction with sodium hypochlorite and formed flocculate, biologic hazards, and interactions with the filling material were evaluated. DATA SOURCES: Relevant publications on the use CHX in endodontics were thoroughly reviewed from the literature published between the years 2007 and 2014. METHOD AND MATERIALS: The authors conducted an electronic search using the English language databases Medline and PubMed. RESULTS: According to the reviewed studies, it was concluded that CHX has proven antimicrobial activity, excellent substantivity, low surface tension, and low cytotoxicity and genotoxicity that depend on the dose and exposed area. There is scientific evidence showing the possibility of tooth staining and formation of brown precipitate when its use is associated with sodium hypochlorite. On the other hand, it is not well established that its use interferes with the quality of endodontic fillings. With respect to the biologic risks, the degradation of CHX may generate para-chloroaniline and free radicals, which are harmful to the vital tissues. There is no established consensus on the potential risk of CHX. CONCLUSION: The final considerations of this review will encourage researchers to seek scientific evidence demonstrating the safety of the use and applicability of CHX in endodontic therapy.

Tratamento do biofilme intracanal de Enterococcus faecalis com suspensões de diferentes nanopartículas e irrigantes convencionais / Treatment of the Enterococcus faecalis root canal biofilm with nanoparticle suspensions and conventional irrigants

Objetivo: O objetivo deste estudo foi avaliar e comparar a efetividade das soluções de hipoclorito de sódio (NaOCl) 1% e 5%, clorexidina (CHX) 2%, suspensões de nanopartículas de prata (Np Ag) 1% e nanopartículas de óxido de zinco (Np ZnO) 26% contra o biofilme de E. faecalis. Material e Métodos: Setenta e seis dentes humanos unirradiculados foram modelados, montados em um aparato específico e esterilizados. Após, 100 μL de uma suspensão de E. faecalis foi inserida nos canais, sendo renovada diariamente por 7 dias. Quatro segmentos radiculares foram analisados por meio de microscopia eletrônica de varredura (MEV) para confirmar a presença do biofilme. Os segmentos radiculares remanescentes foram divididos aleatoriamente em 6 grupos (n = 12), de acordo com a solução irrigadora empregada: G1) solução salina 0,85% (controle); G2) NaOCl 1%; G3) NaOCl 5%; G4) CHX 2%; G5) suspensão de Np Ag 1%; e G6) suspensão de Np ZnO 26%. Concluída a irrigação, a susceptibilidade do biofilme às soluções irrigadoras (n = 10) foi determinada pelo método de plaqueamento e contagem de unidades formadoras de colônias (UFC). Uma análise por meio de MEV foi conduzida em 2 segmentos de cada grupo para visualização da estrutura do biofilme. O conjunto de dados, representados pelos valores médios de UFC para cada grupo, foi analisado estatisticamente pelos testes Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: A efetividade das soluções de NaOCl 5% e Np Ag 1% contra o biofilme intracanal de E. faecalis foi superior comparada à solução salina 0,85% (p < 0,05). NaOCl 5% reduziu 100% das UFC comparado ao grupo controle, seguido pela suspensão de Np Ag 1% (97,6%), Np ZnO 26% (96,1%), NaOCl 1% (94,1%) e CHX 2% (93,1%). Conclusão: Com base na metodologia aplicada, as soluções de NaOCl 5% e Np Ag 1% apresentaram excelente efetividade contra o biofilme de E. faecalis estabelecido no canal radicular...