Endodontic treatment as a Reduction in the Risk of infective Endocarditis in a Male Patient with Eisenmenger Syndrome

This case report aimed to describe the importance of endodontic treatment in reducing infectious foci in patients with Eisenmenger syndrome (ES) and describe the characteristics of ES, so that the endodontist can safely treat these patients. A 57-year-old male with ES sought dental care complaining of dental pain. Irreversible pulpitis was diagnosed in tooth 37 and pulp necrosis in teeth 36, 34 and 31. Tests of prothrombin time (PT), activated partial thromboblastin time (APTT) and international normalized ratio (INR) were prescribed to evaluate the profile of coagulation using Marevan and antibiotic prophylaxis with amoxicillin. The endodontic treatments were performed. At the end, the patient reported no pain or discomfort in the teeth and improved masticatory function. The removal of oral infectious foci in patients with ES is important to reduce the risk of IE, which could seriously compromise the health and overall prognosis of the patient.

Este reporte de caso tuvo como objetivo describir la importancia del tratamiento endodóntico en la reducción de focos infecciosos en pacientes con síndrome de Eisenmenger (SE) y describir las características del SE, para que el endodoncista pueda tratar con seguridad a estos pacientes. Un hombre de 57 años con ES buscó atención dental quejándose de dolor dental. Se diagnosticó pulpitis irreversible en el diente 37 y necrosis pulpar en los dientes 36, 34 y 31. Se solicitaron pruebas de tiempo de protrombina (PT), tiempo de tromboblastina parcial activada (TTPA) y índice internacional normalizado (INR) para evaluar el perfil de coagulación utilizando Marevan y profilaxis antibiótica con amoxicilina. Se realizaron los tratamientos de endodoncia. Al final, el paciente no refirió dolor ni molestias en los dientes y mejoró la función masticatoria. La eliminación de focos infecciosos orales en pacientes con ES es importante para reducir el riesgo de EI, que podría comprometer gravemente la salud y el pronóstico general del paciente.

Effect of different activation methods on the intratubular penetration of CaOH2 paste: Ex-vivo analysis by confocal laser scanning microscopy.

The aim of this study was to evaluate the maximum penetration depth (MPD) and penetration area (PA) of CaOH2 paste agitated by different methods and to measure the pH after performing these methods. Fifty-five mandibular premolars were divided into control, GL and 4 experimental groups, GEC, GXP, GEDDY and GI (n = 11), where the paste was agitated with Easy Clean, XP-endo Finisher, EDDY and Irrisonic, respectively. The canals were instrumented and irrigated with NaOCl. The paste was manipulated with propylene glycol and rhodamine B dye. Root sections were examined using confocal laser scanning microscopy. There was no difference between groups regarding PA (p > 0.05). At 5 mm, MPD was greater in GEC than in GL or GEDDY, and greater in GI than in GL (p < 0.05). At 2 mm, MPD was greater in GEC than in the other groups (p < 0.05). In conclusion, both Easy Clean and Irrisonic promoted deeper paste penetration and were associated with higher pH levels.

Penetrability of a new endodontic sealer: A confocal laser scanning microscopy evaluation.

This study aimed to evaluate the penetration of a new endodontic sealer into the dentinal tubules. Twenty single-rooted teeth were selected. The crown was sectioned, and the canals were instrumented with a reciprocating system. Irrigation was performed with 2 mL of 2.5% sodium hypochlorite between each file change. After instrumentation, the root canals were irrigated with 2 mL of17% EDTA for 3 min followed by saline solution. The specimens were randomized into two groups (n =10) according to the endodontic sealer: AH Plus (AP) or Sealer Plus (SP). All specimens were filled using the lateral compaction technique. Rhodamine B dye (red) was incorporated to the sealers to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. The roots were sectioned 2, 4, and 6 mm from the apex and assessed by CLSM. The root canal level affected the penetration of the sealer, but no statistical significant differences were found between the two experimental groups (p > .05). SP presented similar dentinal penetration and perimeter integrity to the gold standard (AP). RESEARCH HIGHLIGHTS: Sealer Plus presents dentinal penetrability and perimeter integrity similar to the gold standard sealer (AH Plus), demonstrating excellent ability of filling areas of difficult access.