Health changes during Covid-19: a nationwide study with dental students.

OBJECTIVE: To assess the changes in stress levels, social behavior, dietary and parafunctional habits, oral hygiene, among other conditions perceived by dental students in Brazil during the Covid-19 pandemic and evaluated the correlations between stress level and other variables. METHODS: An online questionnaire was developed and validated. Undergraduates enrolled in private and public dental schools were recruited by convenience sampling. Data were collected on the perceived changes regarding stress levels, financial and social characteristics, dietary habits, oral hygiene, health conditions, and parafunctional habits. Quantitative variables were expressed as absolute and relative frequencies. Wilcoxon test evaluated comparisons between perceived changes, and correlations between changes in stress levels and other variables were analyzed by Spearman correlation (α = 0.05). RESULTS: A total of 638 dental students, mean age of 22.95 ± 4.10 years, participated in the study. During the pandemic, the reported stress levels increased while household income decreased (p < 0.05). Late dinners and mindless eating increased in frequency, whereas oral hygiene decreased (p < 0.05). Most of the health conditions and parafunctional habits assessed changed (p < 0.05). Perceived stress levels showed poor negative correlations with household income (rS = -0.14), poor positive correlations with the pressure to contribute financially in the household (rS = 0.19), and poor positive correlations with food choice frequency (rS = 0.15) (p < 0.05). CONCLUSIONS: Dental students reported perceived changes in stress levels, dietary habits, oral hygiene, health conditions, parafunctional habits, and social behavior. Moreover, the results showed poor correlations, as students with higher stress levels tended to have the lowest household income, feel pressured to contribute financially in the household, and present a high meal intake frequency.

XP-endo Finisher effectively reduces hard-tissue debris accumulated in root canals with isthmus after preparation with a reciprocating file system.

This study compared the accumulated hard-tissue debris (AHTD) after preparation with WaveOne Gold (WOG) to XP-endo Shaper (XPS), without and with a supplementary step using XP-endo Finisher (XPF) using clinically applicable irrigation. Twenty-four mesial roots with two canals and single foramen were micro-CT-scanned and matched. Scans were also taken after preparation with WOG or XPS, and after XPF. Irrigation with 2.5% NaOCl (total: 17 ml per canal) and 17% EDTA (2.5 ml per canal) was performed using a 30ga Max-I-Probe needle placed up to the working length. Morphological parameters were calculated and compared within and among groups. XPF significantly reduced unprepared area within XPS and WOG groups, and AHTD within WOG (p < 0.05). There were no significant differences between WOG and XPS after preparation and after XPF (p > 0.05). In conclusion, WOG and XPS produced a similar volume of AHTD, but the supplementary step with XPF decreased the AHTD in the WOG group.

Health changes during Covid-19: a nationwide study with dental students

ABSTRACT OBJECTIVE To assess the changes in stress levels, social behavior, dietary and parafunctional habits, oral hygiene, among other conditions perceived by dental students in Brazil during the Covid-19 pandemic and evaluated the correlations between stress level and other variables. METHODS An online questionnaire was developed and validated. Undergraduates enrolled in private and public dental schools were recruited by convenience sampling. Data were collected on the perceived changes regarding stress levels, financial and social characteristics, dietary habits, oral hygiene, health conditions, and parafunctional habits. Quantitative variables were expressed as absolute and relative frequencies. Wilcoxon test evaluated comparisons between perceived changes, and correlations between changes in stress levels and other variables were analyzed by Spearman correlation (α = 0.05). RESULTS A total of 638 dental students, mean age of 22.95 ± 4.10 years, participated in the study. During the pandemic, the reported stress levels increased while household income decreased (p < 0.05). Late dinners and mindless eating increased in frequency, whereas oral hygiene decreased (p < 0.05). Most of the health conditions and parafunctional habits assessed changed (p < 0.05). Perceived stress levels showed poor negative correlations with household income (rS = −0.14), poor positive correlations with the pressure to contribute financially in the household (rS = 0.19), and poor positive correlations with food choice frequency (rS = 0.15) (p < 0.05). CONCLUSIONS Dental students reported perceived changes in stress levels, dietary habits, oral hygiene, health conditions, parafunctional habits, and social behavior. Moreover, the results showed poor correlations, as students with higher stress levels tended to have the lowest household income, feel pressured to contribute financially in the household, and present a high meal intake frequency.

Micro-Computed Tomographic Analysis of the Shaping Ability of XP-Endo Shaper in Oval-Shaped Distal Root Canals of Mandibular Molars.

OBJECTIVE: To compare the shaping ability of the XP-endo Shaper (XPS) system to the ProTaper Next (PTN) system in oval-shaped distal root canals. METHODS: From 12 mandibular molars, distal roots with moderately curved single oval canals were randomly assorted to be instrumented with XPS (experimental group) or PTN (control group) and then scanned using micro-computed tomography [Scan 1]. The root canals of the XPS samples were prepared following the manufacturer's instructions using 15 insertions (XPS15) and rescanned [Scan 2]. An additional 10 insertions to the working length were applied, totalling 25 insertions (XPS25), and the roots were rescanned again [Scan 3]. PTN samples were prepared up to the X3 instrument (PTNX3) and rescanned [Scan 2]. The dentine removed and the unprepared areas were assessed. Data were analysed using a t-test with significance at α=0.05. RESULTS: XPS25 was associated with a significantly greater dentine removal than XPS15 over the entire root canal length and in all three-thirds of the root canal (P<0.05). XPS25 significantly removed more dentine than PTNX3 in only the coronal third (P<0.05). XPS25 was also associated with a significantly smaller percentage of unprepared areas than XPS15 overall and in the coronal third (P<0.05). PTNX3 was associated with a significantly larger percentage of unprepared areas than XPS15 and XPS25 overall and in the coronal and middle thirds (P<0.05). CONCLUSION: Ten additional movements with XPS significantly improved instrumentation capacity, reducing the percentage of untouched surface areas but also removing more dentine.

The shaping ability of WaveOne Gold, TRUShape and XP-endo Shaper systems in oval-shaped distal canals of mandibular molars: A microcomputed tomographic analysis.

AIM: To compare the shaping ability of a heat-treated centric reciprocating file system (WaveOne Gold), a heat-treated eccentric rotary multifile system (TRUShape 3D Conforming Files), and a heat-treated expandable one-file rotary system (XP-endo Shaper) extending its activation time, in preparing oval-shaped root canals in extracted mandibular molars by means of microcomputed tomography (micro-CT) analysis. METHODOLOGY: Thirty moderately curved oval-shaped distal roots of mandibular molars were selected. The normality of canal length, curvature angle, volume, surface area, structure model index, and aspect ratio were confirmed. The samples were randomly divided into three groups (n = 10). Micro-CT scans were taken before and after canals were instrumented using WaveOne Gold (size 35, .06 taper), or TRUShape (size 30, .06v taper), both following the manufacturer's instructions, or XP-endo Shaper following a new protocol with extended activation time. The mechanical preparation time for each sample was recorded. Pre- and postoperative images were analysed for the percentage of unprepared canal areas and the percentage of removed dentine. Data were compared between groups using the statistical analyses one-way ANOVA and Tukey tests (p < .05). RESULTS: The percentage of unprepared canal areas was significantly higher with WaveOne Gold (% 11.5 ± 4.0) and TRUShape (% 12.4 ± 5.8) compared with XP-endo Shaper (% 5.2 ± 2.6) (p < .05). XP-endo Shaper removed significantly more dentine (3.3 ± 1.5 mm3 ) than WaveOne Gold (1.8 ± 0.8 mm3 ) and TRUShape (1.9 ± 0.8 mm3 ) (p < .05). No significant differences were seen for mechanical preparation time between WaveOne Gold (79 ± 31 s), TRUShape (104 ± 41 s) and XP-endo Shaper (71 ± 23 s) (p > .05). CONCLUSIONS: The comparison of three recognized root canal filing systems has shown that with similar preparation times, the XP-endo Shaper removed more dentine (mm3 ) leaving less unprepared canal wall area (%) than WaveOne Gold and TRUShape when preparing oval-shaped root canals of extracted mandibular molars.

Canal transportation and centering ratio after preparation in severely curved canals: analysis by micro-computed tomography and double-digital radiography.

OBJECTIVES: This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation. MATERIALS AND METHODS: Mesial root canals of mandibular molars with severe curvature (25-70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%). RESULTS: The micro-CT method showed that XPS's shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023). CONCLUSIONS: Micro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups. CLINICAL RELEVANCE: Root canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.

Ability of two single-step restorative materials to avoid crown darkening caused by intracanal minocycline paste.

OBJECTIVES: This study aimed to quantitatively assess the ability of two single-step restorative materials to avoid crown darkening caused by the use of minocycline as an intracanal medicament. MATERIALS AND METHODS: After coronal access and instrumentation, 120 maxillary incisors were divided into four groups (n = 30). Two experimental groups according to the restorative material applied to the inner walls of the access cavity: OB, OptiBond All-In-One + minocycline intracanal paste; U200, RelyX U200 + minocycline intracanal paste. Two control groups without restorative materials: MIN, minocycline intracanal paste and SL, saline intracanal. Color determination was performed using a spectrophotometer at five time points, immediately after materials were applied (baseline), and at 7, 14, 21, and 28 days from the baseline. RESULTS: Decrease in the mean values of L* (luminosity) was observed after insertion of minocycline paste in all groups at all time points. Statistically significant differences were absent between the time points (P > .05). After 28 days, MIN showed significantly more darkening (ΔL*) (- 10.6 ± 7.3) than OB (- 5.4 ± 6.2), U200 (- 5.8 ± 3.9) and SL (- 2.3 ± 1.2) (P < .05). CONCLUSIONS: Crown darkening can be minimized by the previous application of RelyX U200 or OptiBond All-In-One to the inner walls of the access cavity before a minocycline-containing paste is applied as an intracanal medication. CLINICAL RELEVANCE: The American Association of Endodontists Clinical Considerations for Regenerative Procedures in necrotic immature teeth suggests the triple antibiotic paste as an intracanal medication (2018). However, discoloration and crown darkening are common unfavorable outcomes. The clinical protocol suggested in this paper has shown to be able to minimize crown darkening, predictably leading to a better patient-centered clinical success.

Utilização de materiais restauradores autocondicionantes na prevenção de descoloração coronária causada por minociclina / Use of self-etching restorative materials to prevent crown discoloration caused by minocycline

O objetivo desse estudo foi comparar a capacidade de dois materiais restauradores em prevenir a descoloração coronária causada pela minociclina como medicação intracanal e propor uma técnica de fácil implementação para encorajar o uso da pasta tri-antibiótica para desinfecção do sistema de canais radiculares durante procedimentos de regeneração pulpar sem perda estética. Cem dentes foram selecionados, seus canais radiculares foram instrumentados e divididos em quatro grupos de acordo com o tratamento dentinário utilizado: Grupo OB- Agente adesivo OptiBond All-In-One (KERR); Grupo U200- Cimento resinoso auto-condicionante e auto adesivo RelyX U200 (3M ESPE); Grupo MIN- Sem revestimento; Grupo CN- Sem revestimento (controle negativo). Em todos os grupos, com exceção do CN, foi utilizada pasta de minociclina como medicação intracanal coberta por uma bolinha de algodão e vedados com restauração provisória. As medições de cor foram realizadas com um espectrofotômetro no início do estudo (T0), e 7(T7), 14 (T14), 21 (T21) e 28 dias (T28) pós-minociclina. Os resultados obtidos foram submetidos à análise estatística. As diferenças de cor (∆E*) foram crescentes nos grupos CN, OB, U200 e MIN, respectivamente. A diferença de luminosidade (∆L*) foi também crescente nos grupos CN, OB, U200 e MIN, respectivamente. Houve diferença significante entre os grupos MIN e CN, e entre os grupos MIN e U200 (p<0,05). O eixo amarelo-azul (∆b*) não apresentou alteração de cor significante (p>0,05). Uma alteração de cor significante no eixo vermelho-verde (∆a*) foi observada no grupo MIN em relação ao grupo CN (p<0,05). Portanto, conclui-se que a técnica foi fácil de ser implementada, ambos materiais reduziram a descoloração da coroa causada pela pasta de minociclina mas foram ineficazes em impedi-la completamente.

The aim of this work was to assess the ability of two restorative materials to prevent crown discoloration caused by topic use of minocycline as an intracanal medicament and to propose an easy to implement technique to encourage the use of the tri-antibiotic paste to disinfect the root canal system during pulp regeneration procedures without aesthetic depletion. One hundred teeth were divided into four groups after access and instrumentation by the dentinary treatment: Group OB- Self etching bonding agent OptiBond All-In-One (KERR); Group U200- Self etching resin cement RelyX U200 (3M ESPE); Group MIN- Without restorative material; Group CN- Without restorative material. All groups, except CN, received minocycline as intracanal medicament covered by cotton pellet and sealed with provisional restoration. Color determination were performed with an spectrophotometer at the beginning of the study (T0), 7 days (T7), 14 days (T14), 21 days (T21) and 28 days (T28) after intracanal placement of the minocycline paste. The results were statistically analyzed. Overall color difference (∆E*) increased from Grupo CN, Grupo OB, Grupo U200 and Grupo MIN respectively. There was significant difference between groups MIN and CN, and between groups MIN and U200 (p<0,05). Luminosity difference (∆L*) increased from Groupo CN, Groupo OB, Grupo U200 and Grupo MIN respectively. There was significant difference between groups CN and MIN, between groups MIN and OB, and between groups MIN and U200 (p<0,05). Color variance in the blue-yellow axis (∆b*) showed no statistical difference (p>0,05). Color variance in the red-green axis (∆a*) was significant between groups MIN and CN (p<0,05). We concluded that the technique was indeed easy to implement, both materials reduced the crown discoloration caused by the minocycline paste but were unable to prevent it completely.

Avulsion of permanent teeth with open apex: a systematic review of the literature

Introduction: Considered the most serious of dental injuries, avulsion is known as the total displacement of tooth out of its socket. Treatment includes immediate replantation and its success is directly related to several factors. Objective: This paper aimed to review the literature in a systematic way on dental avulsion of permanent teeth with open apex, covering various topics such as: reason for avulsion; storage media; time out of the socket; use of antibiotics; splinting time; tooth vitality; presence of resorption and/or obliteration of pulp canal; and following-up time. Material and methods: PubMed/MedLine database and Dental Traumatology journal were searched, from May to June of 2011, and several studies comprising the current and classic literature were listed using the following terms: tooth avulsion, open apex, permanent and case report. Results and conclusion: Twelve cases reports were selected. Cases of dental trauma in open apex teeth may have a good prognosis if the following steps are taken: the hydration of the tooth and immediately replantation. It is important to search dental care, even if everything seems solved, and the tooth following-up should be performed periodically as informed by the dentist.

Análise radiográfica do tratamento endodôntico clínico da FOUERJ / Radiographic analysis of endodontic treatment of FOUERJ

O exame radiográfico nos permite obter dados importantes da qualidade da obturação e da instrumentação. O índice de sucesso e insucesso pode ser determinado pela radiografia, embora esse exame seja limitado. O objetivo deste trabalho foi avaliar os tratamentos endodônticos realizados por acadêmicos na FOUERJ e a ausência de lesão periapical dos casos em questão. Foram analisadas 1175 radiografias periapicais e observou-se que 65,9% dos pacientes atendidos eram do sexo feminino; 60,1% dos canais radiculares apresentavam obturação 1 a 2mm aquém do ápice radiográfico; 58,5% dos dentes apresentavam adaptação e preenchimento do material obturador satisfatório; 44,6% dos dentes não apresentavam rarefação óssea

The radiographic examination allows us to obtain important data on the quality of the filling and instrumentation. The rate of success and failure can be determined by radiography, although the examination is limited. The aim of this study was to evaluate root canal treatments carried out by academics at FOUERJ and the absence of periapical lesion of the cases in question. 1175 periapical radiographs were analyzed and was observed that 65.9% of patients seen were female, 60.1% had root canal fillings 1 to 2 mm short of the radiographic apex, 58.5% of teeth showed adaptation and satisfactory completion of the filling material, 44.6% of teeth did not showed bone rarefaction

Efeito antibacteriano dos lasers e terapia fotodinâmica contra Enterococcus faecalis no sistema de canais radiculares / Antibacterial effect of the lasers and photodynamic therapy against Enterococcus faecalis in the root canal system

O preparo químico-mecânico (PQM) é crucial para o sucesso do tratamento endodôntico. Neste sentido, metodologias são desenvolvidas a fim de garantir a máxima desinfecção do sistema de canais radiculares. Assim, o objetivo desta revisão de literatura foi avaliar a capacidade dos lasers e da terapia fotodinâmica (PDT) em eliminar o Enterococcus faecalis, fortemente associado ao fracasso da terapia endodôntica. A busca pelos artigos foi realizada de duas formas: por meio dos guias de estudo on line do Journal of Endodontics e por meio das bases de dados: BBO, PUBMED/MEDLINE e OVID. Paralelamente, foi realizada busca cruzada, considerando as referências bibliográficas dos artigos selecionados. Os critérios de inclusão foram: a) os períodos de tempo entre abril de 2000 e fevereiro de 2010; b) artigos que avaliassem o efeito antimicrobiano dos lasers e PDT sobre o E. faecalis. Após a leitura completa dos artigos selecionados, incluíram-se: 15 artigos que avaliaram a capacidade antibacteriana do laser, 10 artigos relativos à PDT e 5 artigos que compararam o laser e a PDT. Baseado nesta revisão, concluiu-se que nenhuma das duas técnicas foi 100% eficaz contra o E. faecalis, mas que foram capazes de reduzir sua presença; a PDT se mostrou aparentemente mais eficaz que o laser no controle desta infecção. Desta forma, as terapias podem ser consideradas aliadas promissoras ao tratamento convencional no controle da infecção endodôntica por E. faecalis, caracterizando-se como terapias complementares.

The chemomechanical disinfection is crucial to the success of endodontic treatment. In this regard, methodologies are developed to ensure maximum disinfection of root canal system. The objective of this literature review was to evaluate the ability of lasers and photodynamic therapy (PDT) in eliminating Enterococcus faecalis, which is strongly associated with failure of endodontic therapy. The search for articles was performed in two ways: through the online study guides in the Journal of Endodontics and, through databases: BBO, PubMed/MEDLINE and OVID. In parallel, we performed cross-searching, given the references of selected articles. Inclusion criteria were: a) the time periods between April 2000 and February 2010; b) articles that evaluate antimicrobial effect of lasers and PDT on E. faecalis. After a complete reading of selected articles, were included: 15 articles that evaluated the antibacterial capacity of the laser, 10 of PDT and 5 that compared laser and PDT. Based on this review, concluded that: neither of the two techniques was 100% effective against E. faecalis, but were able to reduce their presence; PDT apparently showed more effective than laser in controlling this infection. Thus, therapies can be considered promising allied to conventional treatment in the control of endodontic infection by E. faecalis, which is characterized as complementary therapies.