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.

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.

Recommendations for Managing Endodontic Emergencies during Coronavirus Disease 2019 Outbreak.

INTRODUCTION: The management of endodontic emergencies has been particularly challenging during the coronavirus disease 2019 (COVID-19) outbreak because of the possible generation of airborne particles and aerosols. The aim of this report was to contribute to the practice of endodontics by proposing a general protocol for the management of emergencies showing the rationale for remote diagnosis, clinical procedures, and the use of personal protective equipment and barriers at the dental office during the COVID-19 outbreak. METHODS: A review of the literature was conducted up to May 2020 on relevant institutional sites, aiming to retrieve the best updated evidence. The reporting considered the Reporting Tool for Practice Guidelines in Health Care statement. RESULTS: Recommendations from Cochrane Oral Health, the American Dental Association, and the Centers for Disease Control and Prevention were included along with the American Association of Endodontists resources and scientific articles that addressed the issue. CONCLUSIONS: The proposed protocol could contribute to the management of endodontic emergencies at the dental office during the COVID-19 outbreak.