Antimicrobial Activity on Streptococcus mutans and Enterococcus faecalis of Cyperus articulatus Ethanolic Extracts.

Oral diseases are one of the biggest public health problems worldwide, caused by opportunistic pathogens such as Streptococcus mutans and Enterococcus faecalis. Cyperus articulatus (priprioca) is a plant conventionally used in traditional medicine in the Amazon region. However, little is known about the possible dentistry-related uses of extracts from the rhizomes and solid waste generated by the extraction of essential oils from this vegetable. This study aimed to investigate the chemical composition of volatile compounds and antimicrobial activity through the Minimum Inhibitory Concentration test (MIC and assessment of the toxicity by Hens Egg Test-Chorion Allantoic Membrane (HET-CAM) of the ethanolic extracts from Cyperus articulatus intact rhizomes and solid waste. We identified sesquiterpenes as the main constituents, strong antimicrobial activity of the ethanolic extract of intact rhizomes against S. mutans (MIC = 0.29 mg/mL), moderate antimicrobial activity against E. faecalis of the extract obtained from the solid waste (MIC = 1.17 mg/mL), and absence of toxicity for both tested extracts. The absence of irritation and the antibacterial activity of the ethanolic extract from C. articulatus rhizomes and solid waste reveal its potential for use in the alternative control of bacteria that cause oral infections and may present economic viability as a raw material for dental products.

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.

The impact of endodontic irrigating solutions on the push-out shear bond strength of glass fiber posts luted with resin cements.

Resin-based restorative materials, widely used to cement posts, may be influenced by irrigants used during endodontic chemical-mechanical preparation. This study evaluated the impact of endodontic irrigating solutions and adhesive cement systems on the push-out shear bond strength of glass fiber posts to root dentin. Ninety-six bovine incisors were divided into 12 groups (4 irrigants × 3 resin cements; n = 8). Prepared canals were irrigated with saline solution, 2.5% sodium hypochlorite (NaOCl), 5.25% NaOCl, or 2% chlorhexidine gel, and posts were cemented with RelyX ARC, Panavia F, or RelyX U100. The bond strength was evaluated by means of the push-out test, and results were subjected to analysis of variance. The mean bond strength observed for the combination of 5.25% NaOCl irrigant and RelyX U100 cement was significantly lower (8.82 MPa) than the values found for the other groups (P < 0.05). The other combinations of irrigating solution and resin cement had no adverse effect on the bond strength of the glass fiber posts to dentin.

Radix entomolaris - A case report

Introduction: A comprehensive knowledge on the root canal anatomy is a basic prerequisite for the endodontic treatment successful. Mandibular molars may have an additional root located lingually (radix entomolaris) or buccally (radix paramolaris). In the literature, this anatomy variation is considered rare in Caucasian populations. Awareness and understanding of the presence of unusual external and internal root canal morphology contributes to the successful outcome of the root canal treatment. Objective and case report: The purpose of this study was to report a clinical case of successful endodontic treatment in a mandibular molar with pulp necrosis and characterized as radix entomolaris in which the use of magnification and ultrasonic tips (the “microsonics concept”) was fundamental to the management of the variations in the internal anatomy. Conclusion: A better understanding of the root canal morphology is essential for endodontic treatment success, as well as the use of technologic advancements in Endodontics including computed tomography, ultrasonic tips and the operating microscope.

The importance of microsonics concept for optimization of endodontic retreatment outcome: a case report

Introduction: During the past few decades, the endodontic treatment has benefited from the development of new techniques and devices, which have improved the outcome and predictability. Important attributes such as the operating microscope and ultrasonics have found indispensable applications in a number of dental procedures in endodontics. Objective and case report: This study describes a case of endodontic retreatment of a maxillary first molar in which the second mesiobuccal canal could be located by extending the access to the mesial direction further than usual and by a closer inspection of the pulp chamber floor. Conclusion: The "microsonics concept" has enhanced the quality of endodontic treatment and retreatment, becoming increasingly more useful in applications such as localization of root canal orifices.

Assessment of the antibacterial activity of calcium hydroxide combined with chlorhexidine paste and other intracanal medications against bacterial pathogens.

OBJECTIVES: The purpose of this study was to assess the in vitro antibacterial activity of four formulations of calcium hydroxide [Ca(OH)(2)] pastes against Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus mutans. METHODS: A broth dilution test was performed, and the lengths of time for different pastes to kill the microbial cells were recorded and statistically analyzed. The following medications were assessed: Group I - Ca(OH)(2) + 2.0% chlorhexidine (CHX) gel; Group II - Ca(OH)(2) + camphorated paramonochlorophenol (CMCP) and propylene glycol; Group III - Ca(OH)(2) + propylene glycol; Group IV - Ca(OH)(2) + saline. RESULTS: The results showed that E. faecalis was the most resistant microorganism. Groups II and III eliminated all the microbial cells in 15 seconds. Group I took 45 seconds to eliminate E. faecalis. CONCLUSIONS: Under the conditions of this study, it was concluded that all the intracanal medications tested showed antibacterial activity. However, the association of Ca(OH)(2) and PMCC or Ca(OH)(2) and propylene glycol showed a better performance, since Groups II and III took a shorter length of time than the other groups to eliminate S. aureus and E. faecalis.

Avaliação em microscopia eletrônica de varredura da penetração intratubular de diferentes cimentos endodônticos / Depth penetratian af roat canal sealers inta dentinal tubules: a scanning electron microscapic study

A penetração intratubular dos cimentos é importante como forma de promover uma retenção micromecânica da obturação endodôntica à parede dentinária e, dessa forma, melhorar o vedamento desta. Sendo assim, o objetivo deste estudo foi avaliar a capacidade de escoamento intratubular den- tinária de diferentes cimentos endodônticos nos três terços radiculares. Um total de 50 dentes" an- teriores superiores humanos foram preparados, instrumentados e divididos aleatoriamente em cinco grupos, para serem obturados com os cimentos: RealSeal® (GRS), EndoReZ® (GER), AH-PluS™ (GAH), Sealapex' (GSL) e N-Rickert® (GNR), através da técnica de condensação lateral ativa. Após 30 dias armazenados em estufa, os dentes foram clivados, desidratados, metalizados e analisados em Micros- copia Eletrônica de Varredura quanto à profundidade de penetração intratubular dentinária nos três terços radiculares, cervical (C), médio (M) e apical (A). Os resultados mostraram que, independente do terço radicular, GRS obteve níveis estatisticamente maiores (teste ANOVA/Bonferroni, p< 0.05) de penetração intratubular frente aos outros grupos (C- 533,9~m; M- 300,7~m; A- 80,7~m). O GAH (C- 412,2~m; M- 215,4~m A- 43,8~m) é significativamente diferente dos grupos GER (C- 176,3~m; M- 91,7~m; A- 17,6~m), GSL (C- 231,4~m; M- 100,6~m; A- 19,9~m) e GNR (C- 132,4~m; M- 52~m; A- 9~m), que não possuem diferença estatística entre si. Conclui-se que os cimentos resinosos, Real Seal® e AH-PluS™, possuem uma melhor capacidade de escoamento intratubular na dentína quando comparados a outros cimentos testados nesse estudo.

The sealer penetration into the dentinal tubules is important to provide a micromechanical adhesion of sealer cements to dentin and improve the sealing of endodontic obturation. The purpose of this study was to evaluate the penetration of root canal sealers into dentinal tubules in coronal (C), middle (M) and apical thirds (A). Fifty extracted human maxiliary anterior teeth were decoronated, instrumented, and randomly divided in five groups and obturatede with : Real Seal® (GRS), EndoReZ® (GERl, AH-PluS™ (GAH), Sealapex' (GSL) and N-Rickert® (GNR) by lateral condensation. The specimens were stored in 100% relative humiditiy at 3rC for 30 days. After this period, were longitudinally split and prepared for scanning electron microscopy. The focus of observation was the interface between the dentin and the sealing material, the deep penetrationof sealers was measured in three thirds. The results showed GRS was significantly bether than others groups independent of radicular third (C- 533,9~m; M- 300,7~m; A- 80,7~m). There were no significantily differences between GER (C- 176,3~m; M- 91 ,7~m; A- 17,6~m), GSL (C- 231,4~m; M- 100,6~m; A- 19,9~m) and GNR (C- 132,4~m; M- 52~m; A- 9~m) groups, and sho- wed the lower deep penetration. The resin sealers, with the exception of EndoRez sealer, have a better dentin penetration quality than others sealer category.

Retratamento de incisivo lateral superior com dois canais radiculares / Retreatment of the maxillary lateral incisor with two root canals

Para se alcançarem os objetivos do tratamento endodôntico, é necessário o conhecimento da anatomia interna dos dentes, uma vez que esta não reproduz exatamente a anatomia externa dos mesmos. Na literatura, incisivos laterais superiores mostram-se, na maioria dos casos, como elementos unirradiculares, com apenas um canal. Porém, existe a rara incidência de este dente apresentar mais de um canal radicular. Atualmente, o microscópio operatório vem sendo empregado em várias etapas do tratamento endodôntico, com a finalidade de facilitar a resolução de diferentes casos, como estes que apresentam variações anatômicas. Este trabalho relata o retratamento endodôntico de um incisivo lateral superior esquerdo, no qual a não localização de um segundo canal radicular levou ao insucesso do primeiro tratamento. Essa deficiência foi posteriormente suprida pela magnificação visual e aumento da luminosidade, proporcionada pelo microscópio operatório, sendo possível a completa sanificação do sistema de canais radiculares. Conclui-se que, além da necessidade do conhecimento e estudo sobre a anatomia interna, a microscopia operatória pode auxiliar na intervenção em dentes com variações anatômicas, assegurando um melhor prognóstico para o tratamento endodôntico

In order to provide endodontic treatment, it is imperative to know the internal anatomy of the tooth, since it is not exactly like the external anatomy. The literature shows that most of the maxillary lateral incisors are single-rooted and have just one root canal. However, in rare cases, there may be more than one root canal. Today, the dental operating microscope is used in many stages of an endodontic treatment to facilitate the resolution of unusual cases, such as these with anatomical variations. The aim of this study was to describe the endodontic retreatment of a left maxillary lateral incisor, in which a root canal left without appropriate treatment caused the first treatment to fail. This problem was solved with the magnification and lighting provided by the microscope, allowing complete sanitation of the root canals. In conclusion, in addition to allowing a better knowledge and study of the internal anatomy of the tooth, the dental operating microscope can help in the treatment of teeth with varied anatomies, ensuring a better prognosis for the endodontic treatment

Canal mésio-central em primeiro molar inferior / Middle mesial canal of the first mandibular molar

Com o advento da magnificação visual e o aumento da luminosidade proporcionada pela Microscopia Operatória, o clínico vem relatando cada vez mais a incidência de canais que antes acabavam passando desapercebidos e, muitas vezes, levando ao insucesso a terapia endodôntica. Um dos casos que vem despertando a atenção é o de molares inferiores: em sua raiz mesial, entre os habituais canais mésio-vestibular e mésio-lingual, um canal denominado mésio-central vem sendo observado. Este trabalho relata um caso clínico da presença desse canal e faz uma breve revisão de literatura que mostra a incidência do canal mésio-central.