Morphological changes of the apical foramen after enlargement: A scoping review of in vitro studies.

Background: To outline the current evidence on root morphological changes after enlarging the apical foramen with NiTi instruments. Material and Methods: A search was performed in the Virtual Health Library, PubMed, EMBASE, Scopus, Web of Science, Science Direct and SciELO databases, in addition to a manual search in Google Scholar, between January 2017 and October 2023. Articles published in English that describe in vitro studies investigating root morphological changes after instrumentation 1 mm beyond the major apical foramen were included. The quality of evidence in the included studies was also analyzed. Results: The search retrieved 367 articles. Of these, four studies were eligible for data synthesis and analysis, all of them in vitro studies. Synthesis of the results of these in vitro studies showed a larger number of root morphological changes such as experimental dentinal microcraks in samples submitted to instrumentation beyond the apical foramen when compared to micro-CT images obtained before preparation. Conclusions: The in vitro studies analyzed in this scoping review indicate that instrumentation beyond the major foramen of the root canal, promotes morphological changes in this area and that the adoption of standardized methodologies would not only increase the accurate detection and characterization of these changes but also facilitate the application of these findings in clinical trials and patient care. Key words:Endodontics, apical morphology, root canal preparation.

Pulp Canal Obliteration Following Traumatic Dental Injury in an Upper Lateral Incisor: A Case Report with 3-year Follow-up.

Endodontic management of teeth afflicted with pulp canal obliteration faces a challenge due to the heightened risk of complications including excessive wear, perforation, and suboptimal chemomechanical preparation. This report aims to elucidate the clinical endodontic strategy employed in addressing pulp canal obliteration after a history of dental trauma and an associated periradicular lesion in an upper lateral incisor. A patient visited the dental emergency department with symptoms of apical swelling, acute persistent pain, and discoloration of tooth 22. Following comprehensive clinical evaluation and cone-beam computed tomography, the diagnosis of pulp canal obliteration involving the cervical and middle thirds of the tooth, alongside an acute periradicular abscess was established. Root canal was accessed using tomographic image planning, augmented by loupe magnification and ultrasonic instrumentation. Precise identification of the access cavity was radiographically confirmed, preceded by thorough irrigation with 2.5% sodium hypochlorite and subsequent cervical and middle third preparation. Verification of the working length by an electronic apex locator ensured precise apical preparation, followed by passive ultrasonic irrigation to optimize disinfection and to enhance penetrability of intracanal calcium hydroxide medication, administered for 15 days to eliminate microbial invasion. Upon resolution of symptoms, root canal obturation employing thermo-mechanical compaction and coronal sealing with composite resin was accomplished. Radiographic assessment after a one-year interval presented evidence of lesion regression and bone repair. Subsequent cone-beam computed tomography imaging at the three-year follow-up confirmed complete healing of the periradicular tissues, attesting to the efficacy of the endodontic intervention.

Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review.

BACKGROUND: The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS: Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION: Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.

Endodontic and Surgical Management of an Invasive Cervical Resorption in a Maxillary Central Incisor: A Case Report.

The current study aims to report a case of invasive cervical resorption in a maxillary left central incisor with a history of dental trauma. After thorough clinical and tomographic evaluations, cervical cavitation, an irregularity in the gingival contour and crown discoloration were observed. Furthermore, presence of an extensive and well-defined area of invasive cervical resorption with pulp communication was discovered. The suggested diagnosis was asymptomatic irreversible pulpitis. The resorption area was treated with the complete removal of granulation tissue, sealed with light-curing glass ionomer cement. Then, the chemo-mechanical preparation and obturation of the root canal were performed. After two years of clinical follow-up and cone-beam computed tomography examination, there were no clinical signs and symptoms, the filling of the resorption area remained intact, and no hypodense image in the cervical region of tooth #21 could be detected. The management reported in this case presented a possible viable treatment for invasive cervical resorption, provided that correct diagnosis is made.

Clinical Approach of Extensive Periapical Lesion with Periradicular Regenerative Surgery: A Case Report with 7 Year Follow Up

The aim of this study is to report a case of two maxillary incisors with chronic apical abscess and through-and-through lesion submitted to periradicular regenerative surgery, with clinical follow-ups and evaluation through cone-beam computerized tomography for 7 years. In the presentation, there was a persistent sinus tract in the palate and sensibility to touch at the apical region of the central and left lateral maxillary incisors. The initial tomography revealed the presence of an extensive radiolucent area in the apical third of the referred teeth, with loss of the buccal and palatal cortic es. For the treatment, a periradicular regenerative surgery was performed, an association of endodontic surgery with Guided Tissue Regeneration technique, using bovine bone xenograft and bioabsorbable membrane. The clinical and radiographic evaluations, including cone-beam computerized tomography, at seven years postoperatively, showed absence of symptomatology and sinus tract, probing depth within normal standards and apical bone neoformation.

El objetivo de este estudio fue reportar un caso de dos incisivos superiores con absceso apical crónico y lesión transversal sometidos a cirugía regenerativa perirradicular, con seguimiento clínico y evaluación mediante tomografía computarizada de haz cónico durante 7 años. En la presentación, había un trayecto sinusal persistente en el paladar y sensibilidad al tacto en la región apical de los incisivos maxilares laterales central y lateral izquierdo. La tomografía inicial reveló la presencia de una extensa zona radiolúcida en el tercio apical de los dientes referidos, con pérdida de las cortezas bucal y palatina. Para el tratamiento se realizó una cirugía regenerativa perirradicular, asociación de cirugía endodóntica con técnica de Regeneración Tisular Guiada, utilizando xenoinjerto óseo bovino y membrana bioabsorbible. Las evaluaciones clínicas y radiográficas, incluida la tomografía computarizada de haz cónico, a los siete años del posoperatorio, mostraron ausencia de sintomatología y tracto sinusal, profundidad de sondaje dentro de los estándares normales y neoformación ósea apical.

Water activity influence on the simultaneous production of DON, 3-ADON and 15-ADON by a strain of Fusarium graminearum ss of 15-ADON genotype.

The influence of aw on DON and its acetyl derivatives biosynthesis by a strain of Fusarium graminearum s.s. (ITEM 4606) which produces DON, 3-ADON and 15-ADON was evaluated. Trichothecene production was studied on agar wheat 2% at 0.95 and 0.99 aw at different temperatures (10, 15, 20, 25 and 30 °C) and incubation times (7, 14, 21 and 28 days). Statistical analysis (ANOVA) showed that aw, temperature, incubation time and their interactions were significant on the production of DON, 3-ADON and 15-ADON (p < 0.0001). The pattern of toxin production was influenced by aw, showing differences for the three toxins. The maximum accumulation of DON occurred at 30 °C at 0.99 aw (14 d) and at 25 °C at 0.95 aw (7 and 21 d). The highest concentration of 3-ADON at 0.95 aw was observed at 25 °C and 7 days, and it was significantly higher than all the other values registered. At 0.99 aw, the maximum occurred at 30 °C and 21 days, but another significantly high accumulation was observed at 28 days at the same temperature. For 15-ADON, at 0.95 aw, the highest amount of toxin was accumulated at 10 °C, both at 7 and 28 days. At 0.99 aw, a maximum was observed at 10 °C and 7 days, significantly different from the values observed at the other conditions. The toxin accumulated at a higher concentration at 0.95 aw was 15-ADON (173.2 µg/g) and at 0.99 aw, 3-ADON (370.6 µg/g). A marked influence of aw on the maximum toxin accumulation with respect to temperature and time was observed for trichothecene production. This is an important fact to consider when designing predictive models to prevent toxin contamination, both in the field and during storage, especially in intermediate drying stages.

Morphological Study of Root Canals of Maxillary Molars by Cone-Beam Computed Tomography.

The aim of this study was to evaluate the root canal morphology of permanent maxillary molars by cone-beam computed tomography (CBCT) using the classifications of Weine et al. and Vertucci and to correlate the findings with sex, age, position in the dental arch, and prevalence of a second canal in the mesiobuccal root (MB2). A total of 414 scans were evaluated, corresponding to 1,000 teeth. The assessment consisted of coronal, axial, and sagittal reconstructions using i-CAT Workstation®. Type 0 was assigned when neither classification could be applied. The data were entered into an Excel spreadsheet and analyzed using SPSS. The chi-squared test or Fisher's exact test was used to compare the distribution of root canal morphology classified using the two systems. Analysis of the distribution of Weine types showed a predominance of type III in mesiobuccal roots, while type 0 predominated in distobuccal and palatal roots. Vertucci type IV predominated in mesiobuccal and distobuccal roots and type VII in palatal roots. There was no difference in the distribution of morphological canal types in permanent maxillary molars evaluated by CBCT according to sex, age group, or position in the dental arch of the patients. MB2 canals were identified in 68.4% of the teeth evaluated.

Scope of Preparation of Oval and Long-Oval Root Canals: A Review of the Literature.

Successful endodontic treatment depends on cleaning and disinfecting the root canals, in order to provide conditions for three-dimensional filling, which should prevent root canal reinfection. However, anatomical complexities pose a challenge during endodontic treatment. The present study was a literature review carried out in the following databases: PubMed, SciELO, and MEDLINE, which were searched for articles published from 2017 to 2021. Micro-CT studies published in English, which analysed the capacity for preparation of oval and long-oval root canals, were included. The following keywords were used: "oval-shaped canals," "long-oval-shaped canals," "endodontics," and "micro-CT." The aim of this study was to carry out a literature review of micro-CT studies on the scope of the capacity for preparation performed in oval and long-oval root canals with rotary and reciprocating instruments.

Cyclic Fatigue Resistance of Blue Heat-Treated Instruments at Different Temperatures.

The main aim is to evaluate the cyclic fatigue resistance of blue heat-treated instruments with different kinematics. Twenty-four endodontic instruments of the same brand were used for each of three experimental groups: VB (Vortex Blue 40/0.04), RB (RECIPROC Blue 40/0.06), and XB (X1 Blue 40/0.06). The instruments were randomly distributed and subjected to temperatures of 20°C and 37°C. The fatigue test was performed using a stainless steel device. Data were analysed using the Shapiro-Wilk test, Student's t-test, the F test, and Tukey's and Tamhane tests at significance level P=0.05. The instruments' cyclic fatigue resistance at both temperatures differed significantly for each instrument type (P < 0.001). The RB instruments displayed greater cyclic fatigue resistance at the tested temperatures compared with the VB and XB instruments (P < 0.001). Reciprocating kinematics positively influenced cyclic fatigue resistance. Blue heat-treated instruments showed decreased cyclic fatigue resistance as the temperature increased (P < 0.001).

Influence of occlusal reduction on pain after endodontic treatment: a systematic review and meta-analysis.

The purpose of this systematic review was to analyze the influence of occlusal reduction on the postoperative pain levels after endodontic treatment (instrumentation and obturation of the root canal system). This review followed the PRISMA statement and was registered at PROSPERO (CRD42018107918). Two independent reviewers searched the Lilacs, Cochrane Library, PubMed (Medline), Web of Science, Scopus, Scielo, and ScienceDirect for articles published until April 2021. The research question was, "Does occlusal reduction decrease postoperative pain in endodontically treated teeth?". Only randomized clinical trials were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (presence or absence of pain). The search strategies retrieved 4114 studies. Twelve studies were included for qualitative analysis and nine for quantitative analysis. The meta-analysis results did not reveal a significant difference in the reduction of postoperative pain levels for endodontic instrumentation at 6, 12, 24, 48 h and for endodontic obturation at 6 or 12 h after occlusal reduction. According to the GRADE tool, the analyzed outcome was classified as having a moderate level of certainty. It is concluded that occlusal reduction does not interfere with postoperative pain levels after endodontic treatment.

Postoperative Pain after Use of the WaveOne Gold and XP-endo Shaper Systems: A Randomized Clinical Trial.

INTRODUCTION: The present study aimed to clinically compare the incidence of postoperative pain after endodontic treatment of posterior teeth using the WaveOne Gold (WOG; Dentsply Sirona, Ballaigues, Switzerland) and XP-endo Shaper (XPES; FKG Dentaire, La Chaux-de-Fonds, Switzerland) systems. METHODS: In a single-blind randomized clinical trial, 148 vital teeth with an indication for conventional endodontic therapy for prosthetic purposes were treated by 5 specialists following a preestablished protocol. All participants were unaware of the treatment they received. The teeth were randomly divided into 2 groups (n = 74) according to the instrumentation system used (the WOG group and XPES group). The treatments were performed in a single session. The participants were asked to rate the intensity of postoperative pain on a visual analog scale (no pain, mild pain, moderate pain, and severe pain) after 24, 48, and 72 hours and 7 days. RESULTS: The incidence of postoperative pain was higher in the XPES group after 24, 48, and 72 hours compared with those in the WOG group (P < .05). Two participants in the WOG group experienced severe postoperative pain after 24 hours. None of the participants in either group reported pain after 7 days (P > .05, Mann-Whitney test). CONCLUSIONS: Postoperative pain is expected after preparation of the root canal system with the WOG and XPES systems tested, but it only persists for a short period. Although more common after the use of the XPES system, the pain was classified as mild at all time points.

Can discrepancies between Fusarium graminearum trichothecene genotype and chemotype be explained by the influence of temperature in the relative production of 3-ADON and 15-ADON?

Wheat is one of the most important crops in Argentina and worldwide. One of the major diseases affecting the crop is the Fusarium Head Blight (FHB). It is an endemic disease caused mainly by Fusarium graminearum, the most common agent of FHB around the world. The infection is strongly influenced by environmental parameters and occurs mostly when there are favourable conditions of moisture and temperature during wheat anthesis or flowering. This destructive disease affects wheat, barley and other small grains and has the capability of destroying crops, causing great economic losses due to reduced grain quality, and the accumulation of significant levels of mycotoxins such as trichothecenes. The aim of this study was to evaluate the influence of temperature on mycotoxin biosynthesis, on three strains of F. graminearum of 15-ADON genotype and one of 3-ADON genotype, with different capacity of synthesizing DON, 3-ADON and 15-ADON. Trichothecene production of the strains at different temperatures (5, 10, 15, 20, 25, 30 and 35 °C) was evaluated after 7, 14, 21, 28 and 35 d of incubation. The optimum temperature to produce DON and 3-ADON was between 25 and 30 °C, but the maximum production of 15-ADON occurred at a lower temperature (10 °C) for all the strains. Conversely, the minimum production of DON and 3-ADON was recorded between 5 and 10 °C and of 15-ADON between 30 and 35 °C. A possible explanation for the similar accumulation of both acetyl derivatives by strains of different chemotype and genotypes could be that the acetyl derivatives biosynthesis is regulated by temperature.

Tooth autotransplantation using an interdisciplinary approach to rehabilitation in a young patient: Case report with 7-year follow-up.

This case report demonstrates the possibility of functional and aesthetic rehabilitation using an interdisciplinary approach in a child following avulsion of a tooth. Autotransplantation after the development of calcific metamorphosis of the pulp and acute apical periodontitis provided satisfactory repair after root canal treatment. A 7-year-old white boy avulsed the right maxillary central incisor (tooth 11). The extra-alveolar time exceeded 60 minutes, and this triggered external replacement resorption of the avulsed tooth. At 11 years of age, the child underwent tooth autotransplantation. After 4 years of follow-up, intraoral clinical and radiographic examination led to the diagnosis of calcific metamorphosis of the pulp and acute apical periodontitis. The patient had minimally invasive root canal treatment, orthodontic treatment and esthetic rehabilitation with a porcelain crown. Control periapical radiography and tomography of the autotransplanted tooth after 7 years revealed bone repair in the periapical region. This case report indicates that tooth autotransplantation can be used to replace anterior teeth after avulsion followed by replacement resorption. Interdisciplinary management helped to maintain the esthetics and function of the rehabilitated area.

Perceção de autoeficácia parental e estado emocional das mães de recém-nascidos prematuros, no primeiro mês após a alta da UCIN / Perceived parental self-efficacy and emotional state of mothers of preterm infants in the first month after discharge from the NICU

Enquadramento: O internamento de recém-nascidos (RN) prematuros pode estar associado a dificuldades e emoções negativas das suas mães. Contudo, pouco se sabe acerca das respetivas experiências após a alta, tanto ao nível da Perceção de autoeficácia parental (PAP) como ao seu Estado emocional (EE), nomeadamente depressão, face as exigências do seu novo papel. Estas experiências subjetivas podem condicionar as suas capacidades de prestação de cuidados. Objetivos: Analisar a PAP e o EE das mães de RN prematuros, assim como a relação entre ambos. Analisar a relação entre a PAP ou o EE e variáveis obstétricas e neonatais, sociodemográficas, e situacionais, no primeiro mês após a alta. Metodologia: Estudo quantitativo, descritivo e correlacional, transversal, com uma amostra de 33 mães. Os dados foram obtidos através de autorrelato escrito, com um questionário que incluía a Escala de Perceção de Autoeficácia da Parentalidade Materna e a Escala de Depressão Pós-Parto de Edimburgo. A análise foi efetuada com o software IBM SPSS Statistics 24. Resultados: As mães têm, em média, uma PAP elevada, sendo que somente 18.18% indicou uma PAP razoável. Há menor PAP relativamente às dimensões Suscitar Comportamento e Ler Comportamento. Quanto ao EE, a maioria não está em risco de sofrer de depressão. Contudo, 15.15% estão em risco e 24.24% das mães provavelmente sofrem de depressão. Encontraram-se relações negativas com significado estatístico entre a Satisfação com a interação com o filho e o EE, a Satisfação com o apoio familiar e o EE, e a dimensão Tomar Conta e o EE. Conclusão: A avaliação da PAP permitiu identificar dificuldades das mães a nível do Suscitar Comportamento e do Ler Comportamento, pelo que se devem adequar os cuidados de enfermagem. É fundamental a identificação e intervenção em situações de risco, e de depressão pós-parto, permitindo a promoção tanto da segurança, como da saúde, das mães e dos RN prematuros. Sugere-se envolver mais a família (mãe, pai e avós) nos cuidados de modo a potenciar a interação com o RN e o apoio familiar.

The Role of the Dental Surgeon in Controlling the Dissemination of COVID-19: A Literature Review.

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.

Micro-CT analysis of dentinal microcracks on root canals filled with a bioceramic sealer and retreated with reciprocating instruments.

This study aimed to analyze the potential occurrence of dentinal defects after the removal of a root canal filling with two different sealers using Reciproc (RC) or Reciproc Blue (RB). The mesial roots of 60 mandibular molars with a Vertucci type IV configuration were selected. The samples were initially instrumented with Reciproc (R25) and then divided into the following four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC); BC Sealer/Reciproc Blue (BCRB); AH Plus/Reciproc (AHRC); and AH Plus/Reciproc Blue (AHRB). Then, the samples were scanned under micro-CT after obturation and removal of the filling material. Two analyses were conducted. First, an evaluation was performed on all the axial images, and another analysis evaluated each millimeter of the 10 mm from the apex. Dentinal defects were observed in all the samples. All of the identified defects in the images after filling material removal were present in the corresponding images after obturation. The use of AH Plus and EndoSequence BC Sealer, and filling material removal using RC and RB instruments did not induce dentinal defects.

Influence of Temperature on the Cyclic Fatigue Resistance of Reciproc Blue Instruments.

AIM: To evaluate the cyclic fatigue resistance of Reciproc blue (RB) 40/0.06 instruments tested at room temperature (20° ± 0.5°C) and at body temperature (37° ± 0.5°C) in a simulated stainless steel canal. MATERIALS AND METHODS: Twenty-four new RB 40/0.06 instruments were randomly divided into two groups (n = 12) according to the temperature used. Dynamic fatigue testing was performed using an artificial stainless steel canal with a 60° curvature angle and a 5-mm radius of curvature. The temperature was controlled throughout the experiment with an underwater thermometer and a thermostat. The data were analyzed descriptively using the IBM SPSS 23.0 program, considering p < 0.05. RESULTS: The time to fracture of the RB instruments differed significantly between the two temperatures (1083.82 seconds at 20°C and 403.80 seconds at 37°C). No significant differences were found in fragment size. CONCLUSION: An increase in temperature reduces the cyclic fatigue resistance of RB 40/0.06 instruments. The results of the study suggest that an intracanal cooling system can be favorable to the fracture resistance of the tested instruments. CLINICAL SIGNIFICANCE: A cooling system of the root canal system is important in endodontic as it favors the cyclic fatigue resistance of Ni-Ti instruments.

Photobiomodulation Therapy in the Proliferation and Differentiation of Human Umbilical Cord Mesenchymal Stem Cells: An In Vitro Study.

Introduction: Since photobiomodulation therapy (PBMT) favors in vitro mesenchymal stem cell (MSC) preconditioning before MSC transplantation, increasing the proliferation of these cells without molecular injuries by conserving their characteristics, in the present in vitro study we analyzed the effect of PBMT on the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells (hUCMSCs). Methods: Irradiation with an InGaAIP Laser (660 nm, 10 mW, 2.5 J/cm2 , 0.08 cm2 spot size, and 10 s) was carried out. The cells were divided into four groups: CONTROL [cells grown in Dulbecco's Modified Eagle Medium (DMEM)], OSTEO (cells grown in an osteogenic medium); PBMT (cells grown in DMEM+PBMT), and OSTEO+PBMT (cells grown in an osteogenic medium plus PBMT). The cell proliferation curve was obtained over periods of 24, 48 and 72 hours using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Osteogenic differentiation was analyzed by the formation of calcium nodules over periods of 7, 14 and 21 days. Morphometric analysis was performed to quantify the total area of nodular calcification. Results: The highest cell proliferation and cell differentiation occurred in the OSTEO+PBMT group, followed by the PBMT, OSTEO and CONTROL groups respectively, at the observed times (P <0.05). Conclusion: PBMT enhanced the osteogenic proliferation and the differentiation of hUCMSCs during the periods tested, without causing damage to the cells and preserving their specific characteristics, a fact that may represent an innovative pretreatment in the application of stem cells.

Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures.

OBJECTIVES: To compare the remaining root canal filling material, dentin removal, apical transportation, and apical extrusion of debris after the retreatment of canals filled with bioceramic or resin-based sealers using the Reciproc or Reciproc Blue instruments. MATERIALS AND METHODS: Sixty mandibular molars with severely curved mesial roots were selected. The samples were initially instrumented with Reciproc (R25) and then divided into four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC), BC Sealer/Reciproc Blue (BCRB), AH Plus/Reciproc (AHRC), and AH Plus/Reciproc Blue (AHRB). The procedure time was measured, and an Eppendorf tube was used in each root canal to store the debris extrusion. The samples were scanned by micro-CT before and after retreatment. The apical transportation, volume of dentin, and filling material were evaluated. RESULTS: There were no significant differences in the reduction of the volume of obturator material or dentin removal between groups (p > .05). There were also no differences in the amount of extruded material or apical transportation (p > .05). The retreatment time for the AHRC group was significantly lower than that for the other groups (p = .004). CONCLUSIONS: All tested instruments obtained similar efficacy in filling material removal procedures, although no system completely removed the filling material. Retreatment of canals filled with bioceramic BC Sealer may be more time consuming. CLINICAL RELEVANCE: This study reported that Reciproc and Reciproc Blue can be indicated in retreatment of severely curved root canals filled either with bioceramic or resin-based sealers.

Perceção de autoeficácia parental e estado emocional das mães de recém-nascidos prematuros, no primeiro mês após a alta da UCIN / Perception of parental self-efficacy and emotional state of mothers of premature newborns, in the first month after discharge from the NICU

ENQUADRAMENTO: O internamento de recém-nascidos (RN) prematuros pode estar associado a dificuldades e emoções negativas das suas mães. Contudo, pouco se sabe acerca das respetivas experiências após a alta, tanto ao nível da Perceção de autoeficácia parental (PAP) como ao seu Estado emocional (EE), nomeadamente depressão, face as exigências do seu novo papel. Estas experiências subjetivas podem condicionar as suas capacidades de prestação de cuidados. OBJECTIVOS: Analisar a PAP e o EE das mães de RN prematuros, assim como a relação entre ambos. Analisar a relação entre a PAP ou o EE e variáveis obstétricas e neonatais, sociodemográficas, e situacionais, no primeiro mês após a alta. METODOLOGIA: Estudo quantitativo, descritivo e correlacional, transversal, com uma amostra de 33 mães. Os dados foram obtidos através de autorrelato escrito, com um questionário que incluía a Escala de Perceção de Autoeficácia da Parentalidade Materna e a Escala de Depressão Pós-Parto de Edimburgo. A análise foi efetuada com o software IBM SPSS Statistics 24. RESULTADOS: As mães têm, em média, uma PAP elevada, sendo que somente 18.18% indicou uma PAP razoável. Há menor PAP relativamente às dimensões Suscitar Comportamento e Ler Comportamento. Quanto ao EE, a maioria não está em risco de sofrer de depressão. Contudo, 15.15% estão em risco e 24.24% das mães provavelmente sofrem de depressão. Encontraram-se relações negativas com significado estatístico entre a Satisfação com a interação com o filho e o EE, a Satisfação com o apoio familiar e o EE, e a dimensão Tomar Conta e o EE. CONCLUSÃO: A avaliação da PAP permitiu identificar dificuldades das mães a nível do Suscitar Comportamento e do Ler Comportamento, pelo que se devem adequar os cuidados de enfermagem. É fundamental a identificação e intervenção em situações de risco, e de depressão pós-parto, permitindo a promoção tanto da segurança, como da saúde, das mães e dos RN prematuros. Sugere-se envolver mais a família (mãe, pai e avós) nos cuidados de modo a potenciar a interação com o RN e o apoio familiar.