Impact XP-endo finisher on the 1-year follow-up success of posterior root canal treatments: a randomized clinical trial.

OBJECTIVE: To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. METHODS: A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). RESULTS: There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. CONCLUSIONS: The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).

Supplementary use of the XP-endo Finisher on postoperative pain in posterior teeth with periapical lesions: a randomized clinical trial.

OBJECTIVE: This study evaluated the effect of the supplementary use of the XP-endo Finisher on postoperative endodontic pain. METHODS: This study was a randomized clinical trial with a parallel design. Ninety-two posterior teeth with necrotic pulps and apical periodontitis were instrumented with a single file (Reciproc) in a reciprocating movement followed or not (control) by additional instrumentation with XP-endo Finisher. Postoperative pain was assessed 24 h, 48 h, 72 h, and 7 days after the endodontic treatment (single session) using a universal pain assessment tool. The pain level was scored as absent, mild, moderate, or severe. The occurrence of sealer extrusion and flare-up was also recorded. Data on postoperative pain were analyzed through chi-square analysis, and the odds ratio was adjusted using a logistic regression model (α = 0.05). RESULTS: Similar levels and risks of postoperative pain were observed for both interventions, regardless of the assessment time. Approximately half of the participants presented any postoperative pain in the first 24 h after the endodontic treatment, and this occurrence reduced by less than 20% after 72 h. The extrusion of root filling material was observed in 36% of cases, and no participant presented flared-up. CONCLUSIONS: The supplementary use of the XP-endo Finisher file did not affect the incidence or level of postoperative pain reported after the endodontic treatment of posterior teeth with periapical lesions. CLINICAL RELEVANCE: The supplementary use of the XP-endo Finisher did not affect postoperative pain following the endodontic treatment of posterior teeth using a single-file reciprocating system. CLINICAL TRIAL REGISTRATION: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).

Programa de conscientização sobre traumas faciais causados por acidentes motociclísticos na cidade de Lagarto/SE / Awareness program about social trauma caused by motorcycle accidents in the city of Lagarto/SE

Trata-se de um projeto de intervenção que, através da educação em saúde por meio de atividades educativas, tem como objetiva a prevenção dos acidentes motociclísticos, e consequentemente, a redução do número de traumas faciais. O programa de prevenção terá uma duração de seis meses. Após a realização do programa de prevenção, em um segundo momento, será realizado um levantamento que corresponderá ao ano de 2021, para verificar se houve uma diminuição do número de acidentes motociclísticos com traumas dos ossos faciais comparados ao ano anterior, o qual já está catalogado.

Avaliação bibliométrica da produção científica sobre saúde bucal no contexto do sistema único de saúde / Bibliometric evaluation of scientific production on oral health in the context of the single health system

Realizou-se uma busca na base de dados Scopus por artigos científicos que continham em seus títulos, resumos e palavras-chave termos relacionados ao SUS. Foram selecionados artigos originais e revisões de literatura (simples ou sistemáticas), publicados a partir de 1989, sem restrição quanto a língua de publicação ou país de origem. Aproximadamente 900 artigos foram identificados. Após avaliação dos títulos, resumos e palavras-chave, 90 artigos foram incluídos neste estudo, sendo 80 artigos originais e 10 revisões narrativas ou críticas. O período de publicação foi de 2008 a 2021. A média de tempo de publicação destes estudos é de 5,4 anos. Combinados, eles apresentam um total de 412 citações, sendo a média de citação por documento de 4,78 e a média anual de citações de 0,68. Os artigos selecionados foram publicados em 20 periódicos diferentes, sendo 15 internacionais e 5 nacionais. Os artigos selecionados apresentaram 351 autores (média de 3.86 autores por artigo). A análise de palavras-chave demonstrou que cárie dental e câncer de boca foram os temas mais abordados. Considerando temas gerais da saúde pública,os mais abordados foram administração e o acesso aos serviços de saúde odontológicos na Atenção Primária à Saúde. Há uma carência de estudos sobre políticas públicas, intervenção e planejamento em Odontologia para melhor embasar as ações de saúde bucal no âmbito do Sistema Único de Saúde.

Correction: Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: A randomized controlled pragmatic clinical trial.

[This corrects the article DOI: 10.1371/journal.pone.0227347.].

Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: A randomized controlled pragmatic clinical trial.

This trial assessed post-operative pain and healing of apical periodontitis following endodontic therapy with a reciprocating system compared to a crown-down technique with hand files and lateral compaction filling. One-hundred and twenty nonvital anterior teeth with apical periodontitis were randomly treated using either a reciprocating single file followed by matching-taper single-cone filling or a hand file and lateral compaction filling. Postoperative pain was assessed during the 7 days after the treatment, using a visual analogue scale and a verbal rating scale. Apical healing was assessed using the periapical index score after a 12-month follow-up. The hypothesis tested was that both protocols were equivalent and present similar effectiveness in healing periapical lesions. Data were analyzed through two one-sided tests, t-tests, as well as Mann-Whitney and Chi-squared tests (α = 0.05). Logistic regression was used to investigate the association of clinical and demographic factors with the success of treatment. Regardless of the assessment time, no difference in incidence (38%-43% at first 24h), intensity of postoperative pain, and incidence of flare-up (≈ 3%) was observed between the two endodontic protocols. Both protocols resulted in a similar healing rate of apical periodontitis. After 12 months, the success rate ranged from 73% to 78% and the difference between the treatments fell within the pre-established equivalence margin (-0.1; -0.41 to 0.2). Endodontic treatment combining a reciprocating single file with matching-taper single cone showed similar clinical effectiveness to the treatment using hand-file instrumentation and the lateral compaction filling.

Effectiveness of a reciprocating single file, single cone endodontic treatment approach: a randomized controlled pragmatic clinical trial.

OBJECTIVES: To compare the root filling quality, the sealer extrusion, and the healing rates of apical lesions addressed via two endodontic treatment approaches. The hypothesis tested was that both techniques present similar apical periodontitis healing results. MATERIALS AND METHODS: This study was a parallel-design, pragmatic, and randomized clinical trial. One hundred twenty anterior teeth with necrotic pulps and apical periodontitis were randomly allocated to be either instrumented with hand files and obturated with the lateral compaction technique or instrumented with a single file in a reciprocating movement and obturated with a single-cone technique. The root canal filling quality, the occurrence of sealer extrusion, and apical periodontitis healing were the outcomes of interest. Data were analyzed through chi-square analysis, and the odds ratio for healing was adjusted using a logistic regression model (α = 0.05). RESULTS: No significant differences were observed between the endodontic techniques regarding the root filling quality or sealer extrusion. Six months after treatment, both endodontic techniques presented equivalent results regarding apical periodontitis healing. The healing rate was affected only by the periapical status at baseline. CONCLUSIONS: The obturation of the root canal of the anterior teeth using reciprocating file-matched single cones presented a similar quality to that obtained with manual instrumentation followed by the lateral condensation technique. Similar healing rates of apical lesions were also observed. CLINICAL RELEVANCE: For treating anterior teeth with apical periodontitis, a reciprocating single-file, single-treatment protocol was as effective as a traditional protocol combining hand instrumentation and the lateral compaction obturation technique.

In vitro evaluation of tooth discoloration induced by regenerative endodontic therapy and the effectiveness of the walking bleach technique.

BACKGROUND: The present study evaluated the coronal discoloration induced by different materials or blood as well as the effect of internal bleaching on discoloration. METHODS: After tooth color measurement at baseline with a sphere spectrophotometer (CIE L*a*b*), the root canals of molars were partially filled with white mineral trioxide aggregate (MTA), triple antibiotic paste (TAP), or a cotton pellet with bovine blood (control) was placed into the pulp chamber. The color changes were assessed at 30, 60, and 180 days after the procedure. Following the discoloration, internal bleaching was performed with a mixture of sodium perborate and hydrogen peroxide inserted into the pulp chamber, and this mixture was replaced weekly for 3 weeks. At baseline, after staining and after bleaching, the data of each color parameter were individually analyzed by one-way ANOVA, while differences in pooled color changes (∆E00) were assessed by two-way repeated measures ANOVA (α = 0.05). RESULTS: After the staining period, the TAP-stained specimens were darker and greener than the other specimens, and no difference was observed between the teeth stained with blood and those stained with MTA. The walking bleach technique resulted in an improved tooth color without a difference in the color changes among the different groups. CONCLUSION: The TAP-stained specimens had the greatest tooth discoloration, and the discoloration remained the highest after the walking bleach technique. PRACTICAL IMPLICATIONS: This in vitro study demonstrated that TAP yielded higher tooth discoloration, and this color might hinder a satisfactory tooth color from being obtained with the walking bleach technique.

Autogenous Bone Graft Versus Bovine Bone Graft in Association With Platelet-Rich Plasma for the Reconstruction of Alveolar Clefts: A Pilot Study.

OBJECTIVE: To compare the outcomes of 2 different bone graft materials: autogenous bone grafts from mandibular symphysis and bovine bone grafts associated with platelet-rich plasma (PRP). METHODS: Twenty individuals met the inclusion criteria and accepted to participate in the study. Group A patients underwent alveolar bone grafting using autologous bone and group B patients using a bovine bone graft associated with PRP. Cone beam computed tomography scans were taken and reconstructed 3-dimensionally for all patients preoperatively and 1 year postoperatively. RESULTS: A significant reduction was detected for area and volume within group A and group B. Between groups, no significant difference was found for area or volume. CONCLUSIONS: Bovine grafts associated with PRP are a good option for the reconstruction of alveolar clefts and provide good results such as autologous bone grafts.

Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review.

The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.

Fluoride-Releasing Materials to Prevent White Spot Lesions around Orthodontic Brackets: A Systematic Review

Abstract The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.

Resumo A relação entre o uso de aparelhos ortodônticos fixos e desmineralização do esmalte é bem estabelecida. Diferentes abordagens preventivas têm sido sugeridas para este problema, mas ainda permanece controverso qual é o melhor. O objetivo deste estudo foi realizar uma revisão sistemática de ensaios clínicos que investigaram a efetividade de materiais contendo fluoretos para cimentação de bráquetes ou cobrindo a interface de união buscando inibir o desenvolvimento e progressão de lesões de mancha branca. A hipótese nula foi que materiais fluoretados não afetam a incidência de lesões de mancha branca em volta de bráquetes. Uma busca no MEDLINE foi conduzida para ensaios clínicos controlados avaliando o desenvolvimento de lesões de mancha branca em pacientes usando aparelhos ortodônticos fixos, seguido por meta-análise comparando os resultados de pacientes em que materiais usando fluoretos foram utilizados (grupo experimental) com aqueles em que tais materiais não foram usados. O risco relativo agrupado de desenvolvimento de lesões de mancha branca para o grupo experimental foi 0,42 (95% de intervalo de confiança: 0,25 a 0,72); enquanto que, quando materiais liberando fluoretos foram utilizados, o paciente teve 58% menos risco de desenvolver lesões de mancha branca. Em relação à extensão das lesões de mancha branca, a diferença média agrupada entre os grupos experimental e controle não foi estatisticamente significante (-0,12; 95% de intervalo de confiança: -0,29 a 0,04). Em conclusão, os resultados da presente revisão sistemática sugerem que materiais que liberam fluoretos podem reduzir o risco de lesões de mancha branca em volta de bráquetes. Entretanto, quando lesões de mancha branca já ocorreram, não há evidência que materiais que liberam fluoretos reduzem a extensão da lesão.

Effects of solvent volatilization time on the bond strength of etch-and-rinse adhesive to dentin using conventional or deproteinization bonding techniques.

OBJECTIVES: This study determined the effect of the air-stream application time and the bonding technique on the dentin bond strength of adhesives with different solvents. Furthermore, the content and volatilization rate of the solvents contained in the adhesives were also evaluated. MATERIALS AND METHODS: Three adhesive systems with different solvents (Stae, SDI, acetone; XP Bond, Dentsply De Trey, butanol; Ambar, FGM, ethanol) were evaluated. The concentrations and evaporation rates of each adhesive were measured using an analytical balance. After acid-etching and rinsing, medium occlusal dentin surfaces of human molars were kept moist (conventional) or were treated with 10% sodium hypochlorite for deproteinization. After applying adhesives over the dentin, slight air-stream was applied for 10, 30 or 60 sec. Composite cylinders were built up and submitted to shear testing. The data were submitted to ANOVA and Tukey's test (α = 0.05). RESULTS: Stae showed the highest solvent content and Ambar the lowest. Acetone presented the highest evaporation rate, followed by butanol. Shear bond strengths were significantly affected only by the factors of 'adhesive' and 'bonding technique' (p < 0.05), while the factor 'duration of air-stream' was not significant. Deproteinization of dentin increased the bond strength (p < 0.05). Stae showed the lowest bond strength values (p < 0.05), while no significant difference was observed between XP Bond and Ambar. CONCLUSIONS: Despite the differences in content and evaporation rate of the solvents, the duration of air-stream application did not affect the bond strength to dentin irrespective of the bonding technique.

Do metal post-retained restorations result in more root fractures than fiber post-retained restorations? A systematic review and meta-analysis.

INTRODUCTION: Teeth requiring endodontic treatment commonly have compromised a coronal tooth structure that often requires the use of an intraradicular post to retain the coronal restoration. Although usually successful, catastrophic failures requiring extraction have been reported in the literature. The aim of this systematic review was to analyze clinical trials and cohort studies that evaluated the incidence rate of root fractures in post-retained restorations. The hypothesis was that the incidence rate related to the use of metal posts was higher than that of fiber posts. METHODS: A MEDLINE search for clinical studies reporting the incidence of root fractures of restorations retained with fiber posts or metal posts of endodontically treated teeth with a more than 5-year follow-up was conducted from inception to January 2014. Seven randomized clinical trials and 7 cohort studies were included. RESULTS: The pooled survival rate was 90% (95% confidence interval, 85.5-93.3) for metal-based posts and 83.9% (95% confidence interval, 67.6-92.8) for fiber-reinforced posts. The overall incidence rate of root fractures (catastrophic failures) was similar between metal and fiber posts. Prefabricated metal posts and carbon fiber posts had a 2-fold increase in the incidence rate of root fractures compared with cast metal posts and glass fiber posts, respectively. CONCLUSIONS: The results of this study did not show significant differences for root fracture incidence between metal- and fiber posts. However, the studies included in this review presented a high risk of bias, and further well-designed clinical studies are required to confirm these findings.