Apical enlargement favors endodontic irrigation ­ an in vivo study

Aim: This study evaluated the irrigation penetration during root canal instrumentation and the clinical step in which the irrigation solution can be detected in the apical region. Materials and Methods: Twenty necrotic molars were divided according to the irrigation protocol, saline solution with manual active pressure, and 2.5% sodium hypochlorite with dripping delivery. Solution penetration assessment used a radiopaque component added to each irrigant solely before a periapical radiograph. Instrumentation sequence was: #10, and #15 K-files (step 1), cervical flaring using WaveOne Small (step 2), WaveOne Small at working length (step 3), Hero-642 #35/.02 (step 4), and Hero-642 #40/.02 (step 5). The step each contrasted-irrigant reached the 2-mm-apical region was registered. Shapiro-Wilk and Fisher's exact tests were used for comparisons. Results: In step 3, both contrasted-irrigants started to be detected in the apical region, and after step 5, contrasted-irrigants penetrated in 100% of the cases, without significant difference. Conclusion: Considering distal molar roots, the apical enlargement up to an instrument #40.02 favors the irrigation to reach the 2-mm apical region.

Apical root canal cleaning after preparation with endodontic instruments: a randomized trial in vivo analysis.

OBJECTIVES: This study aimed to evaluate vital pulp tissue removal from different endodontic instrumentation systems from root canal apical third in vivo. MATERIALS AND METHODS: Thirty mandibular molars were selected and randomly divided into 2 test groups and one control group. Inclusion criteria were a positive response to cold sensibility test, curvature angle between 10 and 20 degrees, and curvature radius lower than 10 mm. Root canals prepared with Hero 642 system (size 45/0.02) (n = 10) and Reciproc R40 (size 40/0.06) (n = 10) and control (n = 10) without instrumentation. Canals were irrigated only with saline solution during root canal preparation. The apical third was evaluated considering the touched/untouched perimeter and area to evaluate the efficacy of root canal wall debridement. Statistical analysis used t-test for comparisons. RESULTS: Untouched root canal at cross-section perimeter, the Hero 642 system showed 41.44% ± 5.62% and Reciproc R40 58.67% ± 12.39% without contact with instruments. Regarding the untouched area, Hero 642 system showed 22.78% ± 6.42% and Reciproc R40 34.35% ± 8.52%. Neither instrument achieved complete cross-sectional root canal debridement. Hero 642 system rotary taper 0.02 instruments achieved significant greater wall contact perimeter and area compared to reciprocate the Reciproc R40 taper 0.06 instrument. CONCLUSIONS: Hero 642 achieved higher wall contact perimeter and area but, regardless of instrument size and taper, vital pulp during in vivo instrumentation is not entirely removed.

Assessment of Apical Extrusion using Rotary and Reciprocating Systems during Root Canal Retreatment.

AIM: The objective of this study was to assess apical extrusion after filling material removal using two systems, one rotary and one reciprocating. MATERIALS AND METHODS: A total of 34 extracted mandibular premolars with single roots were selected and, posteriorly, prepared and filled. Following material aging for 60 days, teeth were divided into two groups, according to the method used to remove root filling material: group I, ProTaper® Universal Retreatment instruments plus refining with the Hero 642® sequence and group II, WaveOne® instruments. The teeth were fixed in an apparatus designed to collect the extruded material during removal procedure. Data on the amount of debris extruded (mg/weight) were analyzed using the Student's t test with a significance level of 5%. RESULTS: No significant differences were found between the groups with regard to the amount of material extruded during root canal retreatment. CONCLUSION: The present findings suggest that the extrusion of debris during apical root canal retreatment does not depend on the instrument design or the protocol employed. CLINICAL SIGNIFICANCE: Regardless of root canal clearance techniques, debris extrusion eventually occurs during endodontic retreatment and may be related to postoperative pain.

Comparação da acuracidade de localizadores eletrônicos foraminais / Accuracy comparison of electronic apex locators

A Odontometria é uma etapa importante para o sucesso da terapia endodôntica e, para isso, localizadores eletrônicos foraminais são utilizados. O método eletrônico, na obtenção do comprimento de trabalho (CT), tem se mostrado seguro e eficaz, possibilitando uma correta mensuração do dente. Foram comparadas duas marcas diferentes de localizadores eletrônicos foraminais utilizados na obtenção do CT antes e após o preparo cervical e também foram avaliadas possíveis diferenças entre a acuracidade dos aparelhos. Foram utilizados 24 incisivos centrais superiores extraídos obtidos em um banco de dentes. Os dentes foram inseridos em uma base experimental composta por alginato. Imediatamente após o acesso coronário, efetuaram-se as medições eletrônicas iniciais, tendo como critério a marcação "ápice" dos aparelhos NovApex e FinePex. Em sequência, o preparo cervical foi executado e uma nova medida realizada com os dois localizadores eletrônicos. Posteriormente, para a confirmação visual, uma lima tipo Kerr #10 foi introduzida até sua extremidade ser observada na saída foraminal com aumento de oito vezes. Então, posicionou-se o stop de borracha no bordo incisal e mediu-se esse comprimento com uma régua endodôntica milimetrada, obtendo-se o comprimento real do dente. Os dados foram analisados estatisticamente e não verificou-se diferença estatística quanto ao tipo de localizador foraminal utilizado (p=0,927) para esse grupo de dentes. O preparo cervical também não influenciou na medida (p=0,157). O presente estudo demonstrou acurácia de 100% para o localizador NovApex e 99,38% para o localizador FinePex, mostrando ser esse um método eficiente para ser empregado na terapia endodôntica (AU).

Odontometry is an important step for the success of endodontic therapy and, for this, foraminal electronic locators are used. The electronic method, in obtaining the working length (WL), has been shown to be safe and effective, allowing a correct measurement of the tooth. Two different brands of foraminal electronic locators used to obtain the WL before and after cervical preparation were compared and also it was evaluated possible differences between the accuracy of the devices. Twenty four extracted central incisors obtained in a tooth-bank were used. Teeth were inserted into an experimental base composed of alginate. Immediately after the coronary access, the initial electronic measurements were made using the "apex" marking of the NovApex and FinePex locators. In sequence, cervical preparation was performed and a new measurement performed with the two electronic locators. Afterward, for visual confirmation, a Kerr #10 file was introduced until its end was observed at the foraminal output with magnification of eight times. Rubber stop was placed on the incisal edge and the length was measured with a millimeter endodontic ruler, obtaining the actual length of the tooth. The data were analyzed statistically, there was no statistical difference regarding the type of foraminal locator used (p=0.927) for this group of teeth. The cervical preparation also did not influence the measurement (p=0.157). The present study demonstrated an average accuracy of 100% for the NovApex locator and 99.38% for the FinePex locator, proving to be an efficient method to be employed in endodontic therapy (AU).

Pulpotomia na rede pública em municípios da região norte do Rio Grande do Sul / Pulpotomy in public health in northern region cities of Rio Grande do Sul

Objetivo: Avaliar a decisão dos cirurgiões-dentistas frente à utilização da pulpotomia na rede pública em 16 municípios do Rio Grande do Sul, RS. Métodos: O estudo possui desenho transversal, quantitativo, com delineamento descritivo. A amostra não-probabilística, de conveniência, foi formada por 40 cirurgiões-dentistas. A coleta de dados se fez pelo envio de questionários aos profissionais da rede pública, com questões relacionadas à técnica de pulpotomia, e perguntas de relação social. Resultados: os resultados demonstraram que 92,5% (n=37) dos profissionais relataram não realizar tratamento endodôntico no serviço de atendimento público. Em relação à pulpotomia, 52,5% (n=21) realizam a técnica e quanto à técnica ser empregada no serviço público, 77,5% (n=31) relatam que deveria ser empregada. Mais da metade dos profissionais, 67,5% (n=27), responderam que consideram provisória a técnica de pulpotomia. No serviço público em que atuam 57,5% (n=23) não utilizam raio-x. Conclusões: Concluiu-se que um pouco mais da metade dos cirurgiões-dentistas pesquisados realizam a técnica de pulpotomia na rede pública, mesmo sem às vezes possuir as condições ideais para tal, como a ausência de raio-x. Utilizam como substância irrigadora o soro fisiológico e capeamento pulpar o hidróxido de cálcio e acreditando ser viável, porém com caráter provisório(AU)

The present work had the purpose of evaluating the decision of the dental surgeons regarding the use of Pulpotomy in the public health in 16 municipalities of Rio Grande do Sul State, RS, Brazil. The data collection was done by sending questionnaires to dental surgeons, making a sample of 40 professionals, being a study with a descriptive design, constituting a non- probabilistic sample, with questions related to Pulpotomy technique, and questions of relation social. The results showed that 92.5% (n = 37) of the professionals reported not performing endodontic treatment in the public service. Regarding pulpotomy, 52.5% (n = 21) performed the technique and the technique was employed in the public service, 77.5% (n = 31) reported that it should be used. 67.5% (n = 27) of the respondents answered that they consider the Pulpotomy technique to be provisional. In the public service in which they work 57.5% (n = 23) do not use x-ray. However, it was concluded that a little more than half of the surveyed dentists (57.5%) performed the pulpotomy technique in the public health, even without sometimes having the ideal conditions for such, such as the absence of x-ray. They use as irrigating substance saline and pulp capping calcium hydroxide and believing it to be viable, but with a provisional character(AU)

Regaining Apical Patency with Manual and Reciprocating Instrumentation during Retreatment.

INTRODUCTION: Different techniques have been proposed to help achieving apical patency during endodontic treatment and retreatment. The objective of this in vitro study was to compare reestablishment of apical patency in teeth previously subjected to root canal treatment using manual and reciprocating instruments. METHODS AND MATERIALS: A total of 40 single-rooted extracted human mandibular incisors were selected and prepared using the Hero 642 sequence to 45/0.02 and obturated using Tagger's hybrid technique to 1 mm short of the apex. Teeth were divided into two groups according to the type of instrument used to regain patency: group 1, hand K-files and group 2, reciprocating WaveOne Primary files (25/0.08). Fisher's exact test was used in the statistical analysis. Result: In group1, apical patency was regained in 9 of the 20 teeth tested (46%), compared to 20 teeth (100%) in group 2. The difference between the groups was significant (P<0.0001). CONCLUSION: Our study shows that reciprocating instrumentation is more successful in regaining apical patency in single-rooted, previously treated teeth.

Avaliação radiográfica de três métodos de inserção de cimento endodôntico / Radiographic evaluation of three endodontic sealer insertion methods

O cimento é um material indispensável no tratamento endodôntico, com a finalidade de preencher e selar os espaços entre os cones de guta-percha, unindo-os às paredes do canal radicular, promovendo o selamento na região apical, não permitindo que os fluídos provenientes dos tecidos periapicais possam gerar uma recontaminação do sistema de canais. Objetivo: Este trabalho teve como objetivo avaliar radiograficamente a capacidade de penetração do cimento endodôntico AH Plus em canais laterais simulados em relação às técnicas de inserção com lima, cone de guta-percha principal e inserto ultrassônico. Material e método: Trinta pré-molares unirradiculares humanos com forames patentes foram preparados com brocas Gates- Glidden e Largo, e, logo a seguir, com sistema mecanizado e limas de níquel titânio K3. Seis canais laterais foram simulados em cada dente com brocas LN, dois em cada terço, com posterior irrigação ultrassônica passiva. Com os canais secos, os dentes foram divididos em três grupos de acordo com modo de inserção do cimento AH Plus ao canal. Ao término do preenchimento, radiografaram-se os dentes para posterior análise radiográfica. Conclusão: Concluiu-se que o preenchimento dos canais laterais simulados com o cimento AH Plus mostrou melhores resultados com a utilização de inserto ultrassônico.

The cement is an indispensable material in endodontic treatment, in order to fill and seal the spaces between the guta-percha points, linking them to the root canal, providing sealing in the apical region, not allowing the fluids from the tissue periapical can cause a recontamination of the channel system. Aim: This study aims to evaluate the radiographic penetration ability of AH Plus sealer in simulated lateral canals regarding insertion techniques with lime, cone guta-percha master point and ultrasonic insert. Material and method: Thirty human premolars unirradicular with patent foramen were prepared with Gates Glidden and Largo drills, followed by mechanized system files nickel-titanium K3. Six lateral canals were simulated in each tooth with LN drills, two in each third, followed by passive ultrasonic irrigation. With dry channels, three groups were created according to the method of insertion of the AH Plus sealer. At the end of root filling, teeth were radiographed for subsequent analysis. It was concluded that the filling of simulated lateral canals with AH Plus sealer showed better results with the use of ultrasonic insert.

Acute odontogenic maxillary sinusitis treated endodontically ­ two case reports and 15-day CBCT outcome

Patients presented acute recurrences from Otorhinolaryngology treatments with unilateral symptoms compatible with maxillary sinusitis with a dental origin (MSDO). Cone beam computed tomography (CBCT) showed sinus extensive membrane thickening that was not visible at periapical exam associated to the maxillary molar infection in both cases. Respiratory structures assessment was possible using a 6-inches field of view CBCT. Non-surgical endodontic treatment (case 1) performed and retreatment (case 2) showed a fast symptoms relief. Recall examination after 15 days revealed healthy soft tissues with normal periodontal probing and no dental mobility. In addition, 15-day CBCTs revealed initial maxillary sinus membrane recovery after the endodontic approaches in the reported cases. No additional medical intervention nor antibiotics administration were necessary in these MSDO cases management. Long-term follow-up in such cases is advisable to exclude other potential dental or respiratory issues. Diagnose and follow-up using CBCT presented significant sinus membrane thick reduction with no symptom's recurrence after the endodontic treatment

Análise retrospectiva do reparo clínico e radiográfico em cirurgias paraendodônticas / Retrospective analysis of clinical and radiographic repair in paraendodotic surgeries

Este estudo avaliou o índice de sucesso em cirurgias paraendodônticas executadas pelos alunos do Curso de Especialização em Endodontia do Centro de Estudos Odontológicos Meridional - CEOM, Passo Fundo/RS, através de controle clínico e radiográfico em um período de até três anos de proservação. Os pacientes que realizaram as cirurgias paraendodônticas foram rechamados e avaliados com um exame clínico e radiográfico da região operada para determinar o grau de reparo radiográfico de acordo com Rud et al.19 (1972) que classificam em Grupo I - Reparo Completo, Grupo II - Reparo Incompleto (cicatriz fibrosa), Grupo III - Reparo Incerto e Grupo IV - Reparo Insatisfatório (fracasso/insucesso). Após coleta dos dados, as radiografias de proservação de cada caso foram observadas por cirurgiões dentistas que definiram se houve ou não regressão das lesões através da análise das radiografias pré e pós- -cirúrgicas associadas aos dados clínicos. Do total de 43 pacientes submetidos à cirurgia no período de 3 anos, 15 pacientes retornaram para exame clínico e radiográfico. Dos 15 pacientes, um total de 17 dentes foram incluídos na amostra. Enquadraram-se no Grupo I - 11 dentes (64,7%), no Grupo II - 3 dentes (17,6%), no Grupo III - 2 dentes (11,8%) e no Grupo IV - 1 dente (5,9%). A taxa de sucesso agrupando-se os Grupos I e II foi 82,35%. O índice de insucesso foi 17,65%. Concluiu-se que o tratamento cirúrgico como complementar ao tratamento endodôntico pode ser uma alternativa na manutenção dos dentes com saúde e função, apresentando boas taxas de sucesso (AU).

This study evaluated the success rate in paraendodontic surgeries performed by students of the Endodontic Specialization Course of the Center for Southern Dental Studies - CEOM, Passo Fundo/RS, through clinical and radiographic control in a period of up to three years of proservation. Patients who underwent paraendodontic surgeries were recalled and evaluated with a clinical and radiographic examination of the operated region to determine the degree of radiographic repair according to Rud et al.19 (1972), which classify as Group I - Complete Repair, Group II - Incomplete Repair (fibrous scar), Group III - Uncertain Repair, and Group IV - Unsatisfactory Repair (failure/failure). After data collection, the radiographs of each case were reviewed by dental surgeons who defined whether or not there was regression of the lesions through the analysis of pre and post-surgical radiographs associated with the clinical data. Of the 43 patients who underwent surgery within 3 years, 15 patients returned for clinical and radiographic examination. Of the 15 patients, total of 17 teeth were included in the sample. Group I - 11 teeth (64.7%), Group II - 3 teeth (17.6%), Group III - 2 teeth (11.8%), and Group IV - 1 tooth (5.9%). The success rate grouping Groups I and II was 82.35%. The failure rate was 17.65%. It was concluded that the surgical treatment as a complement to the endodontic treatment can be an alternative in the maintenance of the teeth with health and function, presenting good success rates (AU).

Avaliação do número de foraminas e diâmetro da foramina maior nas raízes de molares inferiores / Assessment of foramina number and largest foramina diameter in mandible molar roots

O conhecimento da anatomia e da grande variação na morfologia dental interna é imprescindível para uma boa resolução das etapas do tratamento dos canais radiculares. Em virtude disso, a anatomia dental interna deve ser compreendida desde a câmara pulpar até a região apical, a qual irá abrigar estruturas de suma importância para o tratamento: o forame e as foraminas apicais. Dessa forma, o presente estudo teve como objetivo avaliar o número de foraminas presentes nas raízes mesial e distal de molares inferiores e medir o diâmetro da foramina maior encontrada. Para tal procedimento, realizou-se uma pesquisa in vitro, na qual foram avaliados 91 dentes molares inferiores. Esses elementos foram limpos com peróxido de hidrogênio na cuba ultrassônica e tiveram sua porção apical corada com azul de metileno 1%. O corante dos ápices foi limpo e a região apical, avaliada em microscopia óptica com magnificação de 40 vezes e a análise do número de foraminas, bem como o diâmetro da maior foramina encontrada, foi mensurada no programa Image J versão 1.46R. A análise dos resultados foi feita no programa Excel e, posteriormente, foi feita análise estatística com o programa SPSS. A maioria das raízes mesiais dos primeiros molares inferiores apresentou uma (23,07%) e duas foraminas (23,07%). A maioria das raízes distais (31,86%) apresentou uma foramina (p<0,05). A média do diâmetro da foramina maior encontrada na raiz mesial foi de 0,251 mm e na raiz distal 0,268 mm, sem diferença estatisticamente significante (p= 0,3359) (AU).

The awareness of anatomy and wide shape range of the internal dental morphology is extremely important to achieve good performance in all root canal treatment stages. Due to this, the internal dental anatomy must be known from pulp to the apical region, because meaningful structures are placed in: foramina and apical foramen. So this study aims to assess the number of foramen in mesial and distal mandibular root teeth and measure the largest foramen diameter found. For this procedure, in vitro research was performed, which evaluated 91 molar teeth. The teeth were cleaned with hydrogen peroxide in an ultrasonic cleaner, then their apex portion was colored with 1% methylene blue. Once the dye was taken out from the apical region it was evaluated by a microscopy with 40 times magnification, an analysis of foramen number was performed and the largest foramen was found and measured through Image J versão 1.46R software. The results assessment was done by Excel program and later statistical analysis with SPSS. The majority of the first mandible molar mesial root showed one (23.07%) and two foramen (23.07%). The majority of the distal roots showed one foramen. The diameter average of the largest foramen found were 0.251 mm on mesial root and 0.268 mm on distal root, showing no statistically significant difference (p = 0.3359) (AU).

Influência da conicidade dos instrumentos rotatórios de NiTi no transporte apical û um estudo comparativo com tomografia computadorizada / Influence of taper of NiTi rotary instruments in apical transportation: a comparative study with computed tomography

A proposta deste estudo foi avaliar, ex vivo, a influência da conicidade dos instrumentos rotatórios de níquel-titânio (NiTi) no transporte apical de canais radiculares curvos com tomografia computadorizada. Vinte primeiros molares superiores humanos extraídos foram selecionados e divididos em dois grupos. Os canais radiculares no GrupoHERO 642 (n=10) foram preparados com instrumentos rotatórios de NiTi do sistema HERO 642, conicidade 0,02. Os canais radiculares do Grupo EASY ProDesign (n=10) foram preparados com instrumentos rotatórios de NiTi EASY ProDesign, conicidades múltiplas. O transporte apical foi mensurado comparando imagens de tomografia computadorizada antes do preparo, após o preparo com instrumentos # 35/.02 (Grupo HERO 642) e instrumento # 35/.04 (Grupo EASY ProDesign), e após o preparo com instrumento # 45/.02 (Grupo HERO 642) e instrumento # 40/.04 (Grupo EASY ProDesign). Os dados foram analisados utilizando ANOVA e o nível de significância p. 05. Os valores médios de transporte apical em milímetros (mm) para o Grupo HERO 642 foram 0,93 ± 0,48 mm (#35/.02) e 1,48 ± 0,63 mm (# 45/.02) e para o Grupo EASY ProDesign foram 0,82 ± 0,85 mm (# 35/.04) e 1,03 ± 0,92 mm (# 40/.04). Os instrumentos rotatórios de NiTi de conicidade 0,02 e de múltiplas conicidades mostraram desempenho similar em relação ao transporte apical em canais radiculares curvos.

The aim of this study was to evaluate ex vivo the influence of the taper of nickel-titanium (NiTi) rotary instruments in apical transportation of curved root canals with computed tomography. Twenty extracted maxillary first molars were selected and divided into two groups. The mesiobuccal root canals in Group HERO 642 (n=10) were instrumented with HERO 642 rotary instruments, 0.02 taper. The mesiobuccal root canals in Group EASY ProDesing (n=10) were instrumented with EASY ProDesign rotary instruments, multiple tapers. Apical transportation was measured by comparing tomographic images before preparation, after the preparation with size 35, 0.02 taper (Group HERO 642) and size 35, 0.04 taper (Group EASY ProDesing), after the preparation with size 45, 0.02 taper (Group HERO 642) and size 40, 0.04 (Group EASY ProDesing). Data were analyzed using ANOVA, and significance was set at p.05. The preparation of curved root canals can be accomplished with instruments of diameters and taper larger than 0.02.

A influência da experiência do operador para atingir o comprimento de trabalho durante o retratamento endodôntico / Influence of operator experience to accomplish working length during endodontic retreatment

Frente ao insucesso endodôntico, a primeira opção de tratamento é a reintervenção ou retratamento do canal radicular. Poucos estudos têm trabalhado a temática da experiência do operador no tempo dessa intervenção. Diante dessa lacuna, o presente estudo objetivou avaliar o tempo para atingir o comprimento de trabalho na desobturação de canais radiculares por três operadores. Foram selecionados quarenta e cinco dentes humanos extraídos, uniradiculares, previamente preparados e obturados e, após o envelhecimento do material obturador, submetidos ao método de desobturação com os instrumentos ProTaper Universal Retratamento por diferentes operadores, levando em consideração a sua experiência - um especialista em Endodontia, um aluno de especialização em Endodontia e um aluno de graduação. Os resultados obtidos mostraram que o tempo foi significativamente diferente entre os grupos (p = 0,02); e que o CT não teve diferença estatisticamente significativa no tempo obtido para desobturação (p = 0,05). Como conclusão, houve diferença no tempo para a obtenção do comprimento de trabalho entre os operadores, sendo que o especialista e o aluno de especialização levaram menos tempo para chegar ao comprimento de trabalho do que o aluno de graduação (AU).

When facing endodontic treatment failure, the first treatment option is the reintervention or retreatment of the root canal. Few studies have worked with the issue related to operator experience in the intervention timeline. Due to this gap, this study evaluated the time to accomplish working length of root canals desobturation by three operators. Forty-five extracted uniradiculars human teeth were selected, previously prepared and filled and after aging of the filling material, they were submitted to the desobturation method with ProTaper Universal Retreatment instruments by different operators, taking into account their experience - an Endodontics specialist, a student of Endodontics specialization and an undergraduate student. The results showed that the time was significantly different between groups (p = 0.02); and WL had no statistically significant difference in the time obtained for desobturation (p = 0.05). In conclusion, there was difference in the time to obtain the working length between the operators, as the specialist and the specialization student took less time to reach the working length than the graduate student (AU).

Determinação do tempo necessário para a remoção do material obturador de pré-molares inferiores com limas ProTaper Universal D e Mtwo. R / Determining the necessary time to remove filling material from mandibular premolars using ProTaper universal D and Mtwo. R instruments

Com a evolução técnico-científica ocorrida na Endodontia, torna-se difícil selecionar qual instrumento rotatório é mais eficiente na remoção do material obturador para o retratamento endodôntico. A redução do tempo de trabalho é um fator importante na escolha dos instrumentos endodônticos. Sendo assim, procura-se uma técnica de desobturação rápida e eficiente, visando facilitar a remoção da guta percha dos canais radiculares, com benefícios tanto ao profissional quanto ao paciente. O propósito deste estudo foi avaliar o tempo para se conseguir obter o comprimento de trabalho (CT) dos canais radiculares, utilizando dois diferentes instrumentos pela técnica mecanizada. Para isso, 40 pré-molares inferiores extraídos foram aleatoriamente divididos em dois grupos (n=20), previamente obturados, armazenados e então desobturados. No Grupo 1 foram utilizados os instrumentos ProTaper® Universal D e no Grupo 2 os instrumentos Mtwo.R®. O tempo para obtenção do CT em dentes já tratados endodonticamente foi obtido através de um cronômetro. Os dados foram registrados em tabelas para serem analisados e posteriormente avaliados pelo teste t de Student. Os resultados mostraram que não houve diferença estatística entre os tempos dos dois grupos (p=0,69), porém os instrumentos ProTaper® Universal D foram mais velozes na remoção da guta percha quando foram utilizados os três instrumentos para chegar ao CT (p=0,02)...

Endodontics has advanced on science and techniques, due to this fact itÆs hard to select which is the most efficient rotary instrument to remove filling material when it comes to endodontic retreatment. Reduced working time is an important criteria on the choice of the instrument to be used. Thus, an efficient and fast un-filling technique is required to facilitate the removal of gutta percha from the root canals and assure benefits to both practitioner and patient. This study aimed to assess the time spent to get the root canalsÆ working length (WL) by using two different rotary instruments. Forty extracted mandible premolars were randomly divided into two groups (n=20). The teeth had been previously filled in with filling material then stored and finally they had been unfilled. In Group 1, the unfilling was performed wth ProTaper® Universal D, while for Group 2 the Mtwo.R® was used. A timer was used to determine the necessary time to get the WT on retreated teeth. Data had been recorded in a chart to following analyses by StudentÆs T Test. Results showed no statistical difference between times for both groups (p=0.69), although the ProTaper® Universal D instruments were faster on removing the gutta percha when three instruments were used to reach the WL (p=0.02)...

Ultra-thin porcelain laminates to restore esthetics of anterior teeth: case report

Introduction: The ultra-thin porcelain laminates provide the esthetic harmony to the smile compromised by the presence of diastema between maxillary incisors. Objective: To report the dental aesthetic recovery with ultra-thin porcelain laminates, so-called "contact lenses". Case report: Patient sought treatment reporting presence of diastema between the anterior teeth. After the clinical examination, impressions were made to obtain study models and diagnostic wax-up. Home bleaching was conducted using 10% carbamide peroxide for 21 days. Next, the mock-up with bisacrylic self-curing composite resin and the functional impression were conducted. For cementation, dental surfaces were etched with 37% phosphoric acid followed by applying the adhesive system. The resin cement was inserted within internal part of the contact lenses previously treated with hydrof luoric acid and silane, and the prosthetic samples were positioned over the labial surfaces of the anterior teeth. After light-curing, the finishing procedure was performed. Conclusion: Ultra-thin porcelain laminates (contact lenses) were viable, efficient, and conservative procedures for recovering dental esthetic, with no need of invasive procedures.

Evaluation of three root canal filling techniques through digital radiograph

Introduction: Endodontic obturation consists of root canal filling by antiseptic or inert materials that promote a three-dimensional sealing and stimulate the repair process without interfering with it. Different obturation techniques and materials have been proposed to meet this requirement. Objective: To compare the root canal filling promoted by lateral condensation technique, Tagger's hybrid technique and McSpadden technique by assessing the filling quality through digital radiograph. Material and methods: A total of 45 extracted single-rooted human teeth were used and randomly divided into three experimental groups. After instrumentation, the teeth were filled by lateral condensation (n=15), Hybrid Tagger (n=15), and McSpadden techniques (n=15). Then, digital radiographs were taken with projected increased 10 times, at mesial-distal and buccolingual directions. Results: Visually, few empty spaces were detected at the three root thirds of teeth filled by different techniques. However, statistical analysis (Kruskal-Wallis) found no differences among the different groups, neither among the different thirds nor between both incidences evaluated. Conclusion: It was concluded that the three obturation techniques exhibited similar behavior in relation to the sealing of the root canal through digital radiograph.

Evaluation of postoperative pain in endodontically treated teeth

Introduction: The success of endodontic treatment is directly related to the morphology domain and endodontic infection control. Some factors such as procedural errors (instrumentation, obturation apical deviations and perforations) can cause postoperative pain. Objective: This study aimed to evaluate postoperative pain in endodontically treated teeth at Dentistry Post-graduation Clinic of Meridional School (IMED/CEOM), Passo Fundo/Brazil from January 2010 to June 2013. Material and methods: The study was approved by the Institutional Review Board. After collection, data were analyzed regarding the occurrence of postoperative pain. This research is a quantitative cross-sectional study, whose sample comprised 302 medical records of patients undergoing endodontic treatment from a non-probability sampling. The review of follow-up appointment charts was carried out by the researcher. Results: During the research period and analysis of 302 medical records, 30.80% showed postoperative pain. However, 69.20 % did not feel any pain. Conclusion: It can be concluded that the pain was more frequent when associated with vital pulp, and these data are relevant to the dental clinic.

Histologic evaluation of human pulp tissue after orthodontic intrusion.

INTRODUCTION: The forces applied during orthodontic treatment bring about effects on the teeth and surrounding tissues. The aim of this study was to evaluate the possible changes in the human pulpal tissue resulting from orthodontic intrusion in a 21-day period using histologic examination. METHODS: The sample consisted of 17 young individuals of both sexes between the ages of 12 and 19 years. A total of 34 premolars were evaluated with orthodontic indication of extraction. Because it is a split-mouth study, in each patient, intrusion force of 60 g was applied randomly on 1 of the dental elements experimental group for 21 days. The counterpart control group received no force. After extractions, these dental elements were fixed in 10% formaldehyde, processed automatically, submitted to histotechnical preparation, and stained with hematoxylin-eosin for analysis under optical microscope. RESULTS: The paired Fisher exact test (P ≤ .05) showed a significant increase of fibrous tissue in the experimental group. The nonparametric paired Wilcoxon test (P ≤ .05) showed a significant increase in the number of pulpal nodules in the elements of the experimental group and showed no difference in the number of blood vessels between the groups. Large-caliber vessels and congested elements were observed in 8 of the experimental group elements. CONCLUSIONS: The orthodontic intrusion force, in these conditions, caused vascular changes in the pulpal tissue and also increased the presence of fibrosis and the number of pulp calcifications in the experimental elements.

Histological analysis of cleaning capacity in apical third of flattened root canals with passive ultrasonic irrigation

Introduction and Objective: The aim of this study was to evaluate histologically the passive use of ultrasound for cleaning the apical portion of flattened root canal systems. Material and methods: The sample consisted of 20 extracted human mandibular incisors which were divided into two groups after being prepared with the rotary system Hero 642 up to size #45 surgical diameter: Group A - final irrigation with 4 ml of 2.5% sodium hypochlorite by the conventional technique using a syringe, and Group B - final irrigation with 4 ml of 2.5%, sodium hypochlorite divided into 1 ml amounts which were activated with the passive use of ultrasound for 15 seconds each time, generating a total activation period of 1 minute. Following, the teeth were subjected to morphometric analysis to evaluate the cleaning ability promoted in both groups. Results and Conclusion: Statistical analysis showed significant difference (p < 0.05) between the groups, with the passive ultrasonic irrigation resulting in cleaner canals.

Influência do ângulo de corte radicular na microinfiltração apical, comparando duas técnicas de apicetomia na cirurgia paraendodôntica / Influence of the cutting angle in root apical microleakage, comparing two techniques of apicectomy in paraendodontic surgery

Introdução: a apicetomia é uma modalidade de cirurgia paraendodôntica que consiste na seção da porção apical da raiz. É realizada quando não há a regressão da lesão apical depois de esgotadas as alternativas da terapêutica endodôntica convencional, numa tentativa de eliminação dos micro-organismos apicais e seus produtos tóxicos. Objetivos: o objetivo deste estudo foi verificar a influência do ângulo de corte da raiz na apicetomia em relação à microinfiltração apical, comparando as técnicas de corte do ápice radicular em 90o e 45o. Métodos: utilizaram-se vinte incisivos centrais superiores instrumentados e obturados, divididos aleatoriamente em dois grupos. No grupo A foi realizada a seção da porção apical em 90o e no grupo B, em 45o. Para todos os grupos foi confeccionada retrocavidade com ultrassom e retrobturação com mineral trióxido agregado (MTA). Resultados: os dados obtidos por meio da medida de infiltração linear do corante foram submetidos ao teste Kolmogorov-Smirnov e ao teste de Lavene, que apresentaram distribuição normal e homogeneidade (p > 0,05). Realizou-se, então, a análise inferencial, verificando se existe diferença entre as médias dos grupos através do teste de Anova. Não foi encontrada diferença estatisticamente significativa (p = 0,344) entre os grupos. Conclusão: o ângulo de corte da raiz não influenciou a microinfiltração, pois ambos os cortes avaliados permitiram infiltração apical.

CT evaluation of apical canal transportation associated with stainless steel hand files, oscillatory technique and pro taper rotary system.

This study used computed tomography (CT) to compare apical canal transportation in mesiobuccal canals of maxillary molars prepared with different techniques. Sixty teeth were assigned to 3 groups (n=20), according to the technique used for root canal instrumentation: hand instrumentation with K-Flexofiles, K-Flexofiles activated by an oscillatory system and ProTaper NiTi rotary system. Pre and post-instrumentation CT images were obtained 3 mm short of the apical foramen and were superimposed to compare canal transportation. Data were analyzed statistically by ANOVA and Tukey's test using the SPSS software (α=0.05). In the buccal direction, the manual technique produced significantly less canal transportation than the oscillatory technique (p<0.05) and both were similar to the rotary technique (p>0.05). In the distal and distopalatal directions, the oscillatory technique produced more canal transportation (p<0.05). In the mesiopalatal direction, the oscillatory technique produced more canal transportation than the manual technique (p<0.05), and both were similar to the rotary technique (p>0.05). In conclusion, all techniques produced canal transportation, and the oscillatory technique produced the greatest removal of root dentin toward the innerside of the root curvature.