Lesion Sterilization Tissue Repair: A Review.

As part of lesion sterilization and tissue restoration (LSTR), treatment for primary molars affected by extensive periapical pathosis and extreme resorption entails the use of a triple antibiotic mixture in an appropriate medium. In-depth explanation of all components of LSTR is the main focus of this review of the literature.

LST-R: A method for assessing land surface temperature reduction in urban, hot and semi-arid Global South.

Over the next 30 years, temperatures are expected to increase in hot semi-arid zones. Despite increasing studies on urban heat, cooling measures suitable for this climate zone remain poorly investigated. The proposed method is innovative because it focuses on significant landscape metrics for determining the land surface temperature (LST) and evaluating cooling measures. Recurrence of warm spells was identified analysing the daily air temperatures. Daytime and night-time LST data acquired from space were correlated with landscape metrics extracted from very high-resolution satellite imagery. Stepwise linear regression was used to identify the significant metrics that affected it. Cooling measures were selected considering implementation leeway; performance of existing measures; strengths, weaknesses, opportunities, and threats, equity analyses. Although the method was tested in Niamey, Niger, it can be applied to any city or town in hot semi-arid Global South, requiring decision-making support on cooling policies.•Landscape metrics are consistent with development standard and general requirements.•Evaluation of measures to reduce land surface temperature includes experts... advice.•Equity of measures to reduce land surface temperature is considered.

Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial.

BACKGROUND: Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis. AIM: To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis. DESIGN: Eighty-eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months. RESULTS: At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p = .45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00). CONCLUSION: After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis.

An Unusual Case of Bilateral Radix Entomolaris Treated With Lesion Sterilization and Tissue Repair in Primary First Molars.

Morphological dental anomalies such as supernumerary roots are rare in primary teeth. Their location, frequency, and associated peculiar root canal morphology should be known to a pediatric dentist. It is crucial to carefully examine intraoral radiographs to ensure that such variations do not go undetected. Such variances must be identified to ensure complete cleaning and filling of all root canals. Negligence in treating all canals can result in recurrent infection or treatment failure. Understanding the anatomical variation of the tooth like radix entomolaris (RE), is important for successful dental treatment. This report presents a rare case of bilateral RE of primary mandibular first molars in middle childhood treated with lesion sterilization and tissue repair.

Cryptocurrency market connectedness in Covid-19 days and the role of Twitter: Evidence from a smooth transition regression model.

Τhis paper presents new evidence on connectedness across cryptocurrencies in the era of the Covid-19 pandemic. The results from the TVP-VAR dynamic connectedness approach show that the degree of connectedness is time-varying, indicating a decline during the Covid-19 period. Next, this paper highlights the nonlinear characteristics of the relationship between connectedness and its explanatory variables. The results from the LSTR model indicate that the regression coefficients change smoothly between the low and the upper regimes as anxiety across Twitter users increases. As the latter changes smoothly from low to high values, the impact of higher Disease-based volatility or Twitter-based uncertainty on connectedness turns gradually from positive to negative. The upper regime is dominant during the Covid-19 pandemic. Important implications for investors and policy makers are derived.

Pulpectomia: publicações, evidências científicas e influência da pandemia de Covid-19 / Pulpectomy: publications, scientific evidence and the influence of the COVID-19 pandemic

Objetivou-se analisar o panorama das publicações sobre pulpectomia, de forma geral, além de verificar as evidências acerca do potencial de redução de endotoxinas pelo hidróxido de cálcio e investigar a influência da pandemia de COVID-19 em relação à realização de procedimentos endodônticos em Odontopediatria. Para tanto, foram realizados três estudos. O primeiro visou mapear e discutir, por meio de uma revisão bibliométrica, o panorama das publicações científicas acerca da pulpectomia em dentes decíduos utilizando os termos "pulpectomy", "root canal", "child" AND "preschoolar". O segundo estudo delineou-se como uma revisão sistemática, seguida de metanálise objetivando verificar se existem evidências de redução de endotoxinas antes e depois do uso de hidróxido de cálcio como medicação intracanal em canais radiculares infectados. Riscos de avaliação de viés e metanálises foram realizados. A certeza de evidência foi determinada pelo GRADE. O terceiro estudo pretendeu verificar as possíveis influências da pandemia de COVID-19 na realização de procedimentos endodônticos em Odontopediatria, por meio da aplicação de um questionário eletrônico composto por perguntas divididas em 3 domínios: (1) informações profissionais; (2) gerenciamento de biossegurança e (3) protocolo endodôntico de atendimento antes e durante a pandemia. Após a realização dos três estudos, foi identificada uma tendência na pesquisa científica para a utilização de instrumentação mecanizada e pastas obturadoras mais biocompatíveis e eficazes. Foi possível observar ausência de estudos clínicos multicêntricos sobre procedimentos de pulpectomia em dentes decíduos. A maioria dos estudos foi publicada em periódicos de Odontopediatria, apresentaram ampla variedade de protocolos de tratamento e foram realizados principalmente em países em desenvolvimento, denotando claro viés nas opções de tratamento oferecidas para crianças em todo o mundo, uma vez que o acesso aos serviços de anestesia geral em países desenvolvidos favorece a exodontia dos dentes com comprometimento pulpar. Além disso, concluiu-se que o hidróxido de cálcio reduz os níveis de endotoxinas quando usado como medicação intracanal, mas é incapaz de eliminá-las completamente em dentes permanentes, independentemente de sua associação com alguma solução irrigante. Não foram recuperados artigos em dentes decíduos. No terceiro estudo, a amostra final foi composta por 313 participantes de todos os estados brasileiros. A maioria dos participantes era do sexo feminino (90,35%), e mais da metade cursou Odontopediatria em instituição privada (50,25%) há mais de dez anos (53,63%) e trabalha em metrópole (54,75%). No geral, a maioria dos respondentes atualmente prática Odontopediatria exclusivamente em clínicas privadas (61,63%). Durante a pandemia de COVID-19 foi possível ver um aumento na complexidade dos casos planejados previamente e da quantidade de urgências odontológicas. Levando isso em consideração, muitos odontopediatras sentiram a necessidade de se reinventarem, priorizando técnicas minimamente invasivas e com um menor tempo de consulta. Com isso, pôde-se notar uma tendência pela busca do tratamento endodôntico não instrumental (p<0,01), justamente por ser uma técnica mais rápida e barata. Apesar de já existirem muitos trabalhos publicados acerca da endodontia em dentes decíduos, conforme constatado nos dois primeiros estudos, observa-se que ainda são necessárias novas investigações nessa área. (AU)

The objective was to analyze the overview of publications on pulpectomy, in general, in addition to verifying the evidence about the potential for endotoxin reduction by calcium hydroxide and to investigate the influence of the COVID-19 pandemic in relation to the performance of endodontic procedures in Pediatric Dentistry. Therefore, three studies were carried out. The first aimed to map and discuss, through a bibliometric review, the panorama of scientific publications about pulpectomy in primary teeth using the terms "pulpectomy", "root canal", "child" AND "preschooler". The second study was designed as a systematic review, followed by a meta-analysis aiming to verify if there is evidence of endotoxin reduction before and after the use of calcium hydroxide as an intracanal medication in infected root canals. Bias assessment risks and meta-analyses were performed. The certainty of evidence was determined by GRADE. The third study aimed to verify the possible influences of the COVID-19 pandemic on the performance of endodontic procedures in Pediatric Dentistry, through the application of an electronic questionnaire composed of questions divided into 3 domains: (1) professional information; (2) biosafety management and (3) endodontic care protocol before and during the pandemic. After carrying out the three studies, a trend in scientific research towards the use of mechanized instrumentation and more biocompatible and effective filling pastes was identified. It was possible to observe the absence of multicenter clinical studies on pulpectomy procedures in primary teeth. Most studies were published in pediatric dentistry journals, presented a wide variety of treatment protocols, and were carried out mainly in developing countries, denoting a clear bias in the treatment options offered to children around the world, since access to care services general anesthesia in developed countries favors extraction of teeth with pulp involvement. Furthermore, it was concluded that calcium hydroxide reduces the levels of endotoxins when used as an intracanal medication but is unable to completely eliminate them in permanent teeth, regardless of its association with some irrigating solution. No articles in primary teeth were retrieved. In the third study, the final sample consisted of 313 participants from all Brazilian states. Most of the participants were female (90.35%), and more than half had studied Pediatric Dentistry at a private institution (50.25%) for over ten years (53.63%) and worked in a metropolis (54.75% ). Overall, the majority of respondents currently practice Pediatric Dentistry exclusively in private clinics (61.63%). During the COVID-19 pandemic, it was possible to see an increase in the complexity of previously planned cases and the number of dental emergencies. Taking this into account, many pediatric dentists felt the need to reinvent themselves, changing case plans, prioritizing minimally invasive techniques and with less chair time. Thus, a trend towards the search for non-instrumental endodontic treatment (p<0.001) could be noted, precisely because it is a faster and cheaper technique. Although there are many published works about endodontics in deciduous teeth, as seen in the first two studies, it was observed that further investigations are still needed. (AU)

Pulpectomia: publicações, evidências científicas e influência da pandemia de Covid-19 / Pulpectomy: publications, scientific evidence and the influence of the COVID-19 pandemic

Objetivou-se analisar o panorama das publicações sobre pulpectomia, de forma geral, além de verificar as evidências acerca do potencial de redução de endotoxinas pelo hidróxido de cálcio e investigar a influência da pandemia de COVID-19 em relação à realização de procedimentos endodônticos em Odontopediatria. Para tanto, foram realizados três estudos. O primeiro visou mapear e discutir, por meio de uma revisão bibliométrica, o panorama das publicações científicas acerca da pulpectomia em dentes decíduos utilizando os termos "pulpectomy", "root canal", "child" AND "preschoolar". O segundo estudo delineou-se como uma revisão sistemática, seguida de metanálise objetivando verificar se existem evidências de redução de endotoxinas antes e depois do uso de hidróxido de cálcio como medicação intracanal em canais radiculares infectados. Riscos de avaliação de viés e metanálises foram realizados. A certeza de evidência foi determinada pelo GRADE. O terceiro estudo pretendeu verificar as possíveis influências da pandemia de COVID-19 na realização de procedimentos endodônticos em Odontopediatria, por meio da aplicação de um questionário eletrônico composto por perguntas divididas em 3 domínios: (1) informações profissionais; (2) gerenciamento de biossegurança e (3) protocolo endodôntico de atendimento antes e durante a pandemia. Após a realização dos três estudos, foi identificada uma tendência na pesquisa científica para a utilização de instrumentação mecanizada e pastas obturadoras mais biocompatíveis e eficazes. Foi possível observar ausência de estudos clínicos multicêntricos sobre procedimentos de pulpectomia em dentes decíduos. A maioria dos estudos foi publicada em periódicos de Odontopediatria, apresentaram ampla variedade de protocolos de tratamento e foram realizados principalmente em países em desenvolvimento, denotando claro viés nas opções de tratamento oferecidas para crianças em todo o mundo, uma vez que o acesso aos serviços de anestesia geral em países desenvolvidos favorece a exodontia dos dentes com comprometimento pulpar. Além disso, concluiu-se que o hidróxido de cálcio reduz os níveis de endotoxinas quando usado como medicação intracanal, mas é incapaz de eliminá-las completamente em dentes permanentes, independentemente de sua associação com alguma solução irrigante. Não foram recuperados artigos em dentes decíduos. No terceiro estudo, a amostra final foi composta por 313 participantes de todos os estados brasileiros. A maioria dos participantes era do sexo feminino (90,35%), e mais da metade cursou Odontopediatria em instituição privada (50,25%) há mais de dez anos (53,63%) e trabalha em metrópole (54,75%). No geral, a maioria dos respondentes atualmente prática Odontopediatria exclusivamente em clínicas privadas (61,63%). Durante a pandemia de COVID-19 foi possível ver um aumento na complexidade dos casos planejados previamente e da quantidade de urgências odontológicas. Levando isso em consideração, muitos odontopediatras sentiram a necessidade de se reinventarem, priorizando técnicas minimamente invasivas e com um menor tempo de consulta. Com isso, pôde-se notar uma tendência pela busca do tratamento endodôntico não instrumental (p<0,01), justamente por ser uma técnica mais rápida e barata. Apesar de já existirem muitos trabalhos publicados acerca da endodontia em dentes decíduos, conforme constatado nos dois primeiros estudos, observa-se que ainda são necessárias novas investigações nessa área. (AU)

The objective was to analyze the overview of publications on pulpectomy, in general, in addition to verifying the evidence about the potential for endotoxin reduction by calcium hydroxide and to investigate the influence of the COVID-19 pandemic in relation to the performance of endodontic procedures in Pediatric Dentistry. Therefore, three studies were carried out. The first aimed to map and discuss, through a bibliometric review, the panorama of scientific publications about pulpectomy in primary teeth using the terms "pulpectomy", "root canal", "child" AND "preschooler". The second study was designed as a systematic review, followed by a meta-analysis aiming to verify if there is evidence of endotoxin reduction before and after the use of calcium hydroxide as an intracanal medication in infected root canals. Bias assessment risks and meta-analyses were performed. The certainty of evidence was determined by GRADE. The third study aimed to verify the possible influences of the COVID-19 pandemic on the performance of endodontic procedures in Pediatric Dentistry, through the application of an electronic questionnaire composed of questions divided into 3 domains: (1) professional information; (2) biosafety management and (3) endodontic care protocol before and during the pandemic. After carrying out the three studies, a trend in scientific research towards the use of mechanized instrumentation and more biocompatible and effective filling pastes was identified. It was possible to observe the absence of multicenter clinical studies on pulpectomy procedures in primary teeth. Most studies were published in pediatric dentistry journals, presented a wide variety of treatment protocols, and were carried out mainly in developing countries, denoting a clear bias in the treatment options offered to children around the world, since access to care services general anesthesia in developed countries favors extraction of teeth with pulp involvement. Furthermore, it was concluded that calcium hydroxide reduces the levels of endotoxins when used as an intracanal medication but is unable to completely eliminate them in permanent teeth, regardless of its association with some irrigating solution. No articles in primary teeth were retrieved. In the third study, the final sample consisted of 313 participants from all Brazilian states. Most of the participants were female (90.35%), and more than half had studied Pediatric Dentistry at a private institution (50.25%) for over ten years (53.63%) and worked in a metropolis (54.75% ). Overall, the majority of respondents currently practice Pediatric Dentistry exclusively in private clinics (61.63%). During the COVID-19 pandemic, it was possible to see an increase in the complexity of previously planned cases and the number of dental emergencies. Taking this into account, many pediatric dentists felt the need to reinvent themselves, changing case plans, prioritizing minimally invasive techniques and with less chair time. Thus, a trend towards the search for non-instrumental endodontic treatment (p<0.001) could be noted, precisely because it is a faster and cheaper technique. Although there are many published works about endodontics in deciduous teeth, as seen in the first two studies, it was observed that further investigations are still needed. (AU)

Exploring other paradigms in primary tooth endodontics, a narrative review / Explorando otros paradigmas en endodoncia de dientes primarios. una revisión narrativa / Explorando outros paradigmas em endodontia dentária decídua, uma revisão narrativa

Irreversible pulp inflammation and pulpal necrosis in teeth must be treated by means of conventional endodontic therapy, which presents unavoidable and known limitations in boys and girls. Due to this, the "Sterilization of the injury and tissue repair" therapy has reappeared, which could overcome the complications of conventional endodontic techniques. Therefore, the purpose of this study is to review the current literature regarding the application of this therapy. The Sterilization of the lesion and tissue repair technique uses abundant irrigation and an antibiotic paste (metronidazole, minocycline and ciprofloxacin) at the entrance of the root canals for the therapy of primary teeth with poor prognosis, where conventional endodontic treatment is not indicated. . The objective of the technique is to promote the healing of the periapical tissues and increase the permanence of the tooth in the mouth at a time closer to natural exfoliation. The Sterilization of the lesion and tissue repair technique is an effective alternative for the endodontic management of temporary teeth with a poor prognosis.

La Inflamación pulpar irreversible y necrosis pulpar en dientes deben tratarse por medio de la terapia endodóntica convencional, la que presenta limitaciones inevitables y conocidas en niños y niñas. Debido a esto ha resurgido la terapia "Esterilización de la lesión y reparación de tejidos", la que podría sortear las complicaciones de las técnicas endodónticas convencionales. Por lo tanto, el propósito de este estudio es revisar la literatura actual con respecto a la aplicación de esta terapia. La técnica Esterilización de la lesión y reparación de tejidos usa abundante irrigación y una pasta antibiótica (metronidazol, minociclina y ciprofloxacino) a la entrada de los conductos radiculares para la terapia de dientes primarios con pronóstico malo, en donde el tratamiento endodóntico convencional no está indicado. El objetivo de la técnica es promover la curación de los tejidos periapicales y aumentar la permanencia del diente en boca a un tiempo más cercano a la exfoliación natural. La técnica Esterilización de la lesión y reparación de tejidos es una alternativa eficaz para el manejo endodóntico de dientes temporales con pronóstico malo.

A inflamação pulpar irreversível e a necrose pulpar em dentes devem ser tratadas por meio da terapia endodôntica convencional, que apresenta limitações inevitáveis ​​e conhecidas em meninos e meninas. Com isso, ressurgiu a terapia de "Esterilização da lesão e reparo do tecido", o que poderia superar as complicações das técnicas endodônticas convencionais. Portanto, o objetivo deste estudo é revisar a literatura atual a respeito da aplicação dessa terapia. A técnica de esterilização da lesão e reparo tecidual utiliza irrigação abundante e pasta antibiótica (metronidazol, minociclina e ciprofloxacina) na entrada dos canais radiculares para terapia de dentes decíduos com mau prognóstico, onde o tratamento endodôntico convencional não é indicado. O objetivo da técnica é promover a cicatrização dos tecidos periapicais e aumentar a permanência do dente na boca em um momento mais próximo da esfoliação natural. A técnica de esterilização da lesão e reparo tecidual é uma alternativa eficaz para o manejo endodôntico de dentes temporários com mau prognóstico.

Técnica endodôntica sem instrumentação com pasta CTZ: indicação para dentes decíduos necrosados em saúde pública / Endodontic technique without instrumentation with CTZ paste: Indication for necrotic deciduous teeth in public health

O objetivo desse estudo foi revisar a literatura recente acerca da utilização do TENI com pasta antibiótica CTZ para tratamento de dentes decíduos necrosados e observar condutas de cirurgiões dentistas da rede de Atenção Primária em Saúde do município do RJ quanto aos casos de necrose pulpar em dentes decíduos, obtendo-se dados necessários à elaboração de protocolo clínico para tratamento de tais casos, a ser proposto à Secretaria Municipal de Saúde do RJ (SMS-RJ). A abordagem de dentes decíduos com necrose pulpar representa um desafio em odontopediatria. A conduta biológica da Terapia de Esterilização da Lesão e Reparo Tecidual (LSTR, Lesion Sterilization and Tissue Repair) ou tratamento endodôntico não instrumental (TENI), envolve a aplicação tópica de pasta antibiótica. O TENI com a pasta antibiótica CTZ, que contém uma associação de cloranfenicol, tetraciclina, óxido de zinco e eugenol, apresenta potencial para uso em saúde pública devido à sua baixa complexibilidade, rapidez e baixo custo. Sendo assim, este estudo observacional com documentação indireta e direta, consistiu em uma revisão da literatura recente acerca da utilização da pasta antibiótica CTZ para tratamento de dentes decíduos com envolvimento pulpar e de um estudo observacional transversal exploratório que avaliou condutas de cirurgiões dentistas da Atenção Primária em Saúde do município do RJ (APS-RJ) quanto aos casos de necrose pulpar em dentes decíduos. A revisão da literatura foi realizada através de buscas nas bases PUBMED, BVS, WEB OF SCIENCE, COCHRANE e SCOPUS usando os termos "ctz paste", "ctz", "tooth, deciduous" e "primary molars" com data limitada entre 2015 e janeiro de 2021, sendo obtidos 13 artigos ao final. A pasta CTZ mostrou atividade antimicrobiana satisfatória sobre Enterecoccus faecalis, Staphylococcus aureus, Klebisiella pneumonia, Escherichia coli e Candida albicans. Estudos in vitro e in vivo demonstraram que a pasta apresenta biocompatibilidade. A frequência de sucesso clínico variou de 37% a 100% e o sucesso radiográfico de 29,7% a 97,4%. O estudo observacional transversal exploratório foi realizado através de questionário eletrônico auto aplicado enviado para 579 CDs da APS-RJ, a fim de identificar suas condutas em quatro situações clínicas de necrose pulpar em dente decíduo. Verificou-se também existência de protocolo para atendimento desses casos e o conhecimento sobre o TENI com pasta CTZ. Os dados foram analisados descritivamente. Um total de 90 CD responderam ao questionário, sendo 82,2% do sexo feminino, 42,2% com idade entre 41 e 50 anos e 17,8% com e/ou cursando pós-graduação em Odontopediatria. A conduta mais frequente para dentes posteriores foi o tratamento endodôntico sem instrumentação, variando de 42,2% a 63,3%. Para dente anterior, 50% optaram pelo tratamento endodôntico com instrumentação. O material mais usado foi OZE com medicamentos associados paramonoclorofenol canforado, tricresol ou formocresol, variando de 44,4% a 64,4% entre os casos. 53,3% conhecem o TENI com pasta CTZ e a maioria (75,6%) afirmou não haver protocolo clínico para esses casos em sua unidade, sendo utilizadas terapias pulpares sem embasamento científico. Foi elaborado protocolo clínico que utiliza o TENI com pasta CTZ para tratamento dos dentes decíduos necrosados a ser oferecido à SMSRJ. (AU)

The aim of this study was to review the recent literature on the use of TENI with CTZ antibiotic paste for the treatment of necrotic primary teeth and to investigate the conduct of Public Health primary care dentists in the city of Rio de Janeiro regarding cases of pulp necrosis in primary teeth, obtaining the necessary data to elaborate a clinical protocol to treat such cases, to be proposed to the Public Health Department of Rio de Janeiro (PHD RJ). The approach of primary teeth with pulp necrosis represents a challenge in pediatric dentistry. The biological approach of Lesion Sterilization and Tissue Repair (LSTR) or non-instrumental endodontic treatment (NIET) involves the topical application of antibiotic paste. TENI with the antibiotic paste CTZ, which contains an association of chloramphenicol, tetracycline, zinc oxide and eugenol, has potential for use in public health due to its low complexity and low cost. Therefore, this observational study with indirect and direct documentation, consisted of a review of recent literature on the use of CTZ antibiotic paste for the treatment of primary teeth with pulp involvement and an exploratory cross-sectional observational study that evaluated the conduct of Public Health primary care dentists in RJ regarding cases of pulp necrosis in primary teeth. The literature review was performed through searches in the PUBMED, BVS, WEB OF SCIENCE, COCHRANE and SCOPUS databases using the terms "ctz paste", "ctz", "tooth, deciduous" and "primary molars" with a limited date between 2015 and January 2021, with 13 articles being obtained at the end. The CTZ paste showed satisfactory antimicrobial activity against Enterecoccus faecalis, Staphylococcus aureus, Klebisiella pneumonia, Escherichia coli and Candida albicans. In vitro and in vivo studies showed that CTZ paste presents biocompatibility. The frequency of clinical success ranged from 37% to 100% and radiographic success from 29.7% to 97.4%. The exploratory cross-sectional observational study was carried out through an electronic survey sent to 579 dentists of the PH primary care in the city of RJ, to identify their conduct in four clinical situations of pulp necrosis in primary teeth. It was also investigated the existence of a clinical protocol for these cases and knowledge about NIET with CTZ paste. Data were analyzed descriptively. A total of 90 dentists responded to the survey, 82.2% female, 42.2% aged between 41 and 50 and 17.8% with and/or attending a postgraduate course in Pediatric Dentistry. The most frequent approach for posterior teeth was endodontic treatment without instrumentation, ranging from 42.2% to 63.3%. For anterior teeth, 50% opted for endodontic treatment with instrumentation. The most used material was OZE with drugs associated with camphorated phenol, tricresol or formocresol, ranging from 44.4% to 64.4% among the cases. 53.3% know about TENI with CTZ paste and the majority (75.6%) stated that there is no clinical protocol for these cases in their unit, and pulp therapies are used without scientific bases. A clinical protocol was developed using NIET with CTZ paste for the treatment of deciduous necrotic teeth to be offered to PHD RJ. (AU)

Evaluation of the antimicrobial efficacy of two combinations of drugs on bacteria taken from infected primary teeth (in vitro).

PURPOSE: Using a combination of metronidazole, ciprofloxacin and minocycline (3Mix) for root canal disinfection of primary teeth is a well-known technique known as the lesion sterilisation and tissue repair therapy. Minocycline has the potential to cause discoloration in treated teeth and the permanent successors. This study aimed to assess the efficacy of a new combination of antibacterial drugs, in which minocycline is replaced with clindamycin. METHODS: Thirty hopeless primary teeth according to our inclusion criteria were extracted and enrolled. The experiment was conducted in two parts: aerobic and anaerobic, and the efficacy of the two drug combinations, namely the 3Mix and the other mix (metronidazole, ciprofloxacin and clindamycin), for elimination of bacteria isolated from the primary teeth was evaluated and compared. Data were analysed using SPSS 21 via descriptive statistics and Friedman and Wilcoxon tests. Level of significance was considered at 0.05. RESULTS: Except for minocycline, none of the other antibiotics in the studied concentrations (25, 50 and 100 µg/mL) were able to eliminate all the bacteria. Clindamycin alone was weaker than minocycline, but its combination with metronidazole and ciprofloxacin had the same potency with no significant difference. CONCLUSIONS: Replacement of minocycline with clindamycin in the 3Mix composition is practical and can be generalised to clinical studies and ultimately to the clinical setting.

Clinical evaluation of 3 Mix and Other Mix in non-instrumental endodontic treatment of necrosed primary teeth.

PROBLEM CONSIDERED: The objective was to evaluate and compare the clinical and radiographic efficacy of two different combinations of antibacterial drugs when used in non-instrumental endodontic treatment of necrosed primary teeth. MATERIALS AND METHOD: Forty teeth were randomly divided into two groups, viz. groups A and B having 20 teeth each. In Group A, 3 Mix (ciprofloxacin, metronidazole, and minocycline) and in Group B, Other Mix (ciprofloxacin, ornidazole, and minocycline) mixed with propylene glycol were used. Medication cavities of Group-A and B were filled with 3 Mix and Other Mix respectively followed by restoration of teeth. Clinical evaluation was done at 3 months whereas, clinical and radiographic evaluation was done at 6 and 12 months, respectively. RESULTS: Both the groups showed 100% clinical success whereas, radiographic success rate was 81% with 3 Mix and 92% with Other Mix but, was not statistically significant. CONCLUSIONS: Both the antibacterial pastes can be used effectively in non instrumental endodontic treatment of necrosed primary teeth and require more clinical trials to prove its efficacy.