Análise de pH externo radicular, pós irrigação e medicação intracanal com diferentes materiais / Analysis of external radicular pH, after intracanal irrigation and medication with different materials

O objetivo do presente estudo foi avaliar o pH externo radicular de dentes bovinos pré-selecionados. Neste estudo foram utilizadas soluções irrigadoras, ácido peracético 0,25%, hipoclorito de sódio 2,5% e hipoclorito de sódio 6% associadas ao EDTA e as medicações intracanais, ultracal, hidróxido de cálcio P.A. associado à clorexidina gel 2% e hidróxido de cálcio P.A. associado ao propilenoglicol. O Preparo químico mecânico foi realizado com as limas easy logic e as soluções agitadas com easy clean durante 3 minutos, após os dentes foram imersos em água deionizada em eppendorfs estéreis e mantidos em estufa a 37°C. O pH externo foi mensurado utilizando fitas de pH no período de 3, 24, 72 horas, 7 e 14 dias. A normalidade dos valores obtidos de cada ensaio foi testada através do teste Kolmogorof- Smirnov e o teste estatístico foi ANOVA de uma via e comparações múltiplas de Tukey. Os resultados mostraram que os grupos apresentaram diferença estatística entre eles, entretanto apresentaram alcalinidade durante o período avaliado de 24, 48,72 horas, 7 e 14 dias. Concluiu-se que as soluções associadas às diferentes medicações mostraram pH alcalino, apresentando diferença entre os grupos avaliados nos tempos de 3, 24, 72 horas, 7 e 14 dias, no entanto mostraram resultados satisfatórios, podendo ser utilizados na endodontia(AU)

The objective of the present study was to evaluate the external root pH of pre-selected bovine teeth. In these study irrigation solutions, 0.25% peracetic acid, 2.5% sodium hypochlorite, sodium hypochlorite 6% associated with EDTA and intracanal medications, ultracal, calcium hydroxide PA associated with chlorhexidine gel 2% and P.A. calcium hydroxide associated with propyleneglycol. The mechanical chemical preparation was performed with the easylogic files and the solutions stirred with easy clean for 3 minutes, after the teeth were immersed in deionized water in sterile eppendorfs and kept in an oven at 37 °C. The external pH was measured using pH tapes in the period of 3, 24, 72 hours, 7 and 14 days. The normal values obtained from each test were tested using the KolmogorofSmirnov test and the statistical test chosen was oneway ANOVA and Tukey's multiple comparisons. The results showed that the groups presented statistical difference between them, however they presented alkalinity during the evaluated period of 24, 48, 72 hours, 7 and 14 days. It was concluded that the solutions associated with the different medications showed alkaline pH, presenting a difference between the groups evaluated at 3, 24, 72 hours, 7 and 14 days, however they showed satisfactory results and could be used in endodontics(AU)

Efeito do hipoclorito de sódio na retenção de pinos de fibra de vidro: revisão de literatura / Effect of sodium hypochlorite on fiber posts retention: literature review

O objetivo desse trabalho foi realizar uma revisão de literatura sobre o efeito do hipoclorito de sódio na retenção de pinos de fibra de vidro. Uma busca por artigos foi feita em bases eletrônicas de dados (Pubmed, Bireme e Scielo). Os resumos foram selecionados de acordo com o tema proposto, baixados e lidos para inserir no trabalho somente os pontos principais de cada trabalho e, assim, formular a revisão de literatura com informações atuais sobre o assunto proposto. A discussão foi realizada para compreender os resultados e chegar a considerações finais da revisão fazendo uma conexão com a prática clínica. As conclusões foram baseadas na hipótese de que o hipoclorito de sódio tem efeito negativo na retenção de pinos de fibra de vidro. A presente revisão de literatura mostrou, a partir dos achados dos estudos, que o uso do hipoclorito de sódio pode interferir na retenção de pinos de fibra de vidro ao canal radicular, principalmente quando a irrigação final com EDTA 17% não é realizada(AU)

The objective of this work was to perform a literature review on the effect of sodium hypochlorite on fiber posts retention. A search for articles was done in electronic databases (Pubmed, Bireme and Scielo). The abstracts were selected according to the proposed theme, downloaded and read to insert in the work only the main points of each article and, thus, to formulate the literature review with current information on the proposed subject. The discussion was conducted to understand the results and come to the final considerations of the review by making a connection with clinical practice. The conclusions were based on the hypothesis that sodium hypochlorite has a negative effect on fiber posts retention. The present literature review showed, from the study findings, that the use of sodium hypochlorite can interfere on fiber posts retention to the root canal, especially when the 17% EDTA final irrigation is not performed(AU)

Organizing Pneumonia After Exposure to Sodium Hypochlorite: A Case Report.

Organizing pneumonia (OP) is a rare inflammatory lung disease with a difficult diagnosis and sparse mentions in the literature. In most cases, the etiology is unknown but may be associated with infections, systemic disorders, exposure to industrial toxins and environmental pollutants, or even drug toxicity. This report describes a 77-year-old male who presented to the hospital with nonproductive cough, myalgias, fever, and progressive weight loss after prolonged exposure to sodium hypochlorite. The patient was treated with multiple courses of antibiotics with no pathogen isolation. Chest CT revealed condensation foci of all pulmonary lobes. His clinical history, laboratory results, and CT images led to the diagnosis of OP, which was confirmed with a transbronchial lung biopsy. The patient was treated with oral prednisolone with clinical improvement and discharge one week after the beginning of the corticosteroid treatment. OP diagnosis can be challenging and, if not considered, may lead to a delay in providing appropriate treatment to the patients, which can often lead to a prolonged hospital stay and poor outcomes.

Ph externo de dentes bovinos com pasta de hidróxido de cálcio / External pH of bovine teeth using hydroxide paste

The aim of this study was to evaluate the external pH root of bovine teeth, using calcium hydroxide paste (Ultracal XS Ultradent) and (CALEN-SS WHITE) as intra canal medication. Thus ten bovine teeth (n=10/group) were used and they had their apex sealed with composite resine. These teeth had four perforations of 2 mm depth which were made with spherical tip diamond number 1014 in each of them. The chemical-mechanical preparation was made manually with limes type K up to #80. The canal system irrigation had sodium hypochlorite 4% during the instrumentation plus EDTA 17% under agitation with ultrasound (Profi II ceramic Dabi Atlante) during 20 seconds, three times, totalizing one minute. Subsequently the canals were filled with the intra canal medication (Ultracal XS Ultradent) and (CALEN-SS WHITE). The dental crowns were sealing with Bioplic. Immediately, every tooth was placed in ependorfs containing miliQ water. After that, the external pH was measured with pH tape ribbon Merck trademark (pH 0-14) and it was made every 24 hours for 21 days. The results of this experiment showed that the dressing used could not alcalinize the dentin in its outer surface once the modulator, Milli-Q water, had a little change. Concluding, the calcium hydroxide paste inside the root bovine tooth could promoted a small change in the external environment, which was represented by Milli-Q water(AU)

O objetivo deste estudo foi avaliar o pH externo radicular de dentes bovinos, utilizando pasta de hidróxido de cálcio (Ultracal XS Ultradent) e (Calen ­ SS WHITE), como medicação intracanal. Foram utilizados 10 dentes bovinos (n=10/grupo), selados no ápice com resina composta e com quatro perfurações de 2 mm de profundidade realizadas com uma ponta diamantada esférica n°1014 em cada corpo de prova. O preparo químico mecânico foi feito manualmente com limas tipo Kerr até a lima #80. A irrigação dos canais foi feita com hipoclorito de sódio a 4% durante a instrumentação e EDTA 17% sob agitação com ultrassom (Profi II ceramic Dabi Atlante) durante 20 segundos, três vezes, totalizando um minuto. Posteriormente os canais radiculares foram preenchidos com a medicação intracanal (Ultracal XS Ultradent) e com (Calen ­ SS WHITE) e o selamento coronário com bioplic. Imediatamente após, cada dente foi colocado em eppendorfs contendo água miliquezada, logo o pH externo radicular foi medido com a fita de pH da marca Merck (pH 0-14), de 24 em 24 horas durante 21 dias. Os resultados obtidos neste experimento mostraram que a medicação intracanal não conseguiu alcalinizar a massa dentinária em sua superfície externa já que o modulador, água Milli-Q, alterou-se pouco, concluindo-se que a pasta de hidróxido de cálcio no interior do canal radicular de dente bovino promoveu pequena alteração no meio externo representado pela água Mili-Q(AU)

Evaluation of an Indigenously Prepared Herbal Extract (EndoPam) as an Antimicrobial Endodontic Irrigant: An Ex Vivo Study.

BACKGROUNDG: Root canal irrigation plays a pivotal role in endodontics. Constant increase in antibiotic resistance and side effects caused by synthetic irrigants has shifted the research toward developing herbal alternatives. The current study aims to assess the ex vivo effectiveness of an indigenously prepared herbal extract "EndoPam" and compare it with the conventional endodontic irrigants for disinfection of root canals infected with Enterococcus faecalis. MATERIALS AND METHODS: As a preliminary study of the antimicrobial efficacy of the test irrigants, an Agar diffusion study was conducted, and zone of inhibition measured. Forty extracted mandibular premolars with straight root canals were selected and standardized to 12 ± 1 mm in length. Root canals were prepared using rotary ProTaper system until F3 instrument and were infected with the culture of E. faecalis for three weeks. Specimens were divided into four groups (n = 10). Group 1: EndoPam (. INGREDIENTS: Syzigium aromaticum, Eucalyptus globulus, Cinnamomum zeylanicum and Mentha piperita), Group 2: 2% chlorhexidine, Group 3: 5.25% Sodium hypochlorite, Group 4: Normal Saline. Irrigation was performed for each group. Samples were inoculated and incubated for 24 h at 37°C for qualitative analysis qualitative analysis. RESULTS: In the preliminary Agar diffusion study, EndoPam exhibited a zone of inhibition comparable to that of sodium hypochrorite. The diameter of the inhibition zone was in the following order: 2% chlorhexidine gluconate > EndoPam > 5.25% NaOCl > Normal Saline. The qualitative assay done by culturing the bacteria after a period of 3 weeks showed no bacterial growth in any of the tested irrigants, except in normal saline. CONCLUSION: It was found that the experimental product was as effective as conventional irrigants in reducing the microbial count.

Effect of passive ultrasonic agitation during final irrigation on cleaning capacity of hybrid instrumentation.

OBJECTIVES: To evaluate the effect of passive ultrasonic agitation on the cleaning capacity of a hybrid instrumentation technique. MATERIALS AND METHODS: Twenty mandibular incisors with mesiodistal-flattened root shape had their crowns sectioned at 1 mm from the cementoenamel junction. Instrumentation was initiated by catheterization with K-type files (Denstply Maillefer) #10, #15, and #20 at 3 mm from the working length. Cervical preparation was performed with Largo bur #1 (Dentsply Maillefer) followed by apical instrumentation with K-type files #15, #20 and #25, and finishing with ProTaper F2 file (Denstply Maillefer). All files were used up to the working length under irrigation with 1 mL of 2.5% sodium hypochlorite (Biodynâmica) at each instrument change. At the end of instrumentation, the roots were randomly separated into 2 groups (n = 10). All specimens received final irrigation with 1 mL of 2.5% sodium hypochlorite. The solution remained in the root canals in Group 1 for one minute; and ultrasonic agitation was performed in Group 2 for one minute using a straight tip inserted at 1 mm from working length. The specimens were processed histologically and the sections were analyzed under optic microscope (×64) to quantify debris present in the root canal. RESULTS: The samples submitted to ultrasonic agitation (Group 2) presented significant decrease in the amount of debris in comparison with those of Group 1 (p < 0.05). CONCLUSIONS: The hybrid instrumentation technique associated with passive ultrasonic agitation promoted greater debris removal in the apical third of the root canals.

Effect of passive ultrasonic agitation during final irrigation on cleaning capacity of hybrid instrumentation

OBJECTIVES: To evaluate the effect of passive ultrasonic agitation on the cleaning capacity of a hybrid instrumentation technique. MATERIALS AND METHODS: Twenty mandibular incisors with mesiodistal-flattened root shape had their crowns sectioned at 1 mm from the cementoenamel junction. Instrumentation was initiated by catheterization with K-type files (Denstply Maillefer) #10, #15, and #20 at 3 mm from the working length. Cervical preparation was performed with Largo bur #1 (Dentsply Maillefer) followed by apical instrumentation with K-type files #15, #20 and #25, and finishing with ProTaper F2 file (Denstply Maillefer). All files were used up to the working length under irrigation with 1 mL of 2.5% sodium hypochlorite (Biodynamica) at each instrument change. At the end of instrumentation, the roots were randomly separated into 2 groups (n = 10). All specimens received final irrigation with 1 mL of 2.5% sodium hypochlorite. The solution remained in the root canals in Group 1 for one minute; and ultrasonic agitation was performed in Group 2 for one minute using a straight tip inserted at 1 mm from working length. The specimens were processed histologically and the sections were analyzed under optic microscope (x64) to quantify debris present in the root canal. RESULTS: The samples submitted to ultrasonic agitation (Group 2) presented significant decrease in the amount of debris in comparison with those of Group 1 (p < 0.05). CONCLUSIONS: The hybrid instrumentation technique associated with passive ultrasonic agitation promoted greater debris removal in the apical third of the root canals.

Efetividade in situ do Chlor-Xtra® na dissolução do tecido pulpar em canais radiculares ovais / Sodium hypoucorite with reduced surface tension does not improve insire pulp dissolution

O objetivo deste estudo foi avaliar a dissolução do tecido pulpar pelo NaOCl contendo em sua composição agentes redutores da tensão superfical (Chlor-Xtra®) quando comparados ao NaOCl convencional. Com esta finalidade 44 dentes unirradiculares humanos com tecido pulpar preservado em solução de formol a 10% foram agrupados em 22 pares de acordo com a semelhança de sua anatomia interna previamente avaliada por radiografias. Os canais foram instrumentados com sistema Protaper Universal® e todo o processo de irrigação teve, além do tempo, seu volume e fluxo controlado por meio automatizado por meio do sistema Vatea® Endodontic Iirrigation Device. Após cada canal que compunha um par ter sido instrumentado empregando-se uma das diferentes soluções testadas, as quais foram previamente avaliadas quanto a sua tensão superficial, ambos foram devidamente preparados e enviados para processamento e análise histológica. Cortes a 0,5, 1,2,3 e 4mm do ápice foram realizados, corados e fotografados. As imagens foram analisadas por meio do programa AxioVision® a fim de estabelecer o percentual de tecido remanescente em relação à área total do canal nos segmentos estudados. As análises referentes a tensão superficial revelaram que o Chlor-Xtra® demonstrou possuir significativamente menor tensão superficial quando comparado ao NaOCL convencional (p>0,05). A análise estatística por meio do test T student das áreas dos canais, demonstrou que o pareamento das amostras foi eficiente entre os grupo NaOCl e Chlor-Xtra® (p>0,05). Em relação ao Percentual de Tecido Remanescente (PTR), os resultados revelaram por meio de análise feita pelo teste Kruskal-Wallis e o teste de correlação de Spearman que o nível de corte influencia significantemente o PTR (P<0,05).Por fim, o teste de Mann-Whitney indicou que o PTR não é influenciado pela solução irrigadora utilizada (P>0,05). A partir da análise dos ...

Sodium hypochlorite solutions with added wetting agents are advertised to dissolve necrotic tissue in root canals faster than counterparts without lowered surface tension. This was tested in the current study using extracted, single-rooted teeth with oval canals that contained pulp tissue. Formerly vital extracted teeth (N = 44) with similar anatomy were radiographically paired and chemomechanically prepared. In one tooth, a 5.25% NaOCl solution with reduced surface tension was used, in the other a pure, technical-grade NaOCl solution of 5.25%. Percentage of remaining pulp tissue (PRPT) was histologically assessed in root cross-sections. The non-Gaussian raw data was subjected to Kruskal-Walis and Mann-Whitney U tests to verify the respective effect of level of cross-section and solution on the PRPT.The relationship between level of cross-section and PRPT was estimated by Spearman correlation test. Alpha-type error was set at 5%. The level of section significantly influenced the PRPT (P<0.05), whereas the PRPT was not influenced by the solution used (P>0.05). A significant inverse correlation was found between the level of section and PRPT (P<0.05, r = -0.330). The lower the distance to the apex, the higher the PRPT, regardless of the solution used.Contrary to the advertised statement, the dental solution with reduced surface tension did not dissolve vital pulp tissue in oval root canals any better than a conventional NaOCl solution of similar strength. Closer to the apex, pulp tissue dissolution is less efficient, irrespective of the solution.

Efetividade in situ do Chlor-Xtra® na dissolução do tecido pulpar em canais radiculares ovais / Sodium hypoucorite with reduced surface tension does not improve insire pulp dissolution

O objetivo deste estudo foi avaliar a dissolução do tecido pulpar pelo NaOCl contendo em sua composição agentes redutores da tensão superfical (Chlor-Xtra®) quando comparados ao NaOCl convencional. Com esta finalidade 44 dentes unirradiculares humanos com tecido pulpar preservado em solução de formol a 10% foram agrupados em 22 pares de acordo com a semelhança de sua anatomia interna previamente avaliada por radiografias. Os canais foram instrumentados com sistema Protaper Universal® e todo o processo de irrigação teve, além do tempo, seu volume e fluxo controlado por meio automatizado por meio do sistema Vatea® Endodontic Iirrigation Device. Após cada canal que compunha um par ter sido instrumentado empregando-se uma das diferentes soluções testadas, as quais foram previamente avaliadas quanto a sua tensão superficial, ambos foram devidamente preparados e enviados para processamento e análise histológica. Cortes a 0,5, 1,2,3 e 4mm do ápice foram realizados, corados e fotografados. As imagens foram analisadas por meio do programa AxioVision® a fim de estabelecer o percentual de tecido remanescente em relação à área total do canal nos segmentos estudados. As análises referentes a tensão superficial revelaram que o Chlor-Xtra® demonstrou possuir significativamente menor tensão superficial quando comparado ao NaOCL convencional (p>0,05). A análise estatística por meio do test T student das áreas dos canais, demonstrou que o pareamento das amostras foi eficiente entre os grupo NaOCl e Chlor-Xtra® (p>0,05). Em relação ao Percentual de Tecido Remanescente (PTR), os resultados revelaram por meio de análise feita pelo teste Kruskal-Wallis e o teste de correlação de Spearman que o nível de corte influencia significantemente o PTR (P<0,05).Por fim, o teste de Mann-Whitney indicou que o PTR não é influenciado pela solução irrigadora utilizada (P>0,05). A partir da análise dos...

Sodium hypochlorite solutions with added wetting agents are advertised to dissolve necrotic tissue in root canals faster than counterparts without lowered surface tension. This was tested in the current study using extracted, single-rooted teeth with oval canals that contained pulp tissue. Formerly vital extracted teeth (N = 44) with similar anatomy were radiographically paired and chemomechanically prepared. In one tooth, a 5.25% NaOCl solution with reduced surface tension was used, in the other a pure, technical-grade NaOCl solution of 5.25%. Percentage of remaining pulp tissue (PRPT) was histologically assessed in root cross-sections. The non-Gaussian raw data was subjected to Kruskal-Walis and Mann-Whitney U tests to verify the respective effect of level of cross-section and solution on the PRPT.The relationship between level of cross-section and PRPT was estimated by Spearman correlation test. Alpha-type error was set at 5%. The level of section significantly influenced the PRPT (P<0.05), whereas the PRPT was not influenced by the solution used (P>0.05). A significant inverse correlation was found between the level of section and PRPT (P<0.05, r = -0.330). The lower the distance to the apex, the higher the PRPT, regardless of the solution used.Contrary to the advertised statement, the dental solution with reduced surface tension did not dissolve vital pulp tissue in oval root canals any better than a conventional NaOCl solution of similar strength. Closer to the apex, pulp tissue dissolution is less efficient, irrespective of the solution...

Bonding to wet or dry deproteinized dentin: micro tensile bond strength and confocal laser micromorphology analysis

Aim: To investigate the influence of deproteinization and moisture condition (wet vs. dry) on the bond strength and micromorphology of resin-dentin bonding interfaces. Methods: Dentin surfaces were etched with 37% phosphoric acid for 15 s and rinsed with water. Four groups (n = 10) were tested: WET: dentin was left visibly moist; DRY: dentin was dried with compressed air; WET-D: dentin was deproteinized for 60 s using 10% NaOCl solution and left moist; DRY-D: dentin was deproteinized and dried. Prime&Bond 2.1 adhesive was applied and the teeth were restored with composite resin. Microtensile test was carried out after 24 h, and failure modes classified under magnification. Data were subjected to two-way ANOVAand Tukey’s test (P < 0.05). The bonding micromorphology was analyzed by confocal laser scanning microscopy. Results: The group DRY showed significantly lower bond strength (P < 0.05) than the other groups, which were similar to each other (P > 0.05). Adhesive failures were predominant. Analysis of micromorphology showed formation of a collagen-resin hybrid layer only for the non-deproteinizedgroups. Adhesive penetration into the dentinal tubules was deeper for the DRY-D compared to the WETD group. Conclusion: The bond strength was not dependent on the moisture condition and a more homogeneous hybridization was obtained when dentin was deproteinized.