Search

Objective: This study aimed to evaluate the bacterial reduction effect of disinfection protocols used in mandibular molars infected by Enterococcus faecalis. Methods: Eighty extracted mandibular molars were prepared and inoculated with E. faecalis for 2 months. The teeth were then divided into 2 control groups (n=4) and 4 experimental groups (n=18) according to the disinfection protocol utilized: G1. WaveOne Gold (WOG), passive ultrasonic irrigation (PUI) and Ultracal; G2. WOG, PUI and calcium hydroxide (CH); G3. WOG, XP-Endo Finisher (XPF) and Ultracal; G4. WOG, XPF and CH. Bacteriological samples were collected previously (S1), after preparation (S2), final agitation (S3) and intracanal dressing (S4). Microbial growth was assessed according to culture turbidity and UV spectrophotometry. Statistical analyses used the Friedman test for paired samples and Kruskal-Wallis test for non-paired data (p<0.05). Results: No protocol eliminated E. faecalis effectively. The S2, S3 and S4 samples were statistically different from the S1 samples in G1, G2, G3 and G4 (p<0.05). Statistical differences were observed in bacterial reduction between G1 and G2 and G1 and G3 after the intracanal medicament (S4) (p<0.05). Conclusion: The combination of WOG with PUI and CH disinfection protocol showed higher percentages of bacterial reduction. [ABSTRACT FROM AUTHOR]

Introduction: Glass ionomer cements (GICs) have been gaining prominence as material for atraumatic restorative treatment (ART) due to their acceptable physicochemical and biological properties. Objective: To analyze the surface morphology, chemical constitution, and antimicrobial action of GICs used for ART in posterior primary teeth. Material and methods: The tested materials were Vitro Molar®, Ketac Cem Easymix® and Riva Self Cure®. For the structural and chemical analysis, polyethylene tubes with an internal diameter of 3 mm and 3 mm in length were prepared, filled, and then transferred to a chamber with 95% relative humidity and a temperature of 37oC. The surface morphology of the tested materials was examined by scanning electron microscopy (SEM) and main components were investigated by energy-dispersive X-ray microanalysis. For the antimicrobial efficacy analyses, strains of Streptococcus mutans (ATCC 27853) were used. Petri dishes with brain heart infusion agar (BHIA) were inoculated with the microbial suspensions and three cavities were made in each agar plate and filled with one of the GICs. The plates were pre-incubated for 1 hour at room temperature and then incubated at 37oC for 24 to 48 hours. The inhibition zone around each well was recorded in mm. Results: SEM revealed irregular and rough external surface. Cracking was not observed. The main constituents were found to be aluminum, silicon, sodium, and fluoride. Barium was only observed in Vitro Molar®, while lanthanum was only observed in Ketac Cem Easymix®. Elemental mapping of the outer surface revealed high concentration of aluminum and silicon. Inhibition halos were only observed in Riva Self Cure®. Conclusion: The GICs presented irregular outer surfaces and similar chemical elements. Only Riva Self Cure® showed antibacterial action against the S. mutans. [ABSTRACT FROM AUTHOR]

Introduction: Root canal preparation is essential for the adequate sanitization of dentinal tubule systems, allowing favorable conditions for sealing in the cervical-apical direction. Objective: To analyze the frequency of morphological defects produced in continuous and reciprocating rotation instruments after repeated uses by scanning electron microscopy (SEM). Material and methods: Forty-five replicates of prototyped lower molars were randomly assigned to three groups according to the system used: G1. Biorace®, G2. V-File®, or G3. Protaper Next®. After root canal preparation, all the instruments were washed in an ultrasonic vat and subsequently analyzed by SEM to visualize the morphological defects (dullness of the edges, grooves, microcavities, and cracks) in images obtained with a magnification of 50x to 1500x. To determine defects on each instrument’s surface, the active part was divided into 14 parts, with segments on the two sides from 1 to 7. assessed using chi-square tests. Results: Defects were observed in all tested instruments, with statistically significant differences between the systems (P<0.05). BioRace® system was associated with a significant higher number of defects, than V-File® (P<0.05) but was not significantly different from ProTaper Next® (P>0.05). No significant difference was observed between V-File® and ProTaper Next® groups (P>0.05). Conclusion: All the analyzed instruments showed defects in the active surface after repeated use. [ABSTRACT FROM AUTHOR]

Introduction: Fiberglass Posts (FGPs) associated with composite resin foundation materials have become the primary alternative to restoring teeth with root canal treatment presenting excessive coronal destruction. Despite technical evolution, loss of retention between FGP and root dentine continues to be reported. Aim: To examine the effect of endodontic retreatment protocols on the bond strength of FGP to radicular dentine. Materials and Methods: This in-vitro study was conducted at Evangelical University of Goiás, Brazil from August 2019 to June 2020. A total of 30 freshly extracted bovine incisors were instrumented, filled and distributed into three experimental groups with 10 incisors in each groups. Group 1 was control, group 2 had incisors with gutta-percha removed using K-type files and group 3 had incisors with gutta-percha removed using ProTaper Universal Retreatment instruments. After root canal retreatment and re-sealing, the fiber posts were cemented into prepared post spaces using a resin-based cement. Roots were transversally sectioned into six 1 mm thick specimens. The pushout test was performed, and the modes of failure were evaluated. Data were analysed with two-way Analysis of Variance (ANOVA) and Tukey's test. Results: There was no significant difference between the mean bond strength values in group 1, 2 and 3 with p-value >0.05. The cervical third of root canal presented higher bond strength values compared with the middle and apical thirds. However, significant differences were observed only for the control group (p-value=0.005). Adhesive failure between resin cement and radicular dentine was the most prevalent type of failure. Conclusion: The endodontic retreatment protocol did not influence the bond strength of FGP to radicular dentine. [ABSTRACT FROM AUTHOR]

Introduction: Diseases of the pulp and periapical tissues comprise the major reasons for seeking emergency dental care services. Objective: This retrospective cross-sectional study aimed to investigate the prevalence of pulpal and periapical diseases in a central Brazilian population. Material and methods: The sample was comprised of patients treated at the Basic Attention Integrated Clinic of the Dental School of the Universidade de Cuiabá, between 2011 and 2015. The following information was collected from the patients' records: sex, age, tooth, anatomical location, and the pulpal or periapical diagnosis. The statistical analysis included frequency distribution and cross-tabulation. The data were analyzed by using χ2 tests. The level of significance was set at 5% for all analyses. Results: The analysis involved 1,277 patients (822 female; 64.4%), aged between 6 and 78 years old. The highest frequency of pulpal and periapical diseases was observed in patients aged 21 to 30 years old (n = 389; 30.5%). A total of 1,488 pulpal and periapical diseases was recorded. Symptomatic pulpitis (n = 467; 31.4%) and infectious symptomatic apical periodontitis (n = 456; 30.6%) were the most common type of diseases. Seven hundred and sixty-seven affected teeth (51.5%) were maxillary teeth, and 1,247 (83.8%) were located in the jaws' posterior region. The most affected teeth were the mandibular molars (n = 516; 34.7%) and maxillary molars (n = 355; 23.9%). Statistically significant difference was observed between the type of pulpal and periapical disease and sex, age, anatomical location (anterior or posterior), and tooth (p < 0.05). Conclusion: There was a higher prevalence of pulpal and periapical diseases in female individuals aged between 21 and 30 years old and involving teeth located in the posterior region of the jaw. [ABSTRACT FROM AUTHOR]

External Root Resorption (ERR) is a pathological condition that can lead to tooth loss if not diagnosed and treated correctly. Calcium Hydroxide Ca(OH)2 is an intracanal medicament, which is used in cases of teeth with pulp necrosis, peri-radicular lesions and ERR. This paper describes the endodontic management of a tooth with severe ERR using injected non-setting Ca(OH)2 paste. A 28-year-old patient was referred for endodontic evaluation of tooth 47, which presented an extensive composite resin restoration and was negative to cold test. Panoramic and periapical radiographs revealed the presence of a filled pulp chamber, calcified root canals, ERR on the mesial and distal roots, and apical periodontitis in the mesial and distal roots. The diagnosis of asymptomatic apical periodontitis and severe ERR was established, and conventional root canal treatment combined with non-setting Ca(OH)2 dressing was chosen. After five months, no more discharge from the root canal was observed, and a decrease in the size of the periapical lesion and arrest of ERR was detected. The root canal was filled, and the patient was referred for restoration. At the 6-months follow-up, radiographic examination evidenced periapical repair and containment of the ERR process. Chemomechanical root preparation in association with a non-setting Ca(OH)2 dressing protocol allows positive outcomes during the management of severe ERR associated with pulp necrosis and periapical inflammation. [ABSTRACT FROM AUTHOR]

Endodontic treatment of immature non-vital teeth poses a considerable challenge. Its goals should include the control of intracanal infection and the promotion of continuous root development. This case report describes an apexification as an alternative strategy for the maintenance of a tooth with incomplete root formation. An 11-year-old female presented with a history of pain and discomfort on the left side of the mandibular region. Intraoral examination revealed the presence of a draining sinus tract located in the buccal mucosa, next to tooth 35, for which a cold test was negative. Periapical radiographs revealed a single-rooted tooth with incomplete root formation and a periapical lesion. A diagnosis of periapical abscess with fistula was made, and a root canal treatment in conjunction with apexification was planned. Cone Beam Computed Tomography (CBCT) imaging was performed which revealed resorption on the buccal side of the root and the destruction of the buccal cortical bone. After six appointments, the intraoral sinus tract had healed, no purulent discharge was observed, and the root apex was closed. The root canal was filled, and the tooth was restored. The three years follow-up examination showed adequate bone repair and the absence of periapical lesion. Apexification shows favourable results for the management of immature non-vital teeth. [ABSTRACT FROM AUTHOR]