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Introdução: As fraturas longitudinais de dentes íntegros ou com restauração de Classe I não são comuns. O envelhecimento e uma maior consciência de dentes fissurados podem explicar o crescente número de casos reportados. Objetivo: O objetivo do presente artigo é descrever dois casos de fratura dentária longitudinal, ocorridas em um pré-molar superior intacto e em um molar inferior com uma restauração de Classe I, com diferentes orientações da linha de fratura. Métodos: Avaliação clínica de dois casos de dentes rachados, evidenciando o diagnóstico e o tratamento. Os fragmentos extraídos foram observados clinicamente e, em um dos dentes, a dinâmica do início e progressão da fratura foi investigada. Resultados: No caso 1, marcas de fratura na superfície dos fragmentos extraídos evidenciaram o local de início e a taxa de progressão da fratura. No caso 2, a observação do dente extraído, com o tecido granulomatoso aderido apenas nos dois terços coronais da raiz, contribuiu para explicar a sobreposição da área de radioluscência, contrastando com a superfície de corte “limpo” do terço apical. Conclusões: As caracterís- ticas clínicas dos dentes rachados destacam a importância da observação dos fragmentos extraídos, para uma melhor compreensão do mecanismo de fratura.

Background: The aim of this study was to compare the WaveOne Gold and ProTaper Next systems regarding the time spent preparing simulated canals performed by an inexperienced student. Material and Methods: 80 simulated L-shaped canals were randomly divided into two groups (n = 40) and numbered in order of instrumentation. Canals were instrumented with WaveOne Gold (group 1) and ProTaper Next (group 2) systems. The effective instrumentation time and the number of instrumentation cycles were recorded. All procedures were performed by the same operator. Statistical analysis was obtained by the Mann-Whitney, Kruskal-Wallis test with significance of p, (undefined)

[Excerpt] The success rates of endodontic treatment can reach levels from 86% to 98% (Abitbol et al., 2003). However, apical periodontitis may still persist or develop after treatment due to various factors, namely coronal leakage, caries or fractures, thus enabling reinfection by microorganisms of the oral cavity or proliferation of microorganisms in persisting endodontic infections (Siqueira, 2001, Correia-Sousa et al., 2015, Melo et al., 2017). Endodontic retreatment aims to reduce the bacterial load to a level that enables periapical healing. Nevertheless, its outcome is poor – about 70.9–83% (Torabinejad et al., 2009, Ng et al., 2011). The cleanliness of root canals cannot be accurately assessed through conventional periapical radiography or magnifying devices, but residual gutta-percha is systematically found in micro-CT scans after retreatment (Oltra et al., 2017). Chloroform and xylene have been widely used as endodontic solvents but concerns about their toxicity and potential carcinogenic effect led to seeking alternatives (Tamse et al., 1986, Metzger et al., 2000, Vajrabhaya et al., 2004, Magalhaes et al., 2007). Essential oils, like eucalyptol or orange oil, are one of the most common alternative groups of solvents used to enhance the dissolution or softening of gutta-percha. However, although they are considered less toxic, they are also reported as less powerful (Zaccaro Scelza et al., 2006, Faria-Junior et al., 2011, Martos et al., 2011). Studies show that, despite all the currently available technology, it is still not possible to achieve the complete removal of the potentially infected filling materials, which prevents total debridement and effective bacteria control (Alves et al., 2016, Keles et al., 2016, Rossi-Fedele and Ahmed, 2017). Although solvents have been indicated to prevent complications, such as ledges or perforations, in retreatment procedures, the literature reports that their use may hinder the cleaning of the root canal (Horvath et al., 2009). Retreatment can be carried out with or without solvents, but professionals often prefer to remove gutta-percha mainly with instrumentation, even though this may be a longer and less predictable procedure (Sae-Lim et al., 2000, Khalilak et al., 2013). Thus, endodontic solvents have almost fallen out of use. A new insight on endodontic retreatment seems to be necessary. [...], (undefined)

Background: Candida albicans is the most prevalent fungi isolated in endodontic infections. In this study, the ability of C. albicans biofilm to tolerate the novel solvent mixtures methyl ethyl ketone (MEK)/tetrachloroethylene (TCE) and MEK/orange oil (OOil) sequentially to the standard irrigation of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic (EDTA) was evaluated. Methods: Biofilm cell cultures of C. albicans SC 5314 were treated sequentially with NaOCl and EDTA and exposed to MEK/TCE or MEK/OOil. The effect of the antimicrobial treatment was evaluated using the disk diffusion method for planktonic culture, and the enumeration of colony-forming units (CFUs) and scanning electron microscope (SEM) for biofilm cell culture. Results: C. albicans mature biofilm (24 h) was significantly reduced in biomass and cell viability after solvent mixtures exposure, compared with the previous NaOCl and EDTA treatments. MEK/OOil combination caused a total reduction of biofilm, while with MEK/TCE, there was a 3-log (CFU/cm2) reduction compared with the sequence NaOCl and EDTA, and a 4-log (CFU/cm2) reduction compared with the control. Conclusions: The additional exposure of a preformed 24 h C. albicans biofilm to novel solvent mixtures MEK/TCE and MEK/OOil caused a positive antibiofilm impact, overcoming the performance of the conventional endodontic irrigating protocol., This article was supported by National Funds through FCT-Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020). This work was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit and grant ref 2020.05720.BD for Liliana Fernandes; BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020-Programa Operacional Regional do Norte., info:eu-repo/semantics/publishedVersion

The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root’s middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p

Objectives: This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity. Methods: Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups (n = 15) of standardized stainless-steel molds filled with softened gutta-percha cones and twelve (n = 15) filled with AH Plus were immersed in the corresponding mixture or individual solvent, in an ultrasonic bath, for either 2 or 5 min. The effect of the solvents was assessed qualitatively by a topographical analysis (scanning electron microscopy) and chemical analysis (Fourier transform infrared spectroscopy), and quantitatively by a weight loss and viscoelastic property (dynamic mechanical analysis) evaluation. The cytotoxicity was assessed on MG63 human osteoblastic cells. Results: The mixtures did not show the formation of new compounds. Both presented significantly higher efficacies compared to their individual solvents, suggesting a synergistic effect. Their dissolution efficacy was similar to that of chloroform, showing high cytocompatibility. Conclusions: The proposed strategy, incorporating ultrasound agitation and profiting from the synergy of adequate solvents, might enhance root canal cleanliness allowing a single-step procedure to dissolve gutta-percha and the sealer remnants, while assuring cytocompatibility with the periapical tissues., This article was supported by National Funds through FCT—Fundação para a Ciência e a Tecnologia,I.P.-V., within CINTESIS, R & D Unit (reference UIDB/4255/2020).

Background: Besides the bad nutritional habits, it has been studied that systemic changes induced by obesity may have repercussions on oral environment. This study evaluated the oral health status of obese adolescents undergoing follow-up at a tertiary hospital in Portugal. Methods: Ninety subjects were classified as obese or severe obese according to the World Health Organization references. Caries experience and periodontal condition were determined by the DMFT index (decayed, missing and filled teeth) and Community Periodontal Index (CPI), respectively. The data for the ages 12 and 15 were compared using Wilcoxon test for one sample to the National Prevalence Study of Oral Diseases (NPSOD), performed in Portugal and published in 2008 and 2015. Results: A mean BMI of 29.4 (± 4.1) was observed, and 64.4% (n = 58) of the subjects were diagnosed with severe obesity. The DMFT of obese adolescents was similar to that of the Portuguese population. At 12 years of age, obese individuals were found to have fewer missing teeth (p = 0.001) and more sealed teeth than those of the same age in Portugal in 2008 (p = 0.012) and 2015 (p = 0.001). At age 15, obese adolescents had fewer decayed teeth (p = 0.017) than individuals of the same age in Portugal (NPSOD, 2008). Conclusions: Obese children and adolescents presented an oral health status similar to that of the Portuguese population at the same age according to the majority of the criteria. These findings can be explained by the health care provided with repeated recommendations for oral hygiene.

Synthetic cathinones abuse remains a serious public health problem. Kidney injury has been reported in intoxications associated with synthetic cathinones, but the molecular mechanisms involved have not been explored yet. In this study, the potential in vitro nephrotoxic effects of four commonly abused cathinone derivatives, namely pentedrone, 3,4-dimethylmethcatinone (3,4-DMMC), methylone and 3,4-methylenedioxypyrovalerone (MDPV), were assessed in the human kidney HK-2 cell line. All four derivatives elicited cell death in a concentration- and time-dependent manner, in the following order of potency: 3,4-DMMC >> MDPV > methylone ≈ pentedrone. 3,4-DMMC and methylone were selected to further elucidate the mechanisms behind synthetic cathinones-induced cell death. Both drugs elicited apoptotic cell death and prompted the formation of acidic vesicular organelles and autophagosomes in HK-2 cells. Moreover, the autophagy inhibitor 3-methyladenine significantly potentiated cell death, indicating that autophagy may serve as a cell survival mechanism that protects renal cells against synthetic cathinones toxicity. Both drugs triggered a rise in reactive oxygen and nitrogen species formation, which was completely prevented by antioxidant treatment with N‑acetyl‑L‑cysteine or ascorbic acid. Importantly, these antioxidant agents significantly aggravated renal cell death induced by cathinone derivatives, most likely due to their autophagy-blocking properties. Taken together, our results support an intricate control of cell survival/death modulated by oxidative stress, apoptosis and autophagy in synthetic cathinones-induced renal injury.

Background: This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. Methods: Twenty-four mandibular incisors were prepared with ProTaper Next (X1, X2) and obturated with the single-cone technique and AH Plus sealer. The teeth were retreated with ProTaper Universal Retreatment and ProTaper Next and divided into two groups (n = 12) according to the final instrument (X3 or X4). All canals were submitted to a supplementary procedure consisting of a mixture of solvents―methyl ethyl ketone/tetrachloroethylene, agitated with EndoActivator. The volume of filling remnants was assessed through micro-computed tomography in the apical 5 mm. Statistical analysis was performed with a significance level of 5%. Results: The supplementary procedure of agitation of the solvent mixture was beneficial in both groups (p &lt, 0.05). There were no statistically significant differences between canals re-prepared until X4 and canals re-prepared until X3 plus solvent (p &gt, 0.05). Conclusions: An additional step with a two-solvent solution potentiated by EndoActivator showed to be very effective for the removal of gutta-percha and resinous sealer remnants from apical root canals of mandibular incisors, avoiding further enlargement.

Objective:This study aimed to evaluate the influence of the instrument regarding the apical fit and type of the alloy and coronal preflaring procedures in the accuracy of Propex Pixi.Methods: A total of 40 extracted human single-rooted permanent teeth with apical diameters of 200 mu m were selected. A #10 K-file was inserted in the root canal until its end could be observed by a dental microscope to obtain the actual working length (WL). Electronic measurements were performed using Propex Pixi to the root apex ("0.0"). Different file alloys (stainless steel [SS] and nickel titanium [NiTi]) and sizes (#10, #15, and #20) were used before and after coronal flaring. Statistical analysis was performed by a factorial analysis of variance (P, (undefined)

Aim The objective of this study was to predict contact points and pressure distribution against canal walls when using NiTi rotary instruments by FEM virtual simulation. Methodology ProTaper Next (PTN) X1 and ProTaper Universal (PTU) S2 were compared. Canal configuration was based on an in vitro testing device. The in vitro canal and file geometries were replicated with computer aided design (CAD) software. CAD geometries (geometrical model) were imported and discretized (numerical model). The typical material model of dentine and MWire alloy was applied. The numerical models of the device and file geometries were used for finite element analysis (FEA). Experimental data from PTN X1 and PTU S2 were used to set-up the material parameter in the numerical model. Stress histories on the root canal contact points patterns due to the PTN X1 and PTU S2 were compared. Results The pressure distribution against canal walls was mainly influenced by the geometry of the file. The material of the file did not affect significantly the results. The PTN X1 was associated with a pressure 80% lower than PTU S2. Conclusions The pressure distribution against canal walls may be predicted by FEA. Virtual design, testing and analysis of file geometries could save considerable time and resources during instrument development

Objetivos: O objetivo deste estudo transversal foi investigar a associação entre a prevalência de dentes com tratamento endodôntico (RFT) ou periodontite apical (AP) e algumas condições sistémicas ou hábitos tabágicos numa população adulta portuguesa. Métodos: Histórias médicas, incluindo idade, género, presença de doenças cardiovasculares (CVD), diabetes mellitus, alergias e hábitos tabágicos, e registos dos tratamentos endodônticos de 421 pacientes (10.540 dentes) foram recolhidos. A prevalência de dentes com tratamento endodôntico e status apical foram avaliados através de radiografias panorâmicas. O status apical foi classificado de acordo com o índice periapical e a AP definida para valores PAI≥3. A análise estatística foi realizada através do PASW Statistics 20.0 utilizando os testes chi-quadrado, valores odds-ratio e intervalos confiança (95%). Resultados: A prevalência da AP e RFT foi de 2,2% e 4,2%, respectivamente. RFT aumentou a possibilidade de ter AP (p, Objectives: The aim of this cross-sectional study was to investigate an association between the prevalence of root-filled teeth (RFT) or apical periodontitis (AP) and some systemic conditions or smoking habits in an adult Portuguese population. Methods: Medical histories, including age, gender, presence of cardiovascular disease (CVD), diabetes mellitus (DM), allergies, smoking status, and endodontic treatment data of 421 patients (10,540 teeth) were recorded. The prevalence of root filled teeth and the periapical status were assessed through panoramic radiographies. Periapical status was classified according to the Periapical index and AP was defined as PAI-score ≥3. Statistic analysis was performed with PASW Statistics 20.0 using qui-square tests, odds-ratio and confidence intervals (95%). Results: The overall prevalence of AP and RFT was 2.2% and 4.2%, respectively. RFT increased the possibility of having AP (p< 0.0001). Men's group showed a higher percentage of teeth with AP (p< 0.0001), less RFT (p = 0.05) and more residual roots (2.3%). Smoking increased the probability of having AP (p = 0.002) and RFT (p = 0.045). A positive correlation was observed between RFT and DM (p = 0.040). No statistically significant difference was found between AP and CVD, DM or allergies neither between RTF and CVD or allergies. Conclusions: The higher prevalence of AP and/or RFT in smoker subjects and in diabetic patients can suggest a relationship between oral and systemic health. More epidemiological studies are required before definitive conclusions can be made.

Objectives: To assess radiographically the technical quality of root fillings placed by undergraduate students at the Faculty of Dental Medicine of the University of Porto. Methods: The records of 318 patients were assessed, of which 225 radiographs of root canal fillings in single-rooted teeth were selected. The radiographs were examined using the VixWin Platinum v1.1 Imaging Software (Gendex, USA). The quality of root canal filling was graded as "acceptable" when both length and density were adequate. Procedural errors were registered. Chi-square tests were used for statistical analysis, considering a 0.05 significance level. Results: Root canal fillings were considered acceptable in 53.3% of the cases. There was a greater percentage of adequate density (70.7%) than adequate length (64%). There was a statistically significant association between the quality of the filling and the type of tooth, with maxillary anterior teeth presenting higher quality (p=0.027). The most common reason for inadequate length was short-filling (33%). There was a statistically significant relationship between the academic year and the density of the fillings (p=0.009). Overall procedural errors occurred in 3.6% of the cases, with the most common being ledge formation and apical transportation. Conclusions: The quality of root canal fillings in single-rooted teeth performed by junior dental students at the University of Porto was considered acceptable in 53.3% of cases., Objetivos: Avaliar radiograficamente a qualidade das obturações de tratamentos endodônticos realizados por estudantes do Mestrado Integrado da Faculdade de Medicina Dentária da Universidade do Porto. Métodos: Foram avaliados os registos de 318 pacientes, dos quais foram selecionadas 225 radiografias periapicais de dentes monorradiculares. As radiografias foram examinadas utilizando o software de imagem VixWin Platinum v1.1 (Gendex, EUA). A qualidade do tratamento endodôntico foi classificada como "aceitável" quando o comprimento e a densidade estavam adequados. Os erros iatrogénicos foram registados. O teste qui-quadrado foi utilizado para análise estatística, considerando um nível de significância de 0,05. Resultados: O tratamento endodôntico foi considerado aceitável em 53,3% dos casos. Houve uma maior percentagem de densidade adequada (70,7%) do que comprimento adequado (64%). Verificou-se uma associação estatisticamente significativa entre a qualidade da obturação e o tipo de dente, sendo os dentes anteriores superiores a apresentar maior qualidade (p = 0,027). A razão mais comum para o comprimento inadequado foram as obturações curtas (33%). Verificou-se uma relação estatisticamente significativa entre o ano letivo e a densidade da obturação (p = 0,009). Erros iatrogénicos ocorreram em 3,6% dos casos, sendo os mais comuns a formação de degraus e o transporte apical. Conclusões: A qualidade dos tratamentos endodônticos em dentes monorradiculares realizados por estudantes de Medicina Dentária da Universidade do Porto foi considerada aceitável em 53,3% dos casos., (undefined)

This work explored a novel approach to enhance the antibacterial activity of commercial Gutta-percha (GP) cones, the most commonly used core filling materials used in endodontic treatment. The reported procedure involved an argon (Ar) plasma treatment (PT) of the GP cone surface, followed by the deposition of a ZnO thin film by magnetron sputtering. The resulting surfaces were evaluated for surface topography, antibacterial activity against Enterococcus faecalis and Staphylococcus aureus, and cytocompatibility with human osteoblastic cells. GP cones treated with NaOCl, a routine chair-side protocol, were also tested as reference. The deposition of a ZnO film on pristine GP cones increased its antibacterial activity. Cones pre-treated with Ar-plasma (PT) and coated with the ZnO thin film presented significantly higher antibacterial activity than that observed on the pristine and, also, compared to the ZnO coated cones. The higher antibacterial activity of PT + ZnO cones appears related to the major effects induced by the PT pre-treatment on the cone surface endowing the deposited ZnO film with a homogeneous nanostructured topography that greatly improved surface reactivity. The modified GP cones maintained an appropriate cytocompatibility with human cells. This novel approach provides ready-to-use cones with enhanced antibacterial activity, improving a strict asepsis protocol during endodontic treatment and preventing secondary endodontic infections., Financial support from the European Union (FEDER funds POCI/01/0145/FEDER/007265) and National Funds (FCT/MEC, Fundação para a Ciência e Tecnologia and Ministério da Educação e Ciência) under the Partnership Agreement PT2020 UID/QUI/50006/2013 is acknowledged. This research was also sponsored by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UID/FIS/04650/2013 and FCT Project 9471 - RIDTI, co-funded FEDER and with reference PTDC/FIS-NAN/1154/2014. J. Borges acknowledges FCT for his Postdoc Grant (SFRH/BPD/117010/2016) and C. Lopes acknowledges FCT for his PhD Grant (SFRH/BD/103373/2014)., info:eu-repo/semantics/publishedVersion

The aim of this study was to investigate in vitro the antimicrobial effect and diffusion against E. faecalis of new intracanal medications on the external root surface. The medications tested were a placebo gel (PC); the new formulations with either 3% nitrofurantoin (NIT) or 3% doxycycline hydrochloride (DX) and 2% chlorhexidine (CHX) gel as positive control. The new formulations were tested using the traditional agar diffusion test (ADT) and an adapted agar diffusion method (AADM), where the teeth were filled with the medications and left to diffuse on agar surface seeded with E. faecalis. In the ADT, the larger zones of microbial growth inhibition were seen in DX, followed by CHX and NIT. In the AADM test only DX and CHX showed antimicrobial effect. Statistically significant differences between groups were observed by the Kruskal-Wallis test (2=47.126; p

Introduction The incorporation of quaternary ammonium polyethylenimine (QPEI) nanoparticles into endodontic sealers induces alterations in their structure and surface properties, which may affect the compatibility with the periapical tissues. This work addressed the behavior of human bone cells exposed to extracts from commercial and QPEI containing AH Plus (DeTrey, Konstanz, Germany) and Pulp Canal Sealer EWT (PCS; Kerr Italia Srl, Salerno, Italy). Methods Freshly mixed AH Plus and PCS or containing 2% QPEI (0.3 mL spread over the well bottom of a 24-well plate) were extracted with culture medium (1.5 mL for 24 hours at 37°C) and diluted (1:20–1:5000). Osteoblastic or osteoclastic cells were cultured in the presence of QPEI particles (1%–10%) and were exposed to the extracts from unmodified and QPEI containing sealers. Results QPEI nanoparticles, at 1% and 2%, did not affect cell behavior. On osteoblastic cells, AH Plus and PCS increased DNA at 1:2500 dilution (levels ≤1:100 were cytotoxic). Alkaline phosphatase activity decreased at dilutions ≤1:500. Comparatively, QPEI containing AH Plus increased DNA at 1:2500 and 1:500 dilutions, and QPEI containing PCS induced ALP activity at 1:2500 and 1:500 dilutions. Regarding osteoclastic cells, DNA increased (AH Plus) or was not affected (PCS) at dilutions up to 1:500 and decreased with more concentrated extracts. Tartrate-resistant acid phosphatase activity decreased with dilutions ≤1:500 for both sealers. QPEI containing sealers presented a similar behavior. The sealers affected some intracellular signaling pathways, and QPEI containing sealers further modulate these mechanisms. Conclusions QPEI nanoparticles, at 2%, did not affect cell behavior. However, the incorporation of 2% QPEI particles into AH Plus and PCS modulates the proliferation and differentiation of bone cells, depending on the sealer and the cell type, without increasing the sealers' cytotoxicity.

Objective: As clinical studies conducted to explore the safety and efficacy of new procedures are considered an important focus in endodontic research, the aim of this controlled clinical study was to compare a laser-assisted endodontic treatment using an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and radial firing tips (RFT) versus the conventional use of 3% sodium hypochlorite and interim calcium hydroxide paste, in teeth with chronic apical periodontitis. Methods: Forty-three single-rooted and premolar teeth were randomly assigned. In group 1, teeth were prepared and irrigated with 3% sodium hypochlorite and calcium hydroxide inter-appointment dressing was applied; in group 2 teeth were prepared with saline solution and irradiated with Er,Cr:YSGG laser using RFT2 (140 μs, 37.5 mJ, 20 Hz) and RFT3 (140 μs, 62.5 mJ, 20 Hz) at the first and second appointments, respectively, four times each, moving at 2 mm/sec-1 from apical to coronal. The primary outcome measure was change in apical bone density at 12 months, using the periapical index (PAI) for blind radiographic assessment. Results: Thirty teeth were examined and subjected to statistical analysis, 12 in the control group and 18 in the test group. There were two treatment failures in the control group that were not included for analysis; both groups exhibited statistically significant decreases in PAI scores. Conclusions: The present findings suggest that for single-rooted and premolar teeth, this laser-assisted protocol can achieve predictable endodontic outcomes, comparable to conventional strategies in 1 year of follow-up.

Barros J , Silva MG , Rodrigues MA , Alves FRF , Lopes MA , Pina-Vaz I , Siqueira JF Jr. Antibacterial,physicochemical and mechanical properties of endodonticsealers containing quaternary ammonium polyethyleniminenanoparticles. International Endodontic Journal, 47, 725–734,2014. Aim To evaluate the antibacterial, physicochemicaland mechanical properties of two endodontic sealersincorporating quaternary ammonium polyethyleni-mine (QPEI) nanoparticles at concentrations of 1%and 2% (w/w).Methodology The sealers tested were AH Plus andPulp Canal Sealer EWT in the commercial unmodifiedform or containing 1% or 2% QPEI. Antibacterialactivity was evaluated using a direct contact test(DCT) against Enterococcus faecalis ATCC 29212 andtwo endodontic isolates (RW35 and RN44). Sealersfreshly mixed or set for 7 days were exposed to bacte-rial suspensions for 10, 30 and 60 min. Setting time,flow test, solubility, apparent porosity, dimensionalchange following setting, wettability, zeta potentialand compressive strength were assessed according tothe International Standard Organization 6876:2001(ISO 6876).Results DCT results revealed that both freshly pre-pared sealers had antibacterial effects unaffected byQPEI incorporation. Both unmodified sealers had lostmuch of their antibacterial effects after 7 days. How-ever, for Pulp Canal Sealer EWT incorporated with1% and 2% QPEI nanoparticles, the antibacterialeffects against all test E. faecalis strains within 30 and60 min of contact were significantly greater than theunmodified formula. Addition of QPEI resulted in nosignificant increase in the antibacterial effects of AHPlus after ageing. As for physicochemical andmechanical tests, setting time, wettability and zetapotential were influenced by the presence of QPEInanoparticles.Conclusion Incorporation of QPEI nanoparticlescan improve the long-term antibacterial activity ofPulp Canal Sealer EWT without relevant changes inphysicochemical and mechanical properties.Keywords: antibacterial activity, endodontic seal-ers, Enterococcus faecalis, nanoparticles, physicochemi-cal properties, quaternary ammonium.

Clinical reports stating the efficacy of novel root canal disinfection protocols are an important focus in endodontic research. This blind randomized clinical trial assessed the clinical efficacy of the erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser radial firing tips (RFT) versus the concomitant use of 3 % sodium hypochlorite and interim calcium hydroxide paste in necrotic teeth with chronic apical periodontitis. We hypothesized to find similar or improved bone healing in the laser-assisted endodontic treatment. Thirty-six anterior and premolar teeth were randomly assigned. In group 1, teeth were prepared with 3 % sodium hypochlorite for irrigation and calcium hydroxide as inter-appointment dressing; in group 2, teeth were prepared with saline solution and irradiated with Er,Cr:YSGG laser using RFT2 (140 μs, 37.5 mJ, 20 Hz) and RFT3 (140 μs, 62.5 mJ, 20 Hz) in the first and second appointment, respectively, four times each, moving at 2 mm s(-1) from apical to coronal. The primary outcome measure was changed in apical bone density at 6 months, using the periapical index (PAI) for blind radiographic evaluation. Twenty-nine patients were examined and subjected to statistical analysis, 12 in group 1 and 17 in group 2. There was one treatment failure in group 1. Both groups gave similar outcomes exhibiting statistically significant decreases in PAI scores.

Introduction: The purpose of this study was to evaluate the use of solvents that are not traditionally used in dentistry for the dissolution of an epoxy resin based sealer and the effect of ultrasonic agitation (UA). Methods: The dissolution of the AH Plus sealer (Dents ply DeTrey, Konstanz, Germany) and the effect of UA in various solvents (eucalyptol, xylene, chloroform, EndoSolv R [Septodont, Cedex, France], EndoSolv E [Septodont], methyl ethyl ketone [MEK], and ethyl acetate) were quantified. The dissolving capacity was assessed by weight loss, Vicker microhardness, scanning electron microscopy (SEM), and X-ray diffraction (XRD). The results were compared with factorial analysis of variance using IBM SPSS Statistics 23.0 software (IBM, Armonk, NY), considering a 0.05 significance level. A preliminary ex vivo study was performed in extracted teeth, with MEK activated by UA as the final irrigation after mechanical removal of the filling material. SEM was used for assessing the cleanliness of the root canal walls. Results: The new solvent proposals, ethyl acetate and MEK, exhibited high dissolution ability, almost reaching chloroform. UA increased dissolution. Vicker values corroborated the dissolution assays. SEM and XRD revealed that solvents affected mainly the organic component of the sealer. Ex vivo results confirmed the immersion model findings. Conclusions: MEK and ethyl acetate proved to be excellent alternatives to chloroform or xylene solvents. MEK presented a high sealer dissolving ability in a short period, especially with UA, without the potential hazards of chloroform, suggesting it is a good approach to AH Plus sealer's dissolution empowered by UA. These results should encourage further studies in order to confirm their clinical relevance., Supported by Fundacao Para a Ciencia e a Tecnologia through the Project UID/EMS/00285/2013., info:eu-repo/semantics/publishedVersion

Objetivos: Determinar a prevalência de periodontite apical (PA) numa população portuguesa e perceber a influência do tabaco no status periapical. Materiais e métodos: Foram avaliados 402 processos clínicos e respetivas radiografias panorâmicas, de pacientes da Clínica Dentária do Instituto de Ciências da Saúde de Viseu da Universidade Católica Portuguesa, com pelo menos 8 dentes em boca e com mais de 18 anos, que foram tratados ou estão em tratamento desde janeiro de 2015 a março de 2016. Procedeu‐se ao registo da presença de PA associada ao hábito comportamental do tabaco, por indivíduo. A classificação quanto à severidade das lesões periapicais foi realizada segundo o índice periapical de Ørstavik (PAI). Os hábitos tabágicos foram registados em não fumadores e fumadores. Resultados: A média de idades da população estudada foi de 46,81 ± 17,5 anos, 57,2% eram do género feminino e 42,8% do género masculino, e a prevalência de indivíduos fumadores foi de 23,9% (do género masculino: 29,7% fumadores; do género feminino: 19,6% fumadores). A prevalência de PA por indivíduo foi de 53,5% sendo que, do total de indivíduos fumadores, 66,7% apresentou pelo menos uma lesão de PA (PAI > = 3). Os valores da associação entre hábitos tabágicos e prevalência de PA apresentaram‐se significativamente relacionados (p < 0,05). Conclusões: A associação entre a prevalência de PA e os hábitos tabágicos, verificada neste estudo, salienta a importância que tem sido atribuída recentemente à influência do status oral na saúde geral do indivíduo.

Although several surgical techniques have been reported, no study has yet reported alternative strategies for endodontic treatment of autogenous transplanted teeth. Therefore, the aim of this clinical report is to present the long-term endodontic outcome of a nonvital autogenously transplanted third molar treated with an Er,Cr:YSGG laser and radial firing tips (RFTs).Autogenous tooth transplantation can be considered an alternative to restore edentulous areas and, in donor's teeth with complete root formation, root canal treatment should be performed up to 14 days following transplantation. In the present case report, the patient returned only after 6 months, with clinical and radiological signs of apical periodontitis (AP) associated with the transplanted tooth.Instead of traditional endodontic chemical irrigants or medications, the protocol for smear-layer removal and root canal disinfection was based on intracanal irradiation with an Er,Cr:YSGG laser and RFTs.After 3-years' follow-up, the complete reestablishment of the periodontal ligament and the arrest of the resorptive process could be noticed.This protocol has shown to be effective for the endodontic treatment of a transplanted multi-rooted tooth with AP. Further randomized clinical trials should be conducted to clearly demonstrate the effectiveness of this laser-assisted endodontic protocol.

ResumoA solução de hipoclorito de sódio, em diferentes concentrações, é o irrigante mais utilizado durante o tratamento endodôntico. Embora a sua utilização seja geralmente segura, sequelas graves podem ocorrer quando da sua extrusão para além do apex do canal radicular, afectando os tecidos periapicais.Neste artigo procura-se alertar o Médico Dentista (e outros profissionais de Saúde Oral) para os principais acidentes que podem ocorrer com o uso do hipoclorito de sódio durante o tratamento endodôntico.AbstractSodium hypochlorite is the most common irrigant used in endodontic practice. Usually, the use of sodium hypochlorite is safe, although severe sequelae may occur if this solution is extruded beyond the root apex. This article's aim is to draw the Dentist's attention (and other oral health professionals) to the principal accidents that may occur with the use of sodium hypochlorite during the endodontic treatment.