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AIM To evaluate several factors that might interfere with the use of electronic root canal length measurement devices (ERCLMDs) in a laboratory setting, including two different embedding media (alginate and electroconductive gel), three different types of devices and the radiographic view on the assessment of the electronic readings. METHODOLOGY Thirty single-rooted extracted human mandibular premolars were selected. After access and canal pre-flaring, a size 10 K-file was inserted in the canal up to the major apical foramen under magnification (×10), and this length was recorded as the actual length (AL) of the canal. Teeth were mounted on a specific endodontic training kit platform (ProTrain). Two different embedding media (electroconductive gel and alginate) and three different ERCLMDs: Apex ID (SybronEndo, Glendora, CA, USA), CanalPro Apex Locator (Coltene-Endo, Cuyahoga Falls, OH, USA) and the Root ZX II (J. Morita, Tokyo, Japan), were tested. Following the measurement at the 0.5 mark of each ERCLMD using alginate, two periapical radiographs (bucco-lingual and proximal views) were taken. The difference between the electronic readings and the AL, as well as the distance from the file tip to the apex of the roots on the radiographs, was calculated. Data were analysed statistically (two-way anova, Tukey's and chi-squared tests) at 5% significance level. RESULTS The incidence of over-extended readings was significantly greater (P

To investigate the genetic association in a sample of replanted teeth, it is necessary to observe the extreme phenotypes, such as, teeth that underwent functional healing and those extracted due to severe external root resorption. Thus, this study aimed to investigate the association of age of the patients, root development, storage media, and polymorphisms in the interleukin 4 (IL4) and interleukin 6 (IL6) genes with teeth that presented extreme outcomes, as functional healing or extraction, in a group whose replantation techniques did not follow the International Association of Dental Traumatology (IADT) 2012 guidelines. Forty-three avulsed and replanted teeth that did not follow IADT 2012 guidelines and underwent functional healing or were extracted were included. Periapical radiographs employed for this study were taken soon after tooth replantation and after 1 year. For genotypic IL4 and IL6 genes analysis, DNA of oral mucosa cells was extracted. Real-time- PCR performed for genotyping polymorphisms in IL4 and IL6 genes. Clinical and genetic variables were analyzed by the Chi-square test and the “Z” test. P values < .05 were considered significant. The results showed that functional healing and extraction were associated with storage media and with the rs2243268 of IL- 4 gene polymorphisms. As conclusion, the C rs2243268 allele of IL4 gene may have a positive relationship with functional healing teeth that were replanted not following the 2012 IADT guidelines. Keeping the tooth dry is associated to a fast loss of avulsed and replanted teeth after 1-year follow-up. Resumo Para investigar a influência genética em uma amostra de dentes reimplantados, é necessário observar os fenótipos extremos, como os dentes que sofreram cura funcional e os extraídos devido à reabsorção radicular externa severa. Assim, este estudo teve como objetivo investigar a associação da idade dos pacientes, desenvolvimento radicular dos dentes, assim como o meio de transporte até o reimplante e polimorfismos nos genes da interleucina 4 (IL4) e da interleucina 6 (IL6) com dentes que apresentaram cura funcional ou extração, em um grupo cujas técnicas de reimplante não seguiu a International Association of Dental Traumatology (IADT) 2012. Foram incluídos 43 dentes avulsionados e reimplantados que não seguiram as diretrizes do IADT, e tiveram cura funcional ou foram extraídos. As radiografias periapicais utilizadas para este estudo foram feitas logo após o reimplante dentário e após 1 ano. Para a análise genotípica dos genes IL4 e IL6, foi extraído DNA de células da mucosa oral. PCR em tempo real realizou a análise dos polimorfismos dos genes. As variáveis clínicas e genéticas foram analisadas pelos testes Qui-quadrado e “Z”. Valores de p

The aim of this in vitro study was to compare the efficiency of a photodynamic therapy (PDT) technique employing rose bengal (RB) and methylene blue (MB) as photosensitizers (PSs) to reduce the viability of Enterococcus faecalis, a well-known pathogen found in root canal systems. Currently, in several clinical applications, including in the field of endodontics, MB is employed in association with a red laser source for the photoinactivation of pathogenic bacteria.In this study, MB was used at 0.01% (31.2 mol/L) in association with a red (660 nm) laser as the excitation source in the MB group (MBG). Alternatively, the same test was performed with RB (25 mol/L) that was associated with a green (532 nm) light laser source in the RB group (RBG). A saline solution (0.9%) was used in the control group. The colony-forming units per milliliter (CFU/mL) were calculated after 24 h of incubation at 37°C, and the statistical analysis was performed using ANOVA.The results showed a significant reduction in the CFU/mL in the RBG group (0.12 × 10PDT may be improved if RB is used in association with a green light laser source for the inactivation of E. faecalis.

Introduction The goal of replantation after dental avulsion is to maintain the tooth in its socket. Presence of vital periodontal ligament cells on the root surface of the replanted tooth and the immunologic status of the patient are factors that protect against root resorption. It is known that dental constituents play an active role in root resorption by inducing specific and non-specific immune responses; however, little information exists regarding the influence of the acquired immune response on replantation. Therefore, the aim of this study was to evaluate the 5-year outcome of replantation in non-atopic and atopic patients. Methods Clinical and radiographic examinations were performed in 62 replanted teeth during a 5-year period. The evaluation of atopy was based on the patients’ personal and family histories and skin prick test results. The χ 2 and the Z tests were used to assess the association between atopy and the outcome of the replanted teeth ( P Results There were significant differences between the 1-year and 5-year outcomes of the replanted teeth ( P P Conclusions Being atopic may offer the advantage of loss of fewer teeth because of replacement resorption, whereas being non-atopic may create an advantage of loss of fewer teeth because of inflammatory root resorption during the first 5 years after trauma.

Objective The study aimed to verify the potential correlation between the detected amount of gram-negative bacteria and the radiographic sizes of the lesions in patients with symptomatic and asymptomatic apical periodontitis. Furthermore, to evaluate whether the expression of receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) and the RANKL/OPG ratio are differentially regulated in both groups. Design Twenty patients with periapical lesions were divided into two groups: symptomatic (SYM) n = 10 and asymptomatic (ASYM) n = 10. After periapical surgery, the lesions were collected and processed for histological examination, and immunohistochemistry. The percentage of RANKL- and OPG-immunopositive areas relative to the total area of the microscopic field was calculated. For gram staining, the number of gram-negative cells per microscopic field was assessed. The radiographs of each patient were processed and measured. The Student’s t -test and the Pearson correlation coefficient were performed. Results The SYM group showed a significantly higher number of gram-negative cells (p = 0.007) when compared to the ASYM group. A higher number of gram-negative bacteria occurred more frequently in larger periapical lesions and the SYM group (p = 0.03). The expression for RANKL and OPG and the RANKL/OPG ratio were not significantly different between the groups. There was a significant positive correlation between the number of bacteria and OPG levels in the SYM group (p = 0.01). Conclusion The number of bacteria seems to influence the symptoms and the radiographic size of a periapical lesion. Gram-negative bacteria may play an important role in OPG activity in the SYM group.

Objective: The objective of the present study was to evaluate the influence of different irrigation solutions on the amount of extruded residues apically, varying the instrumentation technique in manual, continuous rotation, or reciprocation motions. The amounts of residue for each irrigation solution was also assessed. Methods: Two tests were performed. In the first test, 90 mandibular premolars were divided into nine groups (n=10). Each group was subjected to a different technique: ProTaper Universal, WaveOne Gold, or manual instruments, with different irrigation solutions [2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gel, or distilled water]. During the preparation of the root canal, the apically extruded material was collected in previously weighed glass vials. In the second test, irrigation solutions were weighed separately with the same weighing method. Data were analyzed using the Kolmogorov–Smirnov, one-way and two-way ANOVA, Levene, Tukey, and Games–Howell tests. Results: Apically extruded debris was observed in all groups. ProTaper Universal with continuous rotation using 2% CHX gel resulted in the greatest amount of debris (P

Objective: To analyze possible correlations among tubular dentine cement penetration, adhesiveness and apical leakage in fillings performed with gutta percha and an endodontic cement based on epoxy amine resin. Material and Methods: Sixty similar, extracted human mandibular central incisors were irrigated, instrumented and filled following the same protocol. First, apical leakage was quantified by fluid filtration tests. Then, these same specimens were sectioned for analysis of tubular dentine cement penetration and the middle thirds were submitted to push-out tests to analyze the adhesiveness of the fillings. Results: In brief, the means and standard deviations with a confidence interval of 95% were as follows: tubular dentine cement penetration (8.875±4.540), adhesiveness (4.441±2.683) and apical leakage (0.318±0.215). The data were confronted using the Pearson's test (P>0.05), and it was possible to prove that there was no correlation between (1) tubular dentine cement penetration and apical leakage (r2: 0.08276), (2) tubular dentine cement penetration and adhesiveness (r2: -0.2412) and (3) adhesiveness and apical leakage (r2: 0.1340). Conclusion: After analysis of these data, it could be observed that there exists no correlation among the variables analyzed in this study.

– This report presents a case of replantation of a traumatically avulsed central incisor in a 32-year-old woman. The tooth was replanted after a 30-min extra-alveolar period. Emergency unconventional immobilization was performed, using 2–0 chromic gut, and a restorative composite made Gunning-type splint. The tooth is still in place 27 years after replantation (1976 to date) without marked resorption.

Traumatic injuries to permanent teeth are common, and dramatic episodes can occur during childhood. The aim of this paper is to present a report of severe trauma to the orofacial complex of an 8-year old girl that resulted in multiple injuries. The use of the term “dental polytrauma” (concomitant different dental traumatic injuries) is advocated in this case presentation.CitationMartins WD, Westphalen FH, Ditzel Westphalen VP, Souza PHC. Multiple Dentoalveolar Traumatic Lesions: Report of a Case and Proposition of Dental Polytrauma as a New Term. J Contemp Dent Pract 2004 November;(5)4:139-147.

A case of microstomia caused by swallowing caustic soda is presented. A 54-year old man developed a progressive stricture of the circumoral region following accidental ingestion of caustic soda when he was 9 years old. He was treated by a general surgeon who performed bilateral commissurotomies when he was 19 years old and lived normally until he needed major dental prosthetic treatment. His dentist was unable to perform the treatment due to the mouth stricture. The surgical option was to perform bilateral buccal mucosal flaps. A review of the literature and the surgical technique are presented. Citation Martins WD, Westphalen FH, Westphalen VPD. Microstomia Caused by Swallowing of Caustic Soda: Report of a Case. J Contemp Dent Pract 2003 November;(4)4:091-099.

Background. The accepted treatment for extrusive luxation is repositioning of the extruded tooth at the earliest possible opportunity. Case report. Repositioning was not possible in a patient who presented for treatment 4 days after the accident, and therefore, an intentional replantation was performed instead. The tooth was carefully extracted, the blood clot removed from the alveolus and the tooth was then replanted. Conclusion. Intentional replantation involves the deliberate removal of a tooth and its reinsertion into the alveolus almost immediately afterwards. It is now an accepted endodontic procedure. The favourable outcome of this case suggests that intentional replantation of severely extruded teeth may be a treatment option in cases where the tooth cannot be repositioned and if treatment conditions are adequately followed.

The prognosis of traumatized teeth in general and of avulsed teeth in particular depends on prompt and appropriate treatment. Management of traumatic injuries may be a challenge to the non-specialized dentist, as they may occur when dentists are least prepared for it. The objective of this research was to investigate the knowledge of general practitioner dentists about the emergency management of dental avulsion in Curitiba, PR, Brazil. A group of 250 professionals were interviewed. The questions were related to knowledge of how to treat traumatic avulsion of teeth. The results suggest that the level of knowledge on the management of dental avulsion of the general practitioners dentists in Curitiba is adequate.