Análise das propriedades do MTA manipulado com diferentes concentrações de propileno glicol

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Florianópolis, 2014.O emprego do propileno glicol (PG) como veículo do Agregado de Trióxido Mineral (MTA) demonstrou melhorar algumas de suas propriedades físico-químicas e não alterou sua biocompatibilidade. O objetivo deste trabalho foi avaliar o efeito do PG na estabilidade dimensional, na resistência à compressão, na solubilidade e desintegração, e no pH do MTA. O MTA foi preparado com diferentes proporções de PG: G1= MTA + 100% água destilada (AD); G2 = MTA + 80% AD e 20% PG; G3= MTA + 50% AD e 50% PG e G4= 20% AD e 80% PG. Os testes de estabilidade dimensional e de resistência à compressão foram realizados após 24 horas de imersão em água e após 30 dias. Para a análise da solubilidade e do pH, anéis de teflon foram preenchidos com os cimentos e individualmente colocados em potes plásticos com 50 ml de AD (n= 6). Passadas 3 h, 24 h e 7 dias o pH foi analisado, e a solubilidade após 7 dias. A análise estatística foi realizada através do teste ANOVA para comparações entre os grupos e teste Tukey para comparações individuais. O PG não interferiu na estabilidade dimensional e na resistência à compressão do MTA. A solubilidade dos cimentos com 50% e 80% de PG foi menor do que a do grupo preparado com AD (p=0,0194 e p=0,0221) quando úmidos. O PG aumentou o pH do MTA nas primeiras 3 h com diferença estatística para o grupo da AD (p=0,004; p2014-08-06T18:12:37

SUCCESS RATE OF ENDODONTIC TREATMENTS PERFORMED BY UNDERGRADUATE STUDENTS OF THE UNIVERSITY OF SOUTHERN SANTA CATARINA

Introduction: Apical periodontitis is an inflammatory disease of the periradicular tissues caused by microbial(re)contamination of the root canal system. Due to its direct relationship to the quality of endodontictreatment, it is extremely important to carry out longitudinal and cross-sectional studies, following-uptreatments carried out in universities. Aim: To evaluate the success rate of endodontic treatments performedby undergraduate students of the University of Southern Santa Catarina - UNISUL, Pedra Branca, betweenAugust 2015 and July 2017.Materials and Methods: One hundred twenty-four patients with endodontic treatment were contacted. Ofthese, only 27 attended for treatment follow-up, adding up to a total of 32 treatments analyzed. All teeth wereclinically and radiographically evaluated, and the potential indicators related to endodontic treatment successor failure were analyzed. The frequencies of each criterion were calculated, and the data analyzed using theChi-Square test (α = 5%).Results: 9 cases (28.13%) were considered failure, either because they were associated with symptoms or becausethere was a periapical alteration. In addition, 88.88% of the failure cases had temporary restorative material.Association was observed only between the number of root canals and symptoms (P = 0.049). Two of the 3treated teeth with multiple root canals showed symptoms at the follow-up. The endodontic success rate was71.87%.Conclusion: The success rate of the 32 endodontic treatments performed by undergraduate students fromUNISUL was 71.87%

Calcium hydroxide induces mineralized tissue neoformation: a case report

Trauma in the anterior teeth is a relatively common occurrence during childhood, having as main consequence teeth with incomplete root development and open apices. Patient, male, leucoderma, 10 years old, attended the Dental Clinic of the Southern University of the State of Santa Catarina, reporting as main complaint fracture in the crown of element 11. After clinical and radiographic examination, it was possible to identify the incomplete apexogenesis of this tooth and the presence of necrotic pulp. Aiming to stimulate neoformation of mineralized tissue at the dental apex, the calcium hydroxide based dressing was used. He remained for eight months, always with radiographic control. Apexification was observed radiographically and proved through the use of an instrument introduced inside the canal. The use of calcium hydroxide as intracanal medication for eight months stimulated mineralized tissue neoformation in the apical region of element 11 and allowed endodontic treatment

Influência da temperatura de armazenamento nas propriedades físico-químicas e adesivas de diferentes cimentos endodônticos e os efeitos da sobre-extensão da obturação na incidência de dor pós-operatória

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Florianópolis, 2023.O presente estudo investigou a influência de três diferentes temperaturas de armazenamento no escoamento, na alteração dimensional, na solubilidade, no pH e na resistência de união (RU) de cimentos endodônticos à dentina do canal radicular. Ainda, revisou sistematicamente a literatura com o objetivo de responder a seguinte pergunta de pesquisa: a sobre-extensão de material obturador aumenta a incidência de dor pós-operatória? Para isso, os cimentos BioRoot RCS, Endomethasone N, Bio-C Sealer e AH Plus Jet, permaneceram por 30 dias em temperaturas controladas de 5oC, 20oC ou 35oC. O teste de escoamento foi baseado nas normas ISO 6876 (2012). Os testes de alteração dimensional e a solubilidade foram avaliados pelas normas ISO 6876 (2002, 2012). A avaliação do pH deu-se pela análise da água, na qual os discos utilizados no teste de solubilidade foram individualmente imersos. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis, post hoc de Dunn (a = 0,05), ANOVA de Friedman e post hoc de Durbin-Conover (a = 0,05). Para o teste de RU à dentina, fatias de dentina radicular humana com 1,0 mm de espessura tiveram três cavidades de 1,2mm de diâmetro realizadas paralelamente à parede do canal radicular e preenchidas com os cimentos BioRoot RCS, Endomethasone N e AH Plus Jet (n=24). Após 7 dias, o teste de RU (push-out) foi realizado e o modo de falha foi analisado em esteomicroscópio. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis e post hoc de Dunn (a = 0,05). Para a revisão sistemática (RS), foram incluídos apenas estudos clínicos randomizados (ECR) comparando a incidência de dor pós-operatória em até 7 dias, em dentes permanentes que receberam tratamento endodôntico primário, com ou sem sobre-extensão de material obturador. A qualidade dos estudos foi avaliada pela ferramenta 2.0 da Cochrane e a meta-análise realizada através do método Mantel-Haenszel e efeito randômico com intervalo de confiança de 95%. As diferentes temperaturas de armazenamento influenciaram nas propriedades físico-químicas dos cimentos testados. No escoamento, só o cimento AH Plus Jet apresentou alteração estatisticamente significativa. Os valores de RU à dentina do canal radicular obtidos para os cimentos BioRoot RCS e Endomethasone N armazenados em 5oC e 35oC foram menores (p<0,05) quando comparados aos cimentos armazenados em 20 oC. A falha mais comum foi a falha adesiva. Doze ECR foram incluídos na RS e as informações necessárias foram extraídas. Seis estudos foram classificados como baixo risco de viés, três como risco incerto e três como alto risco de viés. Três metanálises foram realizadas. Observou-se, nos estudos laboratoriais, que as diferentes temperaturas de armazenamento influenciaram no escoamento, na alteração dimensional, na solubilidade, no pH e na resistência de união à dentina de pelo menos um dos cimentos testados. De modo geral, os cimentos armazenados à 20ºC, temperatura dentro da recomendada por todos os fabricantes, apresentaram melhor desempenho. Além disso, a maioria dos ECR incluídos encontrou uma associação positiva entre a maior incidência de dor pós-operatória e a sobre-extensão de material obturador.Abstract: The present study investigated the influence of three different storage temperatures on flow, dimensional change, solubility, pH, and bond strength (BS) of endodontic sealers to root canal dentin. Also, it aimed to systematically review the literature and answer the following question: does overextension of filling material increase the incidence of postoperative pain? For this, BioRoot RCS, Endomethasone N, Bio-C Sealer and AH Plus Jet sealers remained for 30 days at controlled temperatures of 5ºC, 20ºC or 35ºC. The flow test was based on ISO 6876 (2012) standards. The dimensional change and solubility tests were evaluated according to the ISO 6876 standards (2002, 2012). The pH evaluation was carried out by analyzing the water, in which the disks used in the solubility test were individually immersed. Statistical analysis was performed using Kruskal-Wallis, Dunn's post hoc (a = 0.05), Friedman's ANOVA and Durbin-Conover's post hoc tests (a = 0.05). For the BS to dentin test, slices of human root dentin with 1.0 mm thickness had three 1.2 mm diameter cavities made parallel to the root canal wall and filled with BioRoot RCS, Endomethasone N and AH Plus Jet (n=24). After 7 days, the BS (push-out) was performed, and the failure mode was analyzed under a stereomicroscope. Statistical analysis was performed using Kruskal-Wallis and Dunn's post hoc tests (a = 0.05). For the systematic review (SR), only randomized clinical trials (RCTs) comparing the incidence of postoperative pain within 7 days, in permanent teeth that received primary endodontic treatment, with or without obturation material overextension were included. Study quality was assessed using the Cochrane 2.0 tool and meta-analysis was performed using the Mantel-Haenszel method and random effect with a 95% confidence interval. The different storage temperatures influenced the physicochemical properties of the tested sealers. In terms of flow, only the AH Plus Jet cement showed a statistically significant change. The BS values obtained for BioRoot RCS and Endomethasone N sealers stored at 5ºC and 35ºC were lower (p<0.05) when compared to sealers stored at 20ºC. The most common failure mode was the adhesive failure. Twelve RCTs were included in the SR and the necessary information was extracted. Six studies were classified as low risk of bias, three as uncertain risk of bias and three as high risk of bias. Three meta-analyses were performed. It was observed in laboratory studies that the different storage temperatures influenced the flow, dimensional change, solubility, pH and bond strength to dentin of at least one of the tested sealers. In general, sealers stored at 20ºC, a temperature within the range recommended by all manufacturers, performed better. Furthermore, most RCTs included found a positive association between a higher incidence of postoperative pain and overextension of obturation material

Intracanal Irrigating Solutions Prior to Calcium Hydroxide Medication and Its Effects on Root Dentin Strength

Abstract The aim of this study was to assess the effects of intracanal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetracetic acid (EDTA) prior to calcium hydroxide medication on the compressive strength of root dentin. Forty-eight roots with single and straight canals were instrumented with a crown-down technique using Flexofile files and Gates Glidden burs, under 0.9% sodium chloride (NaCl) irrigation. Root canals were randomly separated into 4 groups (n=12), according to the irrigating solution: Control Group, 0.9% NaCl; GroupNaOCl, 1% NaOCl; GroupEDTA, 17% EDTA; and GroupEDTA+NaOCl, 17% EDTA and 1% NaOCl. Solutions remained for 40 min, renewed every 10 min, except for GroupEDTA+NaOCl, where the solutions were alternated every 10 min. Canals were dried and filled with calcium hydroxide paste, and radiographed. Each canal was sealed and stored at 37 °C for 30 days. After this period, the roots were cut 1 mm below the cementoenamel junction and 6 mm apically from this point in order to obtain 6 mm-long cylinders. The compressive test was conducted with a crosshead speed of 1 mm/min. The means (±SD) (MPa) of compressive strength were: Control Group, 151.23±94.36; GroupNaOCl, 167.50±57.25; GroupEDTA, 108.79±99.88; GroupEDTA+NaOCl, 60.12±92.10. Significant statistical differences among groups were found (ANOVA and Tukey, a=5%, p=0.02). Control Group and GroupNaOCl showed higher means of compressive strength than GroupEDTA+NaOCl. Intracanal irrigation with 17% EDTA and 1% NaOCl produced a significant reduction of dentin compressive strength 30 days after medication with calcium hydroxide

Guided Endodontics in Root Canals with Complex Access: Two Case Reports

Abstract This article reported two clinical cases in which the guided endodontics was used to perform the access to the root canals. The first case presents a 40-year-old female with a history of pain related to the left maxillary canine. After radiographic examination, the presence of severe calcification up to the apical third of the root canal, associated with a periapical radiolucency, was noted. In the second case, an 85-year-old male was referred to our service with pain upon palpation, at the right mandibular first molar. The radiographic images revealed the presence of endodontic treatment and a fiberglass post in the distal root canal, which was associated with extrusion of the filling material and a periapical lesion. The 3D-guides were planned based on cone beam computed tomography and intraoral digital scanning, which were aligned using a specific software. Therefore, implant drills could be guided up to the root canal length required for each case. In the first case, a surgical root canal was created and the patient was free of signs and symptoms after the treatment was completed. In the second case, it was observed that the fiber post was worn by the drill, allowing free access to the filling material. It was possible to perform the endodontic reintervention in a more predictable way and in less time. In both cases, the use of the guided endodontics allowed the preservation of a large part of the dental structure. The procedures were performed faster, without the occurrence of fractures and perforations.</jats:p

Do alternative scaffolds used in regenerative endodontics promote better root development than that achieved with blood clots?

Abstract The aim of this integrative review was to identify whether alternative scaffolds used in regenerative endodontics contribute to better root development, in relation to the increase in root length and thickness of dentin walls, compared with blood clot (BC) scaffolds. The literature search was conducted in PubMed, SciELO and Lilacs databases, using descriptors related to the topic. After applying the eligibility criteria, 11 articles were selected and analyzed according to the proposed aim. Five clinical and six in vivo studies, conducted in animals, compared different types of alternative scaffolds with BCs, with emphasis on platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). All scaffolds, alternative or BC, promoted an increase in root length and dentin wall thickness, with varying percentages of increase between studies. In general, there was a significant increase in root length and dentin thickness promoted by PRF and PRP scaffolds, compared with BC. It was concluded that the majority of the scaffolds tested contributed to the increase in root length and thickness of dentin walls, with emphasis on PRF and PRP.</jats:p

Impact of Heating Exposure on the Micro-Push-Out Bond Strength of Bioceramic Sealers

Introduction. The aim of this study was to evaluate the effect of heating of bioceramic and epoxy resin-based sealers on their micro-push-out bond strength (BS) to root canal dentin. Methods. After criterial selection, 30 human teeth were decoronated and 1-mm thick slices (n = 60) were obtained perpendicularly along tooth axis, from cervical and middle root thirds, with a diamond disc attached to a cutting machine. In each slice, three 1.0-mm diameter orifices were made. After rinsing with 17% EDTA and 2.5% NaOCl, each orifice was filled with Bio-C Sealer or BioRoot RCS or AH Plus, according to the manufacturers’ instructions. After filling, half of the slices (n = 30) were heated at 100°C for 1 min, and the other half were kept at room temperature. After 7 days-controlled storage, micro-push-out test was performed in a Universal Testing Machine. Failures were analyzed using a stereomicroscope. Statistical analysis was performed with One-Way ANOVA and post hoc Tukey (α = 5%) tests. Results. AH Plus demonstrated higher BS values after heating (p=0.001) when compared to nonheated. The other sealers did not show a statistically significant difference (p>0.05). When heated, the average BS values for AH Plus were higher than for BioRoot RCS and Bio-C Sealer (p<0.001). Cohesive failure mode was the most frequent, followed by adhesive and mixed ones. Conclusion. Heating provided a higher push-out BS to root dentin for AH Plus and did not influence BioRoot RCS or Bio-C sealer

Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

Introduction. The present study aimed to investigate the capacity of different irrigation protocols using heated distilled water at 65°C (HDW), in preventing the formation of the brown–orange precipitate observed after the interaction between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods. Forty human canines were selected, prepared, and cleaved in two halves. Images of delimited areas in each root canal thirds were obtained through a stereomicroscope (16x and 40x). After reassembly, the teeth were distributed into four groups (n = 10) according to the final irrigation protocol: G1 (no HDW): EDTA + NaOCl + CHX with conventional irrigation (CI); G2 (HDW + CI): EDTA with passive ultrasonic irrigation (PUI) + NaOCl (PUI) + HDW (CI) + CHX (PUI); G3 (HDW + PUI): EDTA + NaOCl + HDW + CHX with PUI; G4 (HDW + CUI): EDTA (PUI) + NaOCl (PUI) + HDW with continuous ultrasonic irrigation (CUI) + CHX (PUI). After irrigation, the teeth were re-separated and images of the same delimited areas were obtained again. Scores were assigned according to the amount of precipitate observed, comparing the initial and final images. The data were submitted to Kruskal–Wallis, Dunn and Friedman statistical tests (α = 5%). Results. G1(no HDW) showed the highest scores in the analysis between groups (p0.05). Conclusion. The intermediate irrigation with heated distilled water at 65°C prevented the formation of brown–orange precipitate, regardless of the use of ultrasonic activation (PUI or CUI)