Maintenance of Pulp after Horizontal Root Fractures in Three Maxillary Incisors: A Thirteen-Year Evaluation

This case report documents the clinical approach adopted for three upper incisors with horizontal root fracture in the middle or cervical third. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 13 years of follow-up.Keywords: Connective Tissue Cells; Dental Pulp; Tooth Fracture

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

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

Índice de sucesso do tratamento endodôntico dos pacientes atendidos no Centro de Especialidades Odontológicas Success index in endodontic treatment of patients attended at the Dental Specialty Center

Introdução: Os Centros de Especialidades Odontológicas (CEOs) dão continuidade ao tratamento realizado pela rede de atenção básica, ofertando serviços odontológicos especializados. Objetivo: Avaliar a qualidade técnica e o índice de sucesso dos tratamentos endodônticos realizados no CEO-UP no período de abril a dezembro de 2016. Material e métodos: No período de interesse da pesquisa foram realizados 187 tratamentos endodônticos em 170 pacientes. Avaliaram-se os participantes da pesquisa por meio dos dados contidos no prontuário, de exames clínicos e radiográficos. Os dentes tratados endodonticamente foram examinados por um especialista em Endodontia, um ano após a conclusão do tratamento, que avaliou a condição clínica e comparou e analisou as radiografias realizadas no fim do tratamento com as radiografias atuais. Os dados coletados foram apresentados de forma descritiva mediante números absolutos e percentuais. Resultados: Compareceram à avaliação 53 pacientes, totalizando 59 dentes tratados. Destes, 98% apresentavam correta adaptação do material obturador e 84% estavam com o limite apical da obturação adequado. Quanto à condição do dente, 71% estavam restaurados com material definitivo. Oitenta por cento dos dentes não apresentavam lesão periapical, e em 17% a lesão havia diminuído. Conclusão: Os tratamentos endodônticos realizados no CEO-UP possuem uma adequada qualidade técnica, resultando no sucesso do tratamento endodôntico feito por esse serviço.Introdução: Os Centros de Especialidades Odontológicas (CEOs) dão continuidade ao tratamento realizado pela rede de atenção básica, ofertando serviços odontológicos especializados. Objetivo: Avaliar a qualidade técnica e o índice de sucesso dos tratamentos endodônticos realizados no CEO-UP no período de abril a dezembro de 2016. Material e métodos: No período de interesse da pesquisa foram realizados 187 tratamentos endodônticos em 170 pacientes. Avaliaram-se os participantes da pesquisa por meio dos dados contidos no prontuário, de exames clínicos e radiográficos. Os dentes tratados endodonticamente foram examinados por um especialista em Endodontia, um ano após a conclusão do tratamento, que avaliou a condição clínica e comparou e analisou as radiografias realizadas no fim do tratamento com as radiografias atuais. Os dados coletados foram apresentados de forma descritiva mediante números absolutos e percentuais. Resultados: Compareceram à avaliação 53 pacientes, totalizando 59 dentes tratados. Destes, 98% apresentavam correta adaptação do material obturador e 84% estavam com o limite apical da obturação adequado. Quanto à condição do dente, 71% estavam restaurados com material definitivo. Oitenta por cento dos dentes não apresentavam lesão periapical, e em 17% a lesão havia diminuído. Conclusão: Os tratamentos endodônticos realizados no CEO-UP possuem uma adequada qualidade técnica, resultando no sucesso do tratamento endodôntico feito por esse serviço

Capacidade de selamento e penetração intratubular do MTA Fillapex e do AH Plus em dentes humanos

Resumo Introdução O MTA é um importante material de uso na odontologia, com boas propriedades biológicas. As respostas experimentais aos cimentos endodônticos que utilizam este composto no selamento e preenchimento do sistema de canais radiculares, aliados a uma boa instrumentação e limpeza, podem ser importantes no processo de reparo periapical. Objetivo Avaliar in vitro a profundidade de penetração de dois diferentes cimentos endodônticos nos túbulos dentinários e a infiltração bacteriana em obturações com os cimentos AH Plus e MTA Fillapex. Material e método 34 pré-molares monorradiculados humanos foram selecionados, suas coroas removidas e suas raízes padronizadas em 16 mm, a seguir foram, então, divididos aleatoriamente em dois grupos de 15 espécimes e instrumentados com o sistema rotatório Pro Taper. Um grupo foi obturado com o cimento AH Plus (Grupo AH) e outro com MTA Fillapex (Grupo FI). Nestes grupos, avaliaram-se a infiltração coronária de bactérias para Enterococcus Faecalis e a profundidade de penetração nos túbulos dentinários. Para a aferição da infiltração bacteriana, usou-se o teste exato de Fisher; para a penetração intratubular, usou-se o teste-t. Resultado Para a infiltração bacteriana, considerando o número de amostras infiltradas para AH e MTA Fillapex, houve diferença estatística significativa (p=0,0341). Na avaliação da penetração intratubular, a diferença entre os dois grupos de cimentos foi considerada estatisticamente significativa (p=0,0006). Conclusão Ambos os cimentos apresentaram infiltração bacteriana, sendo que o MTA Fillapex teve pior desempenho. A capacidade de penetração nos túbulos dentinários do AH Plus foi significativamente maior que a do MTA Fillapex

Efficacy of protaper instruments during endodontic retreatment

Introduction: The effectiveness of ProTaper Universal and ProTaper Retreatment rotary instruments was compared to the Hedström files in the removal of filling material from root canals. Materials and Methods: Thirty-six extracted human mandibular premolars with a single straight root canal were shaped and filled with gutta-percha and AH Plus. The specimens were stored for 6 months at 37°C and at 100% relative humidity, and then randomly divided into three groups: PTU - removal of filling material performed with ProTaper Universal instruments; PTR - removal of filling material performed with ProTaper Retreatment instruments; HF – removal of filling material performed with Gates-Glidden burs, Hedström files and solvent. After the filling material removal and diaphanization, the specimens were longitudinally sectioned and images of the canal surfaces were scanned. The remaining areas of filling material were measured (Image Tool 3.0), and data was analyzed statistically (Kruskal-Wallis and Dunn tests). The time required for filling removal in each group was also recorded (one-way ANOVA and Tukey's HSD test). Results: All groups presented remnants of filling material; PTU had the smallest amount and HF group presented the highest mean value (P< 0.05) in all the thirds. The cervical third had the smallest amount of material when compared with the other thirds (P< 0.05). HF group required a longer mean time, presenting significant difference (P< 0.05). Conclusion: Considering the time required and the amount of the filling removal, ProTaper Retreatment were not superior to ProTaper Universal, but both rotary instruments were more effective and less time-consuming than Hedström manual files

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

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&#177;4.540), adhesiveness (4.441&#177;2.683) and apical leakage (0.318&#177;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

RESISTENCE TO CYCLIC FATIGUE OF DIFFERENT NICKEL TITANIUM INSTRUMENTS

The objective of this study was to evaluate the dynamic cyclic fatigue resistance of the instruments X1 Blue File (25.06), Pro-R (25.08), Reciproc R25 (25.08) and Reciproc Blue R25 (25.08). 48 instruments ware used, divide into 4 groups (n=12) according to the system test. The dynamic cyclic fatigue test was performed on a specially designed device that performed controlled axial movements. The instruments were activated with reciprocating movement in an artificial zirconia channel, with an angle of 60º, 5 mm radius of curvature and an internal diameter of 1.5 mm. The artificial root was kept submerged in water simulating body temperature (37 ± 1 °C). The instruments were driven until fracture, with the time until failure occurred. The One- Way ANOVA test was used for multi-comparison of samples and the Turkey test was used for two-by-two comparison. A significance level of 5% was adopted. The Pro-R and Reciproc Blue instruments showed a longer time to fracture than the other evaluated instruments (p&lt;0,05). The Reciproc instrument had a longer time to fracture than the X1 Blue File (p&lt;0,05).&nbsp; It can be concluded that the Pro-R and Reciproc Blue instruments were more resistance to cyclic fatigue than the Reciproc and X1 Blue File instruments