Antibacterial Effect of Photodynamic Therapy on Root Canal Disinfection Combined with Different Irrigation Protocols

Introduction: Photodynamic therapy (PDT) is an emerging alternative therapy to conventional endodontic treatment to optimize bacterial elimination. The aim of this study was to evaluate the in vitro antibacterial effect of PDT combined with different irrigation protocols on root canals inoculated with Enterococcus (E.) faecalis. Methods and Materials: Ninety uni-radicular human premolars were prepared and contaminated with E. faecalis for 4 days. Teeth were randomly divided into six groups: positive control group (C+) consisted of conventional needle irrigation with 2.5% sodium hypochlorite (NaOCl); negative control group (C-) consisted of no treatment after contamination; PDT group as treated with 0.005% methylene blue and diode laser irradiation for 90 sec at wavelength of 660 nm, energy of 9 Joules, power of 100 mW; the fourth group consisted of  NaOCl+PDT, the fifth group were treated with passive ultrasonic irrigation (PUI) with NaOCl+PDT (PUI+PDT); and the final group were treated with XP Endo Finisher with NaOCl+PDT (XP Endo+PDT). The contents of the root canals were collected with sterile absorbent paper points at two times: before and 24 h after decontamination protocols. The number of colony-forming units (CFU) was determined for each root canal. ANOVA and the Tukey test were used, with significance set at 5% (P<0.05). Results: The inhibition percentage ranged from 10.72 (C-) to 100% (XP Endo+PDT), with CFU/mL counts differing among all protocols tested (P<0.05). The different protocols significantly influenced bacterial inhibition (P<0.05). However, the XP Endo+PDT protocol resulted in the highest inhibition percentage (100%), followed by NaOCl+PDT (65.85%). Conclusions: PDT combined with different final irrigation protocols was more effective in inhibiting E. faecalis growth than photodynamic therapy alone. XP Endo was the best irrigation protocol to eradicate this microorganism.Keywords: Biofilm; Endodontics; Enterococcus faecalis; Photodynamic Therap

ALTERAÇÕES BUCAIS EM PACIENTES EM UNIDADE DE TERAPIA INTENSIVA: ESTUDO RETROSPECTIVO

Os pacientes críticos podem desenvolver alterações bucais decorrentes do uso de medicamentos, associada a alterações sistêmicas e/ ou ao suporte ventilatório e que pode agravar o quadro de saúde geral. Deste modo, o objetivo do presente estudo é identificar os agentes etiológicos e a frequência de alterações bucais dos pacientes internados em Unidade de terapia intensiva (UTI). Trata-se de um estudo retrospectivo, descritivo utilizando prontuário médico e odontológico em pacientes internados em UTI, entre março de 2021 a março de 2022. Foram avaliados 150 pacientes. O sexo masculino (56,0%) foi mais afetado que o feminino (44,0%). A idade dos pacientes variou entre 1 a 98 anos, com média de 65,2 anos. A maioria dos pacientes apresentou alguma alteração bucal (79,4%). As infecções de origem odontogênicas foram as mais prevalentes (42,7%), seguido por distúrbios da produção de saliva (24,6%). Dessa forma, observa-se que as alterações bucais foram prevalentes nos pacientes em UTI, reforçando a importância do cirurgião-dentista compondo a equipe multiprofissional

The impact of the COVID-19 pandemic on dental trauma attendance: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to analyze the impact of the COVID-19 pandemic on dental trauma patient attendance. The study was registered in the PROSPERO system, using the CRD42021288398 protocol. Searching was performed in PubMed, Scopus, Web of Science, Embase, Lilacs, and OpenGrey databases, using the following keywords: “Tooth injuries,” “Dental trauma,” “Traumatic Dental injury,” and “COVID-19". We included observational studies evaluating dental trauma in the context of the COVID-19 pandemic. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Meta-analysis was performed in RevMan 5.4 software with Odds Ratios as a pooled measure of effect, with a 95% confidence interval, and using random-effects modeling. After applying the eligibility criteria, 32 studies were included for qualitative analysis, in which 10 were used to assess the frequency of dental trauma diagnoses in dental emergencies. Despite the decrease of visits during COVID-19, the analysis revealed no difference between the pandemic and pre-pandemic periods. Regarding the type of dental trauma, two of the studies revealed no differences for the periods before and during the pandemic. This study revealed that the COVID-19 pandemic has not impacted the frequency or type of dental trauma compared to previous periods

Histologic evaluation of pulpotomy performed with ethyl-cyanoacrylate and calcium hydroxide Avaliação histológica de pulpotomia realizada com etil-cianoacrilato e com hidróxido de cálcio

The aim of this study was to evaluate histological aspects of the pulp-dentin complex of dogs submitted to pulpotomy and capped with ethyl-cyanoacrylate and calcium hydroxide. Thirty dog teeth were divided into 2 groups of 15 as follows: Group 1 - ethyl-cyanoacrylate; Group 2 - calcium hydroxide. The pulpotomies were carried out following all of the treatment precautions recommended for dogs. After 30 days the specimens were submitted to histological preparation and were then blindly evaluated by a histologist. Data were analyzed statistically by the Fisher exact test, comparing the two groups. After 30 days, the presence of a hard tissue barrier was observed in 83.3% of Group 1, and in 100% of Group 2 (p = 0.478). A continuous hard tissue barrier was observed in 50% of the ethyl-cyanoacrylate group and 75% of the calcium hydroxide group (p = 0.652). It can be concluded that both materials induced hard tissue barrier formation, but Group 2 had a higher percentage than Group 1, with no significant statistical differences; the differences observed between the different barriers (continuous/non-continuous) were not significant between groups and there was no pulpal necrosis in either group.O objetivo do presente estudo foi avaliar o aspecto histológico do complexo dentino-pulpar de cachorros quando capeado após a pulpotomia com etil-cianoacrilato e hidróxido de cálcio. Trinta dentes de cães foram divididos em 2 grupos de 15 da seguinte forma: Grupo 1 - Etil-cianoacrilato; Grupo 2 - Hidróxido de cálcio. A pesquisa foi realizada tomando-se todos os cuidados recomendados para o tratamento com os cães. Após 30 dias do procedimento realizado os espécimes foram submetidos ao preparo histológico e logo após foram avaliados de forma cega por um histologista. Os resultados foram analisados estatisticamente através do Teste Exato de Fisher. No grupo 1, 83,3% e no grupo 2, 100% dos dentes apresentaram a barreira de tecido duro (p = 0,478). A barreira de tecido duro contínua foi observada em 50% dos casos tratados com etil-cianoacrilato e em 75% dos com hidróxido de cálcio (p = 0,652). Pode-se concluir que tanto o grupo 1 como o grupo 2 induziram a formação da barreira de tecido duro, porém o grupo 2 teve um percentual maior do que o grupo 1, não havendo diferença estatisticamente significante; a diferença observada entre as estruturas das barreiras (contínuas e não-contínuas) não foi significante. A necrose pulpar não foi observada em nenhum grupo

A comparative study of protaper and twisted file nickel titanium instruments in curved canals preparation

Introduction. Root canal instrumentation is performed to achieve cleaning and shaping with maximum preservation of its original anatomy. However, in curved canals this approach may cause excessive damage or canal transportation. The present study aimed to evaluate changes in dentin wall caused by instrumentation of curved canals using two nickel titanium rotary systems, ProTaper and Twisted File. Material and Methods. Twenty five extracted human mandibular first molars with two separated mesial root canals were selected. Distal roots were amputated and 50 canals (25 mesiobuccal and 25 mesiolingual) were randomly assigned into two groups: group 1 - ProTaper, and group 2 - Twisted File. All files were used with torque control engine, following the manufacturer instructions. The final instruments were F3 (group 1) and #30/.06 (group 2). Pre and postoperative cross sections were obtained from coronal, middle, and apical portions. Changes in dentin wall were measured and evaluated using Bramante method and digital image software. Statistical analysis was performed using the Mann Whitney U test (p<0.05). Results. The ammount of dentin removed by ProTaper in cervical and middle canal thirds was significantly greater than with Twisted File (p=0.040 and p=0.043). ProTaper eliminated significantly greater ammount of dentin than Twisted File from mesial wall in coronal sections (p=0.039). Mean differences in distance from the center to other walls were not statistically significant in the middle and apical thirds of both groups (p>0.05). Conclusion. ProTaper system produced greater changes in cross sectional area of the root canal compared to Twisted File system

The impact of the COVID-19 pandemic on dental trauma attendance: a systematic review and meta-analysis

Abstract This systematic review and meta-analysis aimed to analyze the impact of the COVID-19 pandemic on dental trauma patient attendance. The study was registered in the PROSPERO system, using the CRD42021288398 protocol. Searching was performed in PubMed, Scopus, Web of Science, Embase, Lilacs, and OpenGrey databases, using the following keywords: “Tooth injuries,” “Dental trauma,” “Traumatic Dental injury,” and “COVID-19". We included observational studies evaluating dental trauma in the context of the COVID-19 pandemic. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Meta-analysis was performed in RevMan 5.4 software with Odds Ratios as a pooled measure of effect, with a 95% confidence interval, and using random-effects modeling. After applying the eligibility criteria, 32 studies were included for qualitative analysis, in which 10 were used to assess the frequency of dental trauma diagnoses in dental emergencies. Despite the decrease of visits during COVID-19, the analysis revealed no difference between the pandemic and pre-pandemic periods. Regarding the type of dental trauma, two of the studies revealed no differences for the periods before and during the pandemic. This study revealed that the COVID-19 pandemic has not impacted the frequency or type of dental trauma compared to previous periods.</div