Avaliação de materiais restauradores em cavidades retrogradas preparadas com pontas ultra-sonicas

Orientador : Francisco Jose de Souza FilhoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo deste estudo foi comparar, usando réplicas de resina epóxica, a topografia de superfícies apicais de caninos humanos contento cavidades retrógradas preparadas com pontas ultra-sônicas antes e depois de seu preenchimento e acabamento com três diferentes técnicas. Também foi realizada uma avaliação quantitativa da capacidade de selamento marginal dessas obturações retrógradas. Oitenta e uma cavidades retrógradas preparadas em caninos humanos foram divididas em grupos de 27 cada. As cavidades foram preenchidas com Super-EBA, IRM, ou ProRoot-MTA e receberam um acabamento inicial com um brunidor de formato arredondado. Dezoito raízes de cada grupo receberam um acabamento final com brocas carbide de tungstênio 30 lâminas (9 raízes) ou com brocas de 28 mm Zekrya (9 raízes). Fotomicrografias de cada espécime obtidas com um microscópio eletrônico de varredura (MEV), antes e depois do preenchimento das cavidades retrógradas, foram comparadas através de um programa de análise de imagens. Após a análise da interface retrobturação/ dentina os espécimes foram preparados e imersos em uma solução de azul de metileno 2% por 12 horas. As raízes foram então trituradas e preparadas para análise em um espectrofotômetro de absorbância. Resultados obtidos mostraram que quando uma broca foi utilizada para um acabamento final nos materiais, uma área significativa (p 0,05) a incidência de fendas nos grupos retrobturados com MT A ou IRM. As obturações retrógradas feitas com Super EBA e IRM, e acabadas com um brunidor ou com brocas Zekrya apresentaram áreas calculadas das fendas significativamente (p 0,05) a incidência de infiltração entre os materiais testados. O coeficiente de correção de Pearson indica que há uma associação positiva de 55,61 % entre as variáveis, ou seja, o acréscimo da quantidade de corante infiltrado está associado com o acréscimo da área de desadaptação das cavidades retrógradasAbstract: The aim of this study was to compare, using epoxy resin replicas, the surface topography of root ends following ultrasonic preparation, and again after root-end fillings submitted to three different finishing techniques. A quantitatively evaluation of the sealing ability of Super-EBA, IRM and Pro Root MTA root-end fillings was also performed. Eighty-one ultrasonically root-end cavities prepared in human canines, were divided at random into three test groups of 27 each. The cavities were filled with Super-EBA, IRM, or ProRoot-MT A and finished by ball burnishing. Eighteen roots from each group received a final smoothing with either a 30-fluted tungsten carbide finishing bur, or a Zekrya carbide 28 mm bur. Scanning electron micrography (SEM) pictures of each sample were taken prior to and after root-end filling, and dentin/retrofilling interfaces inspected and compared with the aid of an image and analysis system. Samples were then prepared and immersed in 2% methylene blue dye solution for 12 hours. Roots were ground into a powder and prepared for analysis in an absorbency spectrophotometer. Results showed that when a finishing bur was used to finish the set materials, a significant (p 0.05) affect the incidence of gaps in groups retrofilled with MT A or IRM. Super EBA and IRM retrofillings finished with a ball burnisher or a Zekrya bur displayed a significantly (p 0.05) affect the incidence of microleakage among the materials tested. The correlation coefficient of Pearson indicates that there is a positive, 55.61% association between the variables and this coefficient, that is, the increase of the quantity of infiltrated dye is associated with the increase of the root-end filling marginal disruption areaDoutoradoEndodontiaDoutor em Clínica Odontológic

Clinical Diagnosis of Pulp Inflammation Based on Pulp Oxygenation Rates Measured by Pulse Oximetry

Introduction: The objective of this study was to investigate correlations between pulp oxygenation rates (%SpO(2)) and clinical diagnoses of reversible pulpitis (RP), irreversible pulpitis (IP), or pulp necrosis (PN). Methods: Sixty patients who presented with a tooth with endodontic pathology were grouped according to a clinical diagnosis of either RP (n = 20), IP (n = 20), or PN (n = 20). The clinical diagnosis was based on the patient's dental history, periapical radiographs, clinical inspection, and percussion and thermal sensitivity testing. Pulse oximetry (PO) was used to determine pulp oxygenation rates. For every patient, one additional endodontically treated tooth (negative control [NC], n = 60) and one additional healthy tooth with healthy pulp status (positive control [PC], n = 60) were evaluated. Analysis of variance, the Tukey HSD test, and the Student's t test were used for statistical analysis. Results: The mean % SpO(2) levels were as follows: RP: 87.4% (standard deviation [SD] +/- 2.46), IP: 83.1% (SD +/- 2.29), PN: 74.6% (SD +/- 1.96), PC: 92.2% (SD +/- 1.84), and NC: 0% (SD +/- 0.0). There were statistically significant differences between RP, IP, and PM compared with NC and PC and between RP, IP, and PN (all P <= .01). Conclusions: The evaluation of pulp oxygenation rates by PO may be a useful tool to determine the different inflammatory stages of the pulp to aid in endodontic diagnosis. (JEndod 2012;38:880-883

Effects of 3-Dimensional Conformal or Intensity-modulated Radiotherapy on Dental Pulp Sensitivity during and after the Treatment of Oral or Oropharyngeal Malignancies

Introduction: Radiation therapy (RT) of malignant tumors in the head and neck area may have damaging effects on surrounding tissues. The aim of this investigation was to evaluate the effects of RI delivered by 3-dimensional conformal radiotherapy (3D-RT) or intensity-modulated radiotherapy (IMRT) on dental pulp sensitivity. Methods: Twenty patients with oral or oropharyngeal cancer receiving RT with 3D-RT or IMRT underwent cold thermal pulp sensitivity testing (PST) of 2 teeth each at 4 time points: before RT (TP1), the beginning of RT with doses between 30 and 35 Gy (TP2), the end of RT with doses between 60 and 70 Gy (TP3), and 4 to 5 months after the start of RT (TP4). Results: All 40 teeth showed positive responses to PST at TP1 (100%) and 9 at TP2 (22.5%; 3/16 [18.8%] for 3D-RT and 6/24 [25.0%] for IMRT). No tooth responded to PST at TP3 and TP4 (0%). A statistically significant difference existed in the number of positive pulp responses between different time points (TP1 through TP4) for all patients receiving RT (P <= .05), IMRT (P <= .05), and 3D-RT (P <= .05). No statistically significant differences in positive sensitivity responses were found between 3D-RT and IMRT at any time point (TP1, TP3, TP4, P = 1.0; TP2, P = .74). A statistically significant correlation existed between the location of the tumor and PST at TP2 for IMRT (P <= .05) but not for 3D-RT (P = .14). Conclusions: RT decreased the number of teeth responding to PST after doses greater than 30 to 35 Gy. The type of RT (3D-RT or IMRT) had no influence on the pulp responses to PST after the conclusion of RT. (J Endod 2012;38:148-152