Avaliação do desvio apical em canais instrumentados pelos sistemas K3 e ProTaper

OBJECTIVES: this study evaluated the apical deviation of curved root canals instrumented with K3 and ProTaper systems. MATERIAL AND METHODS: twenty root canals of human maxillary and mandibular first molars were employed, which were divided into 2 groups: group A (10 teeth) was instrumented with the K3 system, and group B (10 teeth) with the ProTaper system. Evaluation of deviation was performed by double radiographic exposure. Radiographs were achieved before and after instrumentation, with 0.3-second, thus allowing superimposition of images. Three-dimensional computerized tomograph was performed in 3 specimens in each group, as an additional means to evaluate the apical deviation. RESULTS: were evaluated by the parametric test Student-Newman-Keuls at 5%, which did not reveal significance between groups concerning the apical deviation. The results of computerized tomograph images demonstrated that the larger deviation of the root canal occurred at the distolingual area for both systems. CONCLUSIONS: both techniques produced a mild apical deviation. Computerized microtomography was shown to be accurate for experimental endodontics studies.OBJETIVOS: avaliar o desvio apical de canais radiculares curvos instrumentados pelos sistemas K3 e ProTaper. MATERIAIS E MÉTODOS: foram utilizados 20 canais radiculares de primeiros molares superiores e inferiores humanos, os quais foram divididos em 2 grupos, o grupo A (10 dentes) foi instrumentado pelo sistema K3 e o grupo B (10 dentes) com o sistema ProTaper, a forma de avaliação do desvio foi a dupla exposição radiográfica. As tomadas radiográficas foram feitas antes e após a instrumentação, com um tempo de 0,3 segundos em cada exposição, ocorrendo assim, sobreposição das imagens. Em 3 espécimes, de cada grupo, foi realizada a tomografia computadorizada tridimensional, como forma adicional de avaliar o desvio apical . Os resultados obtidos foram avaliados pelo teste paramétrico Student-Newman-Keuls 5% o qual denotou não haver significância em relação ao desvio apical entre os grupos estudados. Os resultados das imagens de tomografia computadorizada mostraram que o maior desvio do canal radicular ocorreu na área disto-lingual, para ambos os sistemas estudados. CONCLUSÃO: ambas as técnicas promoveram desvio apical. A tomografia computadorizada revelou ser um método de análise promissor em estudos in vitro na área de endodontia

DETECÇÃO PRECOCE DE LESÕES BUCAIS E DOENÇAS INFECCIOSAS: O PAPEL DO DENTISTA NO PROGRAMA SAÚDE DA FAMÍLIA

Introdução: A detecção precoce de lesões bucais e doenças infecciosas é fundamental para o sucesso do Programa Saúde da Família. O dentista desempenha um papel crucial ao realizar exames regulares e educar a comunidade sobre a importância da saúde bucal, contribuindo para a prevenção e tratamento eficaz dessas condições. Objetivo: Analisar qual o papel do dentista na  detecção precoce de lesões bucais e doenças infecciosas, no contexto do programa saúde da família. Metodologia: Estudo do tipo revisão de literatura,  conduzida entre setembro de 2023 e janeiro de 2024, nas bases da LILACS, PUBMED e SCIELO, com os descritores: “Programa saúde da família”; “Dentista”; “Lesões”; “Doenças Infecciosas”. Os critérios de inclusão foram: disponibilidade gratuita, acesso integral, redigidos em português ou inglês, publicados nos últimos 10 anos (2014-2024), já os de exclusão, duplicatas. monografias e dissertações. Ao final, apenas 13 estudos foram selecionados para a amostra. Resultados e Discussões: A atuação proativa do dentista é crucial para impulsionar a promoção abrangente da saúde bucal no Programa Saúde da Família. Além de identificar precocemente lesões e doenças, o profissional estabelece uma conexão próxima com a comunidade, oferecendo orientações e intervenções oportunas, gerando um impacto positivo duradouro na saúde bucal da população atendida. Conclusão: Em conclusão, a atuação do dentista no PSF se destaca pela realização de exames clínicos periódicos, permitindo a identificação precoce de lesões bucais, como por exemplo, abusos e violências. Além disso, desempenha um papel vital na detecção precoce de condições como infecções periodontais e lesões ulcerativas

Wear of K3 and ProTaper files after simulated clinical use in curved canals

Objective: To assess wear, after simulated clinical use of K3 (SybronEndo, Orange, CA, EUA) and ProTaper files (Dentsply-Maillefer, Tulsa, Oklahoma, EUA) in 46 mesiovestibular roots of human maxillary first molars, recently extracted and with mean angulation of 40°.Methods: The teeth were divided as follows: a) K3 (SybronEndo, Orange, CA, EUA) (with radial bands) and b) ProTaper (Dentsply-Maillefer, Tulsa, Oklahoma, EUA) (without radial bands). The files were assessed by scanning electronic microscopy before first use to visualize fabrication defects, and after 7 and 13 cycles of debridement in the canals. Debridement with files K3 (SybronEndo, Orange, CA, EUA) and ProTaper (Dentsply-Maillefer, Tulsa, Oklahoma, EUA) was performed in accordance with the manufacturers’ recommendations. The criteria for wear assessment were: defects (stretching, shortening/spiral inversion, presence of craters), oblique cracks and fracture. After assessment by SEM and before they were used, metal barbs on the crest of the spirals and oblique scratches due to the machining process were found in all the files.Results: In the K3 system (SybronEndo, Orange, CA, USA), after being used seven times, all the instruments showed cutting angle defects,and 25/08 and 25/10 had oblique cracks in the body of the active part leading to ductile fracture after being used for the eighth time. In the ProTaper system (Dentsply-Maillefer, Tulsa, Oklahoma, USA), after being used seven times, in addition to cutting angle defects, the files also presented cracks, and ruptile fracture occurred in F3 during use for the thirteenth time. At the end of preparation, craters were seen along the active part of the files.Conclusion: In the final analysis, it was seen that the system are equivalent with regard to the defects found, irrespective of the active part design,being proportional to the number of cycles of use, and these defects could act as points of greater fragility, favoring fracture

The dentin thickness remaining in the risk zone of mandibular molars after cervical preflaring with four methods

Abstract Introduction Cervical preflaring is an important step of the canal system instrumentation, but can lead to excessive enlargement or root perforation. Objective Evaluate the remaining dentin thickness in the mandibular molars of mesial roots using cone beam computed tomography: Gates-Glidden (crown-down); Gates-Glidden (step-back); LA Axxess and Easy Pro-Design. Material and method Were selected 40 lower molars mesial roots, which were scanned in a cone beam CT scanner before and after preparation. Were obtained five sections of the CT images with an interval of 1 mm from the furcation, and measured the thickness variation between the root canal to the root external portion in analysis software. Result The evaluation of the different levels showed no significance within the same group for the Gates-Glidden group. On the other hand, were observed difference for LA Axxess (p=0.002) and Easy Pro-Design (p=0.005). In the intergroup analysis, were observed difference in all levels, especially for Gates-Glidden in the ascendant order (ANOVA and Tukey). Conclusion Within the limitations of these study, is possible to conclude that the protocol with greater wear in the cervical risk area was the Gates-Glidden in step-back sequence, as the other groups were equivalent (p>0.05)

Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies

Abstract: Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis

The effect of root canal preparation tapers on planktonic bacteria and biofilm reduction in the apical third: A correlative microtomography and microbiological laboratory study

International audienceAim To evaluate the influence of different preparation tapers on the reduction in planktonic bacteria and biofilms of Enterococcus faecalis and Candida albicans in the apical third (4 mm) of the mesial roots of mandibular molars, correlating decontamination with canal shape. Methodology After microtomography analysis for morphological standardization of the canals, 48 mandibular molar roots, each containing two canals (96 canals), were contaminated with E . faecalis and C . albicans and divided into four groups ( n = 11) for canal instrumentation using ProDesign Logic 2 files with different tapers G (.03): # 25.03; G (.04): # 25.04; G (.05): # 25.05; and G (.06): # 25.06 and irrigation with 2.5% sodium hypochlorite. Four roots were examined under a scanning electron microscope (SEM) to qualitatively assess biofilm formation. Eight roots were used as the negative control group (samples were not contaminated). Bacteriological samples were taken exclusively from the apical third of the roots before and after chemical–mechanical preparation and bacterial counts were determined (CFU/mL). The final micro‐CT scan was used to quantify the volume variation and unprepared canal area in the apical third. Statistical analysis was performed using the Kruskal–Wallis, Student–Newman–Keuls and Wilcoxon tests for analysis of microbiological data. anova and the Tukey or Games–Howell test were used for analysis of micro‐CT data and Spearman's test for correlations ( α = 5%). Results All groups showed a significant reduction in bacteria ( p  .05). Conclusion The different preparation tapers influenced root canal shaping in the apical third but did not improve decontamination in this region

Impetigo Infantil: Uma Revisão Abrangente das Considerações Dermatológicas e Pediátricas.

Impetigo is a common and highly contagious bacterial skin infection that mainly affects children around the world. It is characterized by skin lesions, including pustules, vesicles and crusts, often accompanied by itching and discomfort. Studies on the epidemiology of impetigo point to significant variations in the prevalence of impetigo in different geographic regions and age groups. This bacterial infection mainly affects low-income children, affecting more than 2% of the global population, being more prevalent in tropical and subtropical areas, with Oceania standing out as the region with the highest incidence. Impetigo can be divided into two main clinical manifestations: bullous impetigo and non-bullous impetigo. Bullous impetigo is predominantly caused by Staphylococcus aureus and is characterized by flaccid, transparent blisters that develop in the subcorneal layer of the skin. These blisters usually appear in intertriginous regions such as diaper areas, armpits, neck and palms and soles. Non-bullous impetigo is more common and can be primary, resulting from bacterial invasion of intact skin, or secondary, resulting from infection through non-intact skin. The main cause is Staphylococcus aureus, often associated with group A beta hemolytic streptococci. The diagnosis of impetigo is usually made clinically, but laboratory tests, such as culture of fluid from vesicles, pustules, or areas below the edges of crusted plaques, can be used for confirmation. Impetigo is differentiated from other conditions through tests such as a negative Nikolsky sign. Treatment of impetigo involves maintaining antisepsis of the lesions and the use of topical antibiotics, such as fusidic acid, retapamulin and mupirocin, which are effective for localized lesions. Furthermore, for more extensive cases of the disease it is necessary to use systemic antibiotics, and should always choose those with less susceptibility to bacterial resistance.O impetigo é uma infecção bacteriana cutânea comum e altamente contagiosa, que afeta principalmente crianças em todo o mundo. É caracterizado por lesões na pele, incluindo pústulas, vesículas e crostas, muitas vezes acompanhadas de coceira e desconforto. Estudos sobre a epidemiologia do impetigo apontam para variações significativas na prevalência do impetigo em diferentes regiões geográficas e grupos etários. Essa infecção bacteriana afeta principalmente crianças de baixa renda, atingindo mais de 2% da população global, sendo mais prevalente em áreas tropicais e subtropicais, , destacando-se a Oceania como a região com a maior incidência. O impetigo pode ser dividido em duas principais manifestações clínicas: impetigo bolhoso e impetigo não bolhoso. O impetigo bolhoso é predominantemente causado por Staphylococcus aureus e é caracterizado por bolhas flácidas e transparentes que se desenvolvem na camada subcornea da pele. Essas bolhas geralmente aparecem em regiões intertriginosas, como áreas de fraldas, axilas, pescoço e palmas das mãos e plantas dos pés. O impetigo não bolhoso é mais comum e pode ser primário, decorrente da invasão bacteriana na pele íntegra, ou secundário, resultante de infecção através de pele não íntegra. A principal causa é o Staphylococcus aureus, frequentemente associado a estreptococos beta hemolíticos do grupo A. O diagnóstico do impetigo geralmente é feito clinicamente, mas exames laboratoriais, como cultura de fluido de vesículas, pústulas ou áreas abaixo das bordas de placas crostosas, podem ser utilizados para confirmação. O impetigo é diferenciado de outras condições por meio de testes como o sinal de Nikolsky negativo.O tratamento do impetigo envolve a manutenção da antissepsia das lesões e o uso de  antibióticos tópicos, como ácido fusídico, retapamulina e mupirocina, são eficazes para lesões localizadas.Além disso, para casos mais extensos da doença faz-se necessário o uso de antibióticos o sistêmicos, devendo sempre optar por aqueles com menor suscetibilidade a resistência bacteriana

Evaluation of apical deviation in root canals instrumented with K3 and ProTaper systems Avaliação do desvio apical em canais instrumentados pelos sistemas K3 e ProTaper

OBJECTIVES: this study evaluated the apical deviation of curved root canals instrumented with K3 and ProTaper systems. MATERIAL AND METHODS: twenty root canals of human maxillary and mandibular first molars were employed, which were divided into 2 groups: group A (10 teeth) was instrumented with the K3 system, and group B (10 teeth) with the ProTaper system. Evaluation of deviation was performed by double radiographic exposure. Radiographs were achieved before and after instrumentation, with 0.3-second, thus allowing superimposition of images. Three-dimensional computerized tomograph was performed in 3 specimens in each group, as an additional means to evaluate the apical deviation. RESULTS: were evaluated by the parametric test Student-Newman-Keuls at 5%, which did not reveal significance between groups concerning the apical deviation. The results of computerized tomograph images demonstrated that the larger deviation of the root canal occurred at the distolingual area for both systems. CONCLUSIONS: both techniques produced a mild apical deviation. Computerized microtomography was shown to be accurate for experimental endodontics studies.<br>OBJETIVOS: avaliar o desvio apical de canais radiculares curvos instrumentados pelos sistemas K3 e ProTaper. MATERIAIS E MÉTODOS: foram utilizados 20 canais radiculares de primeiros molares superiores e inferiores humanos, os quais foram divididos em 2 grupos, o grupo A (10 dentes) foi instrumentado pelo sistema K3 e o grupo B (10 dentes) com o sistema ProTaper, a forma de avaliação do desvio foi a dupla exposição radiográfica. As tomadas radiográficas foram feitas antes e após a instrumentação, com um tempo de 0,3 segundos em cada exposição, ocorrendo assim, sobreposição das imagens. Em 3 espécimes, de cada grupo, foi realizada a tomografia computadorizada tridimensional, como forma adicional de avaliar o desvio apical . Os resultados obtidos foram avaliados pelo teste paramétrico Student-Newman-Keuls 5% o qual denotou não haver significância em relação ao desvio apical entre os grupos estudados. Os resultados das imagens de tomografia computadorizada mostraram que o maior desvio do canal radicular ocorreu na área disto-lingual, para ambos os sistemas estudados. CONCLUSÃO: ambas as técnicas promoveram desvio apical. A tomografia computadorizada revelou ser um método de análise promissor em estudos in vitro na área de endodontia