A Decision Making: Implant or Endodontic Treatment? A Case Report

The present report describes the successful treatment of a tooth with an endo-perio lesion and an extensive area of bone resorption. The possibility of extraction and dental implant was discussed with the patient. Chemomechanical preparation was performed, and canals were filled with bioceramic cement and gutta-percha cones. After 12 months, clinical and radiographic evaluations showed remarkable remineralization. The decision to perform the endodontic treatment or implant was based on scientific evidence and correct clinical assessment

Perfis epidemiologicos de saude bucal no Brasil e os modelos de vigilancia

Abstract published in English and Portuguese English title: Oral health epidemiology and surveillance models in BrazilNational surveys are important tools for public health surveillance and thus key elements in monitoring health conditions and system performance. In the field of oral health, such surveys began with the oral health survey in 1986 and later in 1996 and with the SBBrasil Project in 2003. The 2010 edition of SBBrasil is the principal oral health surveillance strategy for the production of primary data. In order to contribute to this discussion, this article proposes: (a) to present and discuss the Brazilian experience with nationwide oral health surveys and (b) to discuss the use of data in health surveillance models. One can conclude that oral health surveys in Brazil have great possibilities as a tool for health services and academia. Such surveys have shown evident potential for verifying trends in the oral health profile, as well as for producing valid indicators for use in health services. = Inquéritos nacionais são importantes ferramentas no campo da vigilância em saúde e elementos fundamentais no monitoramento das condições de saúde e do desempenho do sistema. Na saúde bucal, tais inquéritos surgem a partir do primeiro levantamento em saúde bucal de 1986 e, posteriormente, o de 1996 e o Projeto SBBrasil 2003. A edição 2010 do SBBrasil se coloca como a principal estratégia de vigilância em saúde bucal no que diz respeito à produção de dados primários. No sentido de contribuir com essa discussão, este artigo se propôs a: (a) apresentar e discutir a experiência brasileira em inquéritos nacionais de saúde bucal; (b) discutir a utilização dos dados em modelos de vigilância em saúde. Pode-se concluir que os inquéritos de saúde bucal no Brasil têm grandes possibilidades de se estabelecer como ferramenta para os serviços e para a academia. Ficou evidente sua potencialidade em verificar tendências no perfil de saúde bucal, bem como em produzir indicadores válidos para uso em serviços.Angelo Giuseppe Roncalli, Maria Ilma de Souza Côrtes, Karen Glazer Pere

Pulp canal obliteration after traumatic injuries in permanent teeth – scientific fact or fiction?

Abstract: Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies

Antimicrobial Photodynamic Therapy associated with long term success in endodontic treatment with separated instruments: A case report

This paper describes a case with a 5- year follow-up of Antimicrobial Photodynamic Therapy (aPDT) associated with long-term success in endodontic treatment in a tooth with separated instruments. The patient presented with a tooth exhibiting a periapical lesion, slight swelling, and severe pain. A radiograph revealed the presence of two separated files in the middle and apical thirds of the mesial root on a lower first molar. Attempts at bypassing were not successful. In the mesial root, instrumentation was limited to the coronal ends of the separated instruments. The apical patency could not be achieved due to the blockage of the separated files. aPDT was performed in two visits, at a 660-nm wavelength and 100 mW of power, for 90 s to a total energy of 9.0 Joules. Methylene blue solution was used as photosensitizer at concentration of 0005%. A 300-μm light diffusor was coupled to the diode laser and was inserted into the root canal 2 mm short of WL, where it was set to allow better diffusion of light. Each root canal was sealed with gutta-percha by warm vertical compaction and Pulp Canal Sealer™. After 5 years of follow-up, clear evidence of remineralization of the radiolucency and bone healing was observed. This case report suggests that the addition of aPDT to conventional endodontic treatment improved microbial disinfection leading to a successful long-term outcome

Use of technology in endodontics by undergraduate dental students in a south-eastern state of Brazil

Introduction: This study aimed to determine the level of incorporation of current technologies for endodontic treatment in undergraduate dentistry courses in a south-eastern state of Brazil. Methods: For data collection, a self-assessment-based online questionnaire was created using the “Google Forms” platform, consisting of 12 multiple-choice and a few open-ended questions. The questions were related to the use of current technologies for diagnosis, imaging, use of ultrasonics in endodontics, instrumentation, use of apex locator, microscopy, photodynamic therapy and thermoplastic techniques during endodontic treatment. The questionnaire was sent to 54 dental schools in Minas Gerais. Results: The results show low technological incorporation during the various stages of endodontic treatment by undergraduate students in dentistry courses in Minas Gerais. Conclusion: Despite the availability of several technologies to help perform different stages of endodontic treatment, it was observed that most universities do not teach the use of these technologies. Additional studies are needed to correlate how the lack of incorporation of these technologies could impact on the quality of the endodontic learning for undergraduate students

Quantitative Assessment of the Efficacy of Two Different Single-file Systems in Reducing the Bacterial load in Oval-Shaped Canals: A Clinical Study

Introduction: This randomized clinical study compared the in vivo antibacterial efficacy of Reciproc Blue (RB), XP-endo Shaper (XP-S), and XP-endo Shaper associated with XP-endo Finisher (XP-F) systems in infected oval-shaped root canals with primary apical periodontitis. Methods: In this study, 28 human teeth with a single root and a single canal were randomly assigned to 2 groups according to the instrumentation technique: group 1, RB (n = 14) and group 2, XP-endo (XP-S and XP-F, n = 14). The single-rooted teeth were prepared by reciprocating and rotary nickel-titanium instruments with 5.25% sodium hypochlorite irrigation. Samples were collected from the canal at the baseline (S1), after chemomechanical preparation (S2), and after XP-F instrumentation (S3). The DNA extracts were subjected to quantitative analysis for total bacterial counts by quantitative real-time polymerase chain reaction. The data were analyzed using the analysis of variance test, and the level of significance was set at 5%. Results: All samples tested positive for the presence of bacteria at baseline, and the bacterial counts substantially reduced after treatment procedures (P .05). A marked bacterial reduction was observed after the use of the XP-F instrument (P <.01). Conclusions: The XP-S and RB systems sharply reduced the bacterial load in oval-shaped root canals with primary apical periodontitis. XP-F used as a supplementary instrument to chemomechanical preparation promoted a significantly higher bacterial reduction

Ex Vivo Assessment of Photodynamic Therapy in Achieving Microbial Reduction

The study was to assess the effects of photodynamic therapy (PDT) on root canals contaminated by Enterococcus faecalis (E. faecalis). PDT was performed with 0.005% methylene blue dye and with a low-intensity red emission laser. Microbiological samples were collected before, immediately and 72 hours after instrumentation. Although PDT performed with the chosen light parameters promoted additional microbial reduction, this therapy did not achieve a statistically significant reduction of E. faecalis

Eficácia da barreira intracanal contra ainfiltração microbiana em dentes preparados para pino intrarradicular [Efficacy of intracanal barrier against microbial infiltration in teeth prepared for intraradicular post]

Introduction: Intraradicular posts are recommended to improve retention of artificial crowns and distribute intraoral forces along the root. If the space created by partial removal of the filling is not filled properly, massive infiltration of microorganisms from the oral cavity can occur. Objective: The objective of the present study was to evaluate the effectiveness against bacterial infiltration of an intracanal barrier placed directly over the remainder of the root canal filling, after space preparation for the post. Methods: Seventy-two single-rooted human teeth were instrumented, filled and randomly divided into three experimental groups and two control groups. Group 1 received no additional treatment after filling and space preparation, while Groups 2 and 3 received a barrier composed of temporary sealing material 1.0 and 2.0 mm thick, respectively. A culture of Enterococcus faecalis was inoculated in the spaces prepared to receive the intraradicular post, every three days, for a period of 60 days. Infiltration was evaluated daily by the turbidity of the culture medium. Results and Conclusion: There was bacterial infiltration in the three experimental groups, being significantly higher and occurring more quickly in G1 (p0.05) was found between G2 and G3, in relation to the rate and period of infiltration