P7 - Evaluation of extruded material in furcation perforation repair with micro-computed tomography

Background Furcation perforations are pathological conditions of complex treatment and, currently, bioceramics are good options for furcation perforations repair. The aim of this study was to compare the volume of extruded material with micro-computed tomographic (microCT) after Furcation Perforation (FP) repair with Biodentine (BDT) or ProRoot MTA (prMTA) in dogs’ teeth. Materials and methods Forty dogs’ teeth were divided into 2 groups: prMTA (n=20, FP repaired with ProRoot MTA), BDT (n=20, FP repaired with Biodentine). All animal procedures were approved by the institutional Ethical Committee and conformed with the ethical guidelines and regulations of the national Directorate-General for Food and Veterinary (Process number 0421/000/000/2014). The animals were euthanized after 4 months. The volume of extruded material was quantifed using microCT images. Statistical analysis was performed using independent-samples t-test in SPSS™. All diferences were considered signifcant at P≤0.05. Results Total volume of extruded material was signifcantly lower in BDT group than in prMTA group (BDT: 1.42±0.80mm3; prMTA: 2.27±1.67mm3; P=0.049). In both test material groups, microCT showed continuity between the extruded repair material and the surrounding bone. Along with the study’s included outcomes, further evaluation of microCT images allowed the identifcation of new mineralized tissue bridges over the remaining radicular pulp tissue in specimens of both test groups. Conclusions The greater amount of extruded material found for prMTA group is consistent with its lengthier setting time, which may contribute to the unintended compaction of the unset material into the furcation defect. Even though Biodentine presented lesser extrusion, a concomitant histologic study revealed similar results concerning mineralized tissue formation.info:eu-repo/semantics/publishedVersio

Complicações que podem surgir durante o Uso do Hipoclorito de Sódio no Tratamento Endodôntico

ResumoA solução de hipoclorito de sódio, em diferentes concentrações, é o irrigante mais utilizado durante o tratamento endodôntico. Embora a sua utilização seja geralmente segura, sequelas graves podem ocorrer quando da sua extrusão para além do apex do canal radicular, afectando os tecidos periapicais.Neste artigo procura-se alertar o Médico Dentista (e outros profissionais de Saúde Oral) para os principais acidentes que podem ocorrer com o uso do hipoclorito de sódio durante o tratamento endodôntico.AbstractSodium hypochlorite is the most common irrigant used in endodontic practice. Usually, the use of sodium hypochlorite is safe, although severe sequelae may occur if this solution is extruded beyond the root apex. This article's aim is to draw the Dentist's attention (and other oral health professionals) to the principal accidents that may occur with the use of sodium hypochlorite during the endodontic treatment

P32 - Endodontic treatment of a geminated canine - case report

Background Dental gemination is a designation used to identify a disturbance occurred during odontogenesis that causes changes in the shape of the tooth. It is recognized as a failed attempt by a single tooth germ to divide by invagination, resulting in a single wide tooth with a bifd crown. It is a rare condition that occurs with greater prevalence in the primary dentition and afects mostly incisor teeth. Its etiology is not clearly understood, although there is evidence that it may be related to genetic factors, trauma and with some syndromes. Despite being generally asymptomatic, it can manifest clinical alterations like malocclusion, impaction of adjacent teeth and even greater susceptibility to caries and periodontal destruction. Case report A 22-year-old female patient with Fahr’s Syndrome was referred to the endodontic appointment at the Clinica Dentária Universitária of Universidade Católica Portuguesa in Viseu, presenting tooth 23 with symptoms compatible with a state of irreversible pulpitis. Periapical radiographs and CBCT confrmed the diagnosis of geminated tooth with irreversible pulpitis. Endodontic treatment was performed using an operative microscope. The preparation was performed with ProTaperTM Gold F5 using 2.5% sodium hypochlorite irrigation. In the obturation, two techniques were used, continuous wave compaction in the apical third and gutta-percha injection with vertical compaction in the remain canal. The crown was restored with a direct composite. After six months, the tooth maintained the function and there was no symptomatology. The radiograph was normal, predicting a good evolution. Informed consent was obtained for publication. Conclusion Dental gemination is an anomaly diagnosed through clinical and radiological criteria. A careful clinical and radiographic examination, as well as the use of an operative microscope, increases the probability of success and improves the prognosis of endodontic treatment. The recognition and adequate treatment of this anomaly allowed to restore the patient’s function and aesthetics.info:eu-repo/semantics/publishedVersio

O uso sistémico de antibióticos em endodontia: estudo transversal

Objectives: Portugal is one of the European countries with the highest antibiotic consumption rate and, consequently, the highest rates of bacterial resistance. Dentistry's contribution to that problem can be substantial because dentists prescribe approximately 10% of all common antibiotics. The purpose of this study was to characterize the prescription of systemic antibiotics for pulpal and periapical pathology in a sample of Portuguese dentists. Methods: A cross-sectional study was conducted in dentists working in the city of Viseu. A total of 135 questionnaires were distributed among all dental clinics and dental offices of Viseu. Results: The overall response rate was 70% (n = 95). The vast majority of dentists prescribed antibiotics for 8 days (78.9%). The most commonly prescribed antibiotic therapy was the association 875-mg amoxicillin with 125-mg clavulanic acid (82.1%). In cases of sensitivity to penicillin, the most prescribed antibiotics were 500-mg clarithromycin (34.7%) and 500-mg azithromycin (33.7%). A considerable percentage of dentists prescribed antibiotics for situations of irreversible pulpitis, pulp necrosis without systemic involvement, fistula and endodontic retreatment. Conclusions: A considerable part of the inquired dentists prescribed antibiotics inappropriately for endodontic inflammatory conditions such as pulpitis. This kind of behavior could contribute to the world problem of antimicrobial resistance. It is important that dentists understand the importance of restricting the use of antibiotics for cases of severe infection, when they are truly needed.Objetivos: Portugal é um dos países europeus com maior taxa de consumo de antibióticos e, consequentemente, com as maiores taxas de resistência bacteriana. Os médicos dentistas podem contribuir de forma substancial para esse problema, sendo da sua responsabilidade a prescrição de aproximadamente 10% de todos os antibióticos comuns. O objetivo deste estudo foi caracterizar os hábitos de prescrição de antibióticos sistémicos para a patologia pulpar e periapical numa amostra de médicos dentistas portugueses. Métodos: Foi realizado um estudo transversal envolvendo os médicos dentistas da zona geográfica de Viseu. Um total de 135 questionários foi distribuído por todos os consultórios e clínicas médico-dentárias de Viseu. Resultados: A taxa de resposta foi de 70% (n=95). A grande maioria dos médicos dentistas prescreve antibióticos por 8 dias (78,9%). O antibiótico mais frequentemente prescrito foi a associação de amoxicilina com ácido clavulânico 875 / 125 mg (82,1%). Em caso de sensibilização à penicilina, os antibióticos mais prescritos foram a claritromicina 500 mg (34,7%) e azitromicina 500 mg (33,7%). Verificaram-se percentagens consideráveis de abuso de antibióticos em situações de pulpite irreversível, necrose pulpar sem envolvimento sistémico, fístula e em casos de retratamento endodôntico. Conclusões: Uma parte considerável dos médicos dentistas inquiridos prescreve antibióticos inadequadamente para condições endodônticas inflamatórias como a pulpite. Este tipo de comportamento pode contribuir para o problema mundial da resistência antimicrobiana. É importante que o Médico Dentista compreenda a importância de restringir o uso de antibióticos aos casos de infeção grave que necessitam deles.info:eu-repo/semantics/publishedVersio

Impact of a 10 km race on inflammatory and cardiovascular markers: comparison between trained and untrained recreational adults

Previous studies have found that trained athletes had lower changes in circulating levels of inflammatory biomarkers and cardiovascular stress than untrained athletes, upon prolonged or exhausting exercise. Particularly, recreational runners with less training showed higher risk of cardiac injury and dysfunction after a marathon. Presently, we are observing a steadily growing number of young and older adults engaging in running events without having a professional orientation or training, emphasizing the need to assess biochemical markers that allow the evaluation of the acute changes imposed in these recreational athletes. To compare the immediate and 24-hour effects of a 10-km run on inflammatory and cardiovascular biomarkers between recreational athletes, with and without specific running training.info:eu-repo/semantics/publishedVersio

Human gingival fibroblasts response to different endodontic sealers: an in vitro study

Endodontic treatment aims to eliminate infection of the root canals and fill the dental pulp space. The biocompatibility studies of the sealers used in root canals obturation are crucial since they are applied in direct contact with periradicular tissues. Objective: The aim of this study was to evaluate the cytotoxicity of three root canal sealers—AH Plus, Bio MTA+, and Bio C sealer—on immortalized human gingival fibroblasts. Methods: AH Plus, Bio MTA+, and Bio C sealers were evaluated through incubation in real-time and material-conditioned media. Cells were incubated for 24 h and 72 h, at three different concentrations (1, 10, and 100 mg/mL) of each sealer. The cytotoxic activity of the sealers was assessed by Methyl tetrazolium (MTT) and Sulforhodamine B (SRB) assays. Cell morphology and cytogenetic alterations were studied microscopically. Results: MTT and SRB assays revealed similar results within both approaches. Cell culture exposed to sealers through incubation in real-time revealed a cytotoxic effect of AH Plus at 100 mg/mL. Material- conditioned media study revealed a cytotoxic effect of Bio MTA+ and Bio C, increasing with higher compound concentration and reaching 50% with 100 mg/mL. Regarding the cell’s morphology, Bio C sealer revealed a decrease in cell confluence and several morphological changes. AH Plus and Bio MTA+ did not seem to affect the cell confluence however morphology alterations were observed. In the cytogenetic study, a severe decrease of the mitotic index and a large number of chromosomal aberrations were observed. The present study represents an advance in the understanding of the biocompatibility of AH Plus, Bio MTA+, and Bio C sealers. These sealers demonstrated some cytotoxicity, depending on the concentration used. Although more validation studies are still needed, this study brings very relevant results in terms of cytotoxicity, cell morphology, and cytogenetic alterations. Conclusions: These results could help in the selection of the most appropriate compounds to be used in clinical practice as well as to determine the maximum recommended amounts of each sealer. Clinical Relevance: This study highlights the potential cytotoxic effects of three commonly used root canal sealers on human gingival fibroblasts, with varying degrees of impact depending on the concentration used. The results emphasize the importance of careful consideration when selecting and applying these materials in clinical practice.info:eu-repo/semantics/publishedVersio

Apical periodontitis and cardiovascular disease in adults: a systematic review with meta-analysis

BACKGROUND: A potential relationship between oral health and cardiovascular diseases has been proposed. However, uncertainty remains as to whether there is sufficient data to support this association. This review aims to appraise the relationship between apical periodontitis and cardiovascular disease based on data from observational studies. METHODS: The databases Medline (via PubMed) and EMBASE (via Scopus) were searched up to August 2020 for observational studies (case-control, cross-sectional, and cohort) assessing the association of apical periodontitis with cardiovascular disease among adults. Pooled relative risk/odds ratio and 95% confidence interval (CI) were estimated using a random-effects model. Sensitivity analyses and random-effects meta-regressions were performed. RESULTS: The initial search yielded 2537 documents, of which 15 were eligible for inclusion, including 8 cross-sectional studies, 5 case-control studies, and 2 cohort studies. The majority of studies enrolled both men and women, with mean age ranging from 41 to 66 years. In cross-sectional studies, the presence of apical periodontitis was significantly associated with cardiovascular disease with a combined odds ratio of 1.53 (95% CI: 1.02-2.29, p = 0.039; I2 = 75.0%; p < 0.001). In the case-control studies, the combined odds ratio did not show a significant association of apical periodontitis with cardiovascular disease (OR = 1.24; 95% CI: 0.67-2.29, p = 0.494; I2 = 82.1%; p < 0.001). The pooled risk ratio from the 2 cohort studies showed (RR = 1.27; 95% CI: 0.71-2.27, p = 0.413; I2 = 69.1%; p = 0.072) also showed no significant association between apical periodontitis and cardiovascular disease. These results should be interpreted with caution due to the high heterogeneity. CONCLUSIONS: Data derived from cross-sectional studies suggest a weak association between apical periodontitis and cardiovascular disease. As the results were not consistent across study designs, further research is recommended, namely longitudinal studies with long-term follow-up. REGISTRATION: PROSPERO database (CRD42020204379).info:eu-repo/semantics/publishedVersio

#038 BIODENTINE® e CBCT no tratamento de reabsorção radicular externa – caso clinico

Introdução: As reabsorções radiculares externas são caracterizadas pela destruição progressiva do tecido duro devido à atividade clástica. Um diagnostico incorreto pode levar a um tratamento errado e subsequente perda do dente. O tratamento deve visar a supressão completa do tecido de granulação e a reconstrução do defeito pela colocação de um material adequado. Biodentine® tem sido usado como um material de reparação devido à sua bioatividade e biocompatibilidade. Descrição de caso clínico: Paciente caucasiana de 29 anos de idade, apresentou? se na clínica da Universidade Católica Portuguesa de Viseu com uma fístula associada ao dente 12. Após radiografia periapical, detetou?se um espigão de fibra de vidro no canal radicular e a presença de uma reabsorção radicular externa. A realização de CBCT permitiu a confirmação da reabsorção na região distal da raiz. O retratamento endodontico não foi realizado porque o dente tinha uma raiz fina com grande probabilidade de fratura na remoção do espigão de fibra de vidro. Foi realizada uma abordagem cirúrgica onde foi utilizado Biodentine® como material de reparação do defeito de reabsorção. Discussão e conclusões: A reabsorção radicular externa é um processo multifatorial com diversos fatores etiológicos. O CBCT é essencial no diagnóstico e plano de tratamento deste tipo de lesões. Após a realização do controlo após um ano verificou? se a reparação da reabsorção radicular e cicatrização progressiva do defeito ósseo.info:eu-repo/semantics/publishedVersio

#028 CBCT e microscópio no tratamento endodôntico de pré‑molares multicanalares – caso clínico

Introdução: Os pré-molares mandibulares são frequentemente constituídos por uma raiz e um canal, no entanto devemos estar alerta para a possibilidade de prevalência de variabilidades anatómicas. O diagnóstico por imagem é fulcral para a realização de um bom plano de tratamento. O CBCT tem vindo a assumir uma crescente utilidade na identificação de diferentes variabilidades anatómicas. A magnificação permite que a abordagem a câmaras pulpares calcificadas e deteção de canais radiculares apresente uma maior previsibilidade. Descrição do caso clínico: Paciente do sexo masculino, com 67 anos, compareceu na consulta de Endodontia na Clínica Dentária Universitária da Universidade Católica Portuguesa em Viseu encaminhado para ajuda no acesso aos canais radiculares dos dentes 44 e 45 que apresentavam a câmara calcificada. Após confirmação do diagnóstico e análise da ortopantomografia decidiu-se realizar um CBCT no qual se observou que as raízes dos dentes 44 e 45 apresentavam uma forma anatómica invulgar. Com o auxílio do microscópio e pontas ultrassónicas, procedeu-se à deteção da entrada canalar dos dois canais de cada dente e procedeu-se ao tratamento endodôntico, realizando o preparo canalar com o sistema TruNatomy no dente 44 e Reciproc Blue no dente 45. De seguida procedeu-se à obturação recorrendo a várias técnicas e posterior reabilitação com duas coroas de zircónia. Discussão e conclusões: A complexidade da anatomia radicular requer cuidados especiais no diagnóstico e tratamento endodôntico. O uso de CBCT permite entender melhor a anatomia radicular e o sistema canalar. A utilização do microscópio permite uma melhor visualização e a realização de tratamentos que poderiam não ser possíveis de concretizar. O CBCT e o microscópio permitiram realizar um tratamento endodôntico mais conservador e previsível.info:eu-repo/semantics/publishedVersio

Tratamento endodôntico de um canino geminado - caso clínico

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