AH Plus extrusion into periapical tissue: literature review of main related properties and report of clinical cases

The sealers were developed for filling of root canals. Due to their physicochemical and technical properties used for obturation, often, extrusion is observed through apical constriction and occasionally by lateral and secondary canals. Objective: To review the literature on important properties to be considered in AH Plus sealer extrusion and report a case series of this sealer extrusion. Literature review: Articles evaluating the cytotoxicity and biocompatibility properties, besides flow and solubility were selected. Case report: In the presented cases, endodontic treatment was performed with rotary instrumentation and irrigation with 2.5% NaOCl. Obturation employed visual, tactile, and radiographic proof of gutta-percha main cone, and different obturation techniques. There were no reports of pain during and after endodontic treatment. Conclusion: AH Plus has adequate properties for a filling material and causes no major damage to the periapical tissues due to its little cytotoxic

Dental research on collective health at the Meeting of the Sociedade Brasileira de Pesquisa Odontológica (Brazilian Society of Dental Research) : 14-year cut-off point

The Annual Meeting of the Brazilian Society of Dental Research (BSDR) is among the Brazilian prominent scientific events. Since 2001, the event has a new category, so-called Dental Research on Collective Action (DRCA). Objective: To analyze the scientific production in the DRCA category, through abstracts published in the Annals of BSDR, from 2001 to 2015. Material and methods: By active online search, the abstracts published in the Annals of BSDR from the DRCA category, from 2001 to 2015, except for 2012 (n = 771) were accessed. These were then classified by an evaluator into: year of publication (14 years), subject of research (18 categories), age of the sample or living conditions (8 categories), and region of origin (5 regions). Results: The descriptive analysis showed an average rate in DRAC category, in the 14 years analyzed, of 0.03%. The years 2006 (n = 140), 2007 (n = 113), and 2008 (n = 129) included the largest numbers of abstracts, while lower values occurred in 2009 (n = 13) and 2014 (n = 17). Concerning to the subjects, health promotion prevailed in 24.3%, followed by oral health care (18.5%), and health surveillance (11.7%). In the studies including humans (66.3%), the greater involvement was with children (27.0%). The Southeast region prevailed in the presentation of abstracts, with a rate of 66.9%, while smaller representation occurred in the Midwest region (1.6%). Conclusion: The DRCA category was present in the meetings of DRCA, especially by research involving health promotion approach with meaningful participation of theSoutheast region, reflecting the potential scientific development of the region

Knowledge assessment on dental avulsion of private and public school teachers of Curitiba

Dental trauma is one of the most important oral health problems during childhood. It occurs frequently in the school environment and it is extremely important that the professors have knowledge on the subject because the management taken after the accident, directly influences on the prognosis. Objective: The aim of this study was to evaluate the knowledge level about dental avulsion of teachers who work in the private and public elementary schools in the city of Curitiba (PR, Brazil). Material and methods: A questionnaire adapted from Mori et al. (2007) was applied, consisting of three parts, Part I: general demographic data; Part II: basic questions about the importance of emergency management, experience in dental avulsion and the management to be taken in an event of dental avulsion; Part III: Questions about dental avulsion. The chi-square test was used to identify differences in responses for different variables, with significance level of 5%. Results: A total of 98 teachers answered the questionnaire (54 private and 44 municipal schools). Most were women (66% in private and 95.5% in municipal schools), with professional experience between 6-10 years and a postgraduate degree (81.1% of teachers in private schools and 79.9% of teachers in municipal schools). The statistical analysis showed a significant difference between the groups in age and about the emergency procedure for dental avulsion. Conclusion: It can be concluded that knowledge by the elementary schoolteachers in cases of dental avulsion is inadequate

Assessment of the Dentistry undergraduates’ knowledge on tooth avulsion

Dental trauma affects mainly children, teenagers and young adults and the anterior teeth. In dental avulsion, the teeth are completely displaced out of the socket. This dentoalveolar lesion is that causing the most severe functional, esthetic, and psychologic damage to the patient. Objective: To evaluate the knowledge level of Dentistry undergraduates on tooth avulsion and verify whether the course period would be associated with the knowledge level. Material and methods: A questionnaire adapted from Fujita et al.. [5], was applied, consisting of three parts, Part 1: general demographic data; Part 2: questions about the experience in tooth trauma Part 3: knowledge about tooth avulsion. The questionnaire was applied to 706 Dentistry undergraduates from Positivo University (PR), in June, 2015. The chi-square test was used to identify differences in responses for different variables, with significance level of 5%. Results: Most of the students were at the age range from 16 to 20 years-old (47.1%), were female (74.7%), were not trained on first-aid care in cases of tooth trauma (73.9%), and never faced a case of tooth avulsion (68.8%). The course period was statistically and positively associated with the knowledge on dental avulsion. Conclusion: The evaluated Dentistry undergraduate students knew how to manage cases of tooth avulsion. Statistically significant differences occurred in relation to the course period and the knowledge on tooth avulsion

Analysis of the internal anatomy of mandibular molars using different cone-beam computed tomography protocols

The aim of this study was to analyze the root canal anatomy variations of permanent mandibular molars using three different cone-beam computed tomography (CBCT) protocols. Material and methods: Thirty-five freshly extracted first and second mandibular molars were collected and subjected to three CBCT protocols: i-CAT Classic (ICC); i-CAT Next Generation (ICN), and PreXion 3D (PXD). Images were evaluated by two previously calibrated and experienced endodontists. The morphological root canal configurations were classified according to Vertucci. Data were analyzed for frequency, and the binomial and Kappa tests were then performed (α = 0.05). Results: ICC and ICN were able to diagnose a higher percentage of anatomical variations in the mesial roots. In this same root, Vertucci’s type V was the most prevalent, and in distal was the type I. In comparisons of CBCT techniques for agreement, significant differences in the mesial root canals were found in the following: ICC versus (vs) ICN; ICC vs PXD; and ICN vs PXD (p 0.05). The level of agreement in mesial roots was poor or absent, while in distal was moderate. Conclusion: Anatomical variations were found in both root canals, with higher variability in the mesial, highlighting ICC and ICN protocols, and the prevalence of Vertucci’s type V, while in the distal prevailed the type I

Análise radiográfica das aberturas endodônticas de dentes de pacientes referenciados a um Centro de Especialidades Odontológicas Radiographic analysis of endodontic access of patients referenced to a Center of Dental Specialities

Introduction: Coronary access is the first stage of endodontic treatment and aims at direct access to root canals. Objective: To evaluate, by radiographic analysis, endodontic access cavities through radiographic analysis of the teeth of patients coming from primary care referred to the Center of Dental Specialties (CEO) Positivo, Curitiba, PR, Brazil. Material and methods: A total of 226 periapical radiographs taken previous to attending the CDS were analyzed, from August 2015 to August 2017. Three trained and calibrated examiners verified the following criteria: oral cavity region, presence of remaining caries,removal of roof of the pulp chamber, compensatory mesiodistal wear, iatrogenic (suggestive) and temporary restoration. Data were tabulated and analyzed for distribution, followed by bivariate analysis (Fisher’s Exact Test) with significance of 5%. Results: The posterior region prevailed in 70.3% of the sample. There remaining caries were found in 14.2%, insufficient roof removal in 25.2%, iatrogenic in 35.4%, and inadequate height of the temporary restoration in 11.5% of the cases. In the posterior teeth, insufficient mesiodistal compensatory wear was identified in 35.4 of the exams. The bivariate analysis revealed no significant difference when the variable region of the oral cavity was analyzed in relation to the presence of caries (p = 0.393), remaining roof (p = 0.056) and presence of iatrogenic (p = 0.304). Conclusion: It is concluded that there are relevant failures in the endodontic access received in the CDS, which indicates the need for professional training in primary care.Introduction: Coronary access is the first stage of endodontic treatment and aims at direct access to root canals. Objective: To evaluate, by radiographic analysis, endodontic access cavities through radiographic analysis of the teeth of patients coming from primary care referred to the Center of Dental Specialties (CEO) Positivo, Curitiba, PR, Brazil. Material and methods: A total of 226 periapical radiographs taken previous to attending the CDS were analyzed, from August 2015 to August 2017. Three trained and calibrated examiners verified the following criteria: oral cavity region, presence of remaining caries,removal of roof of the pulp chamber, compensatory mesiodistal wear, iatrogenic (suggestive) and temporary restoration. Data were tabulated and analyzed for distribution, followed by bivariate analysis (Fisher’s Exact Test) with significance of 5%. Results: The posterior region prevailed in 70.3% of the sample. There remaining caries were found in 14.2%, insufficient roof removal in 25.2%, iatrogenic in 35.4%, and inadequate height of the temporary restoration in 11.5% of the cases. In the posterior teeth, insufficient mesiodistal compensatory wear was identified in 35.4 of the exams. The bivariate analysis revealed no significant difference when the variable region of the oral cavity was analyzed in relation to the presence of caries (p = 0.393), remaining roof (p = 0.056) and presence of iatrogenic (p = 0.304). Conclusion: It is concluded that there are relevant failures in the endodontic access received in the CDS, which indicates the need for professional training in primary care

A expansão rápida de maxila muda a posição natural da cabeça em crianças com constrição maxilar? Uma revisão sistemática e meta-análise

Objective: a systematic review was performed to evaluate the natural head position (NHP) in children with maxillary constriction before and after rapid maxillary expansion (RME). Material and Methods: a comprehensive search was carried out in the MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The annual conference of the IADR abstracts (1990–2017) and unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and “Periódicos CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) Theses Databases”. The studies compared the natural head position in patients submitted rapid maxillary expansion (RME) and untreated patients both with maxillary constriction. Results: a total of 3023 studies were identified, three remained in qualitative study and all these studies were considered at “unclear” risk of bias in the key domains. Only two studies presented similar data to be included in the meta-analysis. Both studies evaluated the natural head position, through the angle between nasion-sella line and true vertical (SN-Ver). The meta-analyses demonstrated that after 12 months follow-up, the SN-Ver angle decreased by 3.39 degrees (95% confidence interval [CI]=0.57 to 6.21; p=0.02). Conclusion: the RME promoted increase in SN-VER angle in child after 12 months for intervention; however, there are few studies in the literature about this topic, and there is a need of further well-designed trials to investigate this alteration.Objetivo: uma revisão sistemática foi realizada para avaliar se a posição natural da cabeça (PNS) muda em crianças com constrição maxilar antes e após expansão rápida da maxila (ERM). Material e método: uma pesquisa foi realizada no MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO e Cochrane Library sem restrições. Também foram pesquisadas a conferência anual dos resumos da IADR (1990–2017) e o registro de ensaios não publicados e em andamento. As dissertações e teses foram pesquisadas usando os bancos de dados ProQuest Dissertations e “Periódicos CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) de Teses”. Os estudos compararam a posição natural da cabeça em pacientes submetidos a expansão rápida da maxila (ERM) e pacientes não tratados, ambos com constrição maxilar. Resultados: um total de 3023 estudos foram identificados, três permaneceram em estudo qualitativo e todos esses estudos foram considerados de risco "pouco claro" de viés nos principais domínios. Apenas dois estudos apresentaram dados semelhantes para serem incluídos na meta-análise. Ambos os estudos avaliaram a posição natural da cabeça, através do ângulo entre a linha násio-sela e a vertical verdadeira (SN-Ver). As meta-análises demonstraram que, após 12 meses de acompanhamento, o ângulo SN-Ver diminuiu 3,39 graus (intervalo de confiança de 95% [IC] = 0,57 a 6,21; p = 0,02). Conclusão: o ERM promoveu aumento do ângulo SN-VER na criança após 12 meses de intervenção; no entanto, existem poucos estudos na literatura sobre esse tópico, e há necessidade de mais estudos bem delineados para investigar essa alteração

Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

<div><p>Abstract: The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.</p></div