Endodontic and Orthodontic Management of Traumatically Intruded Teeth with Horizontal Root Fracture: A Case Report

This report describes the case of an 8-year-old boy that was referred to endodontic and orthodontic treatment after suffering an injury that led to intrusion of the maxillary right permanent central incisor, palatal displacement of the upper right lateral incisor, and root fracture of both central incisors. Both injured teeth were immature and had open apices. The intruded tooth was repositioned by endodontic and orthodontic management. Endodontic therapy was performed in both teeth with periodical changes of calcium-hydroxide-based paste as root canal dressing and introduction of MTA as an apical barrier. The postoperative course was uneventful with clinical and radiographic success up to 3 and 1/2 years of follow up. In the present case, orthodontic repositioning combined with endodontic therapy constitued a viable alternative treatment for intrusive luxations in immature permanent teeth

Avaliação microbiológica do canal radicular e da reparação apical e periapical após tratamento endodôntico de dentes de cães com vitalidade pulpar e sem vitalidade pulpar com ou sem reação periapical crônica

O objetivo deste estudo foi a avaliação da microbiota dos canais radiculares de dentes de cães sem vitalidade pulpar, com e sem reação periapical crônica por meio dos métodos de cultura microbiológica e hibridação DNA-DNA checkerboard, além da análise da reparação dos tecidos apicais e periapicais após o tratamento endodôntico de dentes sem vitalidade pulpar sem ou com lesão periapical e dentes com vitalidade pulpar. Foram utilizados 60 pré-molares de 3 cães. No grupo I foram realizados os casos de biopulpectomia; no grupo II, após a abertura coronária, os canais radiculares permaneceram expostos por 30 dias, visando a contaminação dos mesmos (necropulpectomia I); e no grupo III, os canais radiculares permaneceram expostos ao meio bucal por 7 dias, sendo a seguir, selados por 60 dias, quando as lesões periapicais foram evidenciadas radiograficamente (necropulpectomia II). Anteriormente ao preparo biomecânico foi realizada a colheita de material dos canais radiculares para análise microbiológica dos dentes sem vitalidade pulpar. O tratamento endodôntico foi realizado em todos os grupos, em uma única sessão, e após 180 dias os cães foram mortos e as peças preparadas para análise histopatológica. Os resultados da análise microbiológica por meio da técnica de cultura demonstraram o predomínio de anaeróbios estritos e aeróbios em relação aos microrganismos facultativos. A técnica de checkerboard demonstrou o predomínio de anaeróbios estritos nas duas situações avaliadas. Nos dois métodos de análise microbiológica foi possível observar maior número de células bacterianas no Grupo II, onde os canais radiculares permaneceram expostos ao meio bucal por 30 dias. Os resultados histopatológicos demonstraram presença de infiltrado inflamatório severo, reabsorção apical e óssea nos grupos II e III, com aspectos semelhantes para... .The aim of this study was to evaluate the microbiota of root canals from dog's teeth, with no pulp vitality, with or without radiographic chronic periapical lesion, using a culture microbiologic method and checkerboard DNA-DNA hybridization technique. The repair of apical and periapical tissues was evaluated after the endodontic treatment of root canals, with no pulp vitality, with or without chronic periapical lesion and with vital pulp. It were used dog's premolars from 3 animals, divided into three groups: group I, treatment of teeth with vital pulps; group II, after coronal opening the root canals were exposed to oral environment during 30 days (teeth with no pulp vitality without chronic periapical lesion); and in group III, the root canals were exposed to oral environment during 7 days, and after this, sealed during 60 days, until the radiographic observation of the presence of periapical lesion. Before the biomechanical preparation, the microbiologic samples were obtained from groups II and III. Endodontic therapy was conducted in three groups, in one-visit treatment, and after 180 days, the dogs were killed and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repairing. The results of microbiologic evaluation using culture technique, showed the predominance of obligate anaerobic and aerobic bacteria in both groups, when compared to facultative species. The method checkerboard demonstrated the predominant occurrence of obligate anaerobes in the both clinical situations that were evaluated. For the two microbiological methods used it was possible to observe a greater number of cells in group II, where the root canals were kept exposed to oral environment during 30 days. The histhological results showed inflammatory... (Complete abstract, click electronic address below).Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Efeito antibacteriano in vitro das soluções Tetraclean, MTAD e modificações: teste de contato direto e ação sobre o biofilme

O objetivo deste estudo foi avaliar a atividade antibacteriana das soluções Tetraclean®, MTAD® e modificações desta formulação sobre uma cepa de Enterococcus faecalis pelo teste de contato direto e frente ao biofilme. Na metodologia de contato direto, uma suspensão de E. faecalis foi exposta às soluções irrigadoras, por períodos de 30 s, 1, 3 e 10 min, e um agente neutralizante foi utilizado. As colônias viáveis foram quantificadas após diluições seriadas e cultura em placas de ágar. Para determinação do número inicial de UFC, água esterilizada foi usada como controle. Para o crescimento do biofilme, amostras de biofilme dentário foram suspensas em BHI (Brain Heart Infusion), e incubadas por 14 dias em anaerobiose, tendo como substrato, discos de hidroxiapatita. Após o período de incubação, os biofilmes foram expostos às soluções irrigadoras por períodos de 30 s, 1 e 3 min. Os biofilmes corados com o Live/Dead Baclight stain (Molecular Probes, Europe BV), que diferencia células viáveis (verde) e células não-viáveis (vermelho) foram observados na microscopia confocal. As imagens do biofilme obtidas pelo software EZ-C1 for Nikon foram transferidas para análise quantitativa da proporção de células viáveis sobre o total de células do biofilme para o software Imaris 5.0. No teste de contato direto, o Tetraclean® eliminou completamente o E. faecalis em 30 s, enquanto o MTAD® e o MTAD® + CTR 0,01% eliminaram após 10 min, e o MTAD® + CTR 0,1% resultou em culturas negativas após 3 min de contato com a suspensão bacteriana. Quando removido o Tween 80 do MTAD®, e acrescida a CTR 0,01%, obteve-se culturas negativas após 1 minuto. Os resultados obtidos pelo método de exposição ao biofilme confirmaram os achados do teste de contato direto.The aim of this study was to evaluate the antibacterial effect of MTAD® and Tetraclean®. The tests were performed on Enterococcus faecalis using the direct exposure test and an in vitro biofilm model. Alternative formulations to MTAD® were also included in the experiments: MTAD® + 0.01% cetrimide (CTR); MTAD® + 0.1% CTR; MTAC (the detergent Tween 80 was substituted for cetrimide) with 0.01% CTR and MTAC (0.1% CTR). In the direct exposure test, a bacterial suspension was mixed with the irrigation solutions. After 30 seconds, 1 minute, 3 minutes and 10 minutes, an inactivator agent was used. The number or viable colonies were calculated after serial 10-fold dilutions and culture in agar plates. To calculate the initial number of colonies, sterilized water was used as a control. Dental biofilm samples were suspended in BHI broth and incubated in anaerobic conditions in hidroxiapatite discs. After incubation for 14 days, the biofilms were exposed to the irrigation solutions for 30 seconds, 1 minute and 3 minutes. Live/Dead Baclight stain (Molecular Probes, Europe BV) was used to diferentiate viable cells (Green) and non viable cells (Red). The samples were observed in the Confocal Laser Microscope. The biofilm images in 3D obtained in the EZ-C1 for Nikon software were transfered to quantitative analysis in the Imaris 5.0 software. The software calculated the ratio of green cells. In the direct exposure test, Tetraclean® and MTAC (0.1% CTR) erradicated E. faecalis in 30 s. MTAD® and MTAD® + 0.01% CTR eliminated E. faecalis after 10 min. MTAD® + 0.1% CTR resulted in negative culture after 3 min. Negative cultures were obtained after 1 min when MTAC (0.01% CTR) was used. The findings from the biofilm exposure method confirmed the results from direct exposure test. The Kruskal-Wallis statistical analysis showed a significant difference in time exposure to irrigant (P<0.001).Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

EVALUACIÓN DEL ÉXITO CLÍNICO Y RADIOGRÁFICO POST-TRATAMIENTO DE DIENTES CON NECROSIS PULPAR Y LESIÓN PERIAPICAL VISIBLE RADIOGRÁFICAMENTE

Uno de los factores imprescindibles para la obtenci&oacute;n del &eacute;xito post-tratamiento endod&oacute;ntico es el material obturador. Para verificar la influencia del tipo de material obturador en la reparaci&oacute;n post-tratamiento endod&oacute;ntico y el consecuente &eacute;xito cl&iacute;nico y radiogr&aacute;fico, nos propusimos a evaluar los tratamientos endod&oacute;nticos de 55 dientes realizados en la cl&iacute;nica de Endodoncia de la Facultad de Odontolog&iacute;a de Araraquara, dividi&eacute;ndolos en 2 grupos, en funci&oacute;n del cemento obturador utilizado: a base de &Oacute;xido de Zinc y Eugenol y a base de Hidr&oacute;xido de Calcio. A trav&eacute;s de los resultados observamos que los 36 dientes obturados con Sealapex, 34 presentaron &eacute;xito cl&iacute;nico y radiogr&aacute;fico. Cuando el cemento usado fue a base de &Oacute;xido de Zinc y Eugenol, de los 19 casos analizados, 3 fracasaron, representando un &iacute;ndice menor de &eacute;xito que el Sealapex. Concluimos que respetando las variables, el cemento Sealapex permite &iacute;ndice m&aacute;s elevado de &eacute;xito post-tratamiento endod&oacute;ntico.SummaryThe root canal filling is one of the most important factors for a successful endodontic treatment. The aim of this study was to evaluate the root canal sealer role in the clinic and radiographic success of teeth who received endodontic treatment. Fifty-five root canals were evaluated after endodontic treatment in the Endodontic Clinic of School Dentistry of Araraquara. There were 2 groups, according to the root canal sealer: zinc oxide and eugenol root canal sealer (Endofill) and calcium hydroxide root canal sealer (Sealapex). The results showed that 32 of 34 teeth treated with Sealapex showed clinic and radiographic success. When the sealer used was Endofill, 3 of 19 evaluated failed; a worst result than that observed in the cases filled with Sealapex. We could conclude that respecting the differences in the sample, the sealer Sealapex allows a high level of clinic and radiographic success.ResumoUm dos fatores imprescind&iacute;veis para a obten&ccedil;&atilde;o do &ecirc;xito p&oacute;s-tratamento endod&ocirc;ntico &eacute; o material obturador. Para verificar a influ&ecirc;ncia do tipo de material obturador na repara&ccedil;&atilde;o p&oacute;s-tratamento endod&ocirc;ntico, e o conseq&uuml;ente sucesso cl&iacute;nico e radiogr&aacute;fico,nos propusemos a avaliar os tratamentos endo&ocirc;nticos de 55 dentes realizados na lc&iacute;nica de Endodontia da Faculdade de Odontologia de Araraquara, dividindo-os em 2 grupos, em fun&ccedil;&atilde;o do cimento obturador utilziado: &agrave; base de &Oacute;xido de Zinco e Eugenol e &agrave; base de Hidr&oacute;xido de C&aacute;lcio. Atrav&eacute;s dos resultados, foi poss&iacute;vel observar que dos 36 dentes obturados com Sealapex, 34 apresentaram sucesso cl&iacute;nico e radiogr&aacute;fico. Quando o cimento utilizado foi &agrave; base de &Oacute;xido de Zinco e eugenol, dos 19 casos analisados, 3 fracassaram, representando um &iacute;ndice menor de sucesso que o Sealapex. Concluimos que, respeitando as vari&aacute;veis, o cimento Sealapex permitiu um &iacute;ndice mais elevado de sucesso p&oacute;s-tratamento endod&ocirc;ntico

Aspecto das paredes dentinárias após preparo dos canais radiculares com diferentes técnicas de instrumentação.

Aspecto das paredes dentinárias após preparo dos canais radiculares com diferentes técnicas de instrumentação

Reliability of assessing dye penetration along root canal fillings using methylene blue

Methylene blue (MB) remains the most frequently used tracer for dye penetration tests of endodontic fillings, despite its chemical reactions with different materials. This study checked whether dye penetration displayed by MB is comparable to Rhodamine B (RB). One hundred and seventy-two root canals were filled with gutta-percha and six sealers. Samples were covered with nail varnish except for the apical area, and immersed in MB or RB solutions under negative pressure. After 24 h, roots were bisected, photographed and the maximal dye penetration recorded. Dye penetrations displayed by MB and RB were compared (Newman-Keuls test). MB and RB displayed comparable results for groups filled with AH Plus, EndoREZ and Polifil (P > 0.05). For Endofill, Sealer 26 and Sealapex, a significant lower dye penetration was observed when MB was used (P < 0.05). Laboratory tests using MB for measuring dye penetration through filled root canals can result in misleading conclusions.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Inhibition of Sodium Hypochlorite Antimicrobial Activity in the Presence of Bovine Serum Albumin

Introduction: This study investigated the inhibition of the antimicrobial activity of sodium hypochlorite (NaOCl) by bovine serum albumin (BSA). The killing of Enterococcus faecalis, Candida albicans, Staphylococcus epidermidis, and Escherichia coil by NaOCl in concentrations from 2% to 0.03% was measured in the presence of BSA in concentrations between 6.7% and 0.1%. Methods: NaOCl, BSA, and microorganism suspensions were mixed, and, after 30 seconds, 6 minutes, and 30 minutes, samples were taken and NaOCl was inactivated by 5% sodium thiosulphate. The microbes were incubated in tryptic soy broth broth for up to 7 days for the detection of growth. Results: All microorganisms were killed within 30 seconds by 0.03% NaOCl when BSA was not present. High concentrations of BSA significantly reduced the antimicrobial activity of NaOCl against the four species. Conclusions: The inhibition of sodium hypochlorite by BSA was directly dependent on their quantitative relationships. The result partly explains the poorer performance in vivo of NaOCl as compared to in vitro experiments. (J Endod 2010;36:268-271)MEC/CAPES[BEX 4146-06/9

In vitro antimicrobial activity of different gutta-percha points and calcium hydroxide pastes

The aim of this study was to evaluate the antimicrobial activity of different trademarks and compositions of gutta-percha points and calcium hydroxide pastes used in endodontic therapy. The evaluated material consisted of gutta-percha points containing calcium hydroxide (Roeko™), gutta-percha points containing chlorhexidine (Roeko™), two convencional gutta-percha points (Endo Points™ and Roeko™) and two calcium hydroxide pastes (Calen™ and Calen/PMCC™). Antimicrobial tests included five species of microorganisms: Escherichia coli (ATCC10538), Staphylococcus epidermidis (ATCC12228), Staphylococcus aureus (ATCC6538), Pseudomonas aeruginosa (ATCC27853), and Micrococcus luteus (ATCC9341). The Agar difusion method was employed. The plates were kept at room temperature for 2 h for prediffusion and then incubated at 37°C for 24 h. The triphenyltetrazolium chloride gel was added for optimization and the zones of inhibition were measured. Statistical evaluation was carried out using analysis of variance and Tukey Test. The obtained results showed that all microbial species used in the study were inhibited by the gutta-percha points containing chlorhexidine and by the calcium hydroxide pastes (Calen™ and Calen/ PMCC™), with similar results (p > 0.05). No antimicrobial activity was observed for the other groups. It was concluded that the gutta-percha points containing chlorhexidine presented antimicrobial activity, whereas the gutta-percha points containing calcium hydroxide did not

Parallel data mining on ATM-connected PC cluster and optimization of its execution environments

Introduction: Endodontic chelators may extrude to apical tissues during instrumentation activating cellular events on periapical tissues. This study assessed in vitro the expression of nitric oxide (NO) concentrations by murine peritoneal macrophages after contact with MTAD (Dentsply/Tulsa, Tulsa, OK), Tetraclean (Ogna Laboratori Farmaceutici, Muggio, Italy), Smear Clear (Sybron Endo, Orange, CA), and EDTA (Biodinamica, Ibipora, PR, Brazil). Methods: Macrophage cells were obtained from Swiss mice after peritoneal lavage. Chelators were diluted in distilled water obtaining 12 concentrations, and MTT assay identified the concentrations, per group, displaying the highest cell viability (analysis of variance, p < 0.01). Selected concentrations were tested for NO expression using Griess reaction. Culture medium and lipopolysaccharide (LPS) were used as controls. Results: Analysis of variance and Tukey tests showed that all chelators displayed elevated NO concentrations compared with the negative control (p < 0.01). MTAD induced the lowest NO expression, followed by Tetraclean, EDTA, and Smear Clear. No difference was observed between MTAD and Tetraclean (p > 0.01), Tetraclean and EDTA (p > 0.01), and EDTA and Smear Clear (p > 0.01). LPS ranked similar to both EDTA and Smear Clear (p > 0.01). Conclusion: The tested endodontic chelators displayed severe proinflammatory effects on murine-cultured macrophages. Citric acid-based solutions induce lower No release than EDTA-based irrigants. (J Endod 2009;35:824-828