Uso de biodentine en la resolución de un fracaso en cirugía paraendodóntica

To present a clinical case report of successful endodontic retreatment, in a maxillary first molar, with symptomatic apical periodontitis in the mesiobuccal root that had already undergone endodontic treatment and paraendodontic surgery.Apatient was referred for evaluation of upper right first molarwith swelling, severe pain and sensitivity to percussion and palpation. She reported having undergone endodontic treatment 1 year ago and, 6 months later, when the symptoms returned, a paraendodontic surgery was performed by the same professional. A cone-beam computed tomography (CBCT) was requested and the images showed extensive bone rarefaction associated with the mesiobuccal root, which had the MB1 canal treated and the MB2 canal untreated. The periapical regionof the apices of the distobuccal and palatine roots showed signs of normality, and the treatment plan was established with selective endodontic retreatment only in the mesiobuccal root, with the location and treatment of the MB2 canal and retreatmentof the MB1 canal. Retreatment was performed in 2 sessions with an intracanal dressing with calcium hydroxidepaste. Thecanals were filled with Biodentine (BD, Septodont, Saint Maur de Fossés, France). Clinically, the patient had no further signs or symptoms and tomographic images showed evidence of bone repair after 24 months.Correct planning and execution of all phasesof endodontic retreatment were fundamental for the success of this case report.Apresentar um relato de caso clínico de sucesso no retratamento endodôntico, em um primeiro molar superior, com periodontite apical sintomática na raiz mesiovestibular que jáhavia passado por um tratamento endodôntico e cirurgia paraendodôntica.Umapaciente foi encaminhada para avaliação do dente 16 apresentando edema, dor forte e sensibilidade àpercussão e palpação. Relatou a realização do tratamento endodôntico há1 ano e, 6 meses após, quando o quadro sintomático retornou, foi realizada uma cirurgia paraendodôntica pelo mesmo profissional. Foi solicitada uma tomografia computadorizada de feixe cônico e as imagens mostraram extensa rarefação óssea associada àraizmesiovestibular, que possuía o canal MV1 tratado e o canal MV2 sem tratamento. O contorno dos ápices das raízes distovestibular e palatina apresentavam sinais de normalidade, sendo estabelecido como plano de tratamento, o retratamento endodôntico seletivo apenas na raiz mesiovestibular, com a localização e tratamento do canal MV2 e retratamento do canal MV1. O retratamento foi realizado em 2 sessões com um curativo de demora com hidróxido de cálcio. Os canais foram obturados com o Biodentine (BD, Septodont, Saint Maur de Fossés, France).Clinicamente, a paciente não apresentou mais sinais ou sintomas e as imagens tomográficas mostraram evidências de reparo ósseo após 24 meses. Um correto planejamento e a execução de todas as etapas do retratamento endodôntico foram fundamentais para o êxito do presente relato de caso.Presentar un reporte de caso clínico de retratamiento endodóntico exitoso, en un primer molar superior,con periodontitis apical sintomática en la raíz mesio-vestibular que ya había sido sometido a tratamiento endodóntico y cirugía paraendodóntica. Un paciente fue remitido para evaluación del diente 16 con tumefacción, dolor intenso y sensibilidad a la percusión y palpación. Refiere haber tenido tratamiento de endodoncia durante 1 año y, 6 meses después, cuando reaparecieron los síntomas, se realizó una cirugía de paraendodoncia por el mismo profesional. Se solicitó una tomografía computarizada de haz cónicoy las imágenes mostraron una extensa rarefacción ósea asociada a la raíz mesio-vestibular, que tenía el canal MV1 tratado y el canal MV2 sin tratar. El contorno de los ápices de las raíces disto-vestibulares y palatinas presentaba signos de normalidad, yse estableció el plan de tratamiento con retratamiento endodóntico selectivo solo en la raíz mesio-vestibular, con localización y tratamiento del canal MV2 y retratamiento del canal MV1. El retratamiento se realizó en 2 sesiones con un apósito permanente con hidróxido de calcio. Los canales se rellenaron con Biodentine (BD, Septodont, Saint Maur de Fossés, Francia). Clínicamente, el paciente no presentó más signos ni síntomas y las imágenes tomográficas mostraron evidencia de reparación ósea después de 24 meses. La correcta planificación y ejecución de todas las etapas del retratamiento endodóntico fueron fundamentales para el éxito de este reporte de caso

Influence of the conditioning technique of a lithium disilicate vitroceramic

Introduction: Lithium disilicate reinforced glass ceramics are materials that require good adhesion to ensure clinical success. Objective: To evaluate the bond strength of resin cements to lithium-disilicateenhanced vitroceramics using different cleaning techniques of recently conditioned ceramics. Material and methods: Twelve ceramic discs (IPS Empress II) were made and inserted into PVC pipes using acrylic resin. The ceramic surface was designed and submitted to a 10% hydrofluoric acid conditioning process for 20s. Then, the specimenswere divided into 3 groups (n = 16) according to the cleaning techniques of recently conditioned ceramics: 1) control - conventional technique (no cleaning after the conditioning process); 2) application of 37% phosphoric acid for 20s; 3) 90% ethyl alcohol bath in a ultrasound tub for 4 min. After cleaning, the silane agent was applied for 1 minute and silicon matrices (1 mm in diameter x 1 mm in height) were made for further application of the resin cement (Vitique, DMG), which was handled according to the manufacturer’s instructions. Four cylinders were prepared on each ceramic surface. The specimens were storedin distilled water for 48 hours and subjected to the micro-shear test in a universal testing machine. After the micro-shear test, a failure analysis of the specimens was performed. Data were submitted to ANOVA (analysis of variance for a criterion) with a significance level of 5%. Results: There was no significant difference between groups (p > 0.05). Conclusion: the cleaning technique of the recently conditioned ceramics does not interfere with the resin/cement bond strength valuesIntroduction: Lithium disilicate reinforced glass ceramics are materials that require good adhesion to ensure clinical success. Objective: To evaluate the bond strength of resin cements to lithium-disilicateenhanced vitroceramics using different cleaning techniques of recently conditioned ceramics. Material and methods: Twelve ceramic discs (IPS Empress II) were made and inserted into PVC pipes using acrylic resin. The ceramic surface was designed and submitted to a 10% hydrofluoric acid conditioning process for 20s. Then, the specimenswere divided into 3 groups (n = 16) according to the cleaning techniques of recently conditioned ceramics: 1) control - conventional technique (no cleaning after the conditioning process); 2) application of 37% phosphoric acid for 20s; 3) 90% ethyl alcohol bath in a ultrasound tub for 4 min. After cleaning, the silane agent was applied for 1 minute and silicon matrices (1 mm in diameter x 1 mm in height) were made for further application of the resin cement (Vitique, DMG), which was handled according to the manufacturer’s instructions. Four cylinders were prepared on each ceramic surface. The specimens were storedin distilled water for 48 hours and subjected to the micro-shear test in a universal testing machine. After the micro-shear test, a failure analysis of the specimens was performed. Data were submitted to ANOVA (analysis of variance for a criterion) with a significance level of 5%. Results: There was no significant difference between groups (p > 0.05). Conclusion: the cleaning technique of the recently conditioned ceramics does not interfere with the resin/cement bond strength value

Influencia de la vibración sónica y el tipo de cemento en la fuerza de unión de los postes de fibra de vidrio después del envejecimiento.

Introduction: This study evaluated the influence of sonic vibration and thermocycling on the bond strength of fiberglass posts using conventional dual-cured and self-adhesive resin cements. Material and Methods: Ninety-six single-rooted endodontically treated teeth were divided randomly into eight groups according to the cement used (dual-cured or self-adhesive resin cement), use of sonic vibration during post accommodation, and aging conditions (24h in distilled water or 5,000 thermal cycles). The fiberglass posts (White Post DC1, FGM) were cleaned with alcohol, treated with silane and cemented with dual-cured (Allcem Core, FGM) or with self-adhesive resin cement (seT, SDI). For groups in which sonic vibration was used, the posts were accommodated, and sonic vibration was applied for 10 s using a special tip placed on top of the post (Sonic Smart Device, FGM). Pull-out tests were performed after storage in distilled water for 24h at 37°C or after thermocycling (5000 cycles, at 5°C and 55°C). The results were evaluated using three-way ANOVA and Tukey’s test (?=0.05). Results: Significant differences were not observed between the bond strengths of dual-cured (87.93±41.81 N) and self-adhesive cement (82.53±41.43 N). Bond strength for the sonic vibration groups (100.36±42.35 N) was significantly higher than for groups without sonic vibration (70.13±34.90 N). There were significant differences between specimens subjected to thermocycling (98.33±39.42 N) and those stored for 24h in distilled water (72.16±39.67 N). Conclusion: It can be concluded that both sonic vibration and thermocycling significantly improved bond strength of fiberglass posts with the two evaluated resin cements.Introducción: Este estudio evaluó la influencia de la vibración sónica y el termociclado en la fuerza de unión de los postes de fibra de vidrio utilizando cementos de resina autoadhesivos y de curado dual convencionales Material y Métodos: Se dividieron aleatoriamente noventa y seis dientes tratados endodónticamente de raíz única en ocho grupos según el cemento utilizado (cemento de resina de curado dual o autoadhesivo), el uso de vibración sónica durante la acomodación posterior y las condiciones de envejecimiento (24 horas agua destilada o 5.000 ciclos térmicos). Los postes de fibra de vidrio (White Post DC1, FGM) se limpiaron con alcohol, se trataron con silano y se cementaron con cemento de curado dual (Allcem Core, FGM) o con cemento de resina autoadhesivo (seT, SDI). Para los grupos en los que se utilizó vibración sónica, se acomodaron los postes y se aplicó la vibración sónica durante 10 s utilizando una punta especial colocada en la parte superior del poste (Sonic Smart Device, FGM). Las pruebas de extracción se realizaron después del almacenamiento en agua destilada durante 24 horas a 37ºC o después del termociclado (5000 ciclos, a 5ºC y 55ºC). Los resultados se evaluaron mediante ANOVA de tres vías y la prueba de Tukey (? = 0.05). Resultados: No se observaron diferencias significativas entre las resistencias de adhesión del cemento de curado dual (87,93 ± 41,81 N) y el cemento autoadhesivo (82,53 ± 41,43 N). La fuerza de unión para los grupos de vibración sónica (100,36 ± 42,35 N) fue significativamente mayor que para los grupos sin vibración sónica (70,13 ± 34,90 N). Hubo diferencias significativas entre los especímenes sometidos a termociclado (98,33 ± 39,42 N) y los almacenados durante 24 h en agua destilada (72,16 ± 39,67 N). Conclusión: Se puede concluir que tanto la vibración sónica como el termociclado mejoraron significativamente la fuerza de unión de los postes de fibra de vidrio con los dos cementos de resina evaluados

HÁBITOS ALIMENTARES E DE HIGIENE ORAL INFLUENCIANDO A SAÚDE BUCAL DA GESTANTE

This work was carried out in 2003 and objectified to investigate food habits and the disregard of the oral hygiene as riskfactors for caries development and periodontal illness in pregnant patients. 34 women were assessed, between 2 and 9 months of gestation,users of a Public Health Unit in Curitiba Metropolitan Area. The authors elaborated and applied, in all the sample, a protocol withodontogram for accomplishment of simplified examination, and presented questions on food habits and oral hygiene. The results shoed that56% of the pregnant had caries, 44% had poor hygiene and 56% did not use dental floss. Low frequency to the dentist’s was 77%, and isdemonstrated by the index of calculation of 56%. From the analyzed women, 100% used sugar to sweeten food and 53% presented highdaily frequency of sugar intake.Este trabajo tuvo como objetivo la investigación de los hábitos alimenticios y de la negligencia de la higiene bucal comofactores de riesgo para el desarrollo de caries y de enfermedades periodontales en pacientes gestantes. Fueron evaluadas 34 mujeres enel periodo de gestación, entre segundo y noveno mes, pacientes de la Unidad de Salud Pública. Fue elaborado y aplicado un protocolocon odontograma para la realización de un examen simplificado, que presentava preguntas sobre hábitos alimenticios y de salud bucal.Los resultados mostraron que 56% de las gestantes tenían caries, 44% tenían una higiene deficiente y 56% no utilizaban hilo dental. Unabaja frecuencia de consulta al dentista (77%) fue demostrada por el índice del cálculo de 56%. Todas las mujeres analizadas utilizabanazúcar para endulzar los alimentos y 53% presentaban una elevada frecuencia diaria de ingestión de este.Este trabalho foi desenvolvido em 2003 e teve como objetivo a investigação dos hábitos alimentares e da negligência dahigiene oral como fatores de risco para o desenvolvimento de cárie e doença periodontal em pacientes grávidas. Foram avaliadas 34mulheres em período de gestação, entre 2 e 9 meses, usuárias de uma Unidade de Saúde Pública da região metropolitana de Curitiba. Foielaborado e aplicado para a amostra, um instrumento de avaliação com um odontograma para realização de exame simplificado, e queapresentava perguntas sobre hábitos alimentares e de higiene bucal. Os resultados mostraram que 56% das gestantes tinham cárie, 44%possuíam uma higiene deficiente e 56% não utilizavam fio dental. A baixa freqüência de consulta ao dentista foi de 77%, e é demonstradapelo índice de cálculo de 56%. Das mulheres analisadas, 100% utilizavam o açúcar para adoçar os alimentos e 53% apresentavam umaalta freqüência diária de ingestão de açúcar

Influence of sonic vibration and cement type on the bond strength of fiberglass posts after aging.

Introduction: This study evaluated the influence of sonic vibration and thermocycling on the bond strength of fiberglass posts using conventional dual-cured and self-adhesive resin cements. Material and Methods: Ninety-six single-rooted endodontically treated teeth were divided randomly into eight groups according to the cement used (dual-cured or self-adhesive resin cement), use of sonic vibration during post accommodation, and aging conditions (24h in distilled water or 5,000 thermal cycles). The fiberglass posts (White Post DC1, FGM) were cleaned with alcohol, treated with silane and cemented with dual-cured (Allcem Core, FGM) or with self-adhesive resin cement (seT, SDI). For groups in which sonic vibration was used, the posts were accommodated, and sonic vibration was applied for 10 s using a special tip placed on top of the post (Sonic Smart Device, FGM). Pull-out tests were performed after storage in distilled water for 24h at 37°C or after thermocycling (5000 cycles, at 5°C and 55°C). The results were evaluated using three-way ANOVA and Tukey’s test (α=0.05). Results: Significant differences were not observed between the bond strengths of dual-cured (87.93±41.81 N) and self-adhesive cement (82.53±41.43 N). Bond strength for the sonic vibration groups (100.36±42.35 N) was significantly higher than for groups without sonic vibration (70.13±34.90 N). There were significant differences between specimens subjected to thermocycling (98.33±39.42 N) and those stored for 24h in distilled water (72.16±39.67 N). Conclusion: It can be concluded that both sonic vibration and thermocycling significantly improved bond strength of fiberglass posts with the two evaluated resin cements.Introducción: Este estudio evaluó la influencia de la vibración sónica y el termociclado en la fuerza de unión de los postes de fibra de vidrio utilizando cementos de resina autoadhesivos y de curado dual convencionalesMaterial y Métodos: Se dividieron aleatoriamente noventa y seis dientes tratados endodónticamente de raíz única en ocho grupos según el cemento utilizado (cemento de resina de curado dual o autoadhesivo), el uso de vibración sónica durante la acomodación posterior y las condiciones de envejecimiento (24 horas agua destilada o 5.000 ciclos térmicos). Los postes de fibra de vidrio (White Post DC1, FGM) se limpiaron con alcohol, se trataron con silano y se cementaron con cemento de curado dual (Allcem Core, FGM) o con cemento de resina autoadhesivo (seT, SDI). Para los grupos en los que se utilizó vibración sónica, se acomodaron los postes y se aplicó la vibración sónica durante 10 s utilizando una punta especial colocada en la parte superior del poste (Sonic Smart Device, FGM). Las pruebas de extracción se realizaron después del almacenamiento en agua destilada durante 24 horas a 37ºC o después del termociclado (5000 ciclos, a 5ºC y 55ºC). Los resultados se evaluaron mediante ANOVA de tres vías y la prueba de Tukey (α = 0.05). Resultados: No se observaron diferencias significativas entre las resistencias de adhesión del cemento de curado dual (87,93 ± 41,81 N) y el cemento autoadhesivo (82,53 ± 41,43 N). La fuerza de unión para los grupos de vibración sónica (100,36 ± 42,35 N) fue significativamente mayor que para los grupos sin vibración sónica (70,13 ± 34,90 N). Hubo diferencias significativas entre los especímenes sometidos a termociclado (98,33 ± 39,42 N) y los almacenados durante 24 h en agua destilada (72,16 ± 39,67 N). Conclusión: Se puede concluir que tanto la vibración sónica como el termociclado mejoraron significativamente la fuerza de unión de los postes de fibra de vidrio con los dos cementos de resina evaluados