Impact of Nonsurgical Treatment of Asymptomatic Apical Periodontitis on the Oral Health-related Quality of Life: A Prospective Study

Introduction: The aim of this study was to evaluate the impact of nonsurgical root canal treatment (nRCT) and the healing of asymptomatic apical periodontitis (AAP) on the oral health-related quality of life (OHRQoL) in a Brazilian population. Materials and Methods: This prospective longitudinal observational study included 56 adults, in which 84 teeth with asymptomatic apical periodontitis underwent nonsurgical root canal treatment. Socio-demographic and medical data were collected; the primary outcome oral health-related quality of life was measured by the short form of the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out by Mann-Whitney U-test, and changes in the oral health-related quality of life scores post-treatment were estimated by Student t-test. Results: The mean age was 51.0±15.2 years, with 53.5% of females. Overall, nRCT significantly improved the OHRQoL (P<0.001, effect size=0.76). Gender (female) was associated with a higher OHRQoL after nRCT (P<0.05). OHIP-14 showed a significant reduction six months after root canal treatment compared to baseline scores. Conclusion: Present findings revealed that nonsurgical root canal treatment improved the oral health-related quality of life in patients with asymptomatic apical periodontitis

Spectrophotometric analysis of dental bleaching after bonding and debonding of orthodontic brackets

Abstract Introduction: The aim of this study was to evaluate the bleaching effect after aging sim- ulation in teeth submitted to bonding and debonding of orthodontic brackets. Materials and methods: For this study, 90 human premolars were selected, and randomly divided into 6 groups: control, bleaching, and other 4 groups submitted to bleaching after bonding and debonding brackets using different methods. Color measurement of sample through the CIE L*a*b* system was performed in three moments: T1 – after brackets debonding, T2 – after staining cycling, and T3 – after bleaching. For evaluation of results among the components L*, a* and b*, the two criteria analysis of variance and the multiple comparison Tukey test (p < 0.05) were used. Results: Statistically significant difference was observed among the groups submitted to brackets bonding and debonding through self-conditioning adhesive system and tungsten drill, also the con- trol and bleaching groups between the moments T1 e T2. Conclusion: Bonding and debonding brackets methods tested in this study showed influence on the sample color change, and after the tooth bleaching process, only the group without brackets previous bonding achieved the color value presented before the staining and aging of samples in the brackets absence

Pharmacological management of postoperative pain in dentistry : a review

Introdução: A dor ocorre por um processo inflamatório e apresenta diferentes intensidades em função de fatores como o tipo e a duração do procedimento odontológico. O controle da dor pós-operatória dá-se por meio do uso de medicamentos, escolhidos por causa dos seus sítios de ação, do tipo de efeito esperado, da duração do efeito e de características individuais do paciente. Outro método é a realizaçãode analgesia preventiva, utilizando medicamentos previamente aos procedimentos para prevenir ou diminuir a sensibilização nervosa no pós-operatório. Objetivos: Revisar e discutir as diferentes classes de medicamentos disponíveis e suas associações para controle da dor pós-operatória. Revisão da literatura: Os medicamentos analisados foram os corticosteroides e anti-inflamatórios não esteroides (Aines), os analgésicos opioides e não opioides, a associação desses medicamentos e aqueles utilizados para analgesia preemptiva. Resultados: Para dor leve e moderada, recomenda-se o uso de um Aine, associado ou não, a um analgésico não opioide. Para dor intensa, pode ser indicada a associação de um Aine a um analgésico opioide. Para analgesia preemptiva, sugere-se o uso de corticosteroide cerca de 1 hora antes do procedimento. Conclusão: A combinação de dois medicamentos parece alcançar melhores resultados em comparação ao uso de um individualmente, mesmo que seja uma associação ou um opioide. A analgesia preemptiva, pelo uso de corticosteroide em dose única previamente aos procedimentos, contribui para o controle efetivo da dor, bem como o uso de anestésico local a longo prazo.Introduction: Pain occurs through an inflammatory process with different intensities due to factors such as the type and duration of the dental procedure. The control of postoperative pain occurs through the use of drugs, chosen due to their sites of action, type of effect expected, effect duration, and the individual characteristics of the patient. Another method is to perform preemptive analgesia, using drugs before the procedures to prevent or decrease postoperative nerve sensitization. Objectives: To report and discuss the different classes of medication available and which associations are the most recommended for use in the dental office. Literature review: The drugs analyzed were the corticosteroids and non-steroidal anti-inflammatory drugs (NSAID), opioid and non-opioid analgesics, the association of these drugs, and those used for preemptive analgesia. Results: For mild and moderate pain, the use of an NSAID associated or not with a non-opioid analgesic is recommended, and, when facing severe pain, the association of an NSAID with an opioid analgesic may be recommended. For preemptive analgesia, it is recommended the use of a corticosteroid about 1 hour before the procedure. Conclusion: The combination of two drugs seems to achieve better results compared to the use of one individually, even if this is an association or an opioid. Preemptive analgesia, through the use of a corticosteroid in a single dose, previously to the procedures contributes in the effective control of pain, as well as the use of a long-term local anesthetic

Incidence of Dentinal Defects and Vertical Root Fractures after Endodontic Retreatment and Mechanical Cycling

Introduction: The aim of this study was to evaluate the incidence of dentinal defects and vertical root fractures (VRFs) after endodontic retreatment and mechanical cycling (MC). Methods and Materials: Two hundred mandibular premolars were selected. Forty teeth were left unprepared (control group). The remaining 160 root canals were prepared with ProTaper instruments and filled by using two different techniques [eighty with lateral compaction (LC) and eighty with single-cone (SC)]. Forty canals from each group (LC and SC) received no further treatment. The remaining eighty teeth were divided into two groups (LCR and SCR) (n=40) in order to undergo the removal of the root filling, re-preparation and refilling with lateral compaction and single-cone, respectively. All of the teeth were subjected to MC (1,000,000 cycles, 130 N, 2.2 Hz and 37°C). The roots were sectioned at 3, 6 and 9 mm from the apex and observed under 20× magnification. The defects were classified as: no defect, VRF and other defects. Statistical analysis was performed using the Fisher’s Exact test and the Chi-Squared tests (α=0.05). Results: MC alone did not promote any other defects or VRFs. Experimental groups presented higher dentinal defects than the control group (P=0.021). Retreatment groups did not present a higher amount of dentinal defects than the groups that were subjected to the first treatment (P&gt;0.05). Conclusion: Endodontic treatment and retreatment, regardless of the filling technique and MC, did not influence the occurrence of dentinal defects or VRFs in the human premolars.Keywords: Defects; Endodontics; Retreatment; Root Cana

Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

OBJECTIVE: This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. MATERIAL AND METHODS: Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. RESULTS: The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>;0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>;0.05). CONCLUSION: Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop

Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial

Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. Objective: The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. Material and Methods: This study included 26 patients who sought emergency care in a Brazilian dental school. The patients were randomly divided into two groups: Co/Ac - oral prescription of codeine (30 mg) plus acetaminophen (500 mg), every 4 h, for 3 days or Tr/Ac - oral prescription of tramadol hydrochloride (37.5 mg) plus acetaminophen (500 mg) on the same schedule. Two factors were evaluated: (1) pain scores recorded by the patients in a pain diary 6, 12, 24, 48, and 72 h after treatment, using the Visual Analogue Scale; and (2) the occurrence of adverse effects. Results: In both groups, there was a reduction in pain scores over time. For the Co/Ac group, there was a significant reduction in the scores 12, 24, 48, and 72 hours after treatment (

Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess : a randomized clinical trial

Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. Objective: The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. Material and Methods: This study included 26 patients who sought emergency care in a Brazilian dental school. The patients were randomly divided into two groups: Co/Ac - oral prescription of codeine (30 mg) plus acetaminophen (500 mg), every 4h, for 3 days or Tr/Ac - oral prescription of tramadol hydrochloride (37.5 mg) plus acetaminophen (500 mg) on the same schedule. Two factors were evaluated: (1) pain scores recorded by the patients in a pain diary 6, 12, 24, 48, and 72 h after treatment, using the Visual Analogue Scale; and (2) the occurrence of adverse effects. Results: In both groups, there was a reduction in pain scores over time. For the Co/Ac group, there was a significant reduction in the scores 12, 24,48, and 72 hours after treatment (P0.05), i.e.,both treatments were effective in controlling pain caused by APA; however, the combination of Tr/Ac caused more adverse reactions as two patients had to stop using the medication. Conclusion: This study suggests that, considering both analgesic efficacy and safety, the combination of codeine and acetaminophen is more effective to control moderate to severe pain from acute periradicular abscesses

Reciprocating and rotatory NiTi instruments used for root canal preparation of primary teeth: a systematic review and meta-analysis

Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments. Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25-0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98-0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies). Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth