SUCCESS RATE OF ENDODONTIC TREATMENTS PERFORMED BY UNDERGRADUATE STUDENTS OF THE UNIVERSITY OF SOUTHERN SANTA CATARINA

Introduction: Apical periodontitis is an inflammatory disease of the periradicular tissues caused by microbial(re)contamination of the root canal system. Due to its direct relationship to the quality of endodontictreatment, it is extremely important to carry out longitudinal and cross-sectional studies, following-uptreatments carried out in universities. Aim: To evaluate the success rate of endodontic treatments performedby undergraduate students of the University of Southern Santa Catarina - UNISUL, Pedra Branca, betweenAugust 2015 and July 2017.Materials and Methods: One hundred twenty-four patients with endodontic treatment were contacted. Ofthese, only 27 attended for treatment follow-up, adding up to a total of 32 treatments analyzed. All teeth wereclinically and radiographically evaluated, and the potential indicators related to endodontic treatment successor failure were analyzed. The frequencies of each criterion were calculated, and the data analyzed using theChi-Square test (α = 5%).Results: 9 cases (28.13%) were considered failure, either because they were associated with symptoms or becausethere was a periapical alteration. In addition, 88.88% of the failure cases had temporary restorative material.Association was observed only between the number of root canals and symptoms (P = 0.049). Two of the 3treated teeth with multiple root canals showed symptoms at the follow-up. The endodontic success rate was71.87%.Conclusion: The success rate of the 32 endodontic treatments performed by undergraduate students fromUNISUL was 71.87%

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

Influence of the apical working length on root canal disinfection and bacterial extrusion

The aim of this study was to evaluate, ex vivo, the influence of the apical working length on disinfection of the root apical third and bacterial extrusion. After the formation of a Enterococcus faecalis 7-day-old biofilm in 24 mesial root canals of extracted mandibular molars, the roots were randomly divided into 2 groups (n = 10), according to the apical working length, performed with Reciproc R25 instruments, and irrigation with sterile 0.85% saline: G1) 1 mm short of the apex, with Buchanan’ patency (WL / -1mm); and G2) in the apical foramen (WL / 0). Four root canals served as control to verify the biofilm formation. After root canal preparation, the remaining biofilm adhered to the walls of the apical third was removed by sonication, aliquots of the bacterial suspension were plated and decontamination was evaluated by counting colony-forming units (CFU). The bacterial extrusion was evaluated by plating aliquots of the irrigating solution that overflowed through the apical foramen during root canal preparation, with subsequent CFU counting. The data were analyzed using Kruskal-Wallis and post hoc Dunn tests (α = 5%). Instrumentation at WL / 0 promoted better decontamination of the apical third (26 ± 20.62 CFU / mL), compared to instrumentation at WL / -1mm (48.75 ± 44.40 CFU / mL) (P = 0.044). There was no significant difference between groups when bacterial extrusion was analyzed (P = 0.079). Reciprocating preparation performed at the apical foramen promoted better decontamination of the root canal apical third. Both apical working lengths extruded similar amounts of bacteria.O objetivo deste estudo foi avaliar, ex vivo, a influência do nível apical de preparo na desinfecção do terço apical do canal radicular e na quantidade de bactérias extruídas. Após a formação de um biofilme de 7 dias de Enterococcus faecalis em 24 canais de raízes mesiais de molares inferiores humanos extraídos, as raízes foram divididas aleatoriamente em 2 grupos (n=10), de acordo com o nível apical do preparo, realizado com o instrumento Reciproc R25, e irrigação com soro fisiológico estéril 0,85%: G1) 1 mm aquém do forame apical, com patência de Buchanan [Comprimento de trabalho (CT)]/-1mm; e G2) no forame apical (CT/0). Quatro canais serviram como controle do experimento para comprovação da formação do biofilme. Após a modelagem, o biofilme remanescente aderido às paredes do terço apical do canal radicular foi removido por sonicação, alíquotas da suspensão bacteriana foram plaqueadas e a descontaminação avaliada por meio da contagem de unidades formadoras de colônias (UFCs). A extrusão de bactérias foi avaliada por meio de plaqueamento de alíquotas da solução irrigadora que extravasou pelo forame apical durante a modelagem, com posterior contagem de UFCs. Os dados foram analisados pelos testes Kruskal-Wallis e post hoc Dunn (α = 5%). A instrumentação no CT/0 promoveu melhor descontaminação do terço apical do canal (26 ± 20,62 UFC/mL), comparada à instrumentação no CT/-1mm (48,75 ± 44,40 UFC/mL) (P = 0,044). Quanto à extrusão bacteriana, não foi evidenciada diferença significativa entre os grupos (P = 0,079). O preparo reciprocante realizado ao nível do forame apical promoveu melhor descontaminação do terço apical dos canais radiculares. Ambos os níveis de preparo extruíram quantidades semelhantes de bactérias

Do Ultraconservative Access Cavities Hinder Endodontic Reintervention in Mandibular Incisors? A Laboratory Investigation

This study assessed the influence of the type of endodontic access cavity on endodontic reintervention. Twenty mandibular central incisors were distributed into two groups (n = 10): TradAC group—traditional access cavities and UltraAC.Inc group—ultraconservative access cavities. After endodontic access, the root canals were prepared and obturated by the single cone technique. The filling material was removed with the Reciproc R25 instrument, followed by reinstrumentation with the R40 instrument. Images acquisition of each root canal hemisection was performed in a stereomicroscope to quantify the amount of remaining filling material. The amount of remaining filling material attached to the root canal walls was expressed in square millimeter (mm2). Data were statistically analyzed (one-way ANOVA and post hoc Student’s t-tests). There was no statistically significant difference between TradAC and UltraAC.Inc groups (p>0.05). None of the tested endodontics’ access showed root canal walls completely free of filling material. Ultraconservative access cavities in mandibular incisors had no negative impact on the filling material removal

ENDODONTIC TREATMENT OF MANDIBULAR MOLAR WITH SUPPLEMENTARY ROOT: CASE REPORT

A proper knowledge of the dental anatomy and its variations is one of the factors that determine the success of endodontic therapy. The first permanent lower molar may have a third root, when located in the buccal region. It is named radix paramolaris and, when located at the lingual region, radix entomolaris. The incidence of this anatomical variation is controversial (1 to 33%). The aim of this case report was to describe the endodontic treatment of a mandibular first molar with a supplementary root (disto-lingual). A 29-year-old male patient complaining of moderate to severe pain in tooth 46 was diagnosed with acute irreversible pulpitis. During the initial radiographic examination, the presence of the additional root was observed. Mechanical preparation was performed with SRF Sequence (MK Life) and ProDesign Logic 2 (Easy Equipment) rotary instruments. Irrigation was performed with 2% chlorhexidine gel and saline solution. The accessory root canal was prepared with a ProDesign Logic 2 rotary file number 25/.04. Root canal obturation was performed with epoxy resin-based cement (AH Plus-Dentsply) by the single-cone technique and hydraulic compression. The treatment was performed in single-session. Afterwards, the tooth was restored with composite resin. Patient is asymptomatic and under clinical and radiographic follow-up. Knowing this unusual root morphology of the mandibular first molar was essential to perform a proper radiographic examination. The inability to recognize and treat this accessory root canal may lead to endodontic failure

Ginkgo biloba in the Aging Process: A Narrative Review

Neurodegenerative diseases, cardiovascular disease (CVD), hypertension, insulin resistance, cancer, and other degenerative processes commonly appear with aging. Ginkgo biloba (GB) is associated with several health benefits, including memory and cognitive improvement, in Alzheimer’s disease (AD), Parkinson’s disease (PD), and cancer. Its antiapoptotic, antioxidant, and anti-inflammatory actions have effects on cognition and other conditions associated with aging-related processes, such as insulin resistance, hypertension, and cardiovascular conditions. The aim of this study was to perform a narrative review of the effects of GB in some age-related conditions, such as neurodegenerative diseases, CVD, and cancer. PubMed, Cochrane, and Embase databases were searched, and the PRISMA guidelines were applied. Fourteen clinical trials were selected; the studies showed that GB can improve memory, cognition, memory scores, psychopathology, and the quality of life of patients. Moreover, it can improve cerebral blood flow supply, executive function, attention/concentration, non-verbal memory, and mood, and decrease stress, fasting serum glucose, glycated hemoglobin, insulin levels, body mass index, waist circumference, biomarkers of oxidative stress, the stability and progression of atherosclerotic plaques, and inflammation. Therefore, it is possible to conclude that the use of GB can provide benefits in the prevention and treatment of aging-related conditions