Postoperative pain after endodontic treatment of necrotic teeth submitted to large apical preparation using oscillatory kinematics

Regardless of the technique applied for chemomechanical preparation, postoperative pain is a very relevant matter in endodontics. Objective: To evaluate postoperative pain after endodontic treatment of necrotic teeth submitted to large apical preparatio

Mandibular First Molar with Six Canals: Case Report of Radix Entomolaris and Middle Mesial Canal

The purpose of this article is to report a successful endodontic treatment of a mandibular first molar with six canals; three root canals in the mesial root, two root canals in the distal root, and one radix entomolaris. The incidence of two anatomical variations presented in this report, middle mesial canal and radix entomolaris, is generally low. Knowledge of the internal anatomy of the root canals and their possible variations, and use of magnification, such as the operating microscope or loupes, can increase the chances of finding additional canals, contributing to the success of endodontic treatment

Capacidade seladora proporcionada por alguns materiais quando utilizados em perfurações na região de furca de molares humanos extraídos

It has been evaluated in vitro the sealing capacity of MTA-Angelus, ProRoot-MTA, Super-EBA and MBP-c when sealing furcal perforations of extracted human molars. The experiment took place with materials both isolated as well as in association with a plaster of Paris matrix applied at the bottom of the perfuration path. The materials sealing capacity was analyzed by dye leakage of rhodamine B 0,2%.The statistical analysis revealed that when isolated and tested (without the matrix), the cement MBP-c presented the smallest coefficient of marginal leakage, followed by the Super-EBA. There was a statistical significance between those and the cements ProRoot - MTA e MTA - Angelus (pAvaliou-se, in vitro, a capacidade seladora, do MTA-Angelus, ProRoot-MTA, Super-EBA e MBP-c, quando utilizados para selar perfurações na região de furca de molares humanos extraídos; quando aplicados isoladamente ou em associação com uma matriz de gesso Paris, aplicada no fundo do trajeto da perfuração. O selamento produzido pelos materiais foi analisado por meio da infiltração do corante rhodamine B 0,2%. A análise estatística aplicada aos dados obtidos demonstrou que, quando utilizado isoladamente (sem matriz), o cimento MBP-c apresentou os menores índices de infiltração marginal, seguido pelo Super-EBA, apresentando diferença estatística significante (p< 0,001) entre esses e os cimentos ProRoot-MTA e MTA-Angelus. Na presença da matriz, o cimento MBP-c também foi superior, havendo diferença estatística significante (

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

Objective: To analyze possible correlations among tubular dentine cement penetration, adhesiveness and apical leakage in fillings performed with gutta percha and an endodontic cement based on epoxy amine resin. Material and Methods: Sixty similar, extracted human mandibular central incisors were irrigated, instrumented and filled following the same protocol. First, apical leakage was quantified by fluid filtration tests. Then, these same specimens were sectioned for analysis of tubular dentine cement penetration and the middle thirds were submitted to push-out tests to analyze the adhesiveness of the fillings. Results: In brief, the means and standard deviations with a confidence interval of 95% were as follows: tubular dentine cement penetration (8.875±4.540), adhesiveness (4.441±2.683) and apical leakage (0.318±0.215). The data were confronted using the Pearson's test (P>;0.05), and it was possible to prove that there was no correlation between (1) tubular dentine cement penetration and apical leakage (r2: 0.08276), (2) tubular dentine cement penetration and adhesiveness (r2: -0.2412) and (3) adhesiveness and apical leakage (r2: 0.1340). Conclusion: After analysis of these data, it could be observed that there exists no correlation among the variables analyzed in this study

Regenerative Endodontic Treatment of a Traumatized Immature Necrotic Permanent Incisor: A Case Report

The current case report documents the clinical approach adopted for a traumatized immature necrotic permanent upper left central incisor after a bike accident. The treatment involved regenerative endodontic procedures (REPs) using “High Plasticity Mineral Trioxide Aggregate” (MTA Repair HP) as a cervical barrier over blood clot. The preservation included three years of follow-up appointments of clinical evaluations and periapical digital radiographs. Cone beam computer tomography (CBCT) was taken at six and thirty-six months for the evaluation of root development

Postoperative Endodontic Pain after Treatment Using XP-endo Finisher: A Randomized Clinical Trial

Introduction: This randomized clinical trial aimed to determine whether the XP-endo finisher combined with or without foraminal enlargement has any significant effect on the incidence and intensity of postoperative pain in necrotic pulps. Materials and Methods: Clinical pain levels were measured after 6, 12, 24, 48, and 72 hours and at 7 postoperative days. All treatments were performed by an endodontist in a single visit. One hundred and twenty patients were included. All patients had a single tooth treated. The patients were divided into four groups: No FE (None Foraminal Enlargement) (n=30), FE (Foraminal Enlargement) (n=30), No FE+XPF (None Foraminal Enlargement+XP-endo Finisher) (n=30) and XPF+FE (XP-endo Finisher and Foraminal Enlargement) (n=30). The canals were irrigated with sodium hypochlorite, shaped using WaveOne Gold Medium file, and then filled by using a matching single cone and AH-Plus sealer. The cavity was filled using glass ionomer cement. Pain intensity was assessed using the visual analog scale. The data were analyzed with the ANOVA and Games-Howell test. The significance level was 5%. Results: The XPF+FE group experienced a higher level of pain, being classified on the visual analog scale as moderate for 48 postoperative hours and mild for 7 postoperative days (P&lt;0.05). In the other groups, the pain was mild, only with different time intervals (P&gt;0.05). Conclusions: Foraminal enlargement associated with XP-endo Finisher may cause moderate postoperative pain

Maintenance of Pulp after Horizontal Root Fractures in Three Maxillary Incisors: A Thirteen-Year Evaluation

This case report documents the clinical approach adopted for three upper incisors with horizontal root fracture in the middle or cervical third. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 13 years of follow-up.Keywords: Connective Tissue Cells; Dental Pulp; Tooth Fracture

Management of Dental Intrusion and Lateral Luxation: Case Report with 10 Years Follow-up

This case report documents the clinical approach adopted for two maxillary incisors with intrusion and lateral luxation trauma. The proposed procedures involved reposition of both teeth, one of them with surgical extrusion and endodontic procedure for both, with 10 years of follow-up.Keywords: Intrusion; Lateral Luxation; Multiple Traum

Management of Multiple Dental Trauma: Case Report with Eight-Year Follow-up

This case report documents the clinical approach adopted for two maxillary incisors with intrusion and horizontal root fracture in the middle third after trauma. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 8 years of follow-up.Keywords: Intrusion; Multiple Trauma; Tooth Fracture

SEALING CAPACITY AND MARGINAL ADAPTATION BY SOME MATERIALS WHEN UTILIZED UNDER FURCATION PERFORATIONS OF HUMAN MOLARS

Foram analisadas a capacidade seladora e a adaptação marginal in vitro, de alguns materiais quando utilizados em perfurações na região de furca. Utilizou-se cento e quatro dentes molares humanos extraídos superiores e/ou inferiores, dos quais oitenta e oito foram usados para analisar o selamento e dezesseis para a adaptação marginal dos materiais seladores utilizados sob M.E.V. Os dentes tiveram suas coroas eliminadas em um nível logo acima do assoalho da câmara pulpar, e as raízes, logo abaixo da região de furca. Em seguida, realizou-se a impermeabilização de toda a superfície externa dos espécimes, e a sua inclusão em uma base de silicona pesada. Ao centro do assoalho de cada espécime, foi realizada uma perfuração com 1,4 mm de diâmetro. Frontalmente às perfurações, na base de silicona, foram realizadas depressões onde foram posicionadas, imediatamente antes da obturação, bolinhas de algodão padronizadas umedecidas com água destilada. Em cada grupo, formou-se 2 subgrupos, um recebendo uma matriz de gesso Paris e o outro não. As obturações das perfurações foram, então, realizadas com os seguintes materiais: Grupo I (MTA Angelus), Grupo II (ProRoot MTA), Grupo III (Super-EBA), Grupo IV (MBP-c). Posteriormente, os espécimes foram imersos em solução corante rhodamine B 0,2% a 37°C, por 48 horas. Após lavagem dos espécimes e remoção da impermeabilização, os mesmos foram seccionados longitudinalmente, expondo-se as perfurações e as possíveis marcas de infiltração. A leitura da infiltração marginal, foi realizada por meio de um microscópio óptico, utilizando-se de escores numéricos 0, 1, 2 e 3, para sua quantificação. Para visualização da adaptação marginal dos materiais obturadores às paredes dentinárias, os espécimes foram submetidos à mesma metodologia descrita anteriormente, exceto quanto à impermeabilização da superfície externa e a imersão na solução corante. Após a presa dos cimento os espécimes, foram submetidos ao M.E.V., obtendo-se fotomicrografias com aumento de 50 e 200X. Os resultados referentes à infiltração marginal, foram submetidos aos testes estatísticos, permitindo as seguintes conclusões: Quando utilizado isoladamente (sem a matriz), o cimento MBP-c apresentou os menores índices de infiltração marginal, seguido pelo Super-EBA, havendo diferença estatística entre esses e os cimentos ProRoot MTA e MTA Angelus (p<0,001). Na presença da matriz de gesso Paris, o cimento MBP-c apresentou os menores índices de infiltração marginal, havendo diferença estatística entre esse e os cimentos ProRoot MTA e MTA Angelus (p<0,05); A matriz de gesso Paris influenciou negativamente, com diferenciação estatística (p<0,05), o selamento produzido pelos cimentos Super-EBA e o MBP-c (p<0,05); A utilização da matriz de gesso Paris evitou o extravasamento dos materiais seladores; Foi observada uma relação direta entre a adaptação marginal e a capacidade de selamento do material.This paper analyses the sealing capacity and the marginal adaptation in vitro of a few materials when utilized under furcal perforations. The experiment utilized a hundred and forty four extracted human mandibular and maxillary molars. From the total amount, eighty-eight were utilized for checking the sealing and sixteen for checking the marginal adaptation under M.E.V. The teeth had its crowns seccionated and removed in an upper level close to the top of the floor of the pulp chamber, and the roots close to the bottom of the furcal area. Following that , there was an impermeabilization of the whole external surface of the specimens, and the inclusion in a heavy silicon base. There was a 1.4mm perforation to the center of the floor of each specimen. Up front to the perforation, in the silicon base, depressions were made and little cotton pellets moisturized with distilled water were positioned before the obturation. In each group, subgroups were created. One receiving a Plaster of Paris matrix and the other no. The obturation of perforations were then, made with the following materials: Group I (MTA Angelus), Group II (ProRoot MTA), Group III (Super-EBA), Group IV (MBP-c). After that, the specimens were submerged in a rhodamine B 0,2% solution at 37°C, for 48 hours. After cleaning the roots and removing the impermeabilization, they were seccionated in the axis direction, thus revealing the perforations and possible leakage marks. The reading of the marginal adaptation was performed by an optical microscope utilizing numerical scores 0, 1, 2 e 3. In order to visualize the marginal adaptation of the obturation materials in regards to the dentinal walls, the specimens were introduced to the same methodology as described before, except for the steps of impermeabilization of the external surface and the submerging in dye. After cement placement, the M.E.V was applied and photos with 50X e 200X were obtained. The results regarding the marginal infiltration were statistically tested. Thus allowing the following conclusions: when isolated and tested (without the matrix), the cement MBP-c presented the smallest coefficient of marginal leakage, followed by the Super-EBA. There was a statistical significance between those and the cements ProRoot MTA e MTA Angelus (p<0,001). In the presence of the Plaster of Paris matrix, the cement MBP-c presented the smallest levels of marginal leakage, having statistical significance between those and the cements ProRoot MTA e MTA Angelus (p<0,05); There was a significant statistical variation, in the marginal leakage of the cements due to the presence of the Plaster of Paris matrix to the Super-EBA and to MBP-c (p<0,05). The utilization of the Plaster of Paris matrix avoided the leakage of the sealing materials. A direct relationship could be found between the marginal adaptation and the material sealing capacit