Long-term cytotoxic effects of contemporary root canal sealers

Objectives The aim of the present study was to investigate the effects of root canal sealers on the cytotoxicity of 3T3 fibroblasts during a period of 5 weeks. Material and Methods Fibroblasts (3T3, 1×105 cells per well) were incubated with elutes of fresh specimens from eight root canal sealers (AH Plus, Epiphany, Endomethasone N, EndoREZ, MTA Fillapex, Pulp Canal Sealer EWT, RoekoSeal and Sealapex) and with elutes of the same specimens for 5 succeeding weeks after immersing in simulated body fluid. The cytotoxicity of all root canal sealers was determined using the MTT assay. Data were analyzed using ANOVA and Tukey's test. Results RoekoSeal was the only sealer that did not show any cytotoxic effects (p<0.05). All the other tested sealers exhibited severe toxicity initially (week 0). MTA Fillapex remained moderately cytotoxic after the end of experimental period. Toxicity of the other tested sealers decreased gradually over time. The evaluated root canal sealers presented varying degrees of cytotoxicity, mainly in fresh mode. Conclusions RoekoSeal had no cytotoxic effect both freshly mixed and in the other tested time points. MTA Fillapex was associated with significantly less cell viability when compared to the other tested root canal sealers

The Multidisciplinary Management of Avulsed Teeth: A Case Report

This paper reports multidisciplinary treatment of a dental trauma case to achieve a favorable prognosis. A healthy 14-year-old girl reported avulsion of teeth 11 and 21 which had occurred three months earlier. The initial treatment consisting of replantation with a semi-rigid splint was performed in hospital. At presentation, the patient was still using the semi-rigid splint. The clinical examination revealed the presence of increased mobility in teeth 11 and 21, and absence of vitality in both. Radiographic examination showed the presence of inflammatory external root resorption in both teeth. The treatment proposed consisted of teeth extraction, a temporary prosthesis followed by adhesive prosthesis, and finally, implant surgery associated with porcelain crowns

Quantitative And Qualitative Analysis Of Microorganisms In Root-filled Teeth With Persistent Infection: Monitoring Of The Endodontic Retreatment.

The aim of this study was to investigate in vivo microorganisms detected in root-filled teeth with post-treatment apical periodontitis and quantify colony-forming units (CFU) during endodontic retreatment. Fifteen root-filled teeth had their previous gutta-percha removed and were randomly instrumented before being divided into three groups and medicated with either [Ca(OH)2 + 2% CHX gel], [Ca(OH)2 + 0.9% NaCl] or 2% CHX gel. Samples were taken after removal of gutta-percha (S1), after chemomechanical preparation using 2% CHX gel (S2), and after inter-appointment dressing (S3) for 7 or 14 days later. Cultivable bacteria recovered from infected root canals at the three stages were counted and identified by means of culture and PCR assay (16S rDNA). Quantitative data were statistically analyzed by using Mann-Whitney test in which pairs of groups were compared (P < 0.05). CFU counts decreased significantly from S1 to S2 (P < 0.05). No significant difference was found between S2 and S3 (P = 0.3093) for all three experimental groups. Chemomechanical preparation and intra-canal dressing promoted significant median reductions of 99.61% and 99.57%, respectively, in the number of bacteria compared to S1 samples. A total of 110 cultivable isolates were recovered by culture technique from 32 different species and 7 different genera. Out of the 13 target species-specific primer of bacteria analyzed, 11 were detected during endodontic retreatment. The great majority of taxa found in post-treatment samples were Gram-positive bacteria, although Gram-negative bacteria were found by molecular methods. Moreover, our results showed that gutta-percha removal and chemomechanical preparation are effective for root canal disinfection, whereas additional intra-canal dressing did not improve disinfection.7302-

Prevalence of sport injuries during the 53th Regional Games in Franca (SP), Brazil

O objetivo do presente estudo foi investigar a prevalência, tipo e localização anatômica das lesões nos atletas durante os 53os Jogos Regionais de 2009. No total, 182 atletas participaram do estudo. A avaliação fisioterápica incluiu dados como local e tipo de lesão e modalidade esportiva. Os resultados mostraram que a média de idade, altura, peso e IMC foram respectivamente 23 anos (±5,9), 1,73 m (±0,11), 71 kg (±14,22) e 24 kg/m² (±4). Proporcionalmente ao número de atletas, o handball foi a modalidade esportiva que apresentou maior número de lesões (4,25%), seguidos pelos atletas de futsal (3,70%), de basquete (2,48%), de voleibol (1,72%) e de futebol (1,63%). O tipo de lesão mais comum foi entorse com 29,7% dos casos (n=54), ocorridos com maior frequência em jogadores de futebol; seguido de contratura - 26,9% (n=49), ocorridos com maior frequência em jogadores de basquete; e contusão - 25,8% (n=47), ocorridos com maior frequência em jogadores de handball e futsal. O tipo de lesão mostrou significativa associação com o tipo de esporte praticado pelo atleta (p=0,0016). Os membros inferiores representaram 71,4% de todas as lesões, sendo o joelho o local mais acometido, com 23,1% dos casos, seguido do tornozelo - 18,1%, coxa - 17%, perna - 10,4% e coluna vertebral - 9,9%. Programas de prevenção para os atletas devem ser desenvolvidos e implantados a fim de reduzir o número de lesões em competições esportivas como os Jogos Regionais.The purpose of this study was to perform a survey about the prevalence, type and location of the injuries occurred in athletes of different modalities during the 53th Regional Games held in 2009. A total of 182 injured athletes being treated at the physical therapy clinic were included. Physical Therapy evaluation was performed to determine the anatomic location and type of injury, as well the sport modality. The results showed that mean age, height, weight and BMI were 23 years (±5.9), 1.73 m (±0.11), 71 kg (±14.22) and 24 kg/m² (±4) respectively. Proportionality to the number of athletes, handball athletes presented with higher number of injuries (4.25%), followed by indoor soccer players (3.7%), basketball (2.48%), volleyball (1.72%) and soccer (1.63%). The most common type of injury were sprains with 29.7% of cases (n=54) and mostly from soccer players; followed by contracture - 26.9% (n=49), mostly from basketball players; and contusion -25.8% (n=47), mostly from handball and indoor soccer players. The type of injury showed a significant association with the sports modality (p=0.0016). The lower limbs accounted for 71.4% of all injuries including knee (23.1%), ankle (18.1%), thigh (17.0%), leg (10.4%) and spine (9.9%). Preventive actions to avoid athletes' injury should be implemented in order to reduce the number of injuries in sports competitions such as in the Regional Games

Evaluation of the biocompatibility of root canal sealers using subcutaneous implants

The purpose of this study was to evaluate in vivo the biocompatibility of Endométhasone, Pulp Canal Sealer EWT and AH-Plus root canal sealers after implantation in rat connective tissue. Twenty-four Wistar-Furth rats were used. Polyethylene tubes were filled with the sealers and implanted into specific dorsal subdermal tissue sites of the rats. Implants were removed after 3, 7 and 30 days, fixed and processed for glycol methacrylate-embedding technique to be examined microscopically. On the 3rd day, there was a mild inflammatory reaction to Pulp Canal Sealer EWT implants, but a severe response to the other sealers with presence of acute inflammatory cells. On the 7th day, tissue organization was more evident with attenuation of the inflammatory reaction, especially for the AH-Plus implants. On the 30th day, connective tissue with few inflammatory cells was observed in contact with all sealer implants. In this time interval, the tissue in contact with Pulp Canal Sealer EWT implants was more organized, while the tissue close to Endométhasone and AH-Plus implants showed a mild persistent inflammatory reaction and had similar results to each other. In conclusion, the sealers had a similar pattern of irritation, which was more severe in the beginning and milder with time, in such a way that all sealers showed a persistent mild reaction. Pulp Canal Sealer EWT yielded better tissue organization than Endométhasone and AH-Plus, which, in turn, showed similar results to each other

Monitoring the effectiveness of root canal procedures on endotoxin levels found in teeth with chronic apical periodontitis

Objective: The aim of this study was to monitor the effectiveness of root canal procedures by using different irrigants and intracanal medication on endotoxin levels found in root canals of teeth with chronic apical periodontitis. Material and Methods: Thirty root canals of teeth with pulpal necrosis associated with periapical lesions were selected and randomly divided into groups according to the irrigants used: GI - 2.5% NaOCl, GII - 2% chlorhexidine (CHX) gel, and GIII - saline solution (SS) (all, n=10). Samples were collected with sterile/apyrogenic paper points before (S1) and after root canal instrumentation (S2), after use of 17% ethylenediaminetetraacetic acid (EDTA) (S3), and after 30 days of intracanal medication (Ca(OH)2+SS) (S4). A turbidimetric kinetic Limulus Amebocyte Lysate assay was used for endotoxin measurement. Results: Endotoxins were detected in 100% of the root canals investigated (30/30), with a median value of 18.70 EU/mL. After S2, significant median percentage reduction was observed in all groups, irrespective of the irrigant tested: 2.5% NaOCl (99.65%) (GI), 2% CHX (94.27%) (GII), and SS (96.79%) (GIII) (all p;0.05). Intracanal medication for 30 days was able to significantly reduce residual endotoxins: 2.5% NaOCl (90%) (GI), 2% CHX (88.8%) (GII), and SS (85.7%) (GIII,

Push-out bond strength of MTA HP, a new high-plasticity calcium silicate-based cement

This study was designed to investigate the resistance to dislodgment provided by MTA HP, a new high-plasticity calcium silicate-based cement. Biodentine and White MTA Angelus were used as reference materials for comparison. Three discs 1 ± 0.1 mm thick were obtained from the middle third of the roots of 5 maxillary canines. Three 0.8-mm-wide holes were drilled on the axial surface of each root disc. Standardized irrigation was performed. Then the holes were dried with paper points and filled with one of the three tested cements. The filled dental slices were immersed in a phosphate-buffered saline (PBS) solution (pH 7.2) for 7 days before the push-out assessment. The Kruskal-Wallis test was applied to assess the effect of each endodontic cement on the push-out bond strength. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05. All specimens had measurable push-out values and no premature failure occurred. There were significant differences among the materials (p <0.05). The Biodentine specimens had the highest push-out bond strength values (p < 0.05). MTA HP had significantly higher bond strength than White MTA (p < 0.05). MTA HP showed better push-out bond strength than its predecessor, White MTA; however, Biodentine had higher dislodgment resistance than both MTA formulations301FUNDAÇÃO CARLOS CHAGAS FILHO DE AMPARO À PESQUISA DO ESTADO DO RIO DE JANEIRO - FAPERJE-26/010.001243/2015; E-26/201.491/201

Monitoring the effectiveness of root canal procedures on endotoxin levels found in teeth with chronic apical periodontitis

Objective: The aim of this study was to monitor the effectiveness of root canal procedures by using different irrigants and intracanal medication on endotoxin levels found in root canals of teeth with chronic apical periodontitis. Material and methods: Thirty root canals of teeth with pulpal necrosis associated with periapical lesions were selected and randomly divided into groups according to the irrigants used: GI - 2.5% NaOCl, GII - 2% chlorhexidine (CHX) gel, and GIII - saline solution (SS) (all, n=10). Samples were collected with sterile/apyrogenic paper points before (S1) and after root canal instrumentation (S2), after use of 17% ethylenediaminetetraacetic acid (EDTA) (S3), and after 30 days of intracanal medication (Ca(OH)2+SS) (S4). A turbidimetric kinetic Limulus Amebocyte Lysate assay was used for endotoxin measurement. Results: Endotoxins were detected in 100% of the root canals investigated (30/30), with a median value of 18.70 EU/mL. After S2, significant median percentage reduction was observed in all groups, irrespective of the irrigant tested: 2.5% NaOCl (99.65%) (GI), 2% CHX (94.27%) (GII), and SS (96.79%) (GIII) (all p0.05). Intracanal medication for 30 days was able to significantly reduce residual endotoxins: 2.5% NaOCl (90%) (GI), 2% CHX (88.8%) (GII), and SS (85.7%) (GIII, p<0.05). No differences were found in the endotoxin reduction when comparing S2 and S4 treatment groups. Conclusion: Our findings demonstrated the effectiveness of the mechanical action of the instruments along with the flow and backflow of irrigant enduring root canal instrumentation for the endotoxin removal from root canals of teeth with chronic apical periodontitis. Moreover, the use of intracanal medication for 30 days contributed for an improvement of endotoxin reduction226490495CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP302575/2009-0sem informação13/02402- 9; 10/13743-3; 10/19136-1; 10/17877-4; 11/09047-

Influence of the apical enlargement size on the endotoxin level reduction of dental root canals

Gram-negative bacteria play an essential role in endodontic infections because they have virulence factors such as endotoxin. Due to its potential cytotoxic activity, special attention has been given to the removal/neutralization of this endotoxin in the root canal system. OBJECTIVE: The aim of this study was to evaluate the influence of the apical enlargement size (AES) by using rotary instruments on the endotoxin level reduction of dental root canals. MATERIAL AND METHODS: Forty root canals of the mandibular premolar teeth were used. Escherichia coli endotoxin (055: B55) was inoculated into thirty root canals. Ten teeth served as the negative control group. After the incubation period, the first endotoxin samples were collected from the root canals with a sterile/apyrogenic paper point for the analysis of the endotoxin units (EU/mL) present before instrumentation (S1). Specimen instrumentation was performed with the Mtwo® rotary system in the sequence 10/.04, 15/.05, 20/.06, 25/.06, 30/.05, 35/.04 and 40/.04. To monitor the effectiveness of increasing apical enlargement on endotoxin removal, the second endotoxin samples were collected from all the root canals after instrumentation with the following instruments: #25/.06- (S2); #30/.05- (S3); # 35/.04- (S4); and #40/.04- (S5). Limulus amebocyte lysate (LAL) was used to quantify the levels of endotoxin. The results were statistically compared by using repeated measures of ANOVA with post hoc Tukey testing. RESULTS: Increasing levels of endotoxin removal was achieved by large sized apical enlargement: S2 (AES #25/.06)- 89.2%, S3 (AES #30/.05)- 95.9%, S4 (AES #35/.04)- 97.8% and S5 (AES #40/.04)- 98.2%. Substantial reduction of endotoxin content was obtained in S4 and S5 compared to S2 (

Jean-Marc Leveratto, Mary Leontsini, Internet et la sociabilité littéraire

Sur la quatrième de couverture de cet ouvrage que complète une courte « présentation » liminaire, Jean-Marc Leveratto et Mary Leontsini témoignent d’un double projet : d’une part, développer la recherche sociologique sur les pratiques de la lecture ; d’autre part, préciser la spécificité et la place du média internet dans le développement de la sociabilité littéraire. L’ambition de l’étude est donc d’abord épistémologique, car elle vise à observer avant tout la complexité des médiations et de..