Anna Carolina Volpi Mello-Moura

Ex vivo performance of five methods for root canal length determination in primary anterior teeth

AIM To evaluate in a laboratory setting the performance of five methods for the determination of root canal length in primary anterior teeth. METHODOLOGY Twenty extracted primary incisors, with at least two-thirds of the root, were used. After access cavity preparation, the teeth were embedded in alginate mixed with 0.9% sodium chloride solution. One operator determined root canal length using tactile sense (T), conventional radiography (RAD), tactile sense and conventional radiography (T + RAD), digital radiography (RDIG) and Root ZX electronic apex locator (EAL) methods. Next, the actual length (AL) was visually determined using a K-file from the coronal reference to the apical foramen or apical resorption level. The measurements obtained through each method were compared to the AL using the intraclass correlation coefficient (ICC) with the limits of agreement calculated with Bland and Altman analysis. The measurements were classified as acceptable (+/-1 mm from the AL) or not (>1 mm shorter or longer), and the McNemar test was employed for method comparison. RESULTS Differences, limits of agreement and ICCs for each method were respectively EAL = -0.29; -1.02 to 0.44; 0.990; T + RAD = 0.17; -2.18 to 2.51; 0.929; RAD = 0.50; -3.41 to 4.41; 0.818; RDIG = 0.95; -3.76 to 5.65; 0.700; and T = -0.48; -5.59 to 4.64; 0.499. The most accurate and acceptable method was the EAL, followed by the T + RAD. : The EAL method performed best for root canal length determination in primary teeth.

Nd:YAG Laser Irradiation Effect on Apical Intracanal Dentin - A Microleakage and SEM Evaluation

The purpose of this in vitro study was to evaluate the effect of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on intracanal dentin surface by SEM analysis and its interference in the apical seal of filled canals. After endodontic treatment procedures, 34 maxillary human incisors were randomly assigned to 2 groups. In the negative control group (n=17), no additional treatment was performed and teeth were filled with vertically condensed gutta-percha; in the laser-treated group (n=17), the root canals were irradiated with Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) before filling as described for the control group. Two specimens of each group were prepared for SEM analysis to evaluate the presence and extent of morphological changes and removal of debris; the other specimens were immersed in 0.5% methylene blue dye (pH 7.2) for 24 h for evaluation of the linear dye leakage at the apical third. SEM analysis of the laser-treated group showed dentin fusion and resolidification without smear layer or debris. The Students t-test showed that the laser-treated group had significantly less leakage in apical third than the control group. Within the limitations of this study, it may be concluded that the morphological changes on the apical intraradicular dentin surface caused by Nd:YAG laser resulted in less linear dye apical leakage.

Low-intensity laser phototherapy enhances the proliferation of dental pulp stem cells under nutritional deficiency

Dental trauma in immature permanent teeth can damage pulp vascularization, which leads to necrosis and cessation of apexogenesis. Studies on tissue engineering using stem cells from human exfoliated deciduous teeth (SHEDs) have yielded promising results. Laser phototherapy (LPT) is able to influence the proliferation and differentiation of these cells, which could improve tissue engineering. SHEDs (eighth passage) were seeded into 96-well culture plates (103 cells/well) and were grown in culture medium supplemented with 15% defined fetal bovine serum (FBS) for 12 h. After determining the appropriate nutrition deficiency status (5% FBS), the cells were assigned into four groups: 1) G1 - 15% FBS (positive control); 2) G2 - 5% FBS (negative control); 3) G3 - 5% FBS+LPT 3 J/cm2; and 4) G4 - 5% FBS+LPT 5 J/cm2. For the LPT groups, two laser irradiations at 6 h intervals were performed using a continuous wave InGaAlP diode laser (660 nm, with a spot size of 0.028 cm2, 10 mW) in punctual and contact mode. Cell viability was assessed via an MTT reduction assay immediately after the second laser irradiation (0 h) and 24, 48, and 72 h later. We found that G3 and G4 presented a significantly higher cell growth rate when compared with G2 (p < 0.01). Moreover, G4 exhibited a similar cell growth rate as G1 throughout the entire experiment (p > 0.05). These findings indicate that LPT with 5 J/cm2 can enhance the growth of SHEDs during situations of nutritional deficiency. Therefore, LPT could be a valuable adjunct treatment in tissue engineering when using stem cells derived from the dental pulp of primary teeth.

Laser for bone healing after oral surgery: systematic review

The purpose of this study is to perform a systematic review on the use of lasers in oral surgery for bone healing. Selection of articles was carried out by two evaluators in Pubmed and Web of Science databases for published articles and OpenGray for gray literature. Search strategy was developed based on the PICO Question “Does the use of lasers after oral surgery improve bone healing?”. Eligibility criteria were: being on laser; evaluate bone healing; involve oral surgery; do not be about implant, periodontics, orthodontics, osteonecrosis or radiotherapy, nor revisions, clinical cases, etc. Data were collected from each article in a structured spreadsheet and a descriptive analysis was performed. Risk assessment of bias of the articles was carried out through the tool elaborated by the Cochrane collaboration. A total of 827 potentially relevant references were identified. No articles were found in OpenGray. Eleven articles met the eligibility criteria and were included in the systematic review. Most of studies were in vivo and in jaw, being conducted with low-power lasers which were applied immediately after the surgical procedure of extraction. Neoformation and bone density were the outcomes of choice and there was a tendency of increase in bone density, neoformation, regeneration, mineralization, or bone condensation when laser was applied. Regarding the bias risk assessment, studies were not clear in reporting most of the parameters. Low-power laser therapy seems to reduce time of bone healing in oral surgery, although there are no defined protocols and the level of evidence is still considered weak.

Oral health status of children and young adults with autism spectrum disorders: systematic review and meta‐analysis

BACKGROUND Individuals with special needs are often affected by oral disorders such as dental caries and periodontal disease. Current data regarding prevalence of these conditions in individuals with autism spectrum disorders (ASD) are controversial. AIM To conduct a systematic review and meta-analysis to verify the prevalence of dental caries and periodontal disease in individuals with ASD, especially children and young adults. DESIGN Searches were conducted through MEDLINE/PubMed, Web of Science, and Scopus databases in December 2015. Studies were included if fulfilled the following eligibility criteria: to evaluate the oral health status of individuals with ASD; to be an observational study; and to assess the prevalence of dental caries and/or periodontal disease. Meta-analyses were conducted considering prevalence of dental caries and periodontal disease in individuals as outcome. RESULTS Search strategy identified 928 potentially relevant articles and seven of them were included in this review. All included studies reported dental caries prevalence, and the pooled prevalence was 60.6% (95% CI: 44.0-75.1). Moreover, only three studies showed prevalence of periodontal disease, resulting in pooled prevalence of 69.4% (95% CI: 47.6-85.0). CONCLUSION Prevalence of dental caries and periodontal disease in children and young adults with ASD can be considered as high, pointing to the need for oral health policies focused on these individuals.

Cytotoxicity evaluation of Curcuma zedoaria (Christm.) Roscoe fluid extract used in oral hygiene products.

Abstract Objective. This in vitro study evaluated the cytotoxic effects of the Curcuma zedoaria (Christm.) Roscoe (popular name: zedoary) fluid extract, as used in preparations for oral hygiene, mostly for anti-septic purposes. Materials and methods. The cell viability and cell growth were assessed by Trypan blue dye exclusion assay using the LMF cell line derived from oral mucosa. Cell viability (short-term assay) was measured 0, 6, 12 and 24 h after contact with the fluid extract. Cell growth (long-term assay) was analyzed in 1, 3, 5 and 7 days. The experimental groups were those testing the fluid extract obtained from the zedoary rhizome and the extractor liquid (ethanol 70° GL) in the concentrations of 0.01–0.0001% v/v. Fresh DMEM were used in the control cultures. Results. Short-term assay—all studied cultures maintained stable cell viability; Long-term assay—there was progressive cell growth in all studied cultures. Conclusion. According to the results, the zedoary fluid extract presents low cytotoxicity and probably can be used in the oral hygiene products.

Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers.

Abstract. This research analyzed the quality of resin-based sealer adaptation after intracanal laser irradiation. Extracted teeth (n=168) were root canal treated and divided into four groups, according to dentin surface treatment: no laser; Nd:YAG laser (1.5 W, 100 mJ, 15 Hz); diode laser (2.5 W in CW), and Er:YAG laser (1 W, 100 mJ, 10 Hz). The teeth were divided into four subgroups according to the sealer used: AH Plus, EndoREZ, Epiphany, and EpiphanySE. For testing the sealing after root canal obturation, the penetration of silver nitrate solution was measured, whereas to evaluate the adaptation and penetration of the sealer into the dentin, environmental scanning electron microscopy (ESEM) was used. The ESEM images were analyzed using a four-grade criteria score by three evaluators. The inter-examiner agreement was confirmed by Kappa test and the scores statistically compared by the Kruskal-Wallis’ test (p<0.05). Both adaptation and sealer penetration in root canals were not affected by the laser irradiation. Nd:YAG and diode laser decreased the tracer penetration for AH Plus, whereas EndoREZ and EpiphanySE performances were affected by Nd:YAG irradiation (p<0.05). It can be concluded that intracanal laser irradiation can be used as an adjunct in endodontic treatment; however, the use of hydrophilic resin sealers should be avoided when root canals were irradiated with Nd:YAG laser.

Evaluation of the Post Orthognathic Surgery Satisfaction: a Comparative Cross-Sectional Study of Patients Class II and III

Abstract The aim of this study was to analyze the degree of postoperative satisfaction regarding facial and dental esthetics, masticatory and respiratory function, and psychosocial factors in patients with dentofacial deformity Class II compared with Class III. The patients were divided into 2 groups with 50 patients in Group 1 (Class II) and 30 patients in Group 2 (Class III). Assessing the degree of postoperative satisfaction, the authors did not observe a significant difference between the groups in terms of improvements in the aesthetic and functional aspects and the psychological impact of the treatment. It can be concluded that regardless of the type of dentofacial changes, the treatment well indicated and conducted, results in significant positive effects on patients lives, both aesthetically and in the function, and psychosocial great benefit.

Pulp Calcification in Traumatized Primary Teeth – Classification, Clinical And Radiographic Aspects

OBJECTIVE The aim of this study was to standardize the nomenclature of pulp alteration to pulp calcification (PC) and to classify it according to type, quantity and location, as well as relate it to clinical and radiographic features. STUDY DESIGN The dental records of 946 patients from the Research and Clinical Center for Dental Trauma in Primary Teeth were studied. Two hundred and fifty PC-traumatized upper deciduous incisors were detected. RESULTS According to radiographic analysis of the records, 62.5% showed diffuse calcification, 36.3% tube-like calcification, and 1.2% concentric calcification. According to the extension of pulp calcification, the records showed: 80% partial calcification, 17.2% total coronal calcification and partial radicular calcification, and 2.8 % total coronal and radicular calcification. As for location, only 2.4% were on the coronal pulp, 5.2% on the radicular pulp and 92.4% on both radicular and coronal pulp. Regarding coronal discoloration, 54% were yellow and 2% gray. In relation to periradicular changes, 10% showed widened periodontal ligament space, 3.1% internal resorption, 10% external resorption, 10.4% periapical bone rarefaction. CONCLUSIONS Since PC is a general term, it is important to classify it and correlate it to clinical and radiographic changes, in order to establish the correct diagnosis, treatment and prognosis of each case.

Use of artificial primary teeth for endodontic laboratory research: experiments related to canal length determination

BackgroundDue to the scarcity of exfoliated/extracted human primary teeth with complete roots, artificial teeth were developed as an alternative to be used for educational and laboratory research purposes. This study aimed to assess the feasibility of using artificial primary teeth for conducting laboratory research through an experiment related to canal length determination, comparing artificial teeth with natural teeth.MethodsThirty anterior and 21 posterior artificial teeth, and the same number of natural primary teeth were selected. After preparing the access cavity, the root canal length was determined by two examiners twice using three different methods: radiography and two electronic apex locators. Then, the actual root canal length was measured by inserting a K-file up to the apical foramen (reference standard). Accuracy was calculated using Bland-Altman analysis and intraclass correlation coefficient (ICC). The inter- and intra-examiner reproducibility was also calculated using the ICC.ResultsThe methods using the electronic apex locators showed better accuracy in both artificial and natural teeth. Trends observed with artificial primary teeth were similar to those observed with natural teeth, except for the results in artificial anterior teeth.ConclusionsThe model of artificial teeth might be a good alternative for educational purposes; however, improvements are necessary to employ these teeth for research purposes when considering experiments for canal length determination.