Cinthya Cristina Gomes

Relationship between the size of patency file and apical extrusion of sodium hypochlorite.

BACKGROUND Sodium hypochlorite (NaOCl) is the most widely used endodontic irrigant because of its excellent antimicrobial, organic tissue dissolving, and lubricating properties. However, it is highly cytotoxic to the periapical tissues. AIM This study evaluated in vitro the extrusion of 5.25% NaOCl through the apical foramina of mesiobuccal (MB) root canals of maxillary first molars in two experimental conditions: Before apical debridement and after apical debridement with different instrument sizes to ensure direct access to the apical foramen (apical patency). MATERIALS AND METHODS Coronal accesses were prepared in 17 teeth and the apical foramina of the distobuccal and palatal root canals were sealed. The teeth were held in acrylic receptacles with the roots turned upwards to reproduce their position in the maxillary dental arch. The receptacles were filled with a starch/KI solution (a reagent that changes its color to blue after contacting NaOCl) covering the roots. The experiment had two phases: P1: Irrigation of the MB canals with 5.25% NaOCl without previous establishment of apical patency; P2: Canal irrigation after use of size 10 K-file and size 15 Flexofile as patency files. Only specimens with no NaOCl extrusion in P1 were assigned to P2. NaOCl was delivered pressureless at the canal entrance. The moment that the starch/KI solution contacted NaOCl was captured on digital photographs. RESULTS AND CONCLUSIONS There was no NaOCl extrusion in nine specimens in P1, but all of these teeth had irrigant extrusion in P2. The 5.25% NaOCl used as an endodontic irrigant showed great capacity to extrude beyond both intact and small-sized apical foramina of MB root canals of maxillary first molars.

Isolation and Taxonomy of Filamentous Fungi in Endodontic Infections

INTRODUCTION The purpose of this study was to research the presence of filamentous fungi in the root canals of teeth with pulp necrosis and periapical lesions and to perform the taxonomic study of the isolates. METHODS Samples collected from 60 root canals with sterile absorbent paper points were inoculated in Sabouraud dextrose agar supplemented with chloramphenicol. The material was cultured from 7-14 days at room temperature to observe mycelial growth. Samples with growth were seeded in media specific for microculture (CYA agar, malt extract agar, or potato dextrose agar). Taxonomy was evaluated by macroscopic examination and optical microscopy. RESULTS Filamentous fungi were isolated in situ from 17 of 60 samples (28.3%). Considering the positive root canal isolates, the genus Aspergillus was isolated from 7 samples (41%); 4 species were identified: Aspergillus ustus, A. granulosus, A. niger, and A. sydowii. Emericella quadriluniata, sexual form of Aspergillus, was isolated from 1 sample. Penicillium species (Penicillium implicatum, P. micsynvisk, P. lividum, and P. citrionigrum) were isolated from 4 samples (24%). Fusarium species (Fusarium moniliforme and F. melanochorum) were isolated from 2 samples (12%). The species Aureobasidium pullulans, Exophiala jeanselmei, Eurotium amstelodame, and Cladosporium sphaerospermum were isolated from 1 sample each. CONCLUSIONS The root canals of teeth with pulp necrosis and periapical lesions might present positive culture for filamentous fungi.

Preparation of Oval-shaped Canals with TRUShape and Reciproc Systems: A Micro–Computed Tomography Study Using Contralateral Premolars

Introduction The purpose of this study was to compare the shaping properties of TRUShape and Reciproc systems during preparation of oval‐shaped canals from contralateral teeth by using micro–computed tomography scanning. Methods Thirteen pairs of freshly extracted contralateral mandibular premolars with a single oval‐shaped canal were selected and divided into 2 groups according to the root canal instrumentation technique, TRUShape and Reciproc. The final apical size of instrumentation was 40/.06 for both systems. Data were statistically analyzed for the increase in canal volume and surface area and the amount of unprepared areas promoted by the 2 systems. Results Preparation with both systems significantly increased the volume and area of the canals (P < .001), with no significant differences between them (P > .05). When the full canal length was evaluated, the amount of uninstrumented areas was significantly larger for Reciproc (30%) than TRUShape (24%) (P < .05). However, analysis restricted to the apical 4‐mm segment revealed no statistically significant difference in untouched areas (25% for Reciproc and 20% for TRUShape) (P > .05). Conclusions Both instrument systems behaved similarly in promoting the increase of root canal volume and surface area. When the full canal length was evaluated, TRUShape instruments showed less unprepared areas than Reciproc. However, this difference did not occur for the apical part of the root canal. None of the techniques could completely prepare oval‐shaped root canals. HighlightsThe shaping ability of TRUShape and Reciproc was evaluated in canals of contralateral teeth.Both systems induced a similar increase in canal volume and surface area.TRUShape resulted in less unprepared areas than Reciproc in the full canal length.There were no significant differences in the amount of unprepared areas in the apical canal.

Aspergillus in endodontic infection near the maxillary sinus

INTRODUCTION Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). CONCLUSION Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients

Abstract Pulpal and periodontal tissues have similar microbiota that allows cross-contamination between the pulp and periodontal tissues. Objective The aim of this study was to investigate the prevalence of isolated Candida albicans from periodontal endodontic lesions in diabetic and normoglycemic patients, and the fungis virulence in different atmospheric conditions. Material and Methods A case-control study was conducted on 15 patients with type 2 diabetes mellitus (G1) and 15 non-diabetics (G2) with periodontal endodontic lesions. Samples of root canals and periodontal pockets were plated on CHROMagar for later identification by polymerase chain reaction (PCR) and virulence test. Results C. albicans was identified in 79.2% and 20.8% of the 60 samples collected from diabetic and normoglycemic patients, respectively. Of the 30 samples collected from periodontal pockets, 13 showed a positive culture for C. albicans, with 77% belonging to G1 and 23% to G2. Of the 11 positive samples from root canals, 82% were from G1 and 18% from G2. Production of proteinase presented a precipitation zone Pz<0.63 of 100% in G1 and 72% in G2, in redox and negative (Pz=1), under anaerobic conditions in both groups. Hydrophobicity of the strains from G1 indicated 16.4% with low, 19.3% with moderate, and 64.3% with high hydrophobicity in redox. In G2, 42.2% had low, 39.8% had moderate, 18% had high hydrophobicity in redox. In anaerobic conditions, G1 showed 15.2% with low, 12.8% with moderate, and 72% with high hydrophobicity; in G2, 33.6% had low, 28.8% had moderate, and 37.6% had high hydrophobicity. There was statistical difference in the number of positive cultures between G1 and G2 (p<0.05) with predominance in G1. There was statistical difference for all virulence factors, except hemolysis (p=0.001). Conclusions Candida albicans was isolated more frequently and had higher virulence in diabetic patients.

The effectiveness of pulp revascularization in root formation of necrotic immature permanent teeth: A systematic review

Abstract Objective. The objective of the present study was to carry out a systematic review to analyse the effectiveness of pulp revascularization in the root formation of necrotic immature permanent teeth, as well as the level of scientific evidence regarding this theme. Materials and methods. The methodology was based on searching electronic databases such as Web of Science, Pubmed, BVS (Medline, Scielo, Lilacs and BBO), Scopus and Cochrane, including manual searches for the references listed in the studies found. The terms used for the literature search were pulp revascularization and endodontics. Results. Initially, 277 articles were identified from the electronic databases; 17 studies remained after analysis and exclusion of duplicates; exclusion criteria also eliminated six articles; 11 remained for evaluation. Conclusions. Although the results found in the present systematic review are relevant, the scientific evidence should be interpreted with caution as the articles report different methods and evaluation parameters. Despite the capacity of the pulp revascularization technique to stimulate the development of the apical closure and thickening of radicular dentin, several aspects still remain unknown, like the key factors of this repair, the type of tissue formed and the long-term prognosis.

Estudo Comparativo Entre Duas Técnicas Obturadoras: Condensação Lateral X Híbrida de Tagger

Objective: To compare the quality and the homogeneity of the filling mass of the root canals gotten through two different filling techniques, the Lateral C...

Análise da Adaptação Marginal de Materiais Retrobturadores

Objetivo: Avaliar a capacidade de adaptacao de diferentes materiais retrobturadores as paredes cavitarias do preparo apical. Metodo: Foram realizadas apicetomia e preparo cavitario empregando-se ultra-som em 24 raizes palatinas de molares superiores (extraidos e conservados em timol a 1%). Para a fase de retrobturacao as raizes foram divididas aleatoriamente em 8 grupos contendo 3 amostras cada: G1 - amalgama, G2 - guta percha, G3 - OZE (Oxido de Zinco e Eugenol), G4 - IRM (Intermediate Restorative Material), G5 - N-Rickert, G6 - Ketac-CEM, G7 - Super-EBA, G8 - MTA (Agregado Trioxido Mineral). A seguir os especimes foram fotografados ao microscopio optico (MO) e eletronico de varredura (MEV) com aumentos de 50x e 150x. Os resultados foram analisados por 3 examinadores calibrados e estabelecidos escores (0- adaptacao do material retrobturador em todas as paredes do preparo apical, 1- ausencia da adaptacao do material retrobturador em uma ou duas paredes do preparo apical, 2-ausencia de adaptacao do material retrobturador em tres ou mais paredes do preparo apical). Os dados foram analisados atraves do teste de Kruskal Wallis. Resultados: A media dos escores entre as amostras foi: Amalgama(MO- 1,22 e MEV- 2), guta percha (MO- 1 e MEV- 2), OZE (MO- 1 eMEV- 1,55), IRM (MO- 2 e MEV- 2), N-Rickert (MO- 1,66 e MEV-1,88), Ketac-CEM (MO- 1,66 e MEV- 1,88), Super-Eba (MO- 0,22 eMEV- 0,55) e MTA (MO- 0 e MEV- 0). Verificou-se diferenca estatisticamente significante entre os grupos (p

Does Conventional Endodontic Treatment Impact Oral Health-related Quality of Life? A Systematic Review

Published online: 21 December 2017 DOI 10.5152/eej.2017.17017 Could conventional endodontic treatment have an impact on oral health-related quality of life? There are still unresolved questions regarding this theme. In order to answer them, a systematic review on the available literature was undertaken to identify the methodological quality of and the risk of bias in all relevant studies. A broad search for articles was conducted, and only articles published before May 2016 were considered for review. The following portals were used: Pubmed, VHL (Medline, SciELO, Lilacs and BBO), Cochrane Library, and Web of Science. The keywords used for the search were ‘quality of life’ and ‘root canal treatment.’ Furthermore, we included MeSH synonyms, related terms and free terms. Articles written in any language were included according to the PICOS approach (population, intervention, comparison, outcome and study design). After application of these eligibility criteria, selected articles were qualified by assessing their methodological quality and potential risk of bias. The initial search identified 302 references. After excluding duplicated abstracts and analysing the titles and abstracts, 6 were selected. One study was added via manual search of the reference lists. From these, 2 were eligible for quality assessment and were classified as being of high methodological quality and as having low risk of bias. Based on these studies, it can be concluded that conventional endodontic treatment improves oral health-related quality of life. However, these results should be interpreted with caution, due to the lack of important methodological details in the included studies. Additional investigations are warranted to provide more evidence on this subject.

Análise comparativa do escoamento de dois cimentos endodônticos:Endofll e AH plus

O escoamento de cimento obturador e fator importante no desempenho clinico do material, pois interfere em sua capacidade de penetrar nos tubulos dentinarios e canais laterais. A proposta deste estudo e avaliar a capacidade de escoamento de dois cimentos endodonticos: Endofill (cimento de Grossman) e AH Plus. Para tal analise, foram realizadas dez amostras de cada material, utilizando-se o metodo da extensibilidade de acordo com a especificacao 57 da ADA para cimentos endodonticos. Esse metodo refere-se a capacidade de se espalmar a superficie de uma preparacao, quando submetida a determinada forca. Seguindo a especificacao de cada fabricante, foram realizadas pesagem e manipulacao dos materiais, sendo 0,5ml do material introduzido em seringa descartavel e depositado sobre placa de vidro de 1 OX1 Ocm. Decorridos 180 segundos do inicio da manipulacao, foi colocado no centro da placa o cimento obturador e sobre este um conjunto composto por outra placa de vidro e uma carga adicional, perfazendo o total de 120g. Apos dez minutos do inicio da mistura, o peso adicional foi removido. As superficies das amostras foram medidas em seus comprimentos horizontal e vertical, com o uso de um paquimetro MITUTOYO (Japao), e por meio do contorno dos perimetros dos halos de escoamento das amostras dos cimentos testados com o auxilio de um programa de computador (Microsoft PowerPoint) a fim de que se obtivesse um parâmetro de comparacao. Foi feita a media aritmetica dos resultados, que foram tambem levados a analise estatistica, na qual pode ser observada uma significância no nivel de 1 por cento para ambos os metodos de medicao. Pode-se concluir que o AH Plus possui maior capacidade de escoamento que o Endofill (AU)