Emílio Carlos Sponchiado

Evaluation of marginal leakage of different temporary restorative materials in Endodontics

Aim: The aim of this study is to assess the coronal marginal leakage of three temporary restorative materials used for root canal sealing after endodontic treatment. Materials and Methods: A total of 88 single-rooted teeth were submitted to biomechanical preparation and filled by lateral condensation technique. After obturation process, the teeth were randomly separated into four groups, being two teeth of each group used as positive and negative control. Temporary sealing was performed as follows: GI - Clip F (VOCO); GII - Bioplic (Biodinβmica); GIII - Vitremer (3M ESPE) and GIV - Ketak N100 (3M ESPE). Next, the specimens were immersed into Indian ink for 30 and 60- days, being 10 specimens for each time interval and then submitted to diaphanization to verify the amount of coronal leakage using a measuring microscope. Results: Leakage mean values within the 30-day period were as follows: Vitremer (0.3 mm), Ketak N100 and Clip F (0.6 mm) and Bioplic (1.7 mm). Within the 60-day period, leakage means were 1.1 mm, 1.5 mm, 2.2 mm and 2.6 mm, respectively. Conclusions: None of the materials was capable of preventing marginal leakage within the 30- and 60-day period. In both time intervals, Bioplic presented the highest mean of leakage and Vitremer the lowest.

Cleaning capacity promoted by motor-driven or manual instrumentation using ProTaper Universal system: Histological analysis

Aim: The aim of this study was to assess the cleaning capacity of the Protaper system using motor-driven or manual instrumentation. Materials and Methods: Ten mandibular molars were randomly separated into 2 groups (n = 5) according to the type of instrumentation performed, as follows: Group 1 - instrumentation with rotary nickel-titanium (Ni-Ti) files using ProTaper Universal System (Dentsply/Maillefer); and, Group 2 - instrumentation with Ni-Ti hand files using ProTaper Universal (Dentsply-Maillefer). Afterwards, the teeth were sectioned transversely and submitted to histotechnical processing to obtain histological sections for microscopic evaluation. The images were analyzed by the Corel Photo-Paint X5 program (Corel Corporation) using an integration grid superimposed on the image. Results: Statistical analysis (U-Mann-Whitney - P < 0.05) demonstrated that G1 presented higher cleaning capacity when compared to G2. Conclusions: The rotary technique presented better cleaning results in the apical third of the root canal system when compared to the manual technique.

Endodontic treatment of mandibular molar with root dilaceration using Reciproc single-file system

Biomechanical preparation of root canals with accentuated curvature is challenging. New rotatory systems, such as Reciproc, require a shorter period of time to prepare curved canals, and became a viable alternative for endodontic treatment of teeth with root dilaceration. Thus, this study aimed to report a clinical case of endodontic therapy of root with accentuated dilaceration using Reciproc single-file system. Mandibular right second molar was diagnosed as asymptomatic irreversible pulpitis. Pulp chamber access was performed, and glide path was created with #10 K-file (Dentsply Maillefer) and PathFile #13, #16 and #19 (Dentsply Maillefer) up to the temporary working length. The working length measured corresponded to 20 mm in the mesio-buccal and mesio-lingual canals, and 22 mm in the distal canal. The R25 file (VDW GmbH) was used in all the canals for instrumentation and final preparation, followed by filling with Reciproc gutta-percha cones (VDW GmbH) and AH Plus sealer (Dentsply Maillefer), using thermal compaction technique. The case has been receiving follow-up for 6 mon and no painful symptomatology or periapical lesions have been found. Despite the difficulties, the treatment could be performed in a shorter period of time than the conventional methods.

Morphological analysis of tissue reaction caused by a new endodontic paste in subcutaneous tissue of rats.

Aim: To assess the biocompatibility of an experimental endodontic paste based on the ethyl acetate fraction of Pothomorphe umbellata + calcium hydroxide, using propylene glycol as vehicle, in connective tissue of rats. Materials and Methods: Fifteen rats had four polyethylene tubes implanted in their backs, with each one containing the experimental paste. The tube side was considered the control group. After 7, 21, and 42 days, animals were euthanized. Results: Intense inflammatory reaction was noticed after 7 days for experimental paste and it was moderate for control group. At 21 days, the inflammatory reaction was moderate for experimental paste and discrete for control group; and at 42 days, it was discrete for experimental paste and control group. Statistical analysis (Dunns test, P < 0.01) demonstrated significant difference between the fibrous capsule area at 7 and 42 days (P > 0.01) for experimental paste. Conclusions: Experimental endodontic paste presented satisfactory tissue reaction in the connective tissue of rats.

In vitro assessment of antimicrobial activity of Pothomorphe umbellata extracts against Enterococcus faecalis

BACKGROUND Due to the complex anatomy of the root canal system, biomechanical preparation is not able to completely eliminate all microorganisms present in the endodontic infections, making it necessary the use of an intracanal medication. AIM The aim of this study was to assess the antimicrobial activity of an intracanal medication containing the ethyl-acetate fraction of Pothomorphe umbellata against Enterococcus faecalis. MATERIALS AND METHODS Fifty seven human maxillary canine teeth were used, of which 54 were infected with E. faecalis every 72 h, for 28 days, and cultured for 24 h. Contaminated teeth were randomly separated into three groups (n = 18) and treated as follows: Group I - calcium hydroxide-based medication; Group II - P. umbellata-based medication; Group III - contaminated teeth without medication. Three teeth were used as negative control. After 7, 14 and 28 days of treatment, six teeth from each group were assessed for the level of microbial growth after each period of treatment. RESULTS The intracanal medication containing P. umbellata was effective against E. faecalis after 7, 14, and 28 days of treatment without statistically significant difference in comparison to calcium hydroxide treatment (Kruskal-Wallis test, P > 0.05). CONCLUSION Ethyl-acetate fraction of P. umbellate was efficient against E. faecalis, making this phytotherapy a viable option for endodontic treatment.

Assessment of apical deviation of root canals after debridement with the Hybrid, ProTaper and PathFile systems

Aim: To assess the occurrence of apical transportation of mesio-vestibular canals of mandibular molars using two rotary techniques and one hybrid technique during shaping and cleaning. Materials and Methods: Forty-five human mandibular molars with a degree of mesial canal/root curvature of 20° to 55° were selected, which were included in acrylic resin blocks and randomly separated into three groups. Group 1-Fifteen teeth were debrided using the ProTaper rotary technique; Group 2-Fifteen teeth were debrided using the Manual Hybrid and ProTaper rotary technique; Group 3-Fifteen teeth were debrided using the PathFile-ProTaper technique. Apical deviation was assessed by the radiographic platform method that enables obtaining superimposed images of the first and last instrument used in root canal preparation in the same radiograph. Apical transportation was measured in millimeters with the aid of the Adobe Photoshop CS4 software. Results: The mean deviation for Group 1 was 0.03 mm, for Group 2, 0.1 mm and for Group 3, 0.08 mm. Statistical analysis (Kruskal-Wallis test) of the results demonstrated that there was no statistically significant difference among the samples ( P >0.05) with regard to the apical deviation. Conclusion: The techniques provided minimum apical deviation.

Prevalence of cervical enamel projection in human molars

Introduction : One of the developmental anomalies of dental enamel is cervical enamel projection (CEP). The aim of this study was to assess the prevalence of CEP in maxillary and mandibular human teeth. Materials and Methods: A total of 234 human molars obtained from the tooth bank of the State University of Amazonas were used in the present study. CEP was classified as Grade 0 (absence of projection), Grade I (discrete extension of cementoenamel junction toward the furcation), Grade II (closer to furcation without invasion), and Grade III (extending to the furcation area). The evaluation was performed using macroscopic inspection of teeth faces (buccal, lingual/palatal, mesial, and distal) with at least one-third of the crown on each face. Results: It was found that 17.1% of the teeth evaluated had CEP, but neither of the projections occurred on the proximal faces. Higher prevalence of CEP was found on the buccal faces and the most commonly grade of CEP found was Grade I (10.3%). Conclusions: It may be concluded that CEP occurs more frequently in mandibular molars and its diagnosis is extremely important since these projections may difficult bacterial plaque removal, leading to an inflammatory process and unnecessary endodontic treatment.

Endodontic Treatment of Maxillary Premolar with Three Root Canals Using Optical Microscope and NiTi Rotatory Files System

The aim of the study was to report a clinical case of endodontic treatment of a maxillary first premolar with three root canals using an optical microscope and rotary instrumentation technique. The main complaint of the patient, a 16-year-old girl, was pain in tooth 14. After clinical and radiographic examination, irreversible pulpitis was diagnosed. An alteration in the middle third of the pulp chamber radiographically observed suggested the presence of three root canals. Pulp chamber access and initial catheterization using size number 10 K-files were performed. The optical microscope and radiographic examination were used to confirm the presence of three root canals. PathFiles #13, #16, and #19 were used to perform catheterization and ProTaper files S1 and S2 for cervical preparation. Apical preparation was performed using F1 file in the buccal canals and F2 in the palatal canal up to the working length. The root canals were filled with Endofill sealer by thermal compaction technique using McSpadden #50. The case has been receiving follow-up for 12 months and no painful symptomatology or periapical lesions have been found. The use of technological tools was able to assist the endodontic treatment of teeth with complex internal anatomy, such as three-canal premolars.