Emílio Carlos Sponchiado Júnior

Morphometrical analysis of cleaning capacity of a hybrid instrumentation in mesial flattened root canals

The cleaning capacity of hybrid and rotary instrumentation techniques in mesial flattened canals of mandibular first molars was evaluated by morphometrical analysis in this study. Twenty human mandibular first molars were randomly assigned into two groups, according to instrumentation technique, as follows: group 1, instrumentation with ProTaper Starter Kit (Dentsply/Maillefer) rotary system; group 2, manual instrumentation using K files (Dentsply/Maillefer) by crown-down technique in middle and apical thirds, cervical preparation with Gates-Glidden #1 and #2 (Dentsply/Maillefer) burs, and to finalise the preparation, ProTaper F2 and F3 rotary files. Serial transverse cross-sections (5 µm) of the apical third, stained with hematoxylin and eosin, were analysed at 100× original magnification. The images were submitted to morphometrical analysis with an integration grid to determine the percentage of root canal area with debris. Statiscal analysis (t-Student, P < 0.05) showed significant difference between the techniques (P < 0.05), although neither completely cleaned the root canal.

Apical Transportation, Centering Ability, and Cleaning Effectiveness of Reciprocating Single-file System Associated with Different Glide Path Techniques.

INTRODUCTION The aim of this study was to evaluate the apical transportation, the centering ability, and the cleaning effectiveness of a reciprocating single-file system associated to different glide path techniques. METHODS The mesial root canals of 52 mandibular molars were randomly distributed into 4 groups (n = 13) according to the different glide path techniques used before biomechanical preparation with Reciproc System (RS): KF/RS (sizes 10 and 15 K-files), NGP/RS (no glide path, only reciprocating system), PF/RS (sizes 13, 16, and 19 PathFile instruments), and NP (no preparation). Cone-beam computed tomography analysis was performed before and after instrumentation for apical third images acquisition. Apical transportation and its direction were evaluated by using the formula D = (X1 - X2) - (Y1 - Y2), and the centering ability was analyzed by the formula CC = (X1 - X2/Y1 - Y2 or Y1 - Y2/X1 - X2). The samples were submitted to histologic processing and analyzed under a digital microscope for debris quantification. The values were statistically analyzed (Kruskal-Wallis, the Dunn multiple comparisons test, P < .05). RESULTS All groups had similar apical transportation values, with no significant difference among them (P > .05). Groups had a tendency toward transportation in the mesial direction. No technique had perfect centering ability (=1.0), with no significant difference among them. KF/RS had larger amount of debris, with statistically significant difference in comparison with NGP/RS (P > .05). CONCLUSIONS The different glide path techniques promoted minimal apical transportation, and the reciprocating single-file system tested remained relatively centralized within the root canal. Also, the different techniques interfered in the cleaning effectiveness of the reciprocating system.

Root canal retreatment using reciprocating and continuous rotary nickel-titanium instruments.

Objective: The complete filling material removal during endodontic retreatment is a clinical procedure difficult to achieve. The aim of this study was to evaluate the efficacy of reciprocating and continuous rotary nickel-titanium instruments used in root canal retreatment. Materials and Methods: Forty freshly extracted human premolars were cleaned and shaped by the crown-down technique, followed by filling by the lateral compaction technique. The teeth were randomly separated into two groups ( n = 20), according to the system used for filling material removal: G1 - Reciproc and G2 - ProTaper Universal Retreatment System. The teeth were photographed under operating microscope at ×8 magnification; and the total area of the root canal and remaining filling material were quantified. Results: No statistically significant difference ( P > 0.05) in residual filling material was observed between groups; however, the time required for filling removal was significantly shorter for Reciproc system ( P Conclusions: It was observed remaining filling material in all teeth, irrespective of the system used; however, root canal retreatment was faster when reciprocating motion was used.Objective: The complete filling material removal during endodontic retreatment is a clinical procedure difficult to achieve. The aim of this study was to evaluate the efficacy of reciprocating and continuous rotary nickel-titanium instruments used in root canal retreatment. Materials and Methods: Forty freshly extracted human premolars were cleaned and shaped by the crown-down technique, followed by filling by the lateral compaction technique. The teeth were randomly separated into two groups (n = 20), according to the system used for filling material removal: G1 - Reciproc and G2 - ProTaper Universal Retreatment System. The teeth were photographed under operating microscope at ×8 magnification; and the total area of the root canal and remaining filling material were quantified. Results: No statistically significant difference (P > 0.05) in residual filling material was observed between groups; however, the time required for filling removal was significantly shorter for Reciproc system (P < 0.05). Conclusions: It was observed remaining filling material in all teeth, irrespective of the system used; however, root canal retreatment was faster when reciprocating motion was used.

Surface characteristics of reciprocating instruments before and after use--a SEM analysis.

The presence of debris, defects and deformations of endodontic reciprocating instruments before and after chemical-mechanical preparation (MCP) was analyzed using scanning electron microscopy (SEM). The following 26 instruments were divided into 2 groups: Waveone (n=13) and Reciproc (n=13) and examined by SEM (150 x magnification) prior to canal preparation at 2 and 4 mm from the tip. The instruments were used in the preparation of mesial root canals of 26 extracted human permanent mandibular molars. The instruments were then washed in ultrasonic bath and subjected to new microscopic analysis of debris and deformation by a score that used the presence or absence of irregular edges, grooves, microcavities and burrs as criteria. After the SEM analysis and with the scores of the examiners, the collected data were subjected to descriptive statistical analysis using the Kruskall-Walis and Mann Whitney test at a 5% significance level. All instruments examined presented debris before and after use. A statistically significant difference was found for defects and deformation between the groups (p<0.05). The presence of defects and deformities was higher in the WaveOne instruments, and Reciproc instruments presented a lower rate.

Histological evaluation of the cleaning effectiveness of two reciprocating single-file systems in severely curved root canals: Reciproc versus WaveOne.

Objective: The aim of this study was to evaluate the cleaning effectiveness achieved with two reciprocating single-file systems in severely curved root canals: Reciproc and WaveOne. Materials and Methods: Twenty-five mesial roots of mandibular molars were randomly separated into two groups, according to the instrumentation system used. The negative control group consisted of five specimens that were not instrumented. The mesial canals (buccal and lingual) in Reciproc Group were instrumented with file R25 and the WaveOne group with the Primary file. The samples were submitted to histological processing and analyzed under a digital microscope. Results: The WaveOne group presented a larger amount of debris than the Reciproc Group, however, without statistically significant difference (P > 0.05). A larger amount of debris in the control group was observed, with statistically significant difference to Reciproc and WaveOne groups (P < 0.05). Conclusions: The two reciprocating single-file instrumentation systems presented similar effectiveness for root canal cleaning.

Effect of passive ultrasonic agitation during final irrigation on cleaning capacity of hybrid instrumentation

Objectives To evaluate the effect of passive ultrasonic agitation on the cleaning capacity of a hybrid instrumentation technique. Materials and Methods Twenty mandibular incisors with mesiodistal-flattened root shape had their crowns sectioned at 1 mm from the cementoenamel junction. Instrumentation was initiated by catheterization with K-type files (Denstply Maillefer) #10, #15, and #20 at 3 mm from the working length. Cervical preparation was performed with Largo bur #1 (Dentsply Maillefer) followed by apical instrumentation with K-type files #15, #20 and #25, and finishing with ProTaper F2 file (Denstply Maillefer). All files were used up to the working length under irrigation with 1 mL of 2.5% sodium hypochlorite (Biodynâmica) at each instrument change. At the end of instrumentation, the roots were randomly separated into 2 groups (n = 10). All specimens received final irrigation with 1 mL of 2.5% sodium hypochlorite. The solution remained in the root canals in Group 1 for one minute; and ultrasonic agitation was performed in Group 2 for one minute using a straight tip inserted at 1 mm from working length. The specimens were processed histologically and the sections were analyzed under optic microscope (×64) to quantify debris present in the root canal. Results The samples submitted to ultrasonic agitation (Group 2) presented significant decrease in the amount of debris in comparison with those of Group 1 (p < 0.05). Conclusions The hybrid instrumentation technique associated with passive ultrasonic agitation promoted greater debris removal in the apical third of the root canals.

Effect of ultrasonic tip designs on intraradicular post removal

Objectives To evaluate the effect of different ultrasonic tip designs on intraradicular post removal. Materials and Methods The crowns of forty human canine teeth were removed, and after biomechanical preparation and filling, the roots were embedded in acrylic resin blocks. The post spaces were made, and root canal molding was performed with self-cured acrylic resin. After casting (Cu-Al), the posts were cemented with zinc phosphate cement. The specimens were randomly separated into 4 groups (n = 10), as follows: G1 - no ultrasonic vibration (control); G2 - ultrasonic vibration using an elongated cylindrical-shaped and active rounded tip; G3 - ultrasonic vibration with a flattened convex and linear active tip; G4 - ultrasonic vibration with active semicircular tapered tip. Ultrasonic vibration was applied for 15 seconds on each post surface and tensile test was performed in a Universal Testing Machine (Instron 4444 - 1 mm/min). Results G4 presented the highest mean values, however, with no statistically significant difference in comparison to G3 (P > 0.05). G2 presented the lowest mean values with statistically significant difference to G3 and G4 (P < 0.05). Conclusions Ultrasonic vibration with elongated cylindrical-shaped and active rounded tip was most effective in reducing force required for intraradicular post removal.

Evaluation of a new protocol for removing metal retainers from multirooted teeth.

INTRODUCTION The aim of this study was to evaluate in vitro a new protocol for removing intraradicular retainers from multirooted teeth applying ultrasonic vibration. METHODS Forty mandibular molars were endodontically treated to receive cast intraradicular retainers, which were distributed into the following 4 groups: group 1: control without a slot and without ultrasound, group 2: control with a slot and without ultrasound, group 3: ultrasonic vibration in the core without a slot, and group 4: ultrasonic vibration in the core with a slot. After the intraradicular retainers were cemented with zinc phosphate, ultrasonic vibration was applied for 1 minute. The test specimens were then submitted to the traction test in the universal testing machine at a speed of 1 mm/min. The maximum traction force required to remove the intraradicular retainer was recorded in newtons, and the data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05). RESULTS The results showed statistically significant differences among the groups tested (group 1 = 234.34 N, group 2 = 201.67 N, group 3 = 139.57 N, and group 4 = 83.23 N). The lowest mean value of traction force recorded was when ultrasonic vibration was applied on the core with a slot. CONCLUSIONS Creating a slot in the core and the ultrasound application on all surfaces and inside the slot reduced the force required for removing intraradicular metal retainers from multirooted teeth cemented with zinc phosphate.

Cleaning capacity of hybrid instrumentation technique using reamer with alternating cutting edges system files: Histological analysis

Aim: The aim of the following study is to evaluate the cleaning capacity of a hybrid instrumentation technique using Reamer with Alternating Cutting Edges (RaCe) system files in the apical third of mesial roots of mandibular molars. Materials and Methods: Twenty teeth were selected and separated into two groups (n = 20) according to instrumentation technique as follows: BioRaCe - chemomechanical preparation with K-type files #10 and #15; and files BioRaCe BR0, BR1, BR2, BR3, and BR4; HybTec - hybrid instrumentation technique with K-type files #10 and #15 in the working length, #20 at 2 mm, #25 at 3 mm, cervical preparation with Largo burs #1 and #2; apical preparation with K-type files #15, #20, and #25 and RaCe files #25.04 and #30.04. The root canals were irrigated with 1 ml of 2.5% sodium hypochlorite at each change of instrument. The specimens were histologically processed and photographed under light optical microscope. The images were inserted onto an integration grid to count the amount of debris present in the root canal. Results: BioRaCe presented the highest percentage of debris in the apical third, however, with no statistically significant difference for HybTec (P > 0.05). Conclusions: The hybrid technique presented similar cleaning capacity as the technique recommended by the manufacturer.

Estudo da demanda ambulatorial da clínica de odontologia da Universidade do Estado do Amazonas

The objective of this study was to evaluate the demand of the clinic of Dentistry of UEA. One hundred patients who were being treated in the discipline of Semiology answered a questionnaire that collected data on demographic and socio-economic profile. The clinical examination showed the nosologic profile, the blood pressure and dental losses profile. Results showed that 52% of patients were female, aged between 20 and 29 years, 48.3% with the incomplete high school and 60.8% with monthly income greater than five minimum wages. As for dental loss, the teeth most affected were the first molars, while 29% have lost the top first molar and 45% the bottom. The prevalent nosologic profile was 31.3% for treatment in the area of Restorative Dentistry followed by 21% of Periodontics and 19% of Surgery. Only one patient had hypertension. Our conclusion is that most of the population that participated on this study was middle-class women with low average level of education and dental precarious table showing many dental losses and requiring more rehabilitation treatments than preventive. With a greater understanding of the reality of the users of the UEA dental clinic it will be possible to improve the planning of care and actions to improve the promotion of health.