Everdan Carneiro

The Accuracy in the Control of the Apical Extent of Rotary Canal Instrumentation Using Root ZX II and ProTaper Instruments: An In Vivo Study

The accuracy of Root ZX II (J. Morita, Kyoto, Japan) to control the apical extent of rotary canal instrumentation in vivo was assessed. Twenty-four premolars with a single canal were selected. The roots were divided in two groups according to the calibration of the automatic apical reverse mechanism of Root ZX II, set at levels 1 and 2. After endodontic access, the preparation was performed with ProTaper instruments (Dentsply Maillefer, Ballaigues, Switzerland) connected to the device. Afterwards, the last file used was introduced into the canal and fixed in place with acrylic resin. The teeth were extracted and ground until exposure of the file. The distance from the instrument tip to the apical foramen was obtained. The percentage of acceptable measurements and the difference between means were submitted to statistical analysis. The differences of setting the reverse mechanism at 1 and 2 were not statistically significant. Both settings were not accurate for determining and controlling the apical extent of rotary instrumentation.

Comparative analysis of leakage in root canal fillings performed with gutta-percha and Resilon cones with AH Plus and Epiphany sealers

OBJECTIVE The aim of this study was to compare the leakage of root canal fillings of gutta-percha or Resilon cones in association with AH Plus or Epiphany sealer. STUDY DESIGN Four groups of premolars (n = 64) were instrumented to size 45/.04 ProFile and filled with laterally compacted gutta-percha cones or Resilon cones in association with AH Plus or Epiphany sealer. The specimens were stored for 2 weeks at 37 degrees C and 100% humidity. After that, leakage was measured using the fluid filtration method and determined as microL/min.10 psi. RESULTS Homogeneity of variance and multiple comparisons tests were performed and indicated that root fillings with the combination of gutta-percha cones and AH Plus sealer showed lower leakage values (P < .05) than the other groups. CONCLUSION Considering the experimental conditions and the results obtained, it was concluded that fillings made with gutta-percha cones in combination with AH Plus sealer had the best performance.

Evaluation of care of dentoalveolar trauma

Objectives The aim of this study was to evaluate cases of dental trauma treated at the specialized center of Pontifical Catholic University of Paraná, Curitiba, Brazil, during a period of 2 years. Material and Methods A total of 647 patients were evaluated and treated between 2003 and 2005. Data obtained from each patient were tabulated and analyzed as to gender, age, etiology, time elapsed after the injury, diagnosis (type of trauma), and affected teeth. Results The results revealed that male individuals aged 7 to 13 years presented the highest prevalence of injury, and falling was the main causal factor. In most cases, the time elapsed between the accident and the first care ranged from 4 to 24 h. A total of 1,747 teeth were affected, with higher incidence of concussion/subluxation and coronal fracture, followed by lateral luxation and avulsion. The permanent maxillary central incisors were the most commonly affected teeth. Conclusion The frequency and causes of dentoalveolar trauma should be investigated for identification of risk groups, treatment demands and costs in order to allow for the establishment of effective preventive measures that can reduce the treatment duration and costs for both patients and oral health services.

Efficacy of five rotary systems versus manual instrumentation during endodontic retreatment

The purpose of this study was to evaluate the efficiency of ProFile, GT, ProTaper, Race and K3 rotary instruments compared with hand K-files for removal of gutta-percha during retreatment. Sixty mandibular premolars were instrumented with GT rotary files and filled by thermomechanical compaction of gutta-percha and AH Plus sealer. The teeth are randomly divided into 6 groups of 10 specimens each. The roots were split longitudinally, digital images were created using a flatbed scanner, and the areas with remaining filling material were demarcated using Image Tool 1.21 software. The results indicate that GT left significantly less (p<0.05) remaining filling material (1.18 ± 1.47) than hand (3.70 ± 3.16) and Hero instruments (2.99 ± 2.58). There was no statistically significant difference (p<0.05) among the others techniques: ProFile (1.99 ± 2.66), ProTaper (2.00 ± 1.99) and K3 (2.71 ± 2.87) when compared with GT. In conclusion, GT, ProFile, ProTaper and K3 were more effective in removing gutta-percha than manual and Hero instruments.

The Influence of Atopy in the Prognosis of the Replantation of Avulsed Teeth

BACKGROUND Replantation is the most indicated procedure for traumatic dental avulsion, but it invariably results in a greater or lower degree of root resorption. The outcomes of these cases can be affected by some well-known factors. Because studies have shown the importance of the innate and acquired immune response in the mechanisms involved in the resorption of bone tissues, an endeavor was made to verify if such an influence applies to dental resorption. METHODS Fifty-seven avulsed, endodontically treated teeth were assessed in the Endodontics Clinic, Pontifical Catholic University of Paraná. Follow-up of the replanted teeth included periodical clinical examinations and radiographs, in accordance with the control rules of the International Association of Dental Traumatology. The evaluation of atopy was based on the patients personal and family history in conjunction with the skin-prick test for five allergen extracts. RESULTS Of the 46 teeth with a favorable outcome, 33 (71.74%) were in atopic patients, and 13 (28.26%) were in non-atopic patients. Of the 11 teeth with an unfavorable outcome, four (36.36%) were in atopic patients, and seven (63.64%) were in non-atopic patients; a greater prevalence of unfavorable prognoses occurred in non-atopic patients. CONCLUSION The outcome after 1 year for avulsed and replanted teeth is more favorable in atopic patients.

Management of horizontal root‐fractured teeth: report of three cases

Horizontal root fractures frequently occur at the maxillary anterior region and sometimes may be healed without endodontic treatment. Diagnosis of horizontal root fractures is mainly reached by the information obtained in clinical and radiographic examinations. The report of three cases presents horizontal root-fractured teeth, at different thirds, which were healed satisfactory with and without endodontic treatment, rigid splint and carefully monitored.

An in vivo evaluation of the Auto Apical Reverse function of the Root ZX II

AIM To evaluate in vivo the accuracy of the Root ZX II (J. Morita) apex locator in controlling the apical extent of rotary instrumentation when using the Auto Apical Reverse (AAR) set at the levels 0.5, 1.0 and 1.5. METHODOLOGY Thirty single-rooted premolar teeth scheduled for extraction were divided into three groups (n = 10), according to the AAR setting 0.5, 1.0 and 1.5. The root canals were prepared using ProTaper (Dentsply Maillefer). After rotary instrumentation, the last file used (F3) was manually introduced into the extent of the root canal preparation and fixed before tooth extraction. The apical third of the root was dissected until exposure of the file. The distance from the file tip to the major apical foramen was obtained. RESULTS Measurements within the range -1.0 to 0.0 mm were obtained in 30% of the teeth with AAR 0.5, 50% with AAR 1.0 and in 0% with AAR 1.5. The proportions test revealed a significant difference between the AAR settings 1.0 and 1.5 (P = 0.0188). Overinstrumentation occurred in 70% of the teeth with AAR 0.5 and in 40% with AAR 1.0. The measurements short of the acceptable range occurred in 10% of the teeth with setting AAR 1.0 and in 100% of the cases with AAR 1.5. A significant difference was found when comparing the percentage of teeth in which the file tip was short and beyond the established range between groups, except when comparing AAR 0.5 and AAR 1.0. CONCLUSION The AAR function of the Root ZX II was not an accurate method for controlling the apical extent of rotary instrumentation in vivo. The setting 0.5 presented overinstrumentation in most of the canals, the setting 1.5 was short in all cases, and the setting 1.0 provided an adequate working length in only 50% of the teeth.

Lack of correlation between tubular dentine cement penetration, adhesiveness and leakage in roots filled with gutta percha and an endodontic cement based on epoxy amine resin

Objective To analyze possible correlations among tubular dentine cement penetration, adhesiveness and apical leakage in fillings performed with gutta percha and an endodontic cement based on epoxy amine resin. Material and Methods Sixty similar, extracted human mandibular central incisors were irrigated, instrumented and filled following the same protocol. First, apical leakage was quantified by fluid filtration tests. Then, these same specimens were sectioned for analysis of tubular dentine cement penetration and the middle thirds were submitted to push-out tests to analyze the adhesiveness of the fillings. Results In brief, the means and standard deviations with a confidence interval of 95% were as follows: tubular dentine cement penetration (8.875±4.540), adhesiveness (4.441±2.683) and apical leakage (0.318±0.215). The data were confronted using the Pearsons test (P>0.05), and it was possible to prove that there was no correlation between (1) tubular dentine cement penetration and apical leakage (r2: 0.08276), (2) tubular dentine cement penetration and adhesiveness (r2: -0.2412) and (3) adhesiveness and apical leakage (r2: 0.1340). Conclusion After analysis of these data, it could be observed that there exists no correlation among the variables analyzed in this study.

Relationship between extra-alveolar time and atopy in the prognosis of the replantation of avulsed teeth.

BACKGROUND The aim of this in vivo study was to evaluate the correlation between the occurrence of root resorption in avulsed and replanted teeth, extra-alveolar time, and the possible influence of Th2 immunologic profile, represented by patients atopy and its influence in the prognosis of the tooth. METHODS This study evaluated the presence or absence of root resorption in 57 avulsed and replanted teeth. The replantation technique and endodontic treatments were performed following the International Association of Dental Trauma guidelines. Follow-up of the replanted teeth included monthly clinical and radiographic examinations during 1 year. The patients medical examination, including the personal and family allergic history, in conjunction with the skin prick test based the evaluation of patients atopy. RESULTS Of the 37 teeth of atopic patients, 33 (89.2%) teeth did not present root resorption. Of these, 27 (72.9%) had an extra-alveolar time of <1 hour and 6 (16.2%) had an extra-alveolar time >1 hour. Four (10.8%) teeth presented root resorption and an extra-alveolar period of time >1 hour. CONCLUSION These results showed the importance of the extra-alveolar time and the predominantly Th2 immunologic profile, represented by atopic patients, that suffered replantation after dental avulsion in a 1-year follow-up.

Efficacy of protaper instruments during endodontic retreatment

Introduction: The effectiveness of ProTaper Universal and ProTaper Retreatment rotary instruments was compared to the Hedström files in the removal of filling material from root canals. Materials and Methods: Thirty-six extracted human mandibular premolars with a single straight root canal were shaped and filled with gutta-percha and AH Plus. The specimens were stored for 6 months at 37°C and at 100% relative humidity, and then randomly divided into three groups: PTU - removal of filling material performed with ProTaper Universal instruments; PTR - removal of filling material performed with ProTaper Retreatment instruments; HF – removal of filling material performed with Gates-Glidden burs, Hedström files and solvent. After the filling material removal and diaphanization, the specimens were longitudinally sectioned and images of the canal surfaces were scanned. The remaining areas of filling material were measured (Image Tool 3.0), and data was analyzed statistically (Kruskal-Wallis and Dunn tests). The time required for filling removal in each group was also recorded (one-way ANOVA and Tukeys HSD test). Results: All groups presented remnants of filling material; PTU had the smallest amount and HF group presented the highest mean value (P< 0.05) in all the thirds. The cervical third had the smallest amount of material when compared with the other thirds (P< 0.05). HF group required a longer mean time, presenting significant difference (P< 0.05). Conclusion: Considering the time required and the amount of the filling removal, ProTaper Retreatment were not superior to ProTaper Universal, but both rotary instruments were more effective and less time-consuming than Hedström manual files.