Flares Baratto Filho

Analysis of the Internal Anatomy of Maxillary First Molars by Using Different Methods

The success of endodontic treatment depends on the identification of all root canals so that they can be cleaned, shaped, and obturated. This study investigated internal morphology of maxillary first molars by 3 different methods: ex vivo, clinical, and cone beam computed tomography (CBCT) analysis. In all these different methods, the number of additional root canals and their locations, the number of foramina, and the frequency of canals that could or could not be negotiated were recorded. In the ex vivo study, 140 extracted maxillary first molars were evaluated. After canals were accessed and detected by using an operating microscope, the teeth with significant anatomic variances were cleared. In the clinical analysis, the records of 291 patients who had undergone endodontic treatment in a dental school during a 2-year period were used. In the CBCT analysis, 54 maxillary first molars were evaluated. The ex vivo assessment results showed a fourth canal frequency in 67.14% of the teeth, besides a tooth with 7 root canals (0.72%). Additional root canals were located in the mesiobuccal root in 92.85% of the teeth (17.35% could not be negotiated), and when they were present, 65.30% exhibited 1 foramen. Clinical assessment showed that 53.26%, 0.35%, and 0.35% of the teeth exhibited 4, 5, and 6 root canals, respectively. Additional root canals were located in this assessment in mesiobuccal root in 95.63% (27.50% could not be negotiated), and when they were present, 59.38% exhibited 1 foramen. CBCT results showed 2, 4, and 5 root canals in 1.85%, 37.05%, and 1.85% of the teeth, respectively. When present, additional canals showed 1 foramen in 90.90% of the teeth studied. This study demonstrated that operating microscope and CBCT have been important for locating and identifying root canals, and CBCT can be used as a good method for initial identification of maxillary first molar internal morphology.

Prosthetic rehabilitation and management of an MTA-treated maxillary central incisor with root perforation and severe internal resorption.

Root canal perforation and root resorption are challenging clinical conditions to correctly diagnose and treat, especially when they occur in anterior teeth. This clinical report describes the computed tomography findings, endodontic treatment, prosthetic rehabilitation, and clinical outcome of an iatrogenic root perforation and internal resorption in a maxillary central incisor. The case management consisted of endodontic retreatment, periodontal surgery, and prosthetic rehabilitation. Gray mineral trioxide aggregate (MTA) was used to fill the resorption space and seal the perforation. The prosthetic treatment was performed with glass fiber-reinforced dowels and all-ceramic crowns. No signs or symptoms, including discomfort, pain, or esthetic defects were observed in 30 months of follow-up.

Tratamento ortodôntico em pacientes com dentes reimplantados após avulsão traumática: relato de caso

introduction: The high prevalence of individuals with dental trauma prior to orthodontic treatment justifies the precautions that should be followed before and during treatment, considering all possible effects of orthodontic movement on traumatized teeth. Among the major traumatic dental injuries, avulsion with subsequent tooth reimplantation entails a higher than average risk of complications, such as pulp necrosis, root resorption and ankylosis. Therefore, it gives orthodontists several reasons for concern. o bjective: This case report sought to analyze the implications of tooth reimplantation after traumatic avulsion in patients requiring orthodontic treatment. conclusions: Tooth movement of a reimplanted tooth after traumatic avulsion is viable provided no signs of abnormality are present. Ankylosed teeth, however, are not amenable to orthodontic movement but should be preserved as space maintainers until root resorption is completed, provided that the teeth do not present with severe infraocclusion. Should an ankylosed tooth be in severe infraocclusion, crown amputation and root burial are indicated as a means to preserve the alveolar bone in the region, since resorption will occur by replacement of the buried root, as was the case in this report. Abstract

Performance in vitro of apex locators in determining root length in primary molars

Objetivo: Avaliar o desempenho in vitro de radiografia digital e de dois localizadores apicais eletronicos, Propex II e Root ZX na determinacao do comprimento de canal em molares deciduos. Metodos: Foram selecionados 25 molares deciduos divididos em dois grupos, G1, sem reabsorcao radicular e G2 com reabsorcao radicular. Os exames foram realizados utilizando todos os metodos por dois examinadores experientes, com intervalo de 1 semana. O padrao ouro foi determinada por exame visual. Os metodos foram analisados estatisticamente em relacao aos valores de reprodutibilidade e correlacionada com o padrao ouro pelo coeficiente de correlacao de Pearson. Resultados: A determinacao de comprimento de canal coincidiu com padrao-ouro em 22,7% para o Root ZX, 17,5% para Propex II e 12,5% para a radiografia digital. valores de correlacao foram maiores no G1, o Root ZX apresentou os maiores valores. Em G2 da radiografia digital apresentou a menor correlacao. No G1, os valores de reprodutibilidade intra-examinador variou 0,925-0,523 e interexaminadores 0,863-0,670. No G2, os valores da reprodutibilidade intra-examinador varia 0,864-0,097, e inter era 0,774-0,379. Conclusao: Concluiu-se que o desempenho dos metodos varia de acordo com a experiencia do examinador. O Root ZX apresentou maior reprodutibilidade e precisao.

Effect of Sonic Vibrations on Bond Strength of Fiberglass Posts Bonded to Root Dentin

Sonic vibrations may improve the bond strength and durability of fiberglass posts by improving adhesive penetration into dentin as well as the cement flow. The objective of this study was to evaluate the effect of sonic vibrations on the bond strength between fiberglass posts and root dentin using the pull-out test. Bovine roots were endodontically treated and divided randomly into four groups (n=12): Group C - conventional cementation (control); Group SA - sonic vibration (Smart Sonic Device, FGM) of the adhesive system and conventional post accommodation; SP group - conventional adhesive application and sonic vibration of the post during accommodation; and SASP - sonic vibration of the system adhesive and the post during accommodation. The posts were cleaned, treated with a silane and adhesive system (Ambar, FGM), and cemented with a dual-cured resin cement (Allcem Core, FGM). After 24 h, the specimens were subjected to mechanical tests and failure analyses. Representative specimens were analyzed by a scanning electron microscope to observe the cementation line. The results were analyzed using ANOVA and Tukeys test (a=5%). The bond strengths were as follows: SASP (90.9±27.1 N), C (121.4±60.6 N), SA (127.6±31.8 N) and SP (156.4±41.3 N). The use of sonic vibrations during the application of adhesive or post cementation separately did not affect the bond strength but had a negative effect when used for both procedures.

Oral tissue response to ovine grafting biomaterial: Morphological and morphometric study using scanning electron and light microscopy tissue response to ovine grafting biomaterial

OBJECTIVE: To evaluate the oral tissue response to an experimental particle ovine biomaterial by scanning electron microscopy (SEM) and light microscopy (LM). MATERIAL AND METHODS: Forty‐eight rats had surgical periodontal defects treated with either blood clotting (control), bovine biomaterial™ (B), or an experimental ovine biomaterial (O). Data from SEM analysis (defect exposure, root surface exposure, diameter of matrix fibers and bundles, and globuli areas; n = 5) were applied to Shapiro–Wilk, Kruskal–Wallis, and Dunns test, whereas LM analysis (tissue cicatrization characteristics and diameter defect; n = 3) had data applied to two‐way analysis of variance. Animals were monitored for 1 and 3 weeks. RESULTS: By SEM, the O samples showed significant differences from B and C in the area of defect exposure (H2,15 = 8.66; P < 0.05). In both periods, O and B samples showed similar results for matrix fiber diameters, differently than C samples (H2,15 = 14.0; P < 0.05). All other SEM variables were considered equivalent among the groups (P > 0.05). Under LM, an acute and chronic granulomatous inflammation was seen in the presence of both biomaterials (B and O, 1 week); both the control and the ovine grafting samples showed mature bone in the repair site (3 weeks); the defect diameter showed similar values among groups, at both monitoring periods (F2,12 = 1.0401; P > 0.05). CONCLUSION: The ovine particles of this study showed a favorable response to oral tissue repair, demonstrating to be a potential source for the development of bone grafting biomaterials. Microsc. Res. Tech. 2012.