RESUMEN

Abstract Objective: To evaluate the periapical healing following root canal treatment in teeth with apical periodontitis (in vivo) and the cytotoxic potential of root canal sealers in vitro. Material and Methods: Apical periodontitis was induced in 60 dogs' teeth and root canals were filled with Sealapex (40 roots), EndoREZ (40 roots), intracanal dressing (20 roots), or left untreated (20 roots). After 30 and 90 days, histopathological analyses were made. In vitro, J774.1 macrophages were stimulated with root canal sealers extracts, cytotoxicity was assessed using lactate dehydrogenase assay, and qRT-PCR was used to analyze TNF-α gene expression. Results: In vivo, smaller apical periodontitis and lower inflammatory cell infiltrate were found in teeth treated with Sealapex compared to EndoREZ. In vitro, EndoREZ was cytotoxic and induced TNF-α gene expression by macrophages differently from Sealapex. Conclusion: Sealapex allowed improved tissue repair following root canal treatment in teeth with apical periodontitis compared to EndoREZ. Synthesis of TNF-α induced by LPS was enhanced by EndoREZ, whereas Sealapex prevented pro-inflammatory gene expression (AU).

Asunto(s)

Animales , Perros , Periodontitis Periapical , Obturación del Conducto Radicular , Técnicas In Vitro , Cavidad Pulpar , Endodoncia , Análisis de Varianza

RESUMEN

Objective: To evaluate the pulpal and periapical response of dogs' teeth after pulpotomy and use of Enamel Matrix Derivative (EMD) as capping agent. Methods: Pulpotomy was performed in 40 teeth from 4 dogs and the remaining pulp tissue was recovered with the following materials: Groups I and IV: EMD (Emdogain®); Groups II and V: calcium hydroxide; Groups III and VI: zinc oxide and eugenol cement. After 7 days (Groups I, II, and III) and 70 days (Groups IV, V, and VI), the animals were euthanized and the teeth were removed and processed for histological analysis; were analyzed using Kruskal-Wallis test followed by Dunn test or Mann Whitney test ( =0.05). Results: 7-day period: in Group I, it was observed a mild to moderate inflammatory infiltrate and intense vascular proliferation while Group II presented a mild inflammatory infiltrate and an intact pulp tissue (p < 0.05). Group III presented a moderate to severe inflammatory infiltrate. 70- day period: Groups IV and VI showed no dentin bridge formation, the remaining pulp tissue presented necrotic areas with inflammatory cells in the periapical region and bone and cementum resorption (p > 0.05). In Group V, there was dentin bridge formation, absence of inflammation and absence of mineralized tissue resorption (p < 0.05). Conclusion: EMD as a capping material after pulpotomy did not show either satisfactory tissue response or capacity of inducing deposition of mineralized tissue in dental pulp.

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Objetivo: Avaliar a resposta pulpar e periapical de dentes de cães após pulpotomia e uso de Derivados de Matriz de Esmalte (EMD) como agente de capeamento. Métodos: A pulpotomia foi realizada em 40 dentes de 4 cães e o tecido pulpar remanescente foi recuperado com os seguintes materiais: Grupos I e IV: EMD (Emdogain®); Grupos II e V: hidróxido de cálcio; Grupos III e VI: cimento de óxido de zinco e eugenol. Após 7 dias (Grupos I, II e III) e 70 dias (Grupos IV, V e VI), os animais foram eutanásiados e os dentes foram removidos e processados para análise histológica; foram analisados pelo teste de Kruskal-Wallis, seguido pelo teste de Dunn ou Mann Whitney ( = 0,05). Resultados: Período de 7 dias: no Grupo I, observou-se infiltrado inflamatório leve a moderado e intensa proliferação vascular, enquanto o Grupo II apresentou infiltrado inflamatório leve e tecido pulpar intacto (p <0,05). O grupo III apresentou infiltrado inflamatório moderado a grave. Período de 70 dias: os grupos IV e VI mostraram, na formação da ponte de dentina, que o tecido pulpar remanescente apresentava áreas necróticas com células inflamatórias na região periapical, reabsorção óssea e de cemento (p> 0,05). No Grupo V, houve formação de ponte de dentina, ausência de inflamação e ausência de reabsorção tecidual mineralizada (p <0,05). Conclusão: O EMD como material de cobertura após pulpotomia não mostrou resposta tecidual satisfatória ou capacidade de induzir deposição de tecido mineralizado na polpa dentária.

Asunto(s)

Animales , Endodoncia , Pulpotomía , Cemento de Óxido de Zinc-Eugenol , Hidróxido de Calcio

RESUMEN

A Endodontia é uma ciência que engloba a etiologia, diagnóstico, prevenção e tratamento da periodontite apical e suas repercussões no organismo. Recu rsos tecnológ icos no diagnóstico, exploração e novas estratégias associadas principalmente à limpeza e desinfecção do sistema de canais radiculares, modelagem e obturação do espaço endodôntico, de acordo com bases biológicas,permitirão a obtenção de melhores padrões de sucesso pós-tratamento.

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Endodontics is a science that embodies etiology, diagnosis, prevention, and treatment of apical periodontitis and its repercussion in the organismo Technological resources in diagnosis and root canal negotiation, and new strategies , associated to mainly cleaning and eliminating the infection of the root canal system, shaping, and filling the endodontic space, according to biological bases, will allow us to reach higher standards of post-treatment success.

Asunto(s)

Cavidad Pulpar , Endodoncia/métodos , Periodontitis Periapical/patología , Preparación del Conducto Radicular

RESUMEN

This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.

Asunto(s)

Materiales de Obturación del Conducto Radicular/farmacología , Tejido Subcutáneo/efectos de los fármacos , Animales , Materiales Biocompatibles/farmacología , Biopsia , Hidróxido de Calcio/farmacología , Colágeno , Tejido Conectivo/efectos de los fármacos , Tejido Conectivo/patología , Fibroblastos/patología , Células Gigantes de Cuerpo Extraño/patología , Tejido de Granulación/efectos de los fármacos , Tejido de Granulación/patología , Macrófagos/patología , Masculino , Ratones , Ratones Endogámicos BALB C , Neutrófilos/patología , Polietileno , Distribución Aleatoria , Salicilatos/farmacología , Tejido Subcutáneo/patología , Factores de Tiempo , Diente Primario , Óxido de Zinc/farmacología , Cemento de Óxido de Zinc-Eugenol/farmacología

RESUMEN

AIM: To investigate the root canal microbiota of primary teeth with apical periodontitis and the in vivo antimicrobial effects of a calcium hydroxide/chlorhexidine paste used as root canal dressing. DESIGN: Baseline samples were collected from 30 root canals of primary teeth with apical periodontitis. Then, the root canals were filled with a calcium hydroxide paste containing 1% chlorhexidine for 14 days and the second bacteriologic samples were taken prior to root canal filling. Samples were submitted to microbiologic culture procedure to detect root canal bacteria and processed for checkerboard DNA-DNA hybridization. RESULTS: Baseline microbial culture revealed high prevalence and cfu number of anaerobic, black-pigmented bacteroides, Streptococcus, and aerobic microorganisms. Following root canal dressing, the overall number of cfu was dramatically diminished compared to initial contamination (P <0.05), although prevalence did not change (P > 0.05). Of 35 probes used for checkerboard DNA-DNA hybridization, 31 (88.57%) were present at baseline, and following root canal dressing, the number of positive probes reduced to 13 (37.14%). Similarly, the number of bacterial cells diminished folowing application of calcium hydroxide/chlorhexidine root canal dressing (P = 0.006). CONCLUSION: Apical periodontitis is caused by a polymicrobial infection, and a calcium hydroxide/chlorhexidine paste is effective in reducing the number of bacteria inside root canals when applied as a root canal dressing.

Asunto(s)

Bacterias Anaerobias/efectos de los fármacos , Cavidad Pulpar/microbiología , Necrosis de la Pulpa Dental/microbiología , Bacterias Gramnegativas/efectos de los fármacos , Periodontitis Periapical/microbiología , Irrigantes del Conducto Radicular/farmacología , Diente Primario/microbiología , Análisis de Varianza , Bacterias Aerobias/efectos de los fármacos , Bacteroides/efectos de los fármacos , Hidróxido de Calcio/farmacología , Distribución de Chi-Cuadrado , Niño , Preescolar , Clorhexidina/farmacología , Recuento de Colonia Microbiana , ADN Bacteriano/análisis , Necrosis de la Pulpa Dental/terapia , Femenino , Humanos , Masculino , Hibridación de Ácido Nucleico , Periodontitis Periapical/terapia , Preparación del Conducto Radicular/métodos , Estadísticas no Paramétricas , Streptococcus/efectos de los fármacos

RESUMEN

This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.

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Neste estudo avaliou-se a resposta do tecido conjuntivo subcutâneo de camundongos BALB/c a materiais obturadores de canal radicular de dentes decíduos: óxido de zinco/eugenol (OZE), pasta Calen® espessada com óxido de zinco (Calen/OZ) e cimento Sealapex®. Os camundongos (n=102) receberam implantes de tubos de polietileno??? e foram divididos em grupos: I, II, III - Calen/OZ (7, 21 e 63 dias, respectivamente); IV, V, VI - Sealapex (7, 21 e 63 dias, respectivamente); VII, VIII, IX - OZE (7, 21 e 63 dias, respectivamente); X, XI - tubo vazio (7 e 21 dias, respectivamente). Os tecidos foram submetidos ao processamento e análise histopatológica descritiva e por meio de escores do fibrosamento, espessura tecidual e infiltrado inflamatório. Para a análise quantitativa mensurou-se a área e a espessura do tecido granulomatoso reacional (TGR). Os resultados foram analisados pelos testes de Kruskal-Wallis, ANOVA e pós-teste de Tukey (?=0,05). Não houve diferença significante (p>0,05) entre os materiais, com relação ao fibrosamento e à espessura do TGR. Contudo, Calen/OZ apresentou infiltrado inflamatório de menor intensidade (p<0,05). A área do TGR foi menor (p<0,05) para Calen/OZ e Sealapex. Pôde-se concluir que Calen/OZ foi o material que apresentou a melhor compatibilidade tecidual, seguido pelos cimentos Sealapex e OZE.

Asunto(s)

Animales , Masculino , Ratones , Materiales de Obturación del Conducto Radicular/farmacología , Tejido Subcutáneo/efectos de los fármacos , Biopsia , Materiales Biocompatibles/farmacología , Colágeno , Hidróxido de Calcio/farmacología , Tejido Conectivo/efectos de los fármacos , Tejido Conectivo/patología , Fibroblastos/patología , Células Gigantes de Cuerpo Extraño/patología , Tejido de Granulación/efectos de los fármacos , Tejido de Granulación/patología , Ratones Endogámicos BALB C , Macrófagos/patología , Neutrófilos/patología , Polietileno , Distribución Aleatoria , Salicilatos/farmacología , Tejido Subcutáneo/patología , Factores de Tiempo , Diente Primario , Cemento de Óxido de Zinc-Eugenol/farmacología , Óxido de Zinc/farmacología

RESUMEN

The purpose of this study was to evaluate the accuracy of electronic apex locators Digital Signal Processing (DSP) and ProPex, for root canal length determination in primary teeth. Fifteen primary molars (a total of 34 root canals) were divided into two groups: Group I - without physiological resorption (n = 16); and Group II - with physiological resorption (n = 18). The length of each canal was measured by introducing a file until its tip was visible and then it was retracted 1 mm. For electronic measurement, the devices were set to 1 mm short of the apical resorption. The data were analysed statistically using the intraclass correlation coefficient (ICC). Results showed that the ICC was high for both electronic apex locators in all situations - with (ICC: DSP = 0.82 and Propex = 0.89) or without resorption (ICC: DSP = 0.92 and Propex = 0.90). Both apex locators were extremely accurate in determining the working length in primary teeth, both with or without physiological resorption.

Asunto(s)

Cavidad Pulpar/anatomía & histología , Odontometría/instrumentación , Procesamiento de Señales Asistido por Computador , Raíz del Diente/anatomía & histología , Diente Primario/anatomía & histología , Humanos , Diente Molar/anatomía & histología , Odontometría/métodos , Resorción Radicular

RESUMEN

This study aimed to assess the response of apical and periapical tissues of dogs' teeth after root canal filling with different materials. Forty roots from dogs' premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort and camphorated paramonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.

Asunto(s)

Cavidad Pulpar/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Diente Primario/efectos de los fármacos , Animales , Diente Premolar/cirugía , Resorción Ósea/etiología , Hidróxido de Calcio/uso terapéutico , Alcanfor/uso terapéutico , Clorofenoles/uso terapéutico , Tejido Conectivo/efectos de los fármacos , Cemento Dental/efectos de los fármacos , Desinfectantes Dentales/uso terapéutico , Cavidad Pulpar/patología , Dentina/efectos de los fármacos , Perros , Combinación de Medicamentos , Edema/etiología , Hidrocarburos Yodados/uso terapéutico , Leucocitos Mononucleares/patología , Ensayo de Materiales , Tejido Periapical/efectos de los fármacos , Tejido Periapical/patología , Ligamento Periodontal/efectos de los fármacos , Ligamento Periodontal/patología , Polietilenglicoles/uso terapéutico , Prednisolona/análogos & derivados , Prednisolona/uso terapéutico , Rifamicinas/uso terapéutico , Preparación del Conducto Radicular/métodos , Resorción Radicular/etiología , Factores de Tiempo , Ápice del Diente/efectos de los fármacos , Ápice del Diente/patología , Diente Primario/patología , Óxido de Zinc/uso terapéutico , Cemento de Óxido de Zinc-Eugenol/uso terapéutico

RESUMEN

INTRODUCTION: This study investigated the inhibition of the antimicrobial activity of sodium hypochlorite (NaOCl) by bovine serum albumin (BSA). The killing of Enterococcus faecalis, Candida albicans, Staphylococcus epidermidis, and Escherichia coli by NaOCl in concentrations from 2% to 0.03% was measured in the presence of BSA in concentrations between 6.7% and 0.1%. METHODS: NaOCl, BSA, and microorganism suspensions were mixed, and, after 30 seconds, 6 minutes, and 30 minutes, samples were taken and NaOCl was inactivated by 5% sodium thiosulphate. The microbes were incubated in tryptic soy broth broth for up to 7 days for the detection of growth. RESULTS: All microorganisms were killed within 30 seconds by 0.03% NaOCl when BSA was not present. High concentrations of BSA significantly reduced the antimicrobial activity of NaOCl against the four species. CONCLUSIONS: The inhibition of sodium hypochlorite by BSA was directly dependent on their quantitative relationships. The result partly explains the poorer performance in vivo of NaOCl as compared to in vitro experiments.

Asunto(s)

Desinfectantes/farmacología , Interacciones Farmacológicas , Pruebas de Sensibilidad Microbiana/métodos , Albúmina Sérica Bovina/farmacología , Hipoclorito de Sodio/farmacología , Animales , Antiinfecciosos Locales/farmacología , Bacterias/efectos de los fármacos , Bovinos , Relación Dosis-Respuesta a Droga , Irrigantes del Conducto Radicular/farmacología

RESUMEN

This study aimed to assess the response of apical and periapical tissues of dogs' teeth after root canal filling with different materials. Forty roots from dogs' premolars were prepared biomechanically and assigned to 4 groups filled with: Group I: commercial calcium hydroxide and polyethylene glycol-based paste (Calen®) thickened with zinc oxide; Group II: paste composed of iodoform, Rifocort® and camphorated paramonochlorophenol; Group III: zinc oxide-eugenol cement; Group IV: sterile saline. After 30 days, the samples were subjected to histological processing. The histopathological findings revealed that in Groups I and IV the apical and periapical regions exhibited normal appearance, with large number of fibers and cells and no resorption of mineralized tissues. In Group II, mild inflammatory infiltrate and mild edema were observed, with discrete fibrogenesis and bone resorption. Group III showed altered periapical region and thickened periodontal ligament with presence of inflammatory cells and edema. It may be concluded that the Calen paste thickened with zinc oxide yielded the best tissue response, being the most indicated material for root canal filling of primary teeth with pulp vitality.

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O objetivo deste estudo foi avaliar a resposta dos tecidos apicais e periapicais de dentes de cães, após obturação dos canais radiculares com diferentes materiais indicados para dentes decíduos. Foram utilizados pré-molares de cães, totalizando 40 raízes que, após pulpectomia e preparo biomecânico, foram divididas em 4 grupos, nos quais os canais radiculares foram obturados com os seguintes materiais: Grupo I - pasta comercial composta de hidróxido de cálcio e polietileno glicol 400 (Calen®) espessada com óxido de zinco; Grupo II - pasta composta de iodofórmio, Rifocort® e paramonoclorofenol canforado; Grupo III - cimento de óxido de zinco e eugenol; e Grupo IV - solução salina. Decorridos 30 dias, as peças foram submetidas ao processamento histológico. De acordo com os resultados da análise histopatológica observou-se que nos Grupos I e IV as regiões apical e periapical apresentaram aspecto de normalidade, com grande número de fibras e células e ausência de reabsorção dos tecidos mineralizados. No Grupo II observou-se infiltrado inflamatório e edema leves, com discreta fibrogênese e reabsorção óssea. O Grupo III apresentou alteração na região periapical e ligamento periodontal ampliado, com presença de células inflamatórias e edema. Os resultados obtidos permitiram concluir que a pasta Calen espessada com óxido de zinco apresentou a melhor resposta tecidual, sendo a mais indicada para a obturação de canais radiculares de dentes decíduos com vitalidade pulpar.

Asunto(s)

Animales , Perros , Cavidad Pulpar/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Diente Primario/efectos de los fármacos , Diente Premolar/cirugía , Resorción Ósea/etiología , Hidróxido de Calcio/uso terapéutico , Alcanfor/uso terapéutico , Clorofenoles/uso terapéutico , Tejido Conectivo/efectos de los fármacos , Combinación de Medicamentos , Cemento Dental/efectos de los fármacos , Desinfectantes Dentales/uso terapéutico , Cavidad Pulpar/patología , Dentina/efectos de los fármacos , Edema/etiología , Hidrocarburos Yodados/uso terapéutico , Leucocitos Mononucleares/patología , Ensayo de Materiales , Tejido Periapical/efectos de los fármacos , Tejido Periapical/patología , Ligamento Periodontal/efectos de los fármacos , Ligamento Periodontal/patología , Polietilenglicoles/uso terapéutico , Prednisolona/análogos & derivados , Prednisolona/uso terapéutico , Rifamicinas/uso terapéutico , Preparación del Conducto Radicular/métodos , Resorción Radicular/etiología , Factores de Tiempo , Ápice del Diente/efectos de los fármacos , Ápice del Diente/patología , Diente Primario/patología , Cemento de Óxido de Zinc-Eugenol/uso terapéutico , Óxido de Zinc/uso terapéutico

RESUMEN

Congenital pathologies are those existing at or dating from birth. Occurrence of congenital cystic lesions in the oral cavity is uncommon in neonates. Eruption cyst (EC) is listed among these unusual lesions. It occurs within the mucosa overlying teeth that are about to erupt and, according to the current World Health Organization (WHO) classification of epithelial cysts of the jaws, EC is a separate entity. This paper presents a case of congenital EC successfully managed by close monitoring of the lesion, without any surgical procedure or tooth extraction. Eruption of the teeth involved, primary central incisors, occurred at the fourth month of age. During this time neither the child nor mother had any complication such as pain on sucking, refusal to feed, airway obstruction, or aspiration of fluids or teeth.

Asunto(s)

Enfermedades del Recién Nacido/patología , Enfermedades Mandibulares/patología , Quistes Odontogénicos/patología , Humanos , Lactante , Recién Nacido , Masculino , Remisión Espontánea , Erupción Dental

RESUMEN

Congenital pathologies are those existing at or dating from birth. Occurrence of congenital cystic lesions in the oral cavity is uncommon in neonates. Eruption cyst (EC) is listed among these unusual lesions. It occurs within the mucosa overlying teeth that are about to erupt and, according to the current World Health Organization (WHO) classification of epithelial cysts of the jaws, EC is a separate entity. This paper presents a case of congenital EC successfully managed by close monitoring of the lesion, without any surgical procedure or tooth extraction. Eruption of the teeth involved, primary central incisors, occurred at the fourth month of age. During this time neither the child nor mother had any complication such as pain on sucking, refusal to feed, airway obstruction, or aspiration of fluids or teeth.

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Patologias congênitas são aquelas que aparecem ao nascimento. A ocorrência de lesões císticas congênitas na cavidade bucal é rara em recém-nascidos. O cisto de erupção (CE) pode ser considerado como lesão rara que se localiza na mucosa que recobre um dente que está próximo do momento de sua erupção. De acordo com a classificação de cistos epiteliais dos maxilares, descrita pela Organização Mundial da Saúde (OMS), os CE são considerados uma entidade distinta. O presente relato descreve um caso clínico de um cisto congênito de erupção tratado com sucesso somente pelo acompanhamento da lesão, sem a necessidade de nenhuma intervenção cirúrgica ou extração dentária. A erupção dos dentes envolvidos (incisivos centrais decíduos) ocorreu aos 4 meses de idade e durante este período não houve reclamações da mãe e/ou da criança em relação a dor para sucção, recusa para se alimentar, obstrução das vias aéreas e aspiração de fluidos ou de dentes.

Asunto(s)

Humanos , Lactante , Recién Nacido , Masculino , Enfermedades del Recién Nacido/patología , Enfermedades Mandibulares/patología , Quistes Odontogénicos/patología , Remisión Espontánea , Erupción Dental

RESUMEN

OBJECTIVE: To evaluate the periapical repair after root canal treatment in the teeth of dogs using CT and conventional radiography and to compare these findings with the gold standard microscopic evaluation. STUDY DESIGN: The animals were divided into three groups according to endodontic treatment performed: Group 1, single-visit endodontic treatment in teeth without apical periodontitis; Group 2, single-visit endodontic treatment in teeth with apical periodontitis; and Group 3, endodontic treatment in teeth with apical periodontitis using calcium hydroxide as a root canal dressing. Group 4 consisted of teeth with apical periodontitis not submitted to root canal treatment and Group 5 consisted of healthy teeth without periapical disease. Radiographic, tomographic, and microscopic evaluations were performed by blind examiners. At 180 days experimental time, CT and radiographic measurements of periapical disease were compared with the gold standard microscopic measurement using intraclass correlation coefficient. Intergroup comparisons considering different methods of periapical lesions measurement or different clinical protocols of root canal treatment were performed by Kruskal Wallis test followed by Dunn. Integrity of lamina dura, presence of radiolucent areas, and presence of root resorption were analyzed by Fisher's exact test. RESULTS: There was discontinuity of the lamina dura and CPD in all teeth from Groups 2, 3, and 4 evaluated by tomography and radiography 45 days after CPD induction. Radiographically, 180 days after root canal treatment, there was no periapical lesion in teeth from Groups 1 and 3, different from groups 2 and 4 (p < .05). The highest reduction in the CPD size was observed on Group 3 (p < .05). According to the tomographic results, there was decrease of the size of the CPD on Group 3 but not on Groups 2 or 4. However, in all groups the periapical lesions presented larger mesio-distal extension if compared with radiography, both 45 days after CPD induction and 180 days after root canal treatment. At 180 days, CT measurements were closely related to microscopic results (ICC = 0.95) differently from radiographic evaluation (ICC = 0.86). CONCLUSION: CT Scan evaluation of periapical repair following root canal treatment provided similar information than that obtained by microscopic analysis, whereas radiographic evaluation underestimated the size do periapical lesion.

Asunto(s)

Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/terapia , Radiografía Dental/métodos , Tratamiento del Conducto Radicular/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Animales , Tomografía Computarizada de Haz Cónico , Perros , Microscopía , Dosis de Radiación , Resorción Radicular/diagnóstico por imagen , Método Simple Ciego , Película para Rayos X

RESUMEN

PURPOSE: The purpose of this study was to evaluate ex vivo the accuracy an electronic apex locator during root canal length determination in primary molars. METHODS: One calibrated examiner determined the root canal length in 15 primary molars (total=34 root canals) with different stages of root resorption. Root canal length was measured both visually with the placement of a K-file 1 mm short of the apical foramen or the apical resorption bevel, and electronically using an electronic apex locator (Digital Signal Processing). Data were analyzed statistically using the intraclass correlation (ICC) test. RESULTS: Comparing the actual and electronic root canal length measurements in the primary teeth showed a high correlation (ICC=0.95). CONCLUSIONS: The Digital Signal Processing apex locator is useful and accurate for apex foramen location during root canal length measurement in primary molars.

Asunto(s)

Cavidad Pulpar/anatomía & histología , Odontometría/instrumentación , Procesamiento de Señales Asistido por Computador/instrumentación , Ápice del Diente/anatomía & histología , Diente Primario/anatomía & histología , Electrónica/instrumentación , Electrónica/estadística & datos numéricos , Humanos , Diente Molar/anatomía & histología , Odontometría/estadística & datos numéricos , Resorción Radicular/patología

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the accuracy of two imaging methods in diagnosing apical periodontitis (AP) using histopathological findings as a gold standard. METHODS: The periapex of 83 treated or untreated roots of dogs' teeth was examined using periapical radiography (PR), cone-beam computed tomography (CBCT) scans, and histology. Sensitivity, specificity, predictive values, and accuracy of PR and CBCT diagnosis were calculated. RESULTS: PR detected AP in 71% of roots, a CBCT scan detected AP in 84%, and AP was histologically diagnosed in 93% (p = 0.001). Overall, sensitivity was 0.77 and 0.91 for PR and CBCT, respectively. Specificity was 1 for both. Negative predictive value was 0.25 and 0.46 for PR and CBCT, respectively. Positive predictive value was 1 for both. Diagnostic accuracy (true positives + true negatives) was 0.78 and 0.92 for PR and CBCT (p = 0.028), respectively. CONCLUSION: A CBCT scan was more sensitive in detecting AP compared with PR, which was more likely to miss AP when it was still present.

Asunto(s)

Periodontitis Periapical/diagnóstico por imagen , Radiografía Dental/métodos , Animales , Tomografía Computarizada de Haz Cónico , Perros , Periodontitis Periapical/patología , Sensibilidad y Especificidad

RESUMEN

INTRODUCTION: Endodontic chelators may extrude to apical tissues during instrumentation activating cellular events on periapical tissues. This study assessed in vitro the expression of nitric oxide (NO) concentrations by murine peritoneal macrophages after contact with MTAD (Dentsply/Tulsa, Tulsa, OK), Tetraclean (Ogna Laboratori Farmaceutici, Muggio, Italy), Smear Clear (Sybron Endo, Orange, CA), and EDTA (Biodinâmica, Ibiporã, PR, Brazil). METHODS: Macrophage cells were obtained from Swiss mice after peritoneal lavage. Chelators were diluted in distilled water obtaining 12 concentrations, and MTT assay identified the concentrations, per group, displaying the highest cell viability (analysis of variance, p < 0.01). Selected concentrations were tested for NO expression using Griess reaction. Culture medium and lipopolysaccharide (LPS) were used as controls. RESULTS: Analysis of variance and Tukey tests showed that all chelators displayed elevated NO concentrations compared with the negative control (p < 0.01). MTAD induced the lowest NO expression, followed by Tetraclean, EDTA, and Smear Clear. No difference was observed between MTAD and Tetraclean (p > 0.01), Tetraclean and EDTA (p > 0.01), and EDTA and Smear Clear (p > 0.01). LPS ranked similar to both EDTA and Smear Clear (p > 0.01). CONCLUSION: The tested endodontic chelators displayed severe proinflammatory effects on murine-cultured macrophages. Citric acid-based solutions induce lower NO release than EDTA-based irrigants.

Asunto(s)

Quelantes/toxicidad , Macrófagos Peritoneales/efectos de los fármacos , Óxido Nítrico/biosíntesis , Irrigantes del Conducto Radicular/toxicidad , Animales , Células Cultivadas , Ácido Cítrico/toxicidad , Ácido Edético/toxicidad , Mediadores de Inflamación/metabolismo , Macrófagos Peritoneales/metabolismo , Ratones

RESUMEN

The purpose of this study was to compare the favorable outcome of root canal treatment determined by periapical radiographs (PRs) and cone beam computed tomography (CBCT) scans. Ninety-six roots of dogs' teeth were used to form four groups (n= 24). In group 1, root canal treatments were performed in healthy teeth. Root canals in groups 2 through 4 were infected until apical periodontitis (AP) was radiographically confirmed. Roots with AP were treated by one-visit therapy in group 2, by two-visit therapy in group 3, and left untreated in group 4. The radiolucent area in the PRs and the volume of CBCT-scanned periapical lesions were measured before and 6 months after the treatment. In groups 1, 2, and 3, a favorable outcome (lesions absent or reduced) was shown in 57 (79%) roots using PRs but only in 25 (35%) roots using CBCT scans (p = 0.0001). Unfavorable outcomes occurred more frequently after one-visit therapy than two-visit therapy when determined by CBCT scans (p = 0.023).

Asunto(s)

Tomografía Computarizada de Haz Cónico/métodos , Cavidad Pulpar/diagnóstico por imagen , Tratamiento del Conducto Radicular , Animales , Diente Premolar/diagnóstico por imagen , Hidróxido de Calcio/uso terapéutico , Resinas Compuestas , Amalgama Dental , Restauración Dental Permanente , Perros , Resinas Epoxi/uso terapéutico , Cementos de Ionómero Vítreo , Gutapercha/uso terapéutico , Metilmetacrilatos/uso terapéutico , Periodontitis Periapical/diagnóstico por imagen , Periodontitis Periapical/terapia , Tejido Periapical/diagnóstico por imagen , Radiografía Dental Digital/métodos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento , Cemento de Óxido de Zinc-Eugenol/uso terapéutico

RESUMEN

Sodium hypochlorite solution is toxic to vital tissues, causing severe effects if extruded during endodontic treatment. This paper presents a report on the tissue damage related to inadvertent extrusion of concentrated sodium hypochlorite solution during root canal treatment. A 65-year-old woman was referred with moderate pain, ecchymosis, and severe swelling of the right side of the face. These symptoms appeared immediately after a root canal treatment of the maxillary right canine, which had been started 21 hours earlier. It was diagnosed as air emphysema related to sodium hypochlorite solution extravasation during the endodontic treatment. To avoid this, an initial radiograph should be taken to determine the correct canal working length and confirm root canal integrity.

Asunto(s)

Extravasación de Materiales Terapéuticos y Diagnósticos/etiología , Tejido Periapical/lesiones , Irrigantes del Conducto Radicular/efectos adversos , Preparación del Conducto Radicular/efectos adversos , Hipoclorito de Sodio/efectos adversos , Anciano , Fístula Dental/etiología , Equimosis/inducido químicamente , Edema/inducido químicamente , Femenino , Humanos , Absceso Periapical/etiología , Tejido Periapical/efectos de los fármacos , Enfisema Subcutáneo/inducido químicamente

RESUMEN

The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p<0.05). AH Plus, Roeko Seal, and Epiphany sealers had similar and satisfactory results (p>0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.

Asunto(s)

Periodontitis Periapical/tratamiento farmacológico , Materiales de Obturación del Conducto Radicular/toxicidad , Animales , Perros , Ensayo de Materiales , Materiales de Obturación del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Estadísticas no Paramétricas

RESUMEN

A determinação do comprimento real de trabalho é uma etapa fundamental para o sucesso clínico, radiográfico e histológico do tratamento endodôntico, principalmente na dentição decídua, com o objetivo de minimizar injúrias periapicais e evitar alterações no germe dos dentes permanentes sucessores. O exame radiográfico é empregado na prática clínica para realização da odontometria, porém a determinação precisa do comprimento do canal radicular é dificultada devido a variações anatômicas, sobreposição de estruturas, distorções, erros técnicos ou erros na projeção. Os localizadores eletrônicos foraminais vêm sendo amplamente utilizados para a realização da odontometria em dentes permanentes, como precisão superior a 90%. Nos últimos anos, esses aparelhos têm sido indicados, também, para dentes decíduos, reduzindo a exposição do paciente infantil à radiação e o tempo de trabalho clínico. O objetivo do presente trabalho será apresentar a indicação, vantagens e eficácia do método eletrônico para odontometria, bem como sua técnica de uso e resultados obtidos na odontometria de dentes decíduos.

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Working length determination is an extremely important step of the endodontic treatment. It is particularly critical in primary teeth in order to minimize periapical injury and possible damage to the permanent successor tooth germ. Radiography is traditionally used for root canal length determination. However, an accurate working length determination is dependent on anatomical variations, interference of anatomical structures or errors in projections. Electronic apex locators have been used for working length determination in permanent teeth with up to 90% accuracy. Over the last years, these devices have also been indicated for primary teeth, reducing the exposure of children to x-rays and the clinical chairtime. The purpose of the present study was to discuss the indications, advantages and the efficacy of electronic working length determination. Additionally, this paper describes a clinical sequence and the published results after using these devices in primary teeth.

Asunto(s)

Endodoncia , Odontometría , Diente Primario