RESUMEN

Purpose: To report on a case of the successful treatment of Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) in a pediatric patient with a prior diagnosis of cerebral vasculitis. Observations: A 16-year-old male with a prior diagnosis of cerebral vasculitis presented without ocular complaints. Visual acuity was 20/20, and color vision remained normal. Fundus examination revealed yellowish-white placoid lesions and retinal pigmented epithelial changes involving the posterior pole. A work-up including a rapid plasma reagin test, complete cell blood count, comprehensive metabolic panel, and urinalysis was within normal limits. A head computed tomography angiography without contrast and a brain magnetic resonance imaging scan were compatible with acute and past episodes of ischemia. Ancillary testing was compatible with an assessment APMPPE. Immunosuppressive and monoclonal antibody therapy resulted in the improvement and remission without residual neurologic deficits and with a BCVA of 20/20. Conclusionand Importance: This case suggests that a diagnosis of cerebral vasculitis should prompt physicians to consider an ophthalmic evaluation that includes a dilated fundus exam, regardless of the presence or absence of ocular symptoms. Ophthalmic findings may affect the diagnostic processes, particularly concerning infectious and non-infectious etiologies, or potentially neoplastic diseases.

RESUMEN

This study evaluated the setting time, pH, calcium ion release, solubility, and chemical structure of four calcium silicate sealers after ultrasonic activation (UA). Five sealers were evaluated: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC), and BioRoot RCS (BR). Ten groups were created based on the use or not of ultrasonic activation: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; and BR/UA. Setting time was performed based on ISO 6876:2012 and ASTM C266-07 specifications. Solubility at 24hs, based on ISO 6876:2012. pH and calcium release were evaluated at 1, 24, 72, and 168hs. Raman spectroscopy was used to evaluate structural changes. Quantitative data were analyzed using One-Way ANOVA and Tukey post-hoc test (α=5%). Raman spectroscopy results were qualitatively analyzed. Setting times and solubility of all sealers were not affected by UA (p>0.05). The highest solubility was found for BCS, BCS/UA; and BR, BR/UA (p<0.05). After 24hs, calcium silicate sealers had higher pH than SP and SP/UA (p<0.05). BR and BR/UA had the highest pH at all time points. SP and SP/UA had stable pH at all time points. SP and SP/UA had the lowest calcium release values at all time points (p<0.05). EBC and EBC/UA calcium release significantly differ at 24,72 and 168hs (p<0.05). No chemical changes were observed during Raman spectroscopy. In conclusion, ultrasonic activation affected calcium ion release only for EndoSequence BC Sealer. Ultrasonic activation did not influence the initial and final setting time, solubility, pH, and chemical structure of any investigated sealers.

Asunto(s)

RESUMEN

A major part of the described species is understudied, falling into the Linnean shortfall. This is a major concern for cryptic species, which require integrative approaches to better evaluate their diversity. We conducted morphological analyses using specimens of Stellifer punctatissimus, S. gomezi, and S. menezesi to reassess their taxonomical identity. We evaluated the allometric and sexual components of the morphology of the Stellifer punctatissimus species complex, and tested and discussed species hypotheses. The combined evidence of our work and previous studies agrees with the current morphological hypothesis of three species, as opposed to the two-lineage molecular hypothesis. However, as cryptic species, they overlap in most their traits, especially females and juveniles. Previously unaccounted variation of allometric and sexually dimorphic characters in this species complex revealed a confounding effect that might explain past and current taxonomic errors. Taxonomical practice of using body depth as a diagnostic character had led to juveniles and females being, respectively, described as a different species or wrongfully identified. Hence, taxonomical studies demand better assessment of allometric and sexual dimorphism components. Herein, we present new characters in a key to the Atlantic species of Stellifer, which disclose size and sexual variation unnoticed in previous studies. The contrasting growth patterns among these species could imply distinct habitat use. As a result, it could be suggested that such species are under different threats, which highlights the need of differential management and conservation strategies.

Asunto(s)

RESUMEN

Aims: This study aimed to evaluate the intraoperative pain (IOP) occurrence in situations of symptomatic irreversible pulpitis (SIP) and symptomatic apical periodontitis (SAP). Materials and Methods: Patients who sought emergency care presenting a diagnosis of SIP or SAP were included. IOP was measured with a Visual Analogue Scale (VAS) after five minutes of local anesthesia, during access to the pulp chamber, root canal exploration and at the end of procedures. In cases where pain was reported during treatment, supplementary anesthesia was performed. Pain scores were recorded and analyzed using a generalized estimating equation model with posthoc comparisons. Results: 56 patients were included. 35 had a diagnosis of SIP; and 21 a diagnosis of SAP. Mean preoperative pain scores for SAP and SIP were 6.69 (±1.54) and 6.39 (±1.48), respectively (p>0.05). In patients with SIP, significant differences were observed between: preoperative scores and other time points; scores after five minutes of local anesthesia and other time points; scores during pulp chamber access and at the end of procedures; and scores during root canal exploration and at the end of procedures (p<0.05). In patients with SAP, significant differences were observed between preoperative pain scores with all other time points (p<0.05). Chi-square test indicated an association between diagnosis and the need for supplementary anesthesia (p<0.05). Conclusions: In conclusion, there is a strong relationship between reduction of moderate/severe pain after application of local anesthesia. The need for supplemental anesthesia is significantly associated to the diagnosis of symptomatic irreversible pulpitis.

RESUMEN

This study evaluated a new method of adhesive system application on the bond strength between fiber post and root dentin using two adhesive systems. The canals of sixty bovine incisors were prepared and obturated. The roots were divided into six groups (n=10) according to the adhesive system (Clearfil SE - CSE and Single Bond Universal - SBU) and the application strategy (microbrush - MB; rotary brush - RB; and ultrasonic tip - US). The glass fiber posts were cemented with resin cement (RelyX ARC). The roots were sectioned perpendicularly to their long axis, and three slices per root were obtained. Previously to the push-out test, confocal laser scanning microscopy (CLSM) was performed to illustrate the interfacial adaptation of the cement to the root canal walls. Failure patterns were analyzed with 40x magnification. Shapiro-Wilk indicated a normal distribution of the data. The bond strength values were compared using one-way ANOVA and Tukey's tests. Student's T test analyzed the differences between the adhesive systems within each third and protocol. A significance level of 5% was used. CSE with RB showed higher mean bond strength values compared to MB (conventional technique) (P < 0.05). US application resulted in intermediate bond strength values for CSE (P > 0.05). The application of SBU using RB generated higher mean bond strength values compared to MB and US (P < 0.05). Adhesive failures were predominant (65.5%). CSE and SBU application with the new rotary brush improved the bond strength of fiber posts to root dentin compared to the conventional strategy.

Asunto(s)

RESUMEN

Assessing scientific literature about prevalence of periapical lesions in individuals with osteoporosis in comparison to those without osteoporosis. Systematic searches were conducted up to November 24th, 2023 in Cochrane Library, EMBASE, MEDLINE/PubMed, SCOPUS, Web of Science and Grey Literature Reports databases. Only observational studies were included. The ROBINS-E tool, a revised Cochrane instrument for assessing bias in nonrandomized exposure studies, was employed. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was utilized to evaluate the certainty of the evidence. From 484 studies, three were included. One of them was categorized as having an exceptionally high risk of bias, while two were deemed to have certain concerns. Two studies reported that osteoporotic patients may have more chances to present a periapical lesion compared to non-osteoporotic patients. One study reported no differences between groups. The GRADE analysis indicated a markedly low level of certainty in the evidence. The present review indicates that osteoporotic patients may present more periapical lesions compared to non-osteoporotic patients. This statement should be cautiously interpreted and further well-designed studies are needed. (EEJ-2023-09-123).

RESUMEN

Schwannomas, also known as neurilemomas, are peripheral nerve sheath neoplasms. They can be sporadic or associated with genetic syndromes including neurofibromatosis type 2 (NF2). Schwannomas may lead to symptoms by exerting pressure on nearby structures, such as nerve and muscle fibers. In this study, we present the case of a 22-year-old female with a history of NF2 who, upon examination, presented with a visibly enlarged salmon-colored mass involving the left inferior rectus that she had since the age of 12 years. Ocular examinations revealed a small left hypertropia and exotropia in all gazes. Magnetic resonance imaging confirmed bilateral involvement of the inferior rectus muscles. She had a partial excisional biopsy of the mass involving the left inferior rectus muscle that confirmed the presence of schwannoma. This case highlights the importance of comprehensive evaluation of sensory and motor functions as well as considering orbital schwannomas in cases of strabismus, especially within the context of neurofibromatosis.

RESUMEN

Introduction: The current study aimed to compare the quality of root canal obturation performed with cold lateral condensation with other obturation techniques. Materials and Methods: Diverse Search was conducted using six electronic/academic databases following PICOS (i.e. population, intervention, control, outcomes, and study design) strategy: (P) Extracted mature permanent teeth; (I) Obturation techniques except for cold lateral condensation; (C) Cold lateral condensation tyechnique; (O) Quality of root canal obturation; and (S) In vitro studies assessing parameters using micro-computed tomography. The statistical method used for the meta-analyses was the "inverse variance DerSimonian-Laird test". The heterogeneity data was calculated using the T2, Cochran Q test, and I2 statistics. Results: Fifteen studies were included for the final analysis; one had a low risk of bias, eight a moderate risk, and six a high risk of bias. Ten studies were selected for meta-analyses; three studies comparing cold lateral condensation with carrier-based gutta-percha techniques [P=0.96; mean difference (MD)=-0.02; confidence interval (CI): (-0.77, 0.73); I2=21%]; three comparing cold lateral condensation with single-cone techniques [P=0.75; MD=-0.39; CI: (-2.77, 1.99); I2=92%]; two comparing cold lateral condensation and thermo-plasticized injectable techniques [P=0.37; MD=5.91; CI: (-7.13,18.94); I2=99%]; and five comparing cold lateral condensation with warm vertical condensation techniques [P<0.0001; MD=5.29; CI=(2.84, 7.74); I2=92%]. The overall effect reported significant results [P=0.0003; MD=2.69; CI=(1.23, 4.16); I2=96%]; favoring fewer voids and gaps for the other used obturation techniques. Conclusions: Cold lateral condensation and single-cone techniques presented no statistical differences. Nonetheless, Warm vertical condensation technique had better results compared to cold lateral condensation.

RESUMEN

Acyl-CoA binding domain containing 5 (ACBD5) is a critical player in handling very long chain fatty acids (VLCFA) en route for peroxisomal ß-oxidation. Mutations in ACBD5 lead to the accumulation of VLCFA and patients present retinal dystrophy, ataxia, psychomotor delay and a severe leukodystrophy. Using CRISPR/Cas9, we generated and characterized an Acbd5 Gly357* mutant allele. Gly357* mutant mice recapitulated key features of the human disorder, including reduced survival, impaired locomotion and reflexes, loss of photoreceptors, and demyelination. The ataxic presentation of Gly357* mice involved the loss of cerebellar Purkinje cells and a giant axonopathy throughout the CNS. Lipidomic studies provided evidence for the extensive lipid dysregulation caused by VLCFA accumulation. Following a proteomic survey, functional studies in neurons treated with VLCFA unravelled a deregulated cytoskeleton with reduced actin dynamics and increased neuronal filopodia. We also show that an adeno-associated virus-mediated gene delivery ameliorated the gait phenotypes and the giant axonopathy, also improving myelination and astrocyte reactivity. Collectively, we established a mouse model with significance for VLCFA-related disorders. The development of relevant neuropathological outcomes enabled the understanding of mechanisms modulated by VLCFA and the evaluation of the efficacy of preclinical therapeutic interventions.

Asunto(s)

RESUMEN

AIM: This study aimed to use the micro-computed tomography to evaluate the interfacial adaptation and the presence of gaps of NeoMTA Plus, BioRoot RCS, and MTA in the root-end cavities. METHODOLOGY: Thirty standardized bovine roots measuring 15 mm in length were selected. Chemical-mechanical preparation was performed up to instrument #80 and obturation with the cold lateral compaction technique with cement based on zinc oxide and eugenol. The roots were kept at 37°C for 7 days. Afterward, apicectomy of the apical 3 mm and a root-end filling cavity was performed at 3 mm depth. Micro-computed tomography (micro-CT) was performed to measure the volume of the retroactivity. The roots were divided by stratified randomization into three groups according to the retro-end filling material: NeoMTA Plus, BioRoot RCS, and MTA. A new micro-CT was performed to assess the presence of voids in the root-end filling material and between it and the canal wall. One-way ANOVA and Tukey tests were performed using the BioEstat 4.0 program. RESULTS: There was no difference in the initial volume values of the root-end cavities (p > .05). After the insertion of root-end filling materials, the most significant volumes of voids were observed in the NeoMTA Plus group (p < .05), with no difference for the BioRoot RCS and MTA Angelus groups (p > .05). CONCLUSION: Micro-computed tomography showed that MTA and BioRoot RCS have better interfacial adaptation and presented fewer number of gaps than NeoMTA Plus when used as root-end filling materials. RESEARCH HIGHLIGHTS: Micro-computed tomography evaluation of different root-end fillings materials.

Asunto(s)

RESUMEN

Abstract This study evaluated the setting time, pH, calcium ion release, solubility, and chemical structure of four calcium silicate sealers after ultrasonic activation (UA). Five sealers were evaluated: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC), and BioRoot RCS (BR). Ten groups were created based on the use or not of ultrasonic activation: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; and BR/UA. Setting time was performed based on ISO 6876:2012 and ASTM C266-07 specifications. Solubility at 24hs, based on ISO 6876:2012. pH and calcium release were evaluated at 1, 24, 72, and 168hs. Raman spectroscopy was used to evaluate structural changes. Quantitative data were analyzed using One-Way ANOVA and Tukey post-hoc test (α=5%). Raman spectroscopy results were qualitatively analyzed. Setting times and solubility of all sealers were not affected by UA (p>0.05). The highest solubility was found for BCS, BCS/UA; and BR, BR/UA (p<0.05). After 24hs, calcium silicate sealers had higher pH than SP and SP/UA (p<0.05). BR and BR/UA had the highest pH at all time points. SP and SP/UA had stable pH at all time points. SP and SP/UA had the lowest calcium release values at all time points (p<0.05). EBC and EBC/UA calcium release significantly differ at 24,72 and 168hs (p<0.05). No chemical changes were observed during Raman spectroscopy. In conclusion, ultrasonic activation affected calcium ion release only for EndoSequence BC Sealer. Ultrasonic activation did not influence the initial and final setting time, solubility, pH, and chemical structure of any investigated sealers.

Resumo Esse estudo avaliou o tempo de presa, pH, liberação de íons cálcio, solubilidade e estrutura química de quatro cimentos à base de silicate de cálcio após a ativação ultrassônica . Cinco cimentos foram avaliados: Sealer Plus (SP - control); Sealer Plus BC (SPBC), Bio C Sealers (BCS), Endosequence BC Sealer (EBC) e BioRoot RCS (BR). Dez grupos foram criados com base no uso ou não de ativação ultrassônica: SP; SP/UA; SPBC; SPBC/UA; BCS; BCS/UA; EBC; EBC/UA; BR; e BR/UA. Tempo de presa foi realizado baseado nas especificações ISO 6876:2012 e ASTM C266-07. Solubilidade em 24hs, baseado na ISO 6876:2012. pH e liberação de cálcio foram avaliados em 1, 24, 72 e 168hs. Espectroscopia Raman foi usada para avaliar alterações estruturais. Os dados quantitativos foram analisados utilizando ANOVA de uma via e teste post-hoc de Tukey (α=5%). Os resultados da espectroscopia Raman foram analisados qualitativamente. Os tempos de presa e a solubilidade de todos os cimentos não foram afetados pelo AU (p>0.05). Maior solubilidade foi encontrada para BCS, BCS/AU; e BR, BR/AU (p<0.05). Após 24hs, os cimentos de silicato de cálcio apresentaram pH mais elevado que SP e SP/AU (p<0.05). BR e BR/AU tiveram o pH mais alto em todos os momentos. SP e SP/AU apresentaram pH estável em todos os momentos. SP e SP/AU tiveram os menores valores de liberação de cálcio em todos os momentos (p<0.05). A liberação de cálcio EBC e EBC/AU diferiram significativamente em 24,72 e 168hs (p<0.05). Nenhuma alteração química foi observada durante a espectroscopia Raman. Em conclusão, a ativação ultrassônica afetou a liberação de íons cálcio apenas para o EndoSequence BC Sealer. A ativação ultrassônica não influenciou o tempo de presa inicial e final, a solubilidade, o pH e a estrutura química de nenhum dos cimentos investigados.

RESUMEN

Abstract This study evaluated a new method of adhesive system application on the bond strength between fiber post and root dentin using two adhesive systems. The canals of sixty bovine incisors were prepared and obturated. The roots were divided into six groups (n=10) according to the adhesive system (Clearfil SE - CSE and Single Bond Universal - SBU) and the application strategy (microbrush - MB; rotary brush - RB; and ultrasonic tip - US). The glass fiber posts were cemented with resin cement (RelyX ARC). The roots were sectioned perpendicularly to their long axis, and three slices per root were obtained. Previously to the push-out test, confocal laser scanning microscopy (CLSM) was performed to illustrate the interfacial adaptation of the cement to the root canal walls. Failure patterns were analyzed with 40x magnification. Shapiro-Wilk indicated a normal distribution of the data. The bond strength values were compared using one-way ANOVA and Tukey's tests. Student's T test analyzed the differences between the adhesive systems within each third and protocol. A significance level of 5% was used. CSE with RB showed higher mean bond strength values compared to MB (conventional technique) (P < 0.05). US application resulted in intermediate bond strength values for CSE (P > 0.05). The application of SBU using RB generated higher mean bond strength values compared to MB and US (P < 0.05). Adhesive failures were predominant (65.5%). CSE and SBU application with the new rotary brush improved the bond strength of fiber posts to root dentin compared to the conventional strategy.

Resumo Este estudo avaliou o efeito de um novo método para aplicação do sistema adesivo na resistência de união entre pino de fibra e dentina radicular usando dois sistemas adesivos. Os canais de sessenta incisivos bovinos foram preparados e obturados. As raízes foram divididas em seis grupos (n=10) de acordo com o sistema adesivo (Clearfil SE - CSE e Single Bond Universal - SBU) e com a estratégia de aplicação (microbrush - MB, escova rotatória - RB e inserto ultrassônico - US). Os pinos de fibra foram cimentados utilizando cimento resinoso (RelyX ARC). As raízes foram seccionadas perpendicularmente ao seu longo eixo e três fatias foram obtidas. Previamente ao teste de push-out, foi realizada microscopia de varredura confocal a laser para ilustrar a adaptação interfacial do cimento às paredes do canal radicular. Os padrões de falha foram analisados com magnificação de 40x. O teste de Shapiro-Wilk indicou distribuição normal dos dados. Os valores de resistência de união foram comparados usando o teste ANOVA de uma via e post hoc de Tukey. As diferenças entre os sistemas adesivos em cada terço e de acordo com cada protocolo foram analisadas pelo teste T de Student. O nível de significância foi de 5%. CSE aplicado com RB apresentou maiores valores médios de resistência de união do que quando aplicado com MB (técnica convencional) (P<0,05). Aplicação com US apresentou valores intermediários de resistência de união para o CSE (P>0,05). A aplicação do SBU utilizando RB gerou maiores valores médios de resistência de união comparados com MB e US (P<0,05). Falhas adesivas foram predominantes (65,5%). A aplicação do CSE e SBU com a nova escova rotatória melhorou a resistência de união dos pinos de fibra à dentina radicular comparados com a estratégia convencional.

RESUMEN

This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

RESUMEN

This study compared the pH and calcium ion release of calcium silicate- (Bio-C Temp) and calcium hydroxide-based (Ultracal XS) medications. Intracanal remnants of both medications were also evaluated using SEM-EDS after the removal protocol. Thirty-five bovine teeth were prepared. Fifteen were filled with Bio-C Temp and 15 with Ultracal XS. Five remained without intracanal medication (control group). Five samples from each experimental time (i.e.. 24, 72, and 168 hours) were used to measure pH and calcium ions release using a digital pH meter and microplate reader, respectively. Afterward, the peaks of the chemical elements composing both medications were analyzed in SEM-EDS. One-way ANOVA and Tukey's post hoc test analyzed the pH and calcium ion release data. Student's t-test compared the medications in each experimental time. SEM-EDS described the percentage of chemical elements in the samples. Bio-C Temp and Ultracal XS showed a significant pH increase from 24 to 168 hours (p<0.05). Ultracal XS showed a higher pH value at 24 hours than Bio-C Temp (p<0.05) but were similar at 72 and 168h (p > 0.05). Calcium ion release did not depend on the experimental period (p > 0.05). Bio-C Temp showed lower calcium ions release than Ultracal XS at 24 hours (p<0.05). SEM-EDS analyses showed the remains of both medications, but the concentration of Si, Al, and W ions was present only in the calcium silicate-based medication. Bio-C Temp presented alkaline pH and a satisfactory calcium ion release over the time. The remaining of both medications were present after the protocols for paste removal.

Asunto(s)

RESUMEN

BACKGROUND: Glioblastoma is a severe brain tumor that requires aggressive treatment involving surgery, radiotherapy, and chemotherapy, offering a survival rate of only 15 months. Fortunately, recent nanotechnology progress has enabled novel approaches and, alongside ferrocenes' unique properties of cytotoxicity, sensitization, and interaction with reactive oxygen species, have brought new possibilities to complement chemotherapy in nanocarrier systems, enhancing treatment results. METHODS: In this work, we developed and characterized a temozolomide-loaded nanoemulsion and evaluated its cytotoxic potential in combination with ferrocene in the temozolomide-resistant T98G and temozolomide-sensitive U87 cell lines. The effects of the treatments were assessed through acute assays of cell viability, cell death, mitochondrial alterations, and a treatment protocol simulation based on different two-cycle regimens. RESULTS: Temozolomide nanoemulsion showed a z-average diameter of 173.37 ± 0.86 nm and a zeta potential of - 6.53 ± 1.13 mV. Physicochemical characterization revealed that temozolomide is probably associated with nanoemulsion droplets instead of being entrapped within the nanostructure, allowing a rapid drug release. In combination with ferrocene, temozolomide nanoemulsion reduced glioblastoma cell viability in both acute and two-cycle regimen assays. The combined treatment approach also reversed T98G's temozolomide-resistant profile by altering the mitochondrial membrane potential of the cells, thus increasing reactive oxygen species generation, and ultimately inducing cell death. CONCLUSIONS: Altogether, our results indicate that using nanoemulsion containing temozolomide in combination with ferrocene is an effective approach to improve glioblastoma therapy outcomes.

Asunto(s)

RESUMEN

Aims: This systematic review aimed to evaluate whether calcium silicate-based sealers are less cytotoxicity and genotoxicity than epoxy resin-based sealers. Materials and Methods: Systematic searches were conducted for studies published up to September 27th, 2022, without restriction for language or year of publication, in the following databases: MEDLINE/PubMed, Scopus, Web of Science and Grey Literature Report. Only in vitrostudies that evaluated the cytotoxicity or genotoxicity of calcium silicate and epoxy resin-based sealers were included. The quality assessment was performed. Results: After duplicate removal and eligibility criteria assessment, a total of thirty-four studies were included. Twenty-eight studies had a low risk of bias, and six studies had amoderate risk of bias. In general, calcium silicate-based sealers had a lower cytotoxic and genotoxic potential than epoxy-resin based sealers.Conclusions: Based on the findings from in vitrostudies, calcium silicate-based sealers are less cytotoxic andgenotoxic than epoxy resin-based sealers

RESUMEN

Aims: To investigate whether bioceramicsealers induce a lower incidence and intensity of postoperative pain compared to other sealers. Materials and Methods: Six electronic databases were searched for studies published up to April 2022, following the PICOS strategy: (P) adult patients undergoing root canal treatment or retreatment; (I) root canal filling using bioceramic sealer; (C) root canal filling using other types of sealers; (O) Primary: postoperative pain incidence and/or intensity; Secondary: number of medication intake; (S) randomizedclinical trials. Risk of bias assessment was performed with the revised Cochrane risk of bias tools for randomized trials (RoB 2). Overall certainty of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Results: Ten studies were included. Eight studies had a low risk of bias, and two had some concerns risk. Meta-analyses showed no differences regarding postoperative pain intensity and incidence between bioceramic sealers and AH Plus. Number of medication intake seemed to be associated to the preoperative diagnosis. Zinc oxide-eugenol sealer demonstrated an intense postoperative pain compared to bioceramic sealers and AH Plus. GRADE analysis showed a low certainty of evidence for all outcomes. Conclusions: There seem to be no differences between bioceramic sealers and AH Plus regarding postoperative pain intensity and incidence. Number of medication intake seem to be associated to the preoperative diagnosis. Zinc oxide-eugenol evoked a more pronounced postoperative pain.

RESUMEN

This review aimed to answer the following question "Does photobiomodulation treatment of the root surface decrease the occurrence of root resorption in reimplanted teeth?" Electronic searches were performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report databases. Risk of bias was evaluated using SYRCLE Risk of Bias tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool was used to assess the certainty of evidence. In total, 6 studies were included. Five studies reported a reduced occurrence of root resorption in teeth that received photobiomodulation treatment of the root surface prior to replantation. Only 1 study reported contradictory results. The photobiomodulation parameters varied widely among studies. GRADE assessment showed a low certainty of evidence. It can be inferred that photobiomodulation treatment of the root surface prior to replantation of teeth can reduce the occurrence of root resorption. Nonetheless, further clinical studies are needed. Trial Registration: PROSPERO Identifier: CRD42022349891.

RESUMEN

OBJECTIVES: Endodontic treatment is one of the most fearful procedures among dentistry, and the use of music during the procedure has been evaluated to control patients' anxiety. This systematic review has been conducted to provide a synthesis of the state of knowledge in this field and aimed to answer the following question: "Can music therapy reduce patient's state anxiety during endodontic treatment?". METHODS: A search was performed in six electronic databases (PubMed, Cochrane Library, Scopus, Web of Science, EMBASE, and Open Gray) for articles published until April 2022. The eligibility criteria, based on the PICOS strategy, were as follows: (P) patients undergoing endodontic treatment; (I) exposure to music; (C) no music; (O) patients' anxiety; (S) only randomized clinical trials. The risk of bias was analyzed according to the Cochrane Risk of Bias tool for randomized controlled trials (RoB 2). The strength of evidence from the included studies was assessed using the Grading of Assessment, Development, and Assessment Recommendations (GRADE) tool. RESULTS: Five eligible studies were retrieved. A low to high risk of bias was verified. Descriptive analysis showed an effect in favor of music intervention, with differences among state anxiety, heart rate and blood pressure. CONCLUSIONS: With a very low quality of evidence, dental care professionals may consider playing background music during endodontic treatment since it is a cost-effective and easy alternative to trying to reduce dental anxiety. CLINICAL RELEVANCE: Five studies were included in this systematic review and showed, with a very low quality of evidence, that music may reduce state anxiety levels on patients during root canal treatment.

Asunto(s)

RESUMEN

This study evaluated the cyclic and torsional fatigue resistance of a new nickel-titanium (Flat File 25.04) instrument on the continuous and reciprocating motion. Sixty instruments of the ProDesign Logic2 25.03 and 25.05 (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil), and MK Flat File 25.04 (n = 20) (MK Life, Porto Alegre, Brazil) were used. For the cyclic fatigue test, an artificial stainless steel simulated canal with an angle of 60° and a radius of curvature of 5 mm located 5 mm from its tip was used. The torque and rotation angle at the instruments' failure on the torsional fatigue test was based on the ISO 3630-1 protocol, in which the 3 mm tip of each instrument was fixed and connected to an electric motor and a load cell. The fractured surface of each fragment was examined by scanning electron microscopy. Data were analyzed using a 1-way analysis of variance and Tukey's test with a significance level of 5%. Flat File 25.04 had lower cyclic fatigue in both kinematics than the Logic instruments (p < .05). Reciprocating motion improved the cyclic fatigue of the tested instruments (p < .05). Flat File 25.04 had similar torque to Logic2 25.05 (p > .05), and both were superior to Logic2 25.03 (p < .05). The angular deflection values were different for the three tested instruments (p < .05), in the decreasing order: Logic2 25.03, 25.05, and Flat File 25.04. Flat File presented good resistance to cyclic and torsional fatigue resistance. Reciprocating motion improved the cyclic fatigue resistance of the instruments and can be considered when using programmable motors. RESEARCH HIGHLIGHTS: Scanning electron microscopy evaluation of different endodontic rotary file and fatigue resistance tests.