RESUMO
OBJECTIVES: To compare the pulp volume of individuals with altered and normal systemic blood pressure (BP) in order to verify if high BP promotes dimensional modifications in the pulp space. MATERIALS AND METHODS: Cone beam computed tomography scans of 91 patients (49 females and 42 males, mean age 31.7 ± 6.38 years) who had a healthy maxillary canine were selected. Values of arterial BP measured at two dental visits were used to classify the sample as normal BP (< 130 × 80 mmHg) and altered BP (≥ 130 × 80 mmHg); 49 patients had normal BP and 42 had altered BP. One oral radiologist evaluated each patient's pulp and tooth volumes, using semi-automatic segmentation, and the tooth length. Data were submitted to Student's t test and logistic regression, with a significance level of 5% (p < 0.05). RESULTS: Pulp volume (p = 0.0027), pulp volume/tooth volume (p = 0.0013), and pulp volume/tooth length (p = 0.0007) ratios were greater in the altered BP group. Conversely, there was no difference in tooth volume between the groups (p = 0.0697). A logistic regression model (p = 0.0002) using pulp volume and age enabled the development of a formula for predicting altered BP, with 68% accuracy. CONCLUSIONS: Individuals with altered systemic BP have greater pulp volumes than those with normal BP. The formula developed in this study may indicate the presence of altered BP. CLINICAL RELEVANCE: As arterial hypertension is a silent disease that produces no warning signs or symptoms, identification of modifications in the pulp volume in cone beam computed tomography scans may be an adjuvant sign of the diagnosis of this disease.
Assuntos
Determinação da Idade pelos Dentes , Hipertensão , Tomografia Computadorizada de Feixe Cônico Espiral , Adulto , Pressão Sanguínea , Tomografia Computadorizada de Feixe Cônico , Polpa Dentária/diagnóstico por imagem , Feminino , Humanos , Hipertensão/diagnóstico por imagem , MasculinoRESUMO
AIM: To investigate the relationship between the microbiota of periodontal pockets (PP) and root canals (RC) in dogs submitted to experimental periodontal disease (ExPD). METHODS: ExPD was induced by combining cotton and wire ligatures. After 125 days, microbiological samples were collected from PP and RC. Strains isolated from 19 teeth were submitted to DNA extraction, 16S rRNA gene amplification and gene sequencing. Pearson's χ2 - and Fisher's exact tests and McNemar's test were used when appropriate. RESULTS: The number of species in PP was greater than in RC, with prevalence of obligate anaerobes and Gram-negative bacteria. In the PP predominated Fusobacterium necrophorum, Porphyromonas gingivalis, Prevotella loescheii, Campylobacter gracilis and Veillonella parvula. In the RC samples, 9 had microbial growth, with predominance of the following genera: Staphylococcus, Streptococcus and Neisseria. Eight genera were common to both sites in the same tooth. PP presented a greater number of species than the RC. No significant difference was observed in the species found in PP and RC in the same tooth. CONCLUSION: Microbial composition of the RC could be modulated by the presence of periodontal disease, especially in cases of severe periodontal destruction. RC microbiota was less complex and diverse than the PP.
Assuntos
Microbiota , Doenças Periodontais , Animais , Cavidade Pulpar , Cães , Bolsa Periodontal , RNA Ribossômico 16SRESUMO
INTRODUCTION: The aim of this study was to evaluate the diversity and similarity of Enterococcus faecalis genotype isolates from multiple oral sites using repetitive sequence-based polymerase chain reaction and arbitrarily primed polymerase chain reaction (AP-PCR). METHODS: Forty-two endodontically treated teeth with apical periodontitis were selected. A total of 126 microbial samples were collected from 3 different sites (saliva, pulp chamber, and root canals, all n = 42) during the nonsurgical retreatment procedures. After growth on m-Enterococcus agar, the colonies were isolated, characterized as gram-positive catalase negative cocci, and identified using an API 20 Strep kit (bioMérieux, Marcy-l'Etoile, France). Seventy-four colonies from 10 patients were confirmed as E. faecalis by polymerase chain reaction (16S ribosomal RNA). Repetitive sequence-based polymerase chain reactions using ERIC and AP-PCR using RW3A primers were performed in all 74 colonies. Fingerprints were analyzed and separated into genotypic groups based on the Dice coefficient percentage of similarity (82% or greater) as determined by ERIC reproducibility assays involving E. faecalis controls. RESULTS: Seven different E. faecalis genotypes (GTs) (GT1 = 27%, GT2 = 17.6%, GT3 = 1.3%, GT4 = 18.9%, GT5 = 9.5%, GT6 = 14.9%, and GT7 = 10.8%) were observed in different subjects and oral sites associated with endodontic failure. Remarkably, in 4 of 5 patients, the same GTs present in the infected root canals were also isolated from either the pulp chamber or the saliva samples. In particular, GT6 was detected in all 3 oral sites of patient 37. CONCLUSIONS: E. faecalis GTs isolated from saliva, the pulp chamber, and the root canal were similar using the Rep-PCR and AP-PCR methods. These findings suggest that coronal microleakage is a conceivable cause of endodontic failure.
Assuntos
Cavidade Pulpar/microbiologia , Enterococcus faecalis/genética , Genótipo , Periodontite Periapical/microbiologia , Reação em Cadeia da Polimerase , Saliva/microbiologia , Dente não Vital/microbiologia , Impressões Digitais de DNA , DNA Bacteriano/análise , Enterococcus faecalis/isolamento & purificação , Humanos , Reação em Cadeia da Polimerase/métodos , Sequências Repetitivas de Ácido Nucleico , Falha de TratamentoRESUMO
The aim of this in vitro study was to evaluate the bond strength of Epiphany resin-based sealer to dentin walls after placement of calcium hydroxide [Ca(OH)2] dressings. Fifteen extracted single-rooted human teeth were instrumented using 2.5% NaOCl + EDTA as irrigants. The teeth were randomly assigned to 3 groups (n=5), according to the intracanal dressing: G1= Ca(OH)2 + saline; G2= Ca(OH)2 + 2% chlorhexidine gluconate (CHX) gel; and G3= saline (control). After 10 days of storage in 100% humidity at 37 degrees C, the dressings were removed and the root canals were filled with Epiphany sealer. After additional 48 h of storage, the specimens were sectioned transversally into 2-mm-thick discs. Push-out tests were performed (1 mm/min, Instron 4411) and the maximum loads at failure were recorded in MPa. One-way ANOVA and Newman-Keuls tests showed a statistically significant decrease in bond strength when a Ca(OH)2 dressing was used before root canal filling with Epiphany (G1= 10.18 +/- 1.99 and G2= 9.98 +/- 2.97) compared to the control group (13.82 +/- 3.9) (p< 0.05). It may be concluded that the use of Ca(OH)2 as an intracanal dressing material affected the adhesion of Epiphany to the root canal walls, but even though the values were within the acceptable range found in the literature.
Assuntos
Hidróxido de Cálcio/química , Colagem Dentária , Materiais Restauradores do Canal Radicular/química , Irrigantes do Canal Radicular/química , Anti-Infecciosos Locais/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Quelantes/uso terapêutico , Clorexidina/análogos & derivados , Clorexidina/uso terapêutico , Desinfetantes de Equipamento Odontológico/uso terapêutico , Dentina/ultraestrutura , Ácido Edético/uso terapêutico , Humanos , Umidade , Teste de Materiais , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Cloreto de Sódio , Hipoclorito de Sódio/uso terapêutico , Estresse Mecânico , Temperatura , Fatores de TempoRESUMO
The aim of this in vitro study was to evaluate the bond strength of Epiphany resin-based sealer to dentin walls after placement of calcium hydroxide [Ca(OH)2] dressings. Fifteen extracted single-rooted human teeth were instrumented using 2.5 percent NaOCl + EDTA as irrigants. The teeth were randomly assigned to 3 groups (n=5), according to the intracanal dressing: G1= Ca(OH)2 + saline; G2= Ca(OH)2 + 2 percent chlorhexidine gluconate (CHX) gel; and G3= saline (control). After 10 days of storage in 100 percent humidity at 37ºC, the dressings were removed and the root canals were filled with Epiphany sealer. After additional 48 h of storage, the specimens were sectioned transversally into 2-mm-thick discs. Push-out tests were performed (1 mm/min, Instron 4411) and the maximum loads at failure were recorded in MPa. One-way ANOVA and Newman-Keuls tests showed a statistically significant decrease in bond strength when a Ca(OH)2 dressing was used before root canal filling with Epiphany (G1= 10.18 ± 1.99 and G2= 9.98 ± 2.97) compared to the control group (13.82 ± 3.9) (p< 0.05). It may be concluded that the use of Ca(OH)2 as an intracanal dressing material affected the adhesion of Epiphany to the root canal walls, but even though the values were within the acceptable range found in the literature.
O objetivo desse estudo in vitro foi avaliar a resistência de união do cimento resinoso Epiphany às paredes dentinárias após aplicação de pastas de hidróxido de cálcio [Ca(OH)2]. Quinze dentes humanos uniradiculares foram igualmente instrumentados sob irrigação com as soluções de NaOCl 2,5 por cento + EDTA. Os dentes foram divididos em três grupos (n=5) e tratados com diferentes pastas de Ca(OH)2: G1= Ca(OH)2 + soro fisiológico; G2= Ca(OH)2 + 2 por cento CHX e G3= tratado apenas com soro fisiológico (grupo controle). Após 10 dias de armazenamento a 37°C e 100 por cento de umidade, as medicações foram removidas e os dentes obturados com o cimento Epiphany. Passadas 48 horas de armazenamento adicional, as amostras foram seccionadas tranversalmente em discos de 2 mm de espessura. Os testes de resistência de união (push-out) foram realizados em máquina de ensaio mecânico (1 mm/min) e os resultados expressos em MPa. Os testes de ANOVA e Newman-Keuls mostraram um significante decréscimo nos valores de resistência de união quando as pastas de Ca(OH)2 foram utilizadas (10,18 ± 1,99 e 9,98 ± 2,97) em comparação ao grupo controle (13,82 ± 3,9) (p<0,05). Pode-se concluir que o uso do Ca(OH)2 como medicação intracanal diminuiu a adesão do cimento Epiphany às paredes dos canais radiculares, embora os valores de resistência de união estejam dentro das médias aceitáveis encontradas na literatura.
Assuntos
Humanos , Hidróxido de Cálcio/química , Colagem Dentária , Materiais Restauradores do Canal Radicular/química , Irrigantes do Canal Radicular/química , Anti-Infecciosos Locais/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Quelantes/uso terapêutico , Clorexidina/análogos & derivados , Clorexidina/uso terapêutico , Desinfetantes de Equipamento Odontológico/uso terapêutico , Dentina/ultraestrutura , Ácido Edético/uso terapêutico , Umidade , Teste de Materiais , Preparo de Canal Radicular , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Cloreto de Sódio , Estresse Mecânico , Hipoclorito de Sódio/uso terapêutico , Temperatura , Fatores de TempoRESUMO
The purpose of this study was to assess the in vitro the antimicrobial efficacy of chlorhexidine gluconate gel as an endodontic auxiliary chemical substance compared to sodium hypochlorite (NaOCl) and chlorhexidine gluconate solution. The antimicrobial efficacy of the tested substances was evaluated using the agar diffusion test. The growth inhibition zones produced by 0.2%, 1% and 2% chlorhexidine gel were evaluated against 5 facultative anaerobic bacteria and 4 pigmented Gram-negative anaerobes, and compared to the results obtained by NaOCl and chlorhexidine solution. The largest growth inhibition zones were produced when the test bacteria were in contact with 2% chlorhexidine gluconate gel (11.79 mm), being significantly different (p<0.05) from the growth inhibition zones produced by all NaOCl concentrations, including 5.25% (9.54 mm). However, there was no statistically significant difference (p>0.05) between the growth inhibition zones obtained with equal concentrations of chlorhexidine solution and gel. The results of this study indicate that, as far as its antimicrobial properties are concerned, chlorhexidine gel has a great potential to be used as an endodontic auxiliary chemical substance.
Assuntos
Clorexidina/análogos & derivados , Desinfetantes de Equipamento Odontológico/farmacologia , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Actinomyces/efeitos dos fármacos , Clorexidina/administração & dosagem , Clorexidina/farmacologia , Contagem de Colônia Microbiana , Desinfetantes de Equipamento Odontológico/administração & dosagem , Enterococcus faecalis/efeitos dos fármacos , Géis , Humanos , Teste de Materiais , Porphyromonas endodontalis/efeitos dos fármacos , Porphyromonas gingivalis/efeitos dos fármacos , Prevotella/efeitos dos fármacos , Prevotella intermedia/efeitos dos fármacos , Irrigantes do Canal Radicular/administração & dosagem , Hipoclorito de Sódio/administração & dosagem , Soluções , Staphylococcus aureus/efeitos dos fármacos , Streptococcus sanguis/efeitos dos fármacos , Streptococcus sobrinus/efeitos dos fármacosRESUMO
The purpose of this study was to assess the in vitro the antimicrobial efficacy of chlorhexidine gluconate gel as an endodontic auxiliary chemical substance compared to sodium hypochlorite (NaOCl) and chlorhexidine gluconate solution. The antimicrobial efficacy of the tested substances was evaluated using the agar diffusion test. The growth inhibition zones produced by 0.2 percent, 1 percent and 2 percent chlorhexidine gel were evaluated against 5 facultative anaerobic bacteria and 4 pigmented Gram-negative anaerobes, and compared to the results obtained by NaOCl and chlorhexidine solution. The largest growth inhibition zones were produced when the test bacteria were in contact with 2 percent chlorhexidine gluconate gel (11.79 mm), being significantly different (p<0.05) from the growth inhibition zones produced by all NaOClconcentrations, including 5.25 percent (9.54 mm). However, there was no statistically significant difference (p>0.05) between the growth inhibition zones obtained with equal concentrations of chlorhexidine solution and gel. The results of this study indicate that, as far as its antimicrobial properties are concerned, chlorhexidine gel has a great potential to be used as an endodontic auxiliary chemical substance.
O objetivo deste estudo foi avaliar in vitro a atividade antimicrobiana do gluconato de clorexidina gel, como irrigante endodôntico, comparando-o ao hipoclorito de sódio (NaOCl) e ao gluconato de clorexidina líquido. A atividade antimicrobiana das substâncias testadas foi avaliada pelo teste de difusão em ágar. As zonas de inibição de crescimento bacteriano produzidas pela clorexidina gel a 0,2 por cento; 1 por cento e 2 por cento foram observados frente a 5 espécies de bactérias anaeróbias facultativas e 4 espécies de anaeróbios estritos, Gram-negativos e produtores de pigmento negro; e comparados com os resultados obtidos pelo NaOCl e pela clorexidina líquida. As maiores zonas de inibição foram produzidas quando as bactérias testadas ficaram em contato com a clorexidina a 2 por cento em gel (11,79 mm), apresentando diferença estatisticamente significante (p<0,05) quando comparados às zonas de inibição de crescimento bacteriano produzidas por todas as concentrações avaliadas de NaOCl, incluindo 5,25 por cento (9,54 mm). No entanto, não houve diferença estatisticamente significante (p>0,05) comparando as zonas produzidas por concentrações equivalentes de clorexidina líquida ou gel. Os resultados indicaram que a clorexidina em gel tem grande potencial para ser usada como substância química auxiliar quanto às suas propriedades antimicrobianas.
Assuntos
Humanos , Clorexidina/análogos & derivados , Desinfetantes de Equipamento Odontológico/farmacologia , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Actinomyces/efeitos dos fármacos , Contagem de Colônia Microbiana , Clorexidina/administração & dosagem , Clorexidina/farmacologia , Desinfetantes de Equipamento Odontológico/administração & dosagem , Enterococcus faecalis/efeitos dos fármacos , Géis , Teste de Materiais , Porphyromonas endodontalis/efeitos dos fármacos , Porphyromonas gingivalis/efeitos dos fármacos , Prevotella intermedia/efeitos dos fármacos , Prevotella/efeitos dos fármacos , Irrigantes do Canal Radicular/administração & dosagem , Soluções , Hipoclorito de Sódio/administração & dosagem , Staphylococcus aureus/efeitos dos fármacos , Streptococcus sanguis/efeitos dos fármacos , Streptococcus sobrinus/efeitos dos fármacosRESUMO
BACKGROUND: The authors evaluated the fracture resistance of endodontically treated teeth filled with either gutta-percha or a new resin-based obturation material. METHODS: The authors prepared and randomly divided 80 single-canal extracted teeth into five groups: lateral and vertical condensation with gutta-percha, lateral and vertical condensation with the new resin-based obturation material, and a control group with no filling material. The specimens were stored in 100 percent humidity for two weeks, mounted in polyester resin and loaded to failure. RESULTS: The authors found statistically significant differences among the experimental groups (P < .05). The groups with the new material displayed higher mean fracture loads and the gutta-percha groups lower mean fracture load values than the control unfilled group. However, the differences were not significant. The groups with the new material displayed significantly higher mean fracture loads than gutta-percha groups independent of the filling technique used. CONCLUSIONS: Filling the canals with the new resin-based obturation material increased the in vitro resistance to fracture of endodontically treated single-canal extracted teeth when compared with standard gutta-percha techniques. CLINICAL IMPLICATIONS; If other properties of the new resin-based obturation material compare favorably with those of gutta-percha for filling the root canal, it should be considered as a replacement for gutta-percha, as the results of this study indicate that it could provide enhanced resistance to tooth fracture.