[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to radiographically evaluate the relationship between the quality parameters of root canal fillings (apical extension, homogeneity, and taper) and periapical status. In addition, groups of teeth and complicating factors of endodontic treatment were assessed.
This retrospective cohort study assessed the quality and periapical status of root-filled canals in a 4- to 7-year follow-up period. Each parameter was dichotomized into ideal and altered conditions. A root-filled canal with an ideal condition for all 3 parameters was considered perfect, whereas the loss of 1 or more ideal conditions defined satisfactory or deficient fillings, respectively. The periapical statuses at baseline and follow-up were classified as normal, slight widening of the apical periodontal ligament, or periapical lesion.
A total of 291 root-filled canals were evaluated. The prevalence of perfect, satisfactory, and deficient fillings was 54.6%, 37.5%, and 7.9%, respectively (P < .05). The periapical status at follow-up showed normal, slight widening of the apical periodontal ligament, or periapical lesion in 69.8%, 19.2%, and 11% of the roots, respectively (P < .05). The multivariate logistic regression showed that only preoperative periapical lesions (odds ratio, 2.99; 95% confidence interval, 1.27-7.03) and altered tapers (odds ratio, 3.73; 95% confidence interval, 1.51-9.24) were significantly associated with postoperative periapical lesions.
Radiographic parameters of the quality of root-filled canals showed a significant relationship with the periapical status. Nevertheless, an altered taper was the main factor associated with the maintenance or development of periapical lesions after 4- to 7-year follow-up period.
Journal of endodontics 12/2010; 36(12):1932-7. DOI:10.1016/j.joen.2010.08.050
[Show abstract][Hide abstract] ABSTRACT: The elimination of microorganisms from root canals is a critical step in endodontic treatment. We aimed to evaluate the antimicrobial effectiveness of an alternating irrigation regimen during chemomechanical preparation (CMP).
During 21 days, root canals of extracted human teeth were infected with Enterococcus faecalis, and colonization was confirmed by scanning electron microscopy (SEM). Canals were irrigated with saline solution (control group), with 5.25% NaOCl followed by a final rinse with 17% EDTA (conventional irrigation group), or with the alternating use of NaOCl and EDTA (alternating irrigation [AI] group). Samples were taken before treatment (S1), after CMP (S2), and during the following 14 days. Two specimens/group were analyzed by SEM.
The AI group yielded negative agar and liquid cultures from immediately after CMP and from the 5th day on, respectively. SEM confirmed several bacterium-free sites in the AI group.
The irrigation regimen based on the alternating use of NaOCl and EDTA seems to be a promising endodontic tool because it promoted the elimination of root canal E. faecalis biofilms throughout the experimental period.
Journal of endodontics 05/2010; 36(5):894-8. DOI:10.1016/j.joen.2010.01.002
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate the standard quality of 1,347 root fillings performed by postgraduate students in Endodontics according to 3 radiographic quality parameters. The analyzed quality parameters included apical extension (AE), taper (TA) and homogeneity (HO), which received scores S2 (ideal standard), S1 (slight deviation) or S0 (accentuated deviation). A perfect filling (PF) received S2 for all parameters. In the absence of one or two S2 score, the fillings were deemed as satisfactory (SF) or deficient (DF), respectively. The results showed 51.7%, 41.5% and 6.8% of PF, SF, and DF, respectively. AE, TA, and HO presented equivalent quality parameters in root-filled canals of mandibular incisors and mandibular premolars (p>0.05). Conversely, in maxillary incisors, canines and distal root of mandibular molars, significant differences (p<0.05) were found between 2 parameters. Besides, there were significant differences (p<0.05) among the measured parameters in root-filled canals of maxillary premolars, all root canals of the maxillary molars and mesial root of the mandibular molars. AE showed the lowest frequency of S2 score for all groups. In conclusion the prevalence of perfect, satisfactory and deficient fillings varied significantly according to the root canal group. The quality parameters categorized fillings in 3 complexity degrees. AE was the most critical parameter of quality in root canal fillings.
[Show abstract][Hide abstract] ABSTRACT: Two patients presented with complaints of recurrent drainage of purulent exudate from sinus tracts, inflammation and pain after endodontic re-treatment of the maxillary left (Case 1) and right (Case 2) lateral incisors. The periapical lesions persisted after apical curettage, apicectomy and root-end filling with silver amalgam. Radiographic examination exposed the poor quality of the endodontic treatments and the silver amalgam root-end fillings, which were associated with periapical radiolucent areas in both teeth. The sinus tract persisted after root canal cleaning and shaping, followed by a calcium hydroxide root canal dressing. The root-end fillings were periapically dislodged with endodontic K-files, and showed progressive displacement by sinus tracts up to elimination in the oral cavity. Follow ups of 42 and 65 months post procedure revealed clinical disappearance of the symptoms, sinus tracts and exudates, and radiographs revealed that the repair process of the periapical radiolucent areas was quite advanced.
Australian Endodontic Journal 07/2009; 35(2):59 - 64. DOI:10.1111/j.1747-4477.2008.00127.x
[Show abstract][Hide abstract] ABSTRACT: This in vitro study evaluated the influence of luting agents on ultrasonic vibration time for intraradicular cast post removal.
After endodontic treatment, 30 roots of extracted human canines were embedded in resin cylinders. The post-holes were prepared at 10 mm depth and their impressions were taken using autopolymerizing acrylic resin. After casting procedures using a nickel-chromium alloy, the posts were randomly distributed into 3 groups (n=10) according to the luting material: G1- zinc phosphate (SS White) (control group), G2 - glass ionomer cement (Vidrion C; SS White), and G3- resin cement (C & B; Bisco). In G3, the adhesive procedure was performed before post cementation. After 24 h, the cement line was removed at the post/tooth interface using a fine diamond bur, and the ST-09 tip of an Enac ultrasound unit was applied at maximum power on all surfaces surrounding the posts. The application time was recorded with a chronometer until the post was completely dislodged and data were analyzed by ANOVA and Tukey's test (p<0.05).
The roots were removed from the acrylic resin and inspected to detect cracks and/or fractures. The means for G1, G2, and G3 were 168.5, 59.5, and 285 s, respectively, with statistically significant differences among them. Two G3 posts resisted removal, one of which developed a vertical fracture line.
Therefore, the cement type had a direct influence on the time required for ultrasonic post removal. Compared to the zinc phosphate and glass ionomer cements, the resin cement required a longer ultrasonic vibration time.
Journal of applied oral science: revista FOB 06/2009; 17(3):145-9. DOI:10.1590/S1678-77572009000300003
[Show abstract][Hide abstract] ABSTRACT: The aim of this in vitro study was to compare the time required for removal of intraradicular cast posts cemented with zinc phosphate (ZF) or glass ionomer cement (GIC), using two Brazilian ultrasound devices (BUD). Seventy two human inferior premolars with single root canals were sectioned transversally at the cementoenamel junction. In each specimen, the root canal was endodontically treated, the post space was prepared to a depth of 9 mm and the canal was molded to obtain a post impression. After the casting procedures, the posts were randomly distributed into 2 groups (n = 36) according to the luting material used: G1 - ZF and G2 - GIC. The tooth and luted post set was then embedded in an acrylic resin block. The groups were then divided into 3 subgroups (n = 12) according to the ultrasound device used: A - Enac (Osada Electric, Japan), used as a control group; B - Profi II Ceramic (Dabi Atlante, Brazil) and C - Jet Sonic Satelec (Gnatus, Brazil). The posts were submitted to the vibration process with maximum power set on all surrounding surfaces. Time of application was recorded with a chronometer until complete post dislodgment, and the data were analyzed by the ANOVA test (p < 0.05). The averages required for post removal in G1 and G2 were respectively 41.42 and 92.03 seconds, with significant statistical difference (p = 0.001). No statistical difference was observed among the three ultrasound devices (p = 0.088), and the BUD presented a performance similar to that of the international gold standard device (Enac). Moreover, the type of luting agent had a greater influence on the time required for post removal than the origin of the ultrasonic unit.
Brazilian oral research 01/2009; 23(1):17-22. DOI:10.1590/S1806-83242009000100004
[Show abstract][Hide abstract] ABSTRACT: Brazilian researchers have shown an increase in scientific production associated with the publication of studies in the literature. This study aimed to evaluate the profile of researchers with scientific productivity grants in the Public Health area at the National Council for Scientific and Technological Development. We analyzed the Lattes curricula of all researchers in the Public Health field in 2004-2006. The variables were: gender, grant category, affiliation, time of completion of the doctorate, national and international papers with their correspondind Qualis, publication of books and book chapters, guidelines for basic scientific research and master's and doctorate's, and journals used for publication . Among researchers, there was similarity of male and female (1,03:1), with most scholars in category 2 (48.39%), spread over 12 states of the federation, with a predominance of Rio de Janeiro and Sao Paulo . Of the total, 73.54% of the recipients are linked to universities and 66.45% of them had completed the doctorate 5 to 15 years before. In scientific literature, there is prevalence of international papers Qualis A and C, and national B. The publication of book chapters was 2.91 times that of books. As for orientation, there is prevalence in the training of masters, followed by doctors and scientific initiation. The journals that concentrated most of the publications were Cadernos de Saúde Pública [Reports in Public Health] and Revista de Saúde Pública [Public Health Journal], respectively. Studies in other areas with similar methodologies will enable better understanding of the national scientific production and definition of strategies of demand-induced research.
Physis Revista de Saúde Coletiva 12/2008; 19(3):761-775.
[Show abstract][Hide abstract] ABSTRACT: Gingival fibromatosis (GF) is characterized by fibrotic enlargement of the gingiva that can be inherited as an isolated trait (named hereditary gingival fibromatosis) or as a component of a syndrome. This article reports one kindred affected by a syndrome characterized by GF associated with dental abnormalities (DA) including generalized thin hypoplastic amelogenesis imperfecta (AI).
To characterize the pattern of inheritance and the clinical features, 70 family members were examined. Hematoxylin and eosin staining, immunohistochemistry, and scanning electronic microscopy (SEM) were performed to identify the alterations on gingiva, teeth, and dental follicles.
Examination of the family pedigree demonstrated multiple consanguineous first-cousin marriages and an autosomal recessive trait of inheritance. Four members demonstrated mild GF in association with DA, including generalized thin hypoplastic AI, intrapulpal calcifications, delay of tooth eruption, and pericoronal radiolucencies involving unerupted teeth. One of those four patients also had mental retardation (MR). MR as an isolated feature was observed in six members, whereas isolated GF was found in one individual. A combination of gingivectomy and gingivoplasty followed by regular dental procedures were performed in these patients. Histologic examination of the gingival enlargement revealed a dense connective tissue containing myofibroblasts, islands of odontogenic epithelium, and calcified psammomatous deposits, which resembled cementicle-like structures by SEM. Pericoronal lesions also showed calcified psammomatous deposits in association with islands of odontogenic epithelium. Enamel ultrastructure analysis revealed normal surface alternating with irregular and porous areas.
To the best of our knowledge, these cases represent a new syndrome within the spectrum of those including GF.
Journal of Periodontology 08/2008; 79(7):1287-96. DOI:10.1902/jop.2008.070520