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INTRODUCTION: Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS: The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS: A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS: According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.
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Objective: The purpose of this systematic review with bibliometric analysis was to map the available scientific evidence on intentional foraminal enlargement (IFE) and explore publication trends. Methods: This review is in accordance with the PRISMA 2020 Statement and is registered on the Open Science Framework. Two independent reviewers carried out a comprehensive search of seven databases (PubMed/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, LILACS, and BBO) up to January 31 st, 2022. Studies that investigated IFE were considered eligible, and the data were analyzed using the VOSViewer software. Results:The search identified a total of 55 IFE-related articles from 10 countries and 25 journals, with an increasing trend for publications over the last decade. The majority of evidence was based on laboratory assays (65.4%), followed by randomized clinical trials (18.1%) with follow-up periods of up to 2 months. The main clinical outcome evaluated was post-operative pain. The highest number of studies were carried out by the State University of Campinas, and published in the Journal of Endodontics. Also, studies with the highest level of evidence found that IFE resulted in greater post-operative pain in the initial days post-treatment. Conclusion:This systematic review with bibliometric analysis mapped the scientific progress and publication trends in the field of IFE, thus shedding light on gaps in the literature with the aim of guiding researchers to conduct more high-impact investigations by performing clinical studies evaluating rates of periapical repair and IFE treatment success using long-term observation periods (AU)
Objetivo: O objetivo desta revisão sistemática com análise bibliométrica foi mapear as evidências científicas disponíveis sobre ampliação foraminal intencional (IFE) e explorar as tendências de publicação. Métodos: Esta revisão está de acordo com a declaração PRISMA 2020 e está registrada no Open Science Framework. Dois revisores independentes realizaram uma busca abrangente em sete bases de dados (PubMed/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, LILACS e BBO) até 31 de janeiro de 2022. Os estudos que investigaram IFE foram considerados elegíveis e os dados foram analisados usando o software VOSViewer. Resultados: A busca identificou um total de 55 artigos relacionados ao IFE provenientes de 10 países e 25 periódicos, com tendência crescente de publicações na última década. A maioria das evidências foi baseada em ensaios laboratoriais (65,4%), seguido de ensaios clínicos randomizados (18,1%) com períodos de follow-up de até 2 meses. O principal desfecho clínico avaliado foi a dor pós-operatória. O maior número de estudos foi realizado pela Universidade Estadual de Campinas e publicado no Journal of Endodontics. Estudos com os maiores níveis de evidência constataram que IFE resultou em maior dor pós-operatória nos primeiros dias pós- tratamento. Conclusão: Esta revisão sistemática com análise bibliométrica mapeou o progresso científico e as tendências de publicação na área de IFE, lançando luz sobre lacunas na literatura com o objetivo de orientar pesquisadores a realizar investigações de maior impacto, realizando estudos clínicos avaliando taxas de reparo periapical e sucesso do tratamento usando essa técnica e com acompanhamento à longo prazo. (AU)
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Bibliometria , Preparo de Canal Radicular , Endodontia , Revisão SistemáticaRESUMO
Introdução: Pinos de fibra de vidro são bastante utilizados quando dentes tratados endodonticamente apresentam grande perda estrutural e necessitam de suporte para a sua reconstrução coronária. A completa adesão do pino à parede do canal radicular é fundamental para o sucesso dessa restauração. Resíduos de cimento endodôntico que permanecem nas paredes dentinárias, mesmo após o preparo para a cimentação, podem interferir negativamente na sua adesão e contribuir para o seu deslocamento. Objetivo: O objetivo da presente revisão de literatura foi avaliar o efeito de diferentes cimentos endodônticos e o tempo decorrido entre a obturação e a cimentação do pino na resistência de união entre o pino e a parede do canal radicular. Métodos: Essa revisão de literatura incluiu 21 estudos que analisaram a influência de cimentos endodônticos na adesão de pinos de fibra de vidro, entre os quais 9 acrescentaram a variável tempo na sua análise, com pinos cimentados logo após a obturação do canal radicular e dias após a obturação. Resultados: Os dentes obturados com cimentos à base de resina demonstraram maior resistência ao deslocamento dos pinos durante os testes. Parece haver uma predominância de menores valores de adesão quando os pinos são cimentados imediatamente após a obturação com cimentos contendo eugenol. Conclusões: Os tipos de cimento endodôntico e o período entre a obturação e a cimentação do pino podem afetar a força de ligação entre a parede do canal radicular e o pino de fibra de vidro (AU).
ntroduction: Glass fiber posts are widely used when endodontically treated teeth present great structural loss and require support for coronal reconstruction. Complete adhesion of the post to the root canal wall is fundamental for the success of this restoration. Endodontic sealer residues that remain on the dentin walls, even after preparation for cementation, may negatively interfere with the adhesion and contribute for post displacement. This literature review evaluated the effect of different endodontic sealers and the time between obturation and post cementation on the bond strength. Methods: This literature review included 21 studies that analyzed the influence of endodontic sealers on the adhesion of glass fiber posts, among which 9 added the variable time in their analysis. Results: Teeth filled with resin-based sealers showed higher post push-out bond strength during testing. There seems to be predominance of lower adhesion values when the posts are cemented immediately after filling with eugenol-containing sealers. Conclusions: The type of endodontic sealer and period between obturation and post cementation can affect the bond strength between root canal wall and the glass fiber post(AU).
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Obturação do Canal Radicular , Cimentação , Vidro , LiteraturaRESUMO
The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain and analgesic intake after root canal treatment, using different root canal sealers. Sixty single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=20), according to the root canal sealer: AH Plus, Endofill or MTA Fillapex. Endodontic treatment was performed in two sessions, and calcium hydroxide was used as the intracanal dressing. Patients were instructed to record pain intensity as none, slight, moderate and severe. Scores from 1 to 4 were attributed to each level of pain after 24 h, 48 h and 7 days. The need for analgesic intake was also recorded. Differences in the incidence of postoperative pain and the need for an analgesic were analyzed using the chi-square test. Differences in pain intensity after treatment were analyzed using the ordinal (linear) chi-square test. No significant differences were detected among the groups in terms of either incidence or intensity of postoperative pain, or need for analgesic intake, at any timepoint (p>0.05). No pain was reported after 7 days. AH Plus, Endofill and MTA Fillapex used for filling root canals resulted in the same rate of postoperative pain and need for analgesic medication.
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Cavidade Pulpar , Hidróxido de Cálcio , Resinas Epóxi , Humanos , Dor Pós-Operatória , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Tratamento do Canal RadicularRESUMO
Abstract The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain and analgesic intake after root canal treatment, using different root canal sealers. Sixty single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=20), according to the root canal sealer: AH Plus, Endofill or MTA Fillapex. Endodontic treatment was performed in two sessions, and calcium hydroxide was used as the intracanal dressing. Patients were instructed to record pain intensity as none, slight, moderate and severe. Scores from 1 to 4 were attributed to each level of pain after 24 h, 48 h and 7 days. The need for analgesic intake was also recorded. Differences in the incidence of postoperative pain and the need for an analgesic were analyzed using the chi-square test. Differences in pain intensity after treatment were analyzed using the ordinal (linear) chi-square test. No significant differences were detected among the groups in terms of either incidence or intensity of postoperative pain, or need for analgesic intake, at any timepoint (p>0.05). No pain was reported after 7 days. AH Plus, Endofill and MTA Fillapex used for filling root canals resulted in the same rate of postoperative pain and need for analgesic medication.
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Humanos , Cavidade Pulpar , Dor Pós-Operatória , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Tratamento do Canal Radicular , Hidróxido de Cálcio , Resinas EpóxiRESUMO
Objetivo: O objetivo deste estudo foi avaliar a prevalência de periodontite apical (PA) em dentes tratados endodonticamente (DTE) e relacioná-la com fatores demográficos, qualidade dos tratamentos endodônticos e restaurações. Material e método: Foram coletados dados de prontuários odontológicos de pacientes que continham levantamentos radiográficos periapicais completos. Nos DTE, arco, grupo dental e presença de PA foram avaliados. Dados sobre a qualidade da obturação do canal radicular, a presença e a qualidade da restauração e o tipo de material restaurador também foram coletados. Os dados foram avaliados por estatística descritiva e Teste Qui-quadrado. Resultados: Dos 70 pacientes incluídos na amostra final, a maioria era do sexo feminino (54,3%) e a idade variou de 13 a 77 anos (47,14 ± 13,18). Dos 1333 dentes avaliados, 73 (5,4%) tinham tratamento endodôntico, sendo a maioria em dentes superiores (74%) e anteriores (52,1%). Dos dentes sem tratamento endodôntico, 320 (25,4%) apresentavam PA. A taxa de falha foi alta (52,8%) e a qualidade da obturação do canal radicular e da restauração foram consideradas inadequadas na maioria dos casos (58,3% e 47,7%, respectivamente). O grupo dentário apresentou relação estatisticamente significante com a presença de PA em DTE, sendo mais frequente nos dentes anteriores (p = 0,019). Conclusão: Concluiu-se que a prevalência de PA em DTE foi alta e o grupo dentário foi o fator que mais influenciou a prevalência de PA nos DTE. (AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Periodontite Periapical , Obturação do Canal Radicular , RadiografiaRESUMO
This clinical study was conducted to correlate the levels of endotoxins and culturable bacteria found in primary endodontic infection (PEI) with the volume of root canal determined by using Cone Beam Computed Tomography (CBCT); and to evaluate the bacterial diversity correlating with clinical features. Twenty patients with PEI were selected and clinical features were recorded. The volume (mm3) of root canal was determined by CBCT analysis. Root canal samples were analyzed by using kinetic LAL-assay test to determine the levels of endotoxins and anaerobic technique to determine the bacterial count (CFU/mL). DNA was extracted from all samples to determine bacterial diversity and quantified by using Checkerboard-DNA-DNA- Hybridization. Culturable bacteria and endotoxins were detected in 100% of the root canal samples. Linear regression analysis revealed a correlation between root canal volume and presence of anaerobic bacteria (p<0.05). Positive correlations were found between bacteria species and presence of different clinical features (p<0.05). After grouping the bacteria species into bacterial complexes, positive associations were found between green, orange and red complexes with presence of sinus tract (p<0.05). This clinical study revealed that larger root canals hold higher levels of culturable bacteria in PEI. Thus, the interaction of different virulent bacteria species in complexes seems to play an important role in the development of clinical features.
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Cavidade Pulpar , Periodontite Periapical , Bactérias , Carga Bacteriana , Endotoxinas , Humanos , Tratamento do Canal RadicularRESUMO
Objetivo: O objetivo deste estudo foi avaliar as alterações químicas e morfológicas em esmalte, dentina e cemento após clareamento interno utilizando microscopia eletrônica de varredura e espectrometria de energia dispersiva. Materiais e Métodos: Setenta e dois incisivos bovinos foram preparados, cortados e clareados por 7 dias com os seguintes agentes clareadores: PH: gel de peróxido de hidrogênio 35%; PH + PS: gel de peróxido de hidrogênio 35% + perborato de sódio; PC: gel de peróxido de carbamida 37%; PC + PS: gel de peróxido de carbamida 37% + perborato de sódio; PS: perborato de sódio + água; e Controle: água deionizada. Os espécimes foram seccionados e preparados para análise em microscopia eletrônica de varredura e análise dos níveis de cálcio, fósforo, oxigênio e carbono usando espectrometria de energia dispersiva. Resultados: Foi observada uma redução significante nos níveis de cálcio em esmalte após clareamento com PC + PS e PC (p < 0,05). Os níveis de carbono (parte orgânica) foram alterados em esmalte. Uma redução significante nos níveis de cálcio foi encontrada na dentina nos grupos PH + PS, PC e PC + PS. Os níveis de fósforo aumentaram após o uso de PS (p < 0,05) e PC (p < 0,05). Níveis de carbono mostraram pequena variação e a maior quantidade foi encontrada nos grupos PC e PC + PS (p < 0,05), nos outros grupos não houve alteração. Uma redução significante nos níveis de cálcio foram encontradas no cemento no grupo PC + PS (p < 0,05). Conclusão: Alterações em esmalte, dentina e cemento ocorreram após o clareamento e essas alterações foram menos significantes quando utilizado perborato de sódio e água
Objective: The aim of this study was to evaluate the morphological and chemical alterations in enamel, dentin and cementum after internal bleaching using scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). Material and Methods: Seventy-two bovine incisor teeth were prepared, cut and bleached for 7 days as follows: HP: 35% hydrogen peroxide gel; HP+SP: 35% hydrogen peroxide gel + sodium perborate; CP: 37% carbamide peroxide gel; CP+SP: 37% carbamide peroxide gel + sodium perborate; SP: sodium perborate + water; and control: deionized water. The specimens were sectioned and prepared for morphological analysis under SEM and analysis of calcium, phosphorus, oxygen and carbon levels using EDS. Results: A significant reduction was found in the calcium levels in enamel after treatment with CP + SP and CP (p < 0.05). Carbon (organic part) was hardly altered in enamel. A significant reduction in the calcium levels was found in dentin in Groups HP+SP, CP and CP+SP. Phosphorus levels increased after SP+H20 (p < 0.05) and CP (p < 0.05). Carbon levels showed little variation and the largest amount was found in Groups CP and CP+SP (p < 0.05); in the other groups there was no alteration. A significant reduction in the calcium levels was found in the cementum in Group CP+SP (p < 0.05). Conclusion: Alterations in the enamel, dentin and cementum compositions occurred after bleaching and these alterations showed to be less significant with sodium perborate and water.
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Animais , Bovinos , Peróxido de Hidrogênio , Microscopia Eletrônica de Varredura , Clareamento DentalRESUMO
Introduction: There is great demand for esthetic treatment by patients who have discolored teeth, because currently aesthetic standards have become stricter and many patients have tooth bleaching procedures performed before or during orthodontic treatment. Objective: To evaluate the bonding of orthodontic brackets to human molars after internal tooth bleaching. Material and method: Forty molars were divided into four groups according to the bleaching agent used: PS) sodium perborate + water; PC) carbamide peroxide; PC + PS) carbamide peroxide + sodium perborate; Cont) water (control group). Bleaching agents placed inside the pulp chambers were replaced every 7 days for 2 weeks, and the brackets were bonded 30 days after the end of bleaching. The shear strength test was performed in a universal testing machine (Emic). Result: ANOVA with a significance level of 5% (p > 0.05), showed no statistically significant difference between groups (p = 0.1214). Conclusion: It was concluded that the different bleaching agents studied did not interfere with the bond strength of brackets to enamel and bonding the brackets 30 days after internal bleaching is a safe procedure. .
Introdução : O apelo estético de pacientes que possuem dentes escurecidos é grande, pois atualmente os padrões estéticos se tornaram rigorosos e muitos pacientes antes ou durante o tratamento ortodôntico, realizam o procedimento de clareamento dental. Objetivo: Avaliar a adesão de braquetes ortodônticos em molares humanos que receberam clareamento interno. Material e método: Quarenta coroas de molares humanos foram divididas em quatro grupos, de acordo com o agente clareador utilizado: SP) perborato de sódio + água; SP) peróxido de carbamida; CP+SP) peróxido de carbamida + perborato de sódio; Cont) água (grupo controle). Os agentes clareadores colocados no interior das câmaras pulpares foram substituídos a cada 7 dias por 2 semanas, e a colagem dos braquetes foi efetuada após 30 dias do final do clareamento. O teste de resistência ao cisalhamento foi realizado em máquina de ensaios universal (Emic). Resultado: O teste estatístico ANOVA com nível de significância de 5% (p >0,05), mostrou que não houve diferença estatística significante entre os grupos (p = 0,1214). Conclusão: Concluiu-se que os diferentes agentes clareadores estudados não interferem na resistência de adesão dos braquetes ao esmalte dentário e a colagem dos braquetes 30 dias após o clareamento interno é um procedimento seguro. .