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This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
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Catastrofização , Ansiedade ao Tratamento Odontológico , Medição da Dor , Dor Pós-Operatória , Tratamento do Canal Radicular , Odontalgia , Humanos , Feminino , Tratamento do Canal Radicular/psicologia , Gravidez , Adulto , Estudos Prospectivos , Ansiedade ao Tratamento Odontológico/psicologia , Dor Pós-Operatória/psicologia , Catastrofização/psicologia , Adulto Jovem , Odontalgia/psicologia , Inquéritos e Questionários , Complicações na Gravidez/psicologia , Modelos Logísticos , Pulpite/psicologia , Pulpite/cirurgia , Pulpite/terapia , Estatísticas não ParamétricasRESUMO
Abstract This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
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Aim: This study evaluated, by the application of questionnaires, the impact of the COVID-19 pandemic on the clinical routine and inspection by the competent authorities, on the flow of patients in the office, as well as on possible changes in Endodontic treatment costs and the amounts charged to patients. Methods: This cross-sectional study was conducted from May 2nd, 2020 to May 6th, 2020, using an online questionnaire with a convenience sample. The inclusion criterion was professionals who perform endodontic treatments in daily clinical practice and who professional setting is private practice. The questionnaire brought questions about the impact on costs and the amount charged to the patient. Results: A total of 1042 questionnaires were answered from all the different states of Brazil, by professional who usually perform Endodontic treatment, and who is working in private practice. A total of 1010 (96.9%) respondents affirm it was necessary to modify the protective equipment in endodontic treatment due to pandemic and longer intervals between appointments was cited by 922 (88.5%), economically affecting the dental practice. There was no association between routine changes and economic impacts with gender, professional experience, area of residence or education level. Conclusion: In conclusion, most dental professionals recognized changes in the routine of endodontic treatment during the COVID-19 pandemic. They have a perception of increase in endodontic costs, and reduction in the volume of patients
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Humanos , Masculino , Feminino , Inquéritos e Questionários , Coronavirus , Consultórios Odontológicos , EndodontiaRESUMO
Introdução: Diante de casos de identificação humana, vários são os registros odontológicos que podem ser utilizados a fim de possibilitar a comparação Post-mortem para identificação. Objetivo: Por meio de um relato de caso pericial, demonstrar a possibilidade da identificação odontolegal a partir de registros odontológicos exigidos por plano de saúde. Relato do Caso: Em 2020, um cadáver do sexo masculino, com uma suspeita de identidade, chegou a um Instituto Oficial de Perícias do Nordeste brasileiro, em estado avançado de decomposição, com características do fenômeno de maceração. A família forneceu, após contato com o dentista do indivíduo, imagens do sistema de um plano odontológico no qual era beneficiário e exigia fotografias para auditoria e consequente liberação de tratamentos odontológicos. Após a disponibilização com poucas horas da descoberta do corpo, prosseguiu-se com o confronto dos dados Ante-mortem (AM) e Post-mortem (PM) para identificação odontolegal. Na ausência de pontos divergentes e havendo congruências relativas quanto ao formato da arcada, tratamentos odontológicos, presença e ausências dentárias, forma e posições dentárias, lesões de cárie, foi possível associar a identidade da vítima desaparecida ao corpo examinado. Conclusão: O caso evidencia a confiabilidade, rapidez e baixo custo do processo de identificação odontolegal por meio do confronto de características individualizadoras AM e PM, que só foi possível pela exigência de imagens intraorais pelo plano odontológico da vítima.
Introduction: In cases of human identification, various dental records can be used in order to help in the comparison of postmortem evidence. Objective: The aim of this study was to demonstrate by the forensic report that dental records, which are required by health insurance, could be utilized to obtain a positive identification of an individual. Case report: In 2020, the body of a male individual was referred to the Official Forensic Institute of Northeast Brazil, his body arrived in advanced stage of decomposition and shows signs of maceration. After contact the dentist of the individual, the family provide his teeth images from dental insurance plan that using them to authorize any dental treatment and for audit purposes. Afterwards the identification was made matching ante-mortem (AM) and post-mortem (PM) data. There are no irreconcilable discrepancies and the available data achieve a positive identification then the body examined matched with the missing victim. Conclusion: The case shows the reliability, rapid and cost-effective identification process through comparing AM data to PM evidences. This has only been possible due to the requirement for intraoral images by the victim's dental insurance plan
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Objetivo: O presente estudo teve por objetivo avaliar, ex vivo, a capacidade de elevação do pH da superfície radicular externa de diferentes pastas de hidróxido de cálcio (HC) utilizadas como medicação intracanal, além da influência da ativação ultrassônica (AUS) durante aplicação no interior do canal radicular. Métodos: Foram utilizados 100 incisivos humanos superiores unirradiculares, que tiveram os canais radiculares modelados e divididos aleatoriamente em seis grupos experimentais (n=15), de acordo com a pasta de HC, tendo como variáveis as medicações utilizadas e a ativação da pasta com AUS no momento da aplicação, além de um grupo controle (n=10): Pasta Calen; HC+clorexidina 2% gel (CX2%); e HC + água destilada. Os dentes foram mantidos imersos em água deionizada e as medidas do pH, verificadas nos períodos de 7, 14, 21 e 28 dias, com auxílio de pHmetro. Resultados: De acordo com os dados obtidos, verificou-se elevação do pH nos períodos de 7 e 14 dias em todos os grupos. Apenas os grupos em que foi utilizada a associação do HC com CX2% apresentou evolução com aumento significativo do pH ao longo dos períodos analisados (p<0,05). A ativação das pastas com AUS proporcionou incremento significativo dos valores de pH (p<0,05). Conclusão: De acordo com a metodologia empregada, pode-se concluir que todas as pastas utilizadas promovem elevação do pH no tecido dentinário, e a ativação das pastas com AUS influencia significativamente na elevação do pH no tecido dentinário (AU).
Objective: The aim of the present study was to evaluate, ex-vivo, the pH elevation capacity on the external root surface of different calcium hydroxide (HC) pastes, utilized as intracanal medication, it was also evaluated the influence of the ultrasonic activation at the application within the root canal. Methods: 100 human single root superior incisors were used, which had their root canals shaped and randomly divided into 6 experimental groups (n=15) according to the following HC pastes: Calen; HC + Chlorhex- idine 2% gel (CX2%); HC + distilled water, utilizing the medications and the ultrasonic activation of the paste at the time of the application as variables and 1 control group (n=10). The teeth were kept immersed in deionized water and the pH parameters were verified in 7, 14, 21 and 28 days with a pH measurement machine. Results: According to the data obtained, pH was elevated in the first week in all groups. Only the groups which the association of HC with CX2% was made, did show a significant increase in the pH level over the analyzed periods (p < 0,05). The activation of the pastes with US provided a significant increase in pH values (p < 0,05). Conclusion: According to the methodology used, we can conclude that all the HC pastes used, promote pH elevation in dentin tissue. And the acti- vation of the pastes with US significantly influences the pH increase in dentin tissue
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Humanos , Pomadas/efeitos adversos , Ultrassom , Hidróxido de Cálcio , Clorexidina , Alcalinização , MétodosRESUMO
Resumo Introdução e objetivo: Ainda são escassos os estudos que avaliam com exatidão o sucesso do tratamento e retratamento endodônticos e quais as falhas que realmente impactam no desfecho dos mesmos. Determinar o índice e os fatores preditivos para o sucesso de tratamentos e retratamentos endodônticos, realizados por alunos de graduação com o mesmo nível de aprendizado. Materiais e métodos: Foram verificados os registros de proservação, com pelo menos 12 meses, dos tratamentos endodônticos realizados na Faculdade de Odontologia de Pelotas, analisando o sucesso ou o fracasso endodôntico, de acordo com critérios clínicos e radiográficos. As variáveis preditivas no resultado do sucesso do tratamento foram: dente, número de canais, coroa dentária, sintomas, diagnóstico da polpa e índice periapical radiográfico. As variáveis relacionadas ao tratamento foram: técnica de instrumentação, número de sessões e limite de instrumentação apical. Resultados: 136 tratamentos endodônticos foram realizados com um acompanhamento de, pelo menos, 12 meses. A avaliação mostrou que o sucesso endodôntico foi influenciado pelo número de sessões (P = 0,015), diagnóstico inicial e grupo dentário (P= 0.014). Também foi possível observar que, quanto maior o índice periapical radiográfico inicial, pior o prognóstico endodôntico (P < 0.001). Conclusão: O índice de sucesso do tratamento endodôntico foi de 96.7% para casos de polpa vital, 87.5% para os casos de necrose pulpar e 92.9% em retratamentos. Estes índices foram influenciados pelo dente tratado, diagnóstico inicial, índice periapical radiográfico inicial e pelo número de sessões utilizadas no tratamento.
Abstract Introduction and objective: There are still few studies that accurately address endodontic success and which failures actually impact the endodontic treatment outcome. Determine success rate and predictive factors for successful endodontic treatment and retreatment by undergraduate students of the same learning level. Materials and methods: The preservation records (12 months) of the endodontic treatments performed in the Faculty of Dentistry of Pelotas were verified, indicating the success or failure of the treatment. Predictive variables in the outcome of successful endodontic treatment or retreatment were: tooth, number of channels, dental crown, symptoms, pulp diagnosis, radiographic periapical index. The treatmentrelated variables were: instrumentation technique, number of sessions and apical instrumentation limit. Results: 136 endodontic treatments were performed with a follow-up of at least 12 months. The evaluation showed that endodontic success was influenced by the number of sessions (P = 0.015), initial diagnosis and dental group (P = 0.014). It was also observed that the higher the initial radiographic periapical index, the worse the endodontic prognosis (P < 0.001). Conclusion: The success rate of endodontic treatment was 96.7% for cases of vital pulp, 87.5% for cases of pulp necrosis and 92.9% for retreatments. These indices were influenced by type tooth, initial diagnosis, initial radiographic periapical index and the number of visits used in the treatment.
Resumen Introducción y objetivo: Todavía hay pocos estudios que aborden con precisión el éxito endodóntico y cuáles fracasos realmente impactan el resultado del tratamiento endodóntico. Determinar la tasa de éxito y los factores predictivos para el tratamiento y el retratamiento exitoso de endodoncia por estudiantes universitarios del mismo nivel de aprendizaje. Materiales y métodos: Se verificaron los registros de conservación (12 meses) de los tratamientos de endodoncia realizados en la Facultad de Odontología de Pelotas, lo que indica el éxito o el fracaso del tratamiento. Las variables predictivas en el resultado de un tratamiento o retratamiento endodóntico exitoso fueron: diente, número de canales, corona dental, síntomas, diagnóstico pulpar, índice periapical radiográfico. Las variables relacionadas con el tratamiento fueron: técnica de instrumentación, número de sesiones y límite de instrumentación apical. Resultados: se realizaron 136 tratamientos de endodoncia con un seguimiento de al menos 12 meses. La evaluación mostró que el éxito endodóntico estaba influenciado por el número de sesiones (P = 0.015), el diagnóstico inicial y el grupo dental (P = 0.014). También se observó que cuanto mayor es el índice periapical radiográfico inicial, peor es el pronóstico endodóntico (P <0.001). Conclusión: La tasa de éxito del tratamiento endodóntico fue del 96.7% para casos de pulpa vital, 87.5% para casos de necrosis pulpar y 92.9% para retratamientos. Estos índices fueron influenciados por el tipo de diente, el diagnóstico inicial, el índice periapical radiográfico inicial y el número de visitas utilizadas en el tratamiento.
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This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.
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Incisivo , Endodontia Regenerativa , Abscesso , Compostos de Cálcio , Criança , Necrose da Polpa Dentária , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Óxidos , SilicatosRESUMO
RESUMO O estudo investigou fatores etiológicos e prevalência de lesões bucofaciais em surfistas profissionais e amadores em Fortaleza, Ceará. Aplicou-se um questionário em 150 surfistas homens e usaram-se testes estatísticos (qui-quadrado e teste t de Student) com nível de significância p < 0,05. Em 56% encontrou-se alguma lesão bucofacial. Queimaduras de lábio e de face, laceração de mucosa e fratura dentária foram as mais prevalentes. Comparando surfistas competidores com não competidores houve significância entre ocorrência de lesões com fundo de rocha (p = 0,032) e com prancha (p = 0,003) e maior presença de lesões entre os competidores (p = 0,003). Conclui-se que fraturas dentárias e queimaduras facial e labial são prevalentes em surfistas e que há mais chances de ocorrência de lesões quanto maiores forem a idade e o tempo de prática.
ABSTRACT The study investigated etiological factors and the prevalence of orofacial lesions in surfers professionals and amateurs in Fortaleza, Brazil. A questionnaire was applied to 150 male surfers and statistical tests (Chi-square and Student t) were used with significance level p <0.05. In 56%, there was some orofacial lesion. Lip and face burns, mucosal laceration and dental fracture were the most prevalent. Comparing competitive surfers with non-competitors there was significance between the occurrence of rock bottom injuries (p=0.032) and surfboard (p=0.003) and greater presence of injuries among competitors (p=0.003). It is concluded that dental fractures and facial and lip burns are prevalent in surfers and that there is a greater chance of occurrence of injuries the greater the age and the time of practice of them.
RESUMEN El estudio investigó factores etiológicos y prevalencia de lesiones bucofaciales en surfistas profesionales y aficionados en Fortaleza, Ceará. Se aplicó un cuestionario en 150 surfistas de sexo masculino y se utilizaron pruebas estadísticas (chi cuadrada y prueba de la t de Student) con un nivel de relevancia estadística de p <0,05. En el 56% se encontró alguna lesión bucofacial. Las más frecuentes fueron quemaduras del labio y de la cara, laceración de mucosa y fractura dental. Al comparar a surfistas competidores con otros no competidores hubo relevancia entre lesiones producidas por el fondo (p = 0,032) y por la tabla (p = 0,003), y mayor existencia de lesiones entre competidores (p = 0,003). Se concluye que las fracturas dentales y las quemaduras facial y labial son frecuentes en surfistas y hay más probabilidad de que se produzcan lesiones cuanto mayor es la edad y el tiempo de práctica.
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O objetivo do presente estudo foi determinar a frequênciae/ou intensidadede dor pós-operatória e os fatores associados a esta ocorrência em tratamentos e retratamentos endodônticos realizados pelas técnicas de instrumentação manual e reciprocante, por estudantesde graduação em Odontologia da Universidade Federal de Pelotas. Para tal, utilizou-se informações dos prontuários de pacientes atendidos por estudantesdo último ano de graduação, no período compreendido entrejaneiro de 2017 ejulho de 2019, totalizando 182 tratamentos. A dor foi registrada por meiodaEscala de Avaliação Numérica da Dor (EAND). Considerou-se como variáveis preditivas no desfecho de dor pós-operatória: dente, número de canais, sintomas, coroa dentária, tratamento indicadoe índice periapical radiográfico. Como variáveis relativas aos tratamentos, técnica de instrumentação, número de sessões e limite apical de instrumentação. Havia relato de dor no momento do tratamento em 28% dos prontuários, enquanto 11,5% não reportaram dor prévia. Em 149 casos (81,9%) incluídos neste estudo não foi relatada a ocorrência de dor pós-operatória, enquanto dor leve foi relatada em 17 casos (9,3%), moderada em 6(3,3%)e intensa em 10(5,5%). Em 67,4% dos casos dos dentes foram tratados até a marcação 0 do localizador apical,enquanto em 32,6% o comprimento foi estabelecido a 1mm desta marcação. Não houve associação entre o tipo de tratamento realizado e a ocorrência de dor pós-operatória (p=0,206). Conclui-se que, entreos fatores avaliados, apenas a sintomatologia prévia apresentou associação com a maior frequência de dor pós operatória (AU).
This study determined the frequency and/or intensity of postoperative pain and factors associated with such occurrence in endodontic treatments and retreatments performed by manual and reciprocating techniques, by undergraduate dental students at the Federal University of Pelotas. For that purpose, data were collected from the records of patients treated by last-term undergraduate students, in the period between January 2017 and July 2019, adding up to 182 treatments. Pain was recorded by the Numerical Pain Rating Scale (NPRS). The following predictive variables were considered in the outcome of postoperative pain: tooth, number of canals, symptoms, dental crown, indicated treatment and radiographic periapical index. The variables related to the treatments included the instrumentation techniques, number of sessions and apical limit of instrumentation. There was report of pain during treatment in 28% of records, while 11.5% did not report previous pain. In 149 cases (81.9%) included in this study there were no reports of postoperative pain, while mild pain was reported in 17 cases (9.3%), moderate in 6(3.3%)and intensive in 10(5.5%). In 67.4% of cases, the teeth were treated up to mark "0"of the apex locator, while in 32.6% the length was established at 1mm from this mark.There was no association between the type of treatment performed and the occurrence of postoperative pain (p=0.206). It was concluded that, among the evaluated factors, only the previous symptomatology was associated with higher frequency of postoperative pain (AU).
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Tratamento do Canal Radicular , Estudantes de Odontologia , Odontalgia , Educação em Odontologia , Endodontia , Dor Pós-Operatória , Brasil/epidemiologia , Estudos Retrospectivos , Interpretação Estatística de Dados , OdontologiaRESUMO
Biofilms are the main cause of endodontic failures. Even the best executed endodontic treatment can fail, when the infection is resistant to treatment or when it is located in inaccessible areas, such as the external surface of the root apex. The purpose of this study was to evaluate, by scanning electron microscopy, the presence of bacterial biofilm on endodontically treated teeth considered clinical failures and suitable for apical surgery. Root apices were collected from 20 teeth undergoing apical surgery and one negative control and analyzed under SEM. Digital photomicrographs of the root apices of 21 specimens at different magnifications were taken. Data were analyzed using descriptive statistics. Apical biofilms were observed in 100% of root canal treatments considered endodontic failure. Topographical analysis of the root apices revealed areas of resorption, microcracks, and apical foramina in 90%, 80%, and 50% of cases, respectively. Within the limits of this study, it can be concluded that endodontic failures present bacterial biofilm in areas inaccessible to conventional endodontic treatment, such as the external surfaces of the root apex.