Objectives: The purpose of this study was to assess the in vitro antibacterial activity of four formulations of calcium hydroxide [Ca(OH)2] pastes against Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus mutans. Methods: A broth dilution test was performed, and the lengths of time for different pastes to kill the microbial cells were recorded and statistically analyzed. The following medications were assessed: Group I – Ca(OH)2 + 2.0% chlorhexidine (CHX) gel; Group II – Ca(OH)2 + camphorated paramonochlorophenol (CMCP) and propylene glycol; Group III – Ca(OH)2 + propylene glycol; Group IV – Ca(OH)2 + saline. Results: The results showed that E. faecalis was the most resistant microorganism. Groups II and III eliminated all the microbial cells in 15 seconds. Group I took 45 seconds to eliminate E. faecalis. Conclusions: Under the conditions of this study, it was concluded that all the intracanal medications tested showed antibacterial activity. However, the association of Ca(OH)2 and PMCC or Ca(OH)2 and propylene glycol showed a better performance, since Groups II and III took a shorter length of time than the other groups to eliminate S. aureus and E. faecalis. (Eur J Dent 2011;5:1-7)

A comprehensive knowledge on the root canal anatomy is a basic prerequisite for the endodontic treatment successful. Mandibular molars may have an additional root located lingually (radix entomolaris) or buccally (radix paramolaris). In the literature, this anatomy variation is considered rare in Caucasian populations. Awareness and understanding of the presence of unusual external and internal root canal morphology contributes to the successful outcome of the root canal treatment.Objective and case report: The purpose of this study was to report a clinical case of successful endodontic treatment in a mandibular molar with pulp necrosis and characterized as radix entomolaris in which the use of magnification and ultrasonic tips (the “microsonics concept”) was fundamental to the management of the variations in the internal anatomy. Conclusion: A better understanding of the root canal morphology is essential for endodontic treatment success, as well as the use of technologic advancements in Endodontics including computed tomography, ultrasonic tips and the operating microscope.

A periodontite apical é causada principalmente por microrganismos e seus fatores de virulência. Esse processo pode estar associado à sobrevivência de seus agentes causadores devido à microinfiltração coronariana após preparo químico-mecânico e preenchimento. No entanto, a periodontite apical persistente pode ser resolvida através de retratamento endodôntico ou cirurgia apical. Além disso, sua associação com doenças sistêmicas tem sido relatada em diferentes estudos. O objetivo do presente estudo é realizar uma revisão de literatura sobre periodontite apical, com ênfase no perfil microbiano atual e modalidades de tratamento. Estudos têm demonstrado significativa heterogeneidade no perfil microbiano, bem como prováveis associações com algumas doenças. Além disso, eles se concentraram principalmente na investigação da periodontite apical persistente com base na biologia molecular. Foi possível concluir que, embora Enterococcus faecalis seja a espécie mais frequentemente associada ao insucesso em tratamentos endodônticos, a incidência de outros microrganismos, como Candida albicans, Streptococcus spp., Actinobacteria spp. nível superior ao de E. faecalis. O retratamento deve sempre ser considerado como a primeira opção para tratar as morbidades, embora a cirurgia possa ser realizada se o retratamento não for bem sucedido.

The knowledge of the complex anatomy of maxillary molars and location of extra canals are essential for diagnosis and endodontic treatment success. Objective: The purpose of this study was to report a clinical case showing a varying number of palatal roots in a second maxillary molar with the aid of operating microscope (OM). Case report: A four-rooted maxillary permanent second molar with 2 separated palatal canals undergone endodontic therapy. After endodontic access, examination of the chamber floor using an operating microscope revealed two distinct palatal canals orifices. A radiograph was taken after the working lengths of each canal were estimated by means of an electronic apex locator which clearly identified the four roots with independent four canals. The canals were instrumented with ProTaper™ rotatory instruments under irrigation with 5% sodium hypochlorite, obturated with Pulp Canal Sealer® and continue wave technique. After completion of root canal treatment, the tooth was restored with composite resin. Results: After endodontic access, the presence of two different palatal canals was found in a second maxillary molar, resulting from a variation in the number of palatal roots of this tooth. Conclusion: The high magnification and clear illumination quality provided by the dental operating microscope increase endodontic treatment success of the variations in the internal anatomy of the tooth.

O objetivo deste estudo foi avaliar, ex vivo, a resistência de união à dentina de dois cimentos endodônticos, sendo um biocerâmico Bio-C Sealer e o outro resinoso AH Plus, através do teste de Push-Out. Todos os dentes foram instrumentados com o sistema Protaper Next até a lima x3, e obturados com cone único. Foram utilizadas 30 amostras de dentes anteriores, divididos em dois grupos (n=15), sendo o grupo BC (Bio-C Sealer) e grupo AH (AH Plus Jet®) ambos com técnica do cone único.  O teste de Push-Out foi realizado nos terços apical, médio e cervical das amostras, conduzido usando uma máquina de teste universal. A comparação entre os dois cimentos endodônticos nos três terços radiculares foi realizada por meio da análise de variância a dois critérios para blocos casualizados. Para as comparações múltiplas recorreu-se ao teste de Tukey. No terço apical a resistência de união foi significativamente maior que a encontrada no terço médio que, por sua vez, mostrou-se estatisticamente mais elevada que no terço cervical. Contudo foi influenciado pelo terço radicular, tanto para o cimento AH Plus Jet®, quanto para o Bio-C Sealer. Concluiu-se que ambos os cimentos AH Plus Jet® e Bio-C Sealer, com análise da resistência de união através de teste Push-Out se comportaram de maneira equivalente.