ResumoObjetivo: O presente estudo procurou acessar o efeito da limpeza do forame apical no reparo de lesões periapicais detectadas radiograficamente. Materiais e métodos: A amostra constituiu-se de 980 dentes selecionados de 25 de fevereiro de 1997 a 15 de março de 2005 que foram submetidos a tratamento endodôntico e exibiram lesões periapicais radiograficamente visíveis. A amostra foi então dividida em dois grupos: Grupo I, 402 tratamentos de canal em que a limpeza do forame apical não foi realizada, e Grupo II, composto pelos 578 dentes restantes onde o procedimento foi realizado. Após um ano, os dentes foram clinica e radiograficamente avaliados. Resultados: No Grupo I, 360 canais (89,55%) não tiveram evidência de lesões periapicais, versus 521 (90,13%) no Grupo II. Presença parcial dessas lesões foi observada em 23 canais (5,72%) no Grupo I versus 27 (4,67%) no Grupo II. O teste qui-quadrado de Pearson não demonstrou significância estatística entre os Grupos I e II (p=0,732). Conclusões: Estes achados sugerem que a limpeza do forame apical não é um determinante para o reparo de lesão periapical. AbstractAim: The present study sought to assess the effect of apical foramen cleaning in the repair of periapical lesions detected by radiography. Methods: The sample comprised 980 teeth collected from 25 February 1997 to 15 March 2005, which had been subjected to endodontic treatment and exhibited radiographically visible periapical lesions. The sample was then divided into two groups: Group I, 402 root canal treatments in which cleaning of the apical foramen had not been performed, and Group II, composed of the remaining 578 root canal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of these lesions was observed in 23 canals (5.72%) in Group I versus 27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%) canals in Group I and 30 in Group II. Pearson's chi-square test showed no statistically significant difference between the Groups I and II (p = 0.732). Conclusions: These findings suggest that foramen cleaning is not a determinant of periapical lesion repair.
bjective:The aim of this randomized clinical trial was to evaluate the frequency of bacteriemia during endodontic treatment, with comparison between two techniques for biomechanical preparation of the root canal system. Materials and methods: The sample comprised 50 patients aged 16 to 52 years, of both genders, which were divided into 2 groups with 25 patients each. Group I underwent biomechanical preparation by the step-back technique, and Group II was treated by the rotary technique with nickel-titanium instruments (K3). Patients were submitted to antisepsis of the oral cavity with chlorhexidine digluconate and three samples of blood were collected for blood culture: preoperatively, immediately after the biomechanical preparation and 10 minutes later. The significance level adopted was 5.0%, and analysis was performed by descriptive and inferential statistics by means of the Fisher's exact test, Fisher-Freeman-Halton test and Student's t test. Data were analyzed on the Statexact and SPSS softwares. Results: All blood cultures achieved before and immediately after preparation were negative. On the other hand, with regard to the blood cultures collected 10 minutes after preparation, one (4%) positive case was found for Group I. However, this difference was not statistically significant (p = 0.50). Conclusion: The frequency of bacteriemia was low and observed just for Group I. Uniterms: Bacteremia; Endocarditis, bacterial; Antibiotic prophylaxis; Root canal therapy.bjetivo: O objetivo deste ensaio clínico randomizado foi avaliar a freqüência de bacteriemia durante o tratamento endodôntico comparando duas técnicas de preparo biomecânico do sistema de canais radiculares. Materiais e métodos: A amostra constou de 50 pacientes, com idade variando entre 16 e 52 anos e de ambos os sexos, sendo dividida em 2 grupos de 25 pacientes. No Grupo I, realizou-se o preparo biomecânico através da técnica escalonada com recuo progressivo programado, e, no Grupo II, por meio técnica rotatória, empregando instrumentos de níquel-titânio (K3). Os pacientes realizaram anti-sepsia da cavidade bucal com gluconato de clorexidina e foram realizadas três coletas de sangue para hemoculturas: no pré-operatório, imediatamente após o preparo biomecânico e 10 minutos depois. O nível de significância foi de 5,0%, e foram utilizadas técnicas de estatística descritiva e inferencial através dos testes exato de Fisher, Fisher-Freeman-Halton e "T" de Student. A análise dos dados foi realizada através do programa Statexact e SPSS. Resultados: As hemoculturas tomadas antes e imediatamente após o preparo, foram todas negativas. Já nas hemoculturas, realizadas 10 minutos após o preparo, foi encontrado um caso (4%) positivo no Grupo I. Esta diferença, entretanto, não foi estatisticamente significante (p = 0,50). Conclusão: Concluiu-se que a freqüência de bacteriemia foi baixa e observada apenas no Grupo I. Unitermos: Bacteriemia; Endocardite bacteriana; Antibioticoprofilaxia; Tratamento do canal radicular. 334J Appl Oral Sci. 2005;13(4):334-9
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