Objective: The aim of this study was to compare the duration of instrumentation and obturation times and quality of root canal filling between rotary and manual instrumentation techniques in primary teeth. Study design: A randomized, controlled clinical trial was performed that included deciduous teeth with pulp necrotic. Forty necrotic teeth were included; 20 were instrumented with a rotary technique (experimental group) and 20 with a manual technique (control group). The time taken for instrumentation and for obturation were recorded in minutes, and the quality of the root canal filling was recorded as optimal, underfilled,or overfilled. Results: The use of the rotary technique diminished the time of instrumentation to 63%and time of obturation to 68%, and it improved the quality of the root canal filling. Conclusion: The use of rotary instruments in the pulpectomy of primary molars represents a promising technique; the time is significantly reduced.
The objective of this study was to identify cultivable microorganisms from primary teeth with necrotic pulps. This experimental study included 21 patients of both sexes between 4 and 7 years of age with necrotic pulps in primary teeth. Twenty-one maxillary and mandibular molars containing at least 1 necrotic canal, an abscess or sinus tract, one or more radiolucent areas in the furcation or periapical region, teeth having at least two thirds of root length, and carious lesions directly exposed to the oral environment were included. After antisepsis of the oral cavity, anesthesia of the affected tooth, and isolation and disinfection of the operative field, 3 sterile absorbent paper points were sequentially placed for 30 seconds for the collection of samples. The samples were immediately processed in an anaerobic chamber, and all isolated microorganisms were identified. Anaerobic species (anaerobic facultative and moderate anaerobes) were isolated in all root canals; 68.4% of root canal samples studied showed a polymicrobial nature. Most of the isolate consisted of Bifidobacterium Spp2 and Streptococcus intermedius. Other less frequently encountered species were Actinomyces israelii, Bifidobacterium spp 1, Clostridium spp, and Candida albicans. Results indicate the existence of combinations of bacterial species in root canal infections of the primary dentition with necrotic pulps, anaerobic bacteria predominating.
Objective: To determine the levels of two sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) and two endogenous opioids (methionine-enkephalin [Met-Enk] and bendorphin [b-End]) in dental pulp tissue samples subjected to controlled orthodontic intrusive forces. Materials and Methods: Sixteen healthy premolars were selected from eight patients who were undergoing extraction for orthodontic purposes. Eight were randomly used as controls, and the other eight were assigned to an experimental group (controlled orthodontic intrusive forces applied for 24 hours). After this period, teeth were extracted, and pulp samples were obtained. All samples were processed to quantify the expression levels of SP, CGRP, Met-Enk, and b-End using commercial radioimmunoassay kits. Results: All samples exhibited basal levels of both neuropeptides and endogenous opioids. After 24 hours of the intrusive stimulus, all patients reported a tolerable discomfort localized at the involved premolar. Only SP was significantly increased (P , .05). For the other molecules, no statistically significant differences were observed (P . .05); however, they expressed important increasing trends. Conclusions: The expression levels of SP and CGRP in dental pulp samples from the experimental group support the positive correlation between the symptomatic clinical scenario and increased expression levels of neuropeptides, clarifying the role of neurogenic inflammation in early injury response. (Angle Orthod. 2014;84:521-526.)
Objective: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigating solution in reducing bacterial loading in necrotic pulpectomized primary teeth. Study design: Forty necrotic teeth were included, 20 irrigated with OPW (experimental group) and 20 with 1% NaOCl (control group); in both groups, 2 microbiological samples from within the canals were taken with a sterile paper point, the first before irrigation (immediately before opening the crown), and the second after instrumentation and final irrigation (before filling). All samples were evaluated by McFarland's scale. Results: After the samples were analyzed before and after irrigation in the control group, there was a significant decrease in bacterial load, as in the experimental group (P < 0.0001). When both groups were compared post irrigation, no significant difference was observed (P = 0.1519). Conclusion: The OPW was as effective as the NaOCl and is suggested as an alternative for irrigating after pulpectomy of necrotic primary teeth.
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