Adhesively cemented fiber-reinforced composite posts are commonly used to reconstruct endodontically treated teeth. Adhesion to intraradicular dentin is complex, and close contact between the resin cements and the dentin is essential. The removal of the smear layer following post space preparation (secondary smear layer) can improve this integration. Different mechanical systems have been used to activate the irrigant inside the root canal. The purpose of this study was to compare, ex-vivo, the removal of the smear layer from the walls of the immediate post space preparation by the action of three mechanized instruments. Forty premolar specimens with a single root canal were selected, endodontically treated, and shaped for glass fiber post cementation with Peeso reamer #1 (Dentsply Sirona, Switzerland) and Macrolock finishing drill #3 (RTD, France). The specimens were randomly divided into 4 groups (n=10): Group C (control); Group PUI (passive ultrasonic irrigation); Group CEP (Rotoprox brush, Hager Werken, Germany) and Group XP (XP-endo Finisher, FKG Dentaire, Switzerland). Post space surfaces were cleaned with 3mL of distilled water; each specimen root split longitudinally to expose the root canals, and prepared for examination in a scanning electron microscope at magnification 350X. The results were analyzed using the Kruskal-Wallis and Friedman tests (p>0.05). RESULTS: Statistically significant differences (p <0.05) were found between Groups C and XP in all three root regions, but not between Groups C, CEP and PIU. Of these, Group CEP showed a better trend in the results of the coronary and middle thirds, without significant difference with Group XP. Although it was difficult to achieve a clean dentin surface after preparation for the fiberglass post, the XP-endo Finisher was the most efficient in removing secondary smear layer, followed by the Rotoprox conical brush.
La situación ideal es volver a reimplantar un diente exarticulado inmediatamente después de la avulsión porque el tiempo extra oral es un factor determinante para el éxito del tratamiento y para un buen pronóstico. Sin embargo, no siempre es posible. El éxito de la reimplantación depende de una serie de factores, los cuales pueden contribuir a acelerar o minimizar la aparición de la reabsorción radicular o anquilosis, teniendo un rol importante en este proceso el tipo y características del me dio utilizado para el almacenamiento temporal durante el tiempo transcurrido entre la avulsión y la reimplantación. Mantener el diente en un medio húmedo adecuado, puede preservar la vitalidad de las células del ligamento periodontal que permanecen en la superficie de la raíz siendo esta la clave del éxito de la reimplantación. Investigaciones recientes impulsaron el desarrollo de medios de almacenamiento que reproducen condiciones similares el medio ambiente alveolar, con osmolalidad ade cuada (presión celular), pH, metabolitos nutricionales y glucosa, creando las mejores condiciones posibles para el almacenamiento. El presente artículo revisa la literatura referida a los diferentes medios de almacenamiento que han sido investigados para dientes avulsionados basado en documentos recuperados de PubMed/Medline, Lilacs. Varios estudios coinciden que la leche entera pasteurizada es uno de los medios con mejor pronóstico entre otras soluciones que puedan estar disponibles en la escena de un accidente.Palabras clave: "medio de almacenamiento", "medio de transporte", "avulsión dental", "reimplantación", "leche" y "propóleos". ABSTRACTThe ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible condition s for storage. This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs Regular pasteurized whole milk is the most frequently recommended and with the best prognosis among other solutions that are likely to be available at the scene of an accident.
Objetivo: Comparar el tiempo empleado por los instrumentos TruNatomy Medium y ProTaper Next X3 para penetrar hasta la longitud de trabajo la masa de obturaciones realizadas con GuttaCore Primary y sellador en conductos curvos simulados.Materiales y métodos: Se prepararon 20 conductos curvos simulados con instrumentos rotatorios WaveOne Gold Primary y se obturaron con GuttaCore Primary y AH Plus. Las muestras fueron divididas en dos grupos de 10 cada uno. Grupo 1: El material de obturación fue penetrado hasta la longitud de trabajo con instrumentos TruNatomy Medium. Grupo 2: El material de obturación fue penetrado hasta la longitud de trabajo con instrumentos ProTaper Next X3. Se registraron los tiempos de penetración requeridos para cada grupo y los valores obtenidos fueron analizados mediante la prueba t de Student. Resultados: Los instrumentos ProTaper Next X3 penetraron la masa del material de obturación más rápidamente que los instrumentos TruNatomy MediumTM. Las diferencias observadas entre ambos instrumentos fueron estadísticamente significativas (P <0.01). Conclusión: Si bien los instrumentos ProTaper Next X3 y TruNatomy MediumTM penetraron la masa de GuttaCore Primary de manera eficiente, ProTaper Next X3 penetró hasta la longitud de trabajo más rápidamente.
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