This study assessed the fracture resistance of simulated immature teeth reinforced with calcium aluminate cement (CAC) or mineral trioxide aggregate (MTA) containing calcium carbonate nanoparticles (nano-CaCO3). The microstructural arrangement of the cements and their chemical constitution were also evaluated. Forty-eight canines simulating immature teeth were distributed into 6 groups (n=8): Negative control - no apical plug or root canal filling; CAC - apical plug with CAC; CAC/nano-CaCO3 - apical plug with CAC+5% nano-CaCO3; MTA - apical plug with MTA; MTA/nano-CaCO3 - apical plug with MTA+5% nano-CaCO3; and Positive control - root canal filling with MTA. The fracture resistance was evaluated in a universal testing machine. Samples of the cements were analyzed under Scanning Electron Microscope (SEM) to determine their microstructural arrangement. Chemical analysis of the cements was performed by Energy Dispersive X-ray Spectroscopy (EDS). The fracture resistance of CAC/nano-CaCO3 was significantly higher than the negative control (p<0.05). There was no significant difference among the other groups (p>0.05). Both cements had a more regular microstructure with the addition of nano-CaCO3. MTA samples had more calcium available in soluble forms than CAC. The addition of nano-CaCO3 to CAC increased the fracture resistance of teeth in comparison with the non-reinforced teeth. The microstructure of both cements containing nano-CaCO3 was similar, with a more homogeneous distribution of lamellar- and prismatic-shaped crystals. MTA had more calcium available in soluble forms than CAC.
O presente estudo sobre tratamento de canais radiculares teve como objetivos: i) fornecer um panorama de atendimentos dos pacientes referenciados pelas Unidades Básicas de Saúde (UBS) de Porto Alegre no CEO da Universidade Federal do Rio Grande do Sul (UFRGS) e ii) investigar a conformidade de preenchimento dos prontuários clínicos dos pacientes atendidos. Foram analisados 242 prontuários. Os dados coletados foram inseridos em uma tabela com as seguintes informações referentes a cada paciente: 1) número do prontuário, 2) idade (anos e meses), 3) gênero (masculino/feminino), 4) dente, 5) número de consultas, 6) presença de radiografia final do dente obturado, restaurado e sem isolamento absoluto (sim/não), 7) qualidade da radiografia (adequada/ inadequada), 8) presença da radiografia final do caso no momento da obturação (sim/não), 9) qualidade da radiografia (adequada/ inadequada), 10) consentimento informado assinado pelo paciente (sim/não), 11) entrevista dialogada preenchida (sim/não), 12) presença da informação sobre o diagnóstico pulpar ou periapical (sim/não), 13) relato da finalização do trata-mento/obturação do dente (sim/não), 14) relato sobre a restauração provisória coronária (sim/não), 15) informação sobre a contra-referência para a UBS (sim/não). Foi realizada análise descritiva (frequência e percentagem) dos dados e correlação entre as variáveis idade (faixa etária) e i) gênero, ii) dente (posterior ou anterior), iii) grupo dentário e iv) número de consultas. Houve predominância de pacientes do sexo feminino (63,2%) em todas as faixas etárias, exceto em pacientes com 60 anos ou mais, onde predominaram pacientes do sexo masculino. Os dentes que mais sofreram intervenção foram os posteriores (60,3%), exceto em pacientes na faixa etária 50 a 59 anos. Os 1os molares foram os dentes que receberam mais tratamento endodôntico (28,9%), principalmente em pacientes adultos-jovens (menores de 19 anos até 39 anos de idade). Na maioria dos casos o tratamento foi concluído em poucas consultas (67,4% das vezes em até 3 consultas). Os pontos negativos observados foram: deficiente armazenamento e qualidade das radiografias; ausência da história médico-odontológica do paciente; falta da descrição do diagnóstico pulpar/periapical e ausência da assinatura do paciente autorizando o tratamento. Os pontos positivos encontrados foram: a finalização do tratamento endodôntico foi documentada em 100% das vezes e a realização da restauração provisória coronária foi documentada na maioria das vezes (95%). Os achados deste estudo, além de evidenciar o perfil de atendimento do CEO-Endodontia da UFRGS, podem contribuir para o desenvolvimento de estratégias que impulsionem mudanças positivas no serviço odontológico, tais como incentivo do pensamento crítico e ético no aluno/profissional em relação à magnitude da importância do correto preenchimento dos prontuários clínicos e geração de ideias que possam aprimorar os meios de armazenamento das radiografias nos prontuários.
Objective To evaluate the apical transportation and centering ability promoted by reciprocating and continuous rotary systems after root canal filling removal. Materials and Methods After obturation, 40 mesial root canals of mandibular molars were distributed into four groups (n = 20) for filling material removal: PTU group–F2 instrument (25.08) of ProTaper Universal system; R25 group–R25 instrument (25.08) of Reciproc system; X2 group–X2 instrument (25.06) of ProTaper Next system and X3 group–X2 instrument (25.06) of ProTaper Next system, followed by X3 instrument (30.07). Cone-beam computed tomographic analysis was performed before and after filling material removal for acquisition of apical images. Apical transportation (AT) and its direction, and centering ability (CA), were assessed using the equations AT = (X1–X2)–(Y1–Y2) and CA = (X1–X2/Y1–Y2 or Y1–Y2/X1–X2), respectively. Data were submitted to the nonparametric Kruskal–Wallis and Dunn multiple comparison tests (p < 0.05) for statistical analysis. Results There was no statistically significant difference among groups for AT (p > 0.05), with a tendency toward transportation in the distal direction. Also, there was no statistically significant difference among groups regarding CA (p > 0.05). Conclusions The different systems, including ProTaper Next, caused AT within the acceptable clinical limit after filling removal. In addition, none of the tested systems presented adequate CA.
BackgroundThe literature is scanty regarding the effect of radiation therapy (RT) on the mechanical properties of immature permanent teeth.AimTo evaluate the effect of RT on the fracture resistance of simulated immature teeth submitted to different types of root reinforcement.DesignSixty‐four human teeth simulating the Cvek stage 3 of root development were distributed into eight groups (n = 8), according to exposure or not to RT (70 Gy) and the root reinforcement method: Group NR (control)—no reinforcement/no RT; Group NR + RT (control)—no reinforcement/RT; Group PO—tricalcium silicate‐based cement (TS) apical plug/canal obturation/no RT; Group PO + RT—TS apical plug/canal obturation/RT; Group TS—canal filling with TS/no RT; Group TS + RT—canal filling with TS/RT; Group FP—TS apical plug/fibreglass post/no RT; and Group FP + RT—TS apical plug/fibreglass post/RT. Fracture resistance was determined using a universal testing machine (0.5 mm/min).ResultsIn the intergroup comparison, nonirradiated teeth had higher fracture resistance (p < .05). Groups FP and FP + RT had higher fracture resistance (p < .001).ConclusionRadiotherapy affected the fracture resistance of simulated immature teeth. Reinforcement with fibreglass posts increased the fracture resistance, regardless of the radiation.
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