A ativação ultrassônica é um dos métodos mais utilizados para aumentar a eficiência mecânica e química dos irrigantes. No entanto, além de possivelmente causar desgastes indesejáveis na parede do canal, questiona-se a eficiência mecânica da irrigação ultrassônica ativada em canais com curvatura acentuada. O presente estudo teve como objetivo avaliar, por meio da microtomografia computadorizada (micro-CT) a influência do grau de curvatura dos canais radiculares nos desgastes dentinários não controlados produzidos pelo uso da Irrigação Ultrassônica Ativada (UAI), no percentual de debris dentinários remanescentes após UAI e o transporte do canal. Foram selecionados canais mesiais de 24 molares inferiores permanentes humanos, sendo 12 dentes com curvatura média de 25,5º (Curvatura Moderada) e 12 dentes com curvatura média de 50,9º (Curvatura Acentuada). Após escaneamento pré-operatório com um Microtomógrafo de raios-X, os canais foram preparados com os instrumentos Mtwo. Os dentes foram divididos em 2 grupos: Grupo CM (n=12) e Grupo CA (n=12). Ambos os grupos receberam irrigação ultrassônica ativada e em seguida foram escaneados novamente. Foram quantificados o volume e a profundidade máxima dos desgastes não controlados das paredes dos canais radiculares, o percentual de debris dentinários remanescentes e o transporte do canal. Foi realizada análise estatística, utilizando o software GraphPad Prism 7, com nível de singnificância de p <0,05. Os resultados mostraram que os grupos, apresentaram resultados semelhantes quanto ao volume de desgaste não controlado, porém o grupo CA apresentou desgastes mais acentuados no terço apical e um maior percentual de debri remanescente nos terços médio, apical e no total do canal radicular, além de promover desvio do canal no terço apical. Este estudo concluiu que curvaturas acentuadas interferem na profundidade do desgaste, na manutenção dos debris e no transporte do canal. / Ultrasonic activation is one of the most widely used supplementary irrigation methods. However, besides Ultrassonic Activated Irrigation (UAI) possibly causes uncontrolled removal of dentin in the root canal walls, it is unknown the efficiency of the ultrasonic irrigation in root canals with severe curvatures. The aim of the present study was evaluate using microcomputed tomography, the influence of the degrees of curvature in the percentage of remaining hard tissue debris, uncontrolled removal of dentin during UAI and root canal transportation. Twenty-four mesial roots of mandibular molars, 12 teeth with a mean curvature of 25.5º (Moderate Curvature) and 12 teeth with a mean curvature of 50.9º (Accentuated Curvature) were selected. After the pre-operative scanning with an X-ray microcomputed tomography, the specimens were prepared to size 35.04. The teeth were divided into two groups: Group CM (n = 12) and Group CA (n = 12). Both groups received ultrasonic irrigation and were scanned again. The maximum deep of the defects, volume of the uncontrolled removal of dentin, the percentage of remaining hard tissue debris and the root canal transportation were quantified. A statistical analysis was performed using GraphPad Prism 7 software, use Mann-Whitney test with a significance level of p <0.05. The results showed that the groups CM and CA had similar results in volume of uncontrolled removal of dentin, but the CA group show maximum deep defects more severe in the apical third, more percentage of hard tissue debri remaining in the middle, apical and total thirds of the canal root canal and a higher transport of the canal in the apical third. This study concluded that severe curves interfered in the maximum depth defects, in the maintenance of the debris and the transport of the canal.

O objetivo do presente estudo foi avaliar, quantitativa e qualitativamente, por meio de microtomografia computadorizada, o percentual de volume e de redução de debris dentinários acumulados (DDA) no sistema de canais radiculares com istmos de raízes mesiais de molares inferiores submetidos à: irrigação por pressão apical positiva; irrigação ultrassônica passiva; finalização do preparo com Self-Adjusting File e finalização do preparo com XP-endo Finisher. Quarenta raízes mesiais de molares inferiores, com curvatura moderada, e presença de dois canais mesiais com istmo único e contínuo verificada por escaneamento em microtomográfo, foram selecionadas. Os canais foram preparados pela técnica de instrumentação reciprocante (WaveOne Small e Primary). Em seguida, a composição dos grupos experimentais foi realizada por meio da técnica de amostragem estratificada, de acordo com o protocolo de irrigação final ou de finalização de preparo biomecânico, em quatro grupos (n=10): Pressão Apical Positiva (PAP), Irrigação Ultrassônica Ativa (IUP), Self-Adjusting File (SAF), e a XP-endo Finisher (XPF). Os protocolos foram realizados durante 2 minutos com 5,5 mL de hipoclorito de sódio a 2,5%. Os espécimes foram submetidos aos exames microtomográfico inicial, após o preparo e após os protocolos de irrigação final ou de finalização do preparo para análise de DDA. A porcentagem de volume e redução de DDA após os protocolos de irrigação final ou de finalização do preparo biomecânico foram comparados estatisticamente entre os grupos por meio de ANOVA e pós-teste de Tukey, com nível de significância de 5%. Foi possível observar redução de DDA após os protocolos de irrigação final e de finalização do preparo biomecânico em todos os grupos avaliados. Os grupos IUP e XPF apresentaram as menores médias de volume e de percentual de volume (%vol) de DDA (0,05±0,06mm³ e 0,61±0,75%; e 0,08±0,09mm³ e 0,81±1,03%, respectivamente) comparados aos grupos PAP e SAF (0,36±0,13mm³ e 3,73±1,59%; e 0,47±0,23mm³ e 4,31±1,87%, respectivamente) (p<0,05). Ainda, o percentual de redução de DDA foi maior nos grupos IUP e XPF (94,05±7,21% e 89,67±10,96%, respectivamente) quando comparados aos grupos PAP e SAF (45,74±15,76% e 41,26±9,96%, respectivamente) (p<0,05). Não houve diferença estatística entre os grupos IUP e XPF; e entre os grupos PAP e SAF (p>0,05). Qualitativamente, os DDA remanescentes foram localizados principalmente no terço apical após o protocolo com IUP; no terço cervical após protocolo com XPF e nos terços médio e apical após protocolos com PAP e SAF. Conclui-se que os protocolos de irrigação ultrassônica passiva e de finalização do preparo com XP-endo Finisher apresentaram maiores remoções de debris dentinários do sistema de canais radiculares com istmos comparados aos protocolos de irrigação por pressão apical positiva e de finalização de preparo com SAF. / The aim of this study was to evaluate, quantitatively and qualitatively, the percent volume and percent reduction of accumulated hard-tissue debris (AHTD) from root canal system with isthmuses of mesial roots of mandibular molars subjected to different final irrigation and final shaping protocols, using micro-computed tomography (micro-CT) analysis. Forty mesial roots of mandibular molars with moderate curvature and two mesial canals with a single and continuous isthmus detected by micro-CT scanning were selected. The canals were prepared by reciprocating instrumentation technique (WaveOne Small and Primary). Then, the composition of the experimental groups was performed by a stratified sampling method, resulting in four groups (n=10), according to the final irrigation or final shaping protocol: Apical Positive Pressure (APP), Passive Ultrasonic Irrigation (PUI), Self-adjusting File (SAF) and XP-endo Finisher (XPF). The protocols were performed with 5.5 mL of 2.5% NaOCl per canal during 2 minutes. The specimens were subjected to preoperative and following preparation, final irrigation or final shaping micro-CT scanning for AHTD analysis. The percent volume and percent reduction of AHTD after final irrigation or final shaping were statistically compared among groups using ANOVA and post hoc Tukey test with a 5% significance level. It was observed a reduction in the percentage of AHTD after final irrigation or final shaping in all groups. The PUI and XPF groups showed the lowest mean of volume and percent volume (%vol) of AHTD (0.05±0.06mm³ and 0.61±0.75%; and 0.08±0.09mm³ and 0.81±1.03%, respectively) when compared with APP and SAF groups (0.36±0.13mm³ and 3.73±1.59%; and 0.47±0.23mm³ and 4.31±1.87%, respectively) (p<0.05). Furthermore, the percent reduction of AHTD was greater in PUI and XPF groups (94.05±7.21% and 89.67±10.96%, respectively) compared with APP and SAF groups (45.74±15.76% and 41.26±9.96%, respectively) (p<0.05). No statistically significant differences were found when comparing PUI and XPF groups or APP and SAF groups (p>0.05). Qualitatively, the remaining DDA were mainly located in the apical third after the protocol with IUP; the cervical third after protocol XPF and in the middle and apical thirds after protocols PAP and SAF. It may be concluded that the passive ultrasound irrigation and final shaping with XP-endo Finisher protocols showed greater AHTD reduction from root canal system with isthmuses of mesial roots of mandibular molars than apical positive pressure and final shaping with SAF.

Hard tissue engineering holds the promise of restoring the function of failed hard tissues and involves growing specific cells on extracellular matrix (ECM) to develop &bdquo / &bdquo / tissue-like&rdquo / structures or organoids. Chitosan is a linear amino polysaccharide that can provide a convenient physical and biological environment in tissue regeneration attempt. To improve chitosan&amp / #8223 / s mechanical and biological properties, it was blended with another polymer gelatin. 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) and N-hydroxysuccinimide (NHS) were used to crosslink the chitosan-gelatin matrix to produce stable structures. These natural polymers are mechanically weak especially to serve as a bone substitude and therefore, an inorganic calcium phosphate ceramic, hydroxyapatite, was incorporated to improve this aspect. The objective of this study was to develop chitosan-gelatin/hydroxyapatite scaffolds for a successful hard tissue engineering approach. For this reason, two types of hydroxyapatite, as-precipitated non-sintered (nsHA) and highly crystalline sintered (sHA) were synthesized and blended into mixtures of chitosan (C) and gelatin (G) v to produce 2-D (film) and 3-D (sponge) structures. The physicochemical properties of the structures were evaluated by scanning electron microscopy, X-Ray Diffraction (XRD), Fourier Transform Infrared-Attenuated Total Reflectance spectrometer (FTIR-ATR), differential scanning calorimetry, contact angle and surface free energy measurements and swelling tests. Mechanical properties were determined through tensile and compression tests. In vitro cell affinity studies were carried out with SaOs-2 cells. MTS assays were carried out to study cell attachment and proliferation on the 2-D and 3-D scaffolds. Several methods such as confocal, fluorescence and scanning electron microscopy were used to examine the cell response towards the scaffolds. Cell affinities of the samples were observed to change with changing chitosan-gelatin ratio and hydroxyapatite addition into the matrices. XRD and FTIR results confirmed the purity of the hydroxyapatite synthesized. Mechanical test results showed that 2-D and 3-D chitosan-gelatin/hydroxyapatite constructs have similar properties as bones, and in vitro studies demonstrated that the prepared matrices have the potential to serve as scaffold materials in hard tissue engineering applications.

O objetivo do presente estudo foi avaliar, quantitativa e qualitativamente, por meio de microtomografia computadorizada, o percentual de volume e de redução de debris dentinários acumulados (DDA) no sistema de canais radiculares com istmos de raízes mesiais de molares inferiores submetidos à: irrigação por pressão apical positiva; irrigação ultrassônica passiva; finalização do preparo com Self-Adjusting File e finalização do preparo com XP-endo Finisher. Quarenta raízes mesiais de molares inferiores, com curvatura moderada, e presença de dois canais mesiais com istmo único e contínuo verificada por escaneamento em microtomográfo, foram selecionadas. Os canais foram preparados pela técnica de instrumentação reciprocante (WaveOne Small e Primary). Em seguida, a composição dos grupos experimentais foi realizada por meio da técnica de amostragem estratificada, de acordo com o protocolo de irrigação final ou de finalização de preparo biomecânico, em quatro grupos (n=10): Pressão Apical Positiva (PAP), Irrigação Ultrassônica Ativa (IUP), Self-Adjusting File (SAF), e a XP-endo Finisher (XPF). Os protocolos foram realizados durante 2 minutos com 5,5 mL de hipoclorito de sódio a 2,5%. Os espécimes foram submetidos aos exames microtomográfico inicial, após o preparo e após os protocolos de irrigação final ou de finalização do preparo para análise de DDA. A porcentagem de volume e redução de DDA após os protocolos de irrigação final ou de finalização do preparo biomecânico foram comparados estatisticamente entre os grupos por meio de ANOVA e pós-teste de Tukey, com nível de significância de 5%. Foi possível observar redução de DDA após os protocolos de irrigação final e de finalização do preparo biomecânico em todos os grupos avaliados. Os grupos IUP e XPF apresentaram as menores médias de volume e de percentual de volume (%vol) de DDA (0,05±0,06mm³ e 0,61±0,75%; e 0,08±0,09mm³ e 0,81±1,03%, respectivamente) comparados aos grupos PAP e SAF (0,36±0,13mm³ e 3,73±1,59%; e 0,47±0,23mm³ e 4,31±1,87%, respectivamente) (p<0,05). Ainda, o percentual de redução de DDA foi maior nos grupos IUP e XPF (94,05±7,21% e 89,67±10,96%, respectivamente) quando comparados aos grupos PAP e SAF (45,74±15,76% e 41,26±9,96%, respectivamente) (p<0,05). Não houve diferença estatística entre os grupos IUP e XPF; e entre os grupos PAP e SAF (p>0,05). Qualitativamente, os DDA remanescentes foram localizados principalmente no terço apical após o protocolo com IUP; no terço cervical após protocolo com XPF e nos terços médio e apical após protocolos com PAP e SAF. Conclui-se que os protocolos de irrigação ultrassônica passiva e de finalização do preparo com XP-endo Finisher apresentaram maiores remoções de debris dentinários do sistema de canais radiculares com istmos comparados aos protocolos de irrigação por pressão apical positiva e de finalização de preparo com SAF. / The aim of this study was to evaluate, quantitatively and qualitatively, the percent volume and percent reduction of accumulated hard-tissue debris (AHTD) from root canal system with isthmuses of mesial roots of mandibular molars subjected to different final irrigation and final shaping protocols, using micro-computed tomography (micro-CT) analysis. Forty mesial roots of mandibular molars with moderate curvature and two mesial canals with a single and continuous isthmus detected by micro-CT scanning were selected. The canals were prepared by reciprocating instrumentation technique (WaveOne Small and Primary). Then, the composition of the experimental groups was performed by a stratified sampling method, resulting in four groups (n=10), according to the final irrigation or final shaping protocol: Apical Positive Pressure (APP), Passive Ultrasonic Irrigation (PUI), Self-adjusting File (SAF) and XP-endo Finisher (XPF). The protocols were performed with 5.5 mL of 2.5% NaOCl per canal during 2 minutes. The specimens were subjected to preoperative and following preparation, final irrigation or final shaping micro-CT scanning for AHTD analysis. The percent volume and percent reduction of AHTD after final irrigation or final shaping were statistically compared among groups using ANOVA and post hoc Tukey test with a 5% significance level. It was observed a reduction in the percentage of AHTD after final irrigation or final shaping in all groups. The PUI and XPF groups showed the lowest mean of volume and percent volume (%vol) of AHTD (0.05±0.06mm³ and 0.61±0.75%; and 0.08±0.09mm³ and 0.81±1.03%, respectively) when compared with APP and SAF groups (0.36±0.13mm³ and 3.73±1.59%; and 0.47±0.23mm³ and 4.31±1.87%, respectively) (p<0.05). Furthermore, the percent reduction of AHTD was greater in PUI and XPF groups (94.05±7.21% and 89.67±10.96%, respectively) compared with APP and SAF groups (45.74±15.76% and 41.26±9.96%, respectively) (p<0.05). No statistically significant differences were found when comparing PUI and XPF groups or APP and SAF groups (p>0.05). Qualitatively, the remaining DDA were mainly located in the apical third after the protocol with IUP; the cervical third after protocol XPF and in the middle and apical thirds after protocols PAP and SAF. It may be concluded that the passive ultrasound irrigation and final shaping with XP-endo Finisher protocols showed greater AHTD reduction from root canal system with isthmuses of mesial roots of mandibular molars than apical positive pressure and final shaping with SAF.

The study of skeletal differences between males and females has rarely taken into account the physical change in hard tissue characteristics with the onset of advanced age. Anatomical change through degenerative modification may pose a challenge when diagnosing the sex of an unknown individual, especially if age is unknown. The aim of this study was to establish whether sexual dimorphism changes with age. This issue was addressed by using three types of procedural analyses. Firstly, standard measuring techniques were utilized to determine sex from 593 individuals. Visual (morphological) assessment was then performed on 608 individuals using sexually dimorphic traits in the distal humerus and pelvis. Lastly, over 300 individuals were analyzed with geometric morphometries using four locations on the postcranial skeleton. Younger females and males (50 years of age and younger) were then compared to older individuals (over 50 years of age) to determine if sexual dimorphism was increasing or decreasing with the onset of age. Long bone measurements of the postcranial skeleton increased with the onset of age in the most osteoporotic sample (South African white females). Males exhibited an increase in size, mainly in the knee and elbow joints, and black females remained static in their measurements with age. Older white females especially can sometimes incorrectly be misclassified as males. Visual techniques indicated that all populations have similar non-metric morphology in the distal humerus and pelvis. Classification accuracies in females decreased when viewing the distal humerus, indicating a decrease in sexual dimorphism at this location. Females appeared static in their pelvic morphology with the onset of age. Males remained sexually dimorphic throughout life in the humerus and pelvis. Geometric morphometries showed that the morphology of the distal humerus is sexually dimorphic, and does not change with age. Morphometries also confirmed the marked sexual dimorphism in the pelvis, and showed virtually no change in sexual dimorphism when comparing young to old groups. / Thesis (PhD)--University of Pretoria, 2009. / Anatomy / Unrestricted

<p>This thesis describes a method of growing a highly adherent nano-porous alumina coating on titanium implant materials, a design which might be useful in hard tissue replacement. Alumina layers were formed by anodisation of aluminium, which had been deposited on titanium and titanium alloys by electron beam evaporation. Mechanical testing showed the coatings’ shear and tensile strength to be ~20MPa and ~10MPa respectively. </p><p>Human osteoblasts were cultured on purchased membranes, produced in the same way with similar characteristics as the coating mentioned above. Cell viability, proliferation and phenotype were assessed by measuring redox reactions, DNA, tritiated thymidine incorporation and alkaline phosphatase production. Results showed normal osteoblastic growth patterns with increasing cell numbers the first two weeks after which cell growth decreased and alkaline phosphatase production increased, indicating that osteoblastic phenotype was retained on the alumina. Flattened cell morphology with filipodia attached to the pores of the material was seen. </p><p>Implants frequently trigger inflammatory responses due to accumulation and activation of cells such as polymorphonuclear granulocytes (PMN), also called neutrophils. Activation and morphology of human PMN in response to nano-porous alumina with two pore sizes (20 and 200 nm) was investigated by luminol-amplified chemiluminescence, granule enzyme deposition measurement, optical and scanning electron microscopy. Activation was observed on both membrane types, however less pronounced on the 200 nm alumina. For both membranes a decrease in activation was seen after coating with fibrinogen, collagen I and serum (more pronounced for the two latter). On fibrinogen-coated alumina many flattened cells were observed, indicating frustrated phagocytosis. Finally when culturing osteoblasts on non-coated and collagen-coated membranes (after exposure to PMN) many more cells had established on the protein-coated surface after 24 h. </p><p>The overall results indicate that it might be possible to produce a novel bone implant coating by anodisation of aluminium deposited on titanium and that this material will support osteoblast adhesion and proliferation. Furthermore neutrophil activation can be suppressed when coating the alumina with collagen I, which is beneficial considering the fact that this protein also is essential for bone formation.</p>

This thesis describes a method of growing a highly adherent nano-porous alumina coating on titanium implant materials, a design which might be useful in hard tissue replacement. Alumina layers were formed by anodisation of aluminium, which had been deposited on titanium and titanium alloys by electron beam evaporation. Mechanical testing showed the coatings’ shear and tensile strength to be ~20MPa and ~10MPa respectively. Human osteoblasts were cultured on purchased membranes, produced in the same way with similar characteristics as the coating mentioned above. Cell viability, proliferation and phenotype were assessed by measuring redox reactions, DNA, tritiated thymidine incorporation and alkaline phosphatase production. Results showed normal osteoblastic growth patterns with increasing cell numbers the first two weeks after which cell growth decreased and alkaline phosphatase production increased, indicating that osteoblastic phenotype was retained on the alumina. Flattened cell morphology with filipodia attached to the pores of the material was seen. Implants frequently trigger inflammatory responses due to accumulation and activation of cells such as polymorphonuclear granulocytes (PMN), also called neutrophils. Activation and morphology of human PMN in response to nano-porous alumina with two pore sizes (20 and 200 nm) was investigated by luminol-amplified chemiluminescence, granule enzyme deposition measurement, optical and scanning electron microscopy. Activation was observed on both membrane types, however less pronounced on the 200 nm alumina. For both membranes a decrease in activation was seen after coating with fibrinogen, collagen I and serum (more pronounced for the two latter). On fibrinogen-coated alumina many flattened cells were observed, indicating frustrated phagocytosis. Finally when culturing osteoblasts on non-coated and collagen-coated membranes (after exposure to PMN) many more cells had established on the protein-coated surface after 24 h. The overall results indicate that it might be possible to produce a novel bone implant coating by anodisation of aluminium deposited on titanium and that this material will support osteoblast adhesion and proliferation. Furthermore neutrophil activation can be suppressed when coating the alumina with collagen I, which is beneficial considering the fact that this protein also is essential for bone formation.

Objetivo: Determinar la prevalencia de patologías bucales en bebés atendidos en el programa de seguimiento del Niño de Alto riesgo del INMP durante el período Enero 2016 a Diciembre 2017 Materiales y métodos: Se recolectó la información de 455 historias clínicas de pacientes pertenecientes al programa de atención estomatológica Niños de Alto Riesgo en el consultorio de Odontopediatría del Instituto Nacional Materno Perinatal. Los datos fueron analizados mediante estadística descriptiva para el análisis univariado donde se aplicaron las medidas estadísticas de frecuencia absoluta y relativa, y análisis bivariado donde se aplicó la prueba de Chi2 y Exacta de Fisher (α=0,05). Resultados: Del total de 455 pacientes, 319 (70.11%) fueron diagnosticados con patologías orales y 136 (29.89%) con boca sana. Además; 127 presentaron patologías en el tejido blando (39.81%) y 192 en el tejido duro (60.19%), siendo este último el más prevalente. Del total de 24 patologías encontradas en la cavidad oral de esta población, las tres más prevalentes fueron síndrome de erupción (18.24%), defecto de desarrollo del esmalte (17.14%) y anquiloglosia (12.97%). Conclusiones: La prevalencia de los pacientes con patologías bucales fue alta (70.11%) y pacientes diagnosticados con boca sana (29.89%). / Objective: The aim of this study was to determine the prevalence of oral pathologies in babies treated in the follow-up program of the High Risk Child of the INMP during the period January 2016 to December 2017 Materials and methods: Information was collected from 455 medical records of patients belonging to the stomatological care program Children of High Risk in the pediatric dentistry office of the National Maternal and Perinatal Institute. The data were analyzed by means of descriptive statistics for the univariate analysis where statistical measurements of absolute and relative frequency were applied, and bivariate analysis where the Chi2 and Fisher Exacta test were applied. (α = 0.05). Results: Of the total of 455 patients, 319 (70.11%) were diagnosed with oral pathologies and 136 (29.89%) with a healthy mouth. Further; 127 presented pathologies in the soft tissue (39.81%) and 192 in the hard tissue (60.19%), the latter being the most prevalent. Of the total of 24 pathologies found in the oral cavity of this population, the three most prevalent were eruption syndrome (18.24%), enamel development defect (17.14%) and ankyloglossia (12.97%). Conclusions: The prevalence of patients with oral pathologies was high (70.11%) and patients diagnosed with healthy mouth (29.89%). / CAPÍTULO 1: INTRODUCCIÓN…………………………………………… CAPÍTULO 2: PLANTEAMIENTO DE LA INVESTIGACIÓN………….. 2.1. Justificación…………………………………………………………… CAPÍTULO 3: OBJETIVOS…………………………………………………. 3.1. Objetivo general………………………………………………………. 3.2. Objetivos específicos………………………………………………… CAPÍTULO 4: MATERIALES Y MÉTODOS……………………………….. 4.1 Diseño del estudio……………………………………………………... 4.2 Población y/o Muestra………………………………………………….. 4.3 Operacionalización de variables………………………………………. 4.4 Técnicas y/o procedimientos………………………………………….. 4.5 Plan de análisis…………………………………………………………. 4.6 Consideraciones éticas…………………………………………………. CAPÍTULO 5: RESULTADOS…………………………………………………. CAPÍTULO 6: DISCUSIÓN…………………………………………………….. CAPÍTULO 7: CONCLUSIONES………………………………………………… CAPÍTULO 8: REFERENCIAS BIBLIOGRÁFICAS…………………………………. ANEXOS……………………………………………………………………. / Tesis

A instrumentação do canal radicular possui como conseqüência a formação de debris dentinários, os quais acumulam-se especialmente nas áreas mais complexas do sistema de canais radiculares. Por este motivo, atenção especial tem sido concedida aos métodos de agitação da substâ ncia química auxiliar, com o intuito de melhorar a sua eficácia química e mecânica. No entanto, não está claro se debris dentinários removidos do interior do canal radicular possuem efeito na qualidade da obturação. Portanto, os objetivos deste estudo foram, com o auxílio da microtomografia computadorizada (micro-CT): avaliar e quantificar a presença de debris dentinários em canais curvos, após o preparo químico-cirúrgico; comparar a remoção desses debris, após uso de Irrigação Ultrassônica Passiva (IUP) ou do sistema EndoVac; e avaliar a qualidade da obturação dos mesmos canais, mensurando o volume de material obturador e de espaços vazios. Vinte e quatro raízes mesiais de molares inferiores humanos extraídos foram divididos aleatoriamente em 2 grupos (n=12), de acordo com o método de irrigação final a ser avaliado. Cada espécime foi submetido a quatro escaneamentos: exame préoperatório, exame pós-preparo, exame pós-irrigação final e exame pós-obturação, com um microtomógrafo de raios-X SkyScan 1176, a uma resolução de 17,42 m. Após preparo químico-cirúrgico os grupos receberam irrigação final com IUP ou com o sistema EndoVac e em seguida obturados com a técnica termoplástica de ondas contínuas de condensação. Após a reconstrução das imagens resultantes dos quatro escaneamentos, o corregistro das mesmas foi realizado com o programa DataViewer. Os programas CTAn e CTvol foram utilizados para binarização dos objetos de interesse, análise volumétrica e reconstrução de modelos 3D do canal radicular, dos debris dentinários e do material obturador. Os dados foram analisados estatisticamente com o programa GraphPad Prism por meio do teste t de Student (p < 0,05). As análises de micro-CT revelaram debris dentinários acumulados no interior dos canais radiculares, ocupando uma porcentagem média em relação ao volume do canal de 2,71% para o grupo IUP e 4,10% para o grupo EndoVac. Não houve diferença entre os grupos quanto à remoção de debris dentinários, nem em relação ao volume de material obturador e de espaços vazios (p > 0,05). Concluiu-se que a IUP e o sistema EndoVac foram igualmente eficientes na remoção de debris dentinários, reduzindo em média 50% do seu volume. Também, a ativação dos irrigantes pelos dois métodos não interferiu na qualidade da obturação do canal radicular. / Root canal preparation has as a consequence the formation of hard-tissue debris, which accumulates specially in the complex areas of the root canal system. For this reason, special attention has been given to methods of agitation of the irrigants, aiming to improve its chemical and mechanical efficiency. However, it is not clear if dentin debris removed from the root canal have impact on the quality of root canal filling. Therefore, the objectives of this study were, with the aid of microcomputed tomography (micro-CT): evaluate and quantify the presence of hard-tissue debris in curved root canals, after chemical-surgical preparation; compare the removal of such debris after final irrigation with Passive Ultrasonic Irrigation (PUI) or with the EndoVac system; and evaluate the quality of filling of the same root canals, measuring the volume of filling material and voids. Twenty-four mesial roots of extracted mandibular human molars were randomly divided into 2 groups (n = 12) according to the method of final irrigation being evaluated. Each specimen was subjected to four scans: preoperative, post-operative, post-final irrigation and post-filling, with a microcomputed tomography SkyScan 1176, at a resolution of 17,42 m. After chemosurgical preparation groups received final irrigation with Passive Ultrasonic Irrigation (PUI) or with EndoVac system and were then filled with the continuous wave condensation thermoplastic technique. After the reconstruction of the images resulted from the four scans, co-registration was performed with the DataViewer software. CTAn and CTvol softwares were used for binarization of the objects of interest, volumetric analysis and reconstruction of 3D models of the root canal, hardtissue debris and the filling material. Data were statistically analyzed with the GraphPad Prism program through t students test (p < 0,05). The analysis of micro- CT showed hard-tissue debris accumulated inside the root canal, occupying an average percentage of 2.71 % for the PUI group and 4.10 % for EndoVac group. There was no difference between the groups regarding the removal of hard-tissue debris, or in relation to the volume of filling material and voids (p > 0.05). It was concluded that the EndoVac and PUI were equally efficient in the removal of hardtissue debris, reducing an average of 50% of its volume. Also, irrigants activation with the two methods did not affect the quality of root canal filling.

A instrumentação do canal radicular possui como conseqüência a formação de debris dentinários, os quais acumulam-se especialmente nas áreas mais complexas do sistema de canais radiculares. Por este motivo, atenção especial tem sido concedida aos métodos de agitação da substâ ncia química auxiliar, com o intuito de melhorar a sua eficácia química e mecânica. No entanto, não está claro se debris dentinários removidos do interior do canal radicular possuem efeito na qualidade da obturação. Portanto, os objetivos deste estudo foram, com o auxílio da microtomografia computadorizada (micro-CT): avaliar e quantificar a presença de debris dentinários em canais curvos, após o preparo químico-cirúrgico; comparar a remoção desses debris, após uso de Irrigação Ultrassônica Passiva (IUP) ou do sistema EndoVac; e avaliar a qualidade da obturação dos mesmos canais, mensurando o volume de material obturador e de espaços vazios. Vinte e quatro raízes mesiais de molares inferiores humanos extraídos foram divididos aleatoriamente em 2 grupos (n=12), de acordo com o método de irrigação final a ser avaliado. Cada espécime foi submetido a quatro escaneamentos: exame préoperatório, exame pós-preparo, exame pós-irrigação final e exame pós-obturação, com um microtomógrafo de raios-X SkyScan 1176, a uma resolução de 17,42 m. Após preparo químico-cirúrgico os grupos receberam irrigação final com IUP ou com o sistema EndoVac e em seguida obturados com a técnica termoplástica de ondas contínuas de condensação. Após a reconstrução das imagens resultantes dos quatro escaneamentos, o corregistro das mesmas foi realizado com o programa DataViewer. Os programas CTAn e CTvol foram utilizados para binarização dos objetos de interesse, análise volumétrica e reconstrução de modelos 3D do canal radicular, dos debris dentinários e do material obturador. Os dados foram analisados estatisticamente com o programa GraphPad Prism por meio do teste t de Student (p < 0,05). As análises de micro-CT revelaram debris dentinários acumulados no interior dos canais radiculares, ocupando uma porcentagem média em relação ao volume do canal de 2,71% para o grupo IUP e 4,10% para o grupo EndoVac. Não houve diferença entre os grupos quanto à remoção de debris dentinários, nem em relação ao volume de material obturador e de espaços vazios (p > 0,05). Concluiu-se que a IUP e o sistema EndoVac foram igualmente eficientes na remoção de debris dentinários, reduzindo em média 50% do seu volume. Também, a ativação dos irrigantes pelos dois métodos não interferiu na qualidade da obturação do canal radicular. / Root canal preparation has as a consequence the formation of hard-tissue debris, which accumulates specially in the complex areas of the root canal system. For this reason, special attention has been given to methods of agitation of the irrigants, aiming to improve its chemical and mechanical efficiency. However, it is not clear if dentin debris removed from the root canal have impact on the quality of root canal filling. Therefore, the objectives of this study were, with the aid of microcomputed tomography (micro-CT): evaluate and quantify the presence of hard-tissue debris in curved root canals, after chemical-surgical preparation; compare the removal of such debris after final irrigation with Passive Ultrasonic Irrigation (PUI) or with the EndoVac system; and evaluate the quality of filling of the same root canals, measuring the volume of filling material and voids. Twenty-four mesial roots of extracted mandibular human molars were randomly divided into 2 groups (n = 12) according to the method of final irrigation being evaluated. Each specimen was subjected to four scans: preoperative, post-operative, post-final irrigation and post-filling, with a microcomputed tomography SkyScan 1176, at a resolution of 17,42 m. After chemosurgical preparation groups received final irrigation with Passive Ultrasonic Irrigation (PUI) or with EndoVac system and were then filled with the continuous wave condensation thermoplastic technique. After the reconstruction of the images resulted from the four scans, co-registration was performed with the DataViewer software. CTAn and CTvol softwares were used for binarization of the objects of interest, volumetric analysis and reconstruction of 3D models of the root canal, hardtissue debris and the filling material. Data were statistically analyzed with the GraphPad Prism program through t students test (p < 0,05). The analysis of micro- CT showed hard-tissue debris accumulated inside the root canal, occupying an average percentage of 2.71 % for the PUI group and 4.10 % for EndoVac group. There was no difference between the groups regarding the removal of hard-tissue debris, or in relation to the volume of filling material and voids (p > 0.05). It was concluded that the EndoVac and PUI were equally efficient in the removal of hardtissue debris, reducing an average of 50% of its volume. Also, irrigants activation with the two methods did not affect the quality of root canal filling.