Aim To evaluate efficacy of XP-3D and TRUShape rotary retreatment system for gutta-percha (GP) removal from root canals. Methodology Root canals of 40 extracted human single rooted teeth were prepared with ProTaper gold rotary system and obturated with hydraulic condensation technique with BC sealer (n=20) or multiple wave technique with ZOE sealer (n=20). Teeth were evaluated with Micro CT and then divided into four groups and in all groups, GP first removed with Gates Glidden drills and patency achieved by K stainless steel files (Kerr) files with chloroform as a solvent. Further canal repreparation accomplished: group A (n=10, BC sealer/hydraulic condensation technique) – GP removal with the XP-3D shaper and finisher; group B (n=10, BC sealer/hydraulic condensation technique) –GP removal with the TRUshape; group C (n=10, ZOE sealer/multiple wave technique) – GP removal with the XP-3D shaper and finisher; group D (n=10, ZOE sealer/multiple wave technique) – GP removal with the TRUshape. Operating time was recorded. Teeth were evaluated with micro-CT of the area of remaining GP/sealer in bucco-lingual and mesial–distal directions. Two-way ANOVA Statistical analysis was performed. Results There was a statistically significant difference among the groups regarding sealer removal (P<0.05), the retreatment of samples with ZOE was more effective than BC Sealer. No significant difference was observed between retreatment rotary systems of group C and D (ZOE Sealers). The volume of remaining obturation material was significantly less in group B than group A (BC Sealers). Mean operating time for group A was 6.71 min, which was significantly higher (P <0.05) than group B (3.78 min), group C (3.76 min) and group D (3.10 min). Conclusion BC sealer has much lower removal efficiency than ZOE sealer regardless of the type of file that is used to remove. TRUshape was the most efficient in gutta-percha removal from the canals when obturated with BC Sealer. The fastest technique to remove gutta-percha and the shortest time to reach working length was observed in group D (n=10, ZOE sealer/multiple wave technique) – GP removal with the TRUshape.

Cone beam computed tomography (CBCT) is the recommended imaging modality of choice for evaluating previous endodontic treatment (1). The aim of this study was to compare treatment planning decisions made when evaluating previous endodontic treatment to determine if treatment planned and projected prognosis differs when digital radiography is used alone or in combination with CBCT. A retrospective chart review was conducted. Patients for whom a CBCT was taken were included in the study. Twenty-eight patients qualified. Patient’s periapical digital radiographs (Dexis©) were evaluated by 2 calibrated endodontists, a treatment plan was identified and a prognosis was projected. Later the same radiographs were viewed with CBCT scan. The CBCT provided significant information 75% of the time. CBCT provided the only information for an accurate diagnosis 17% of the time. Prognosis changed 38% of the time when CBCT was added. An unfavorable or questionable prognosis changed to favorable 30% of the time.

Made available in DSpace on 2014-06-11T19:32:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-25Bitstream added on 2014-06-13T19:22:55Z : No. of bitstreams: 1 hussne_rp_dr_arafo.pdf: 1276610 bytes, checksum: 7f4d8fdd1b972691185e7e46ddaaa250 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O presente trabalho se propôs a avaliar as características geométricas e dimensionais dos instrumentos de NiTi do sistema ProTaper Universal Retratamento bem como sua flexibilidade e resistência torcional. Um total de 102 instrumentos foram empregados neste estudo. Inicialmente, 12 instrumentos de cada formato foram submetidos a uma caracterização geométrica e dimensional por microscopia óptica. Foram avaliados os parâmetros ângulo, comprimento e diâmetro de ponta, comprimento de cada pitch ao longo das hastes e diâmetro do instrumento a cada milímetro da ponta. Após isto, todos os instrumentos foram aleatoriamente divididos em 3 grupos distintos: Grupo 1 contendo 36 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 12 unidades de cada formato para os ensaios de torção; Grupo 2 contendo 36 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 12 unidades de cada formato para os ensaios de flexibilidade; Grupo 3 contendo 30 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 10 unidades de cada formato para os ensaios de torção após estes instrumentos terem sido usados na desobturação de 15 canais radiculares. Tais ensaios de torção e flexibilidade foram executados de acordo com a especificação ISO 3630-1 em um dispositivo de bancada para testes utilizando um programa para aquisição e processamento dos dados especialmente desenvolvido para este fim. Os valores para torque máximo, deflexão angular até a fratura e momento de dobramento foram analisados estatisticamente pelo teste t de Student. Os resultados demonstraram que os instrumentos do Sistema ProTaper Universal Retratamento apresentaram boa padronização geométrica e características de superfície aceitáveis, embora tenham sido verificadas diferenças geométricas e dimensionais entre os instrumentos do sistema. O torque máximo e o momento de dobramento a 45o foram... / The present study has proposed to evaluate the geometric and dimensional features of NiTi ProTaper Universal Retreatment System’s instruments as well as their flexibility and torsional resistance. It was used a total amount of 102 instruments. At the beginning, 12 instruments of each size were analyzed dimensional and geometrically by optical microscopy under parameters of angle, length and tip diameter, pitch’s length along the blade and instrument’s diameter from tip until the end of the active part. After that, all the instruments were randomly divided into 3 different groups: Group 1 having 36 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),12 samples from each size, to be submitted to torsion test; Group 2 having 36 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),12 samples from each size, to be submitted to bending test; Group 3 having 30 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),10 samples from each size, to be submitted to torsion test after being used in 15 root canal unfilling. These torsion and bending tests were performed using a bench test device connected with a software to acquire and process data specially developed to this purpose, according to ISO 3630-1. Maximum torque, angular deflection until fracture and bending moment values were statistically analysed using Student’s t test. The results showed that ProTaper Universal Retreatment System’s instruments presented good geometric standardization and acceptable surface features, however differences were detected among the instruments. The maximum torque and the bending moment at 45º were higher for instruments with larger diameters (D1>D2>D3), even though angular deflection didn’t show this same relationship. Besides, the new instruments showed a higher maximum torque value when compared to the ones who were used in 15 root canals unfilling.

Magister Scientiae Dentium - MSc(Dent) / Statement of problem: Although bioceramic endodontic sealer cements offer various advantages over conventional zinc oxide-based and resin-based cements, questions have been raised about the ability to retreat root canals that have been sealed using these cements. Aims and Objectives: The aim of the study was to determine the retreatability of root canals sealed using a bioceramic calcium silicate-based sealer cement. The objectives were to determine the possibility of achieving working length and apical patency when obturation is done with the master GP placed at working length and when it is short by 3mm. The time it took to achieve these parameters when it was possible to achieve them was also determined. The role of XP Endo Finisher R, a supplementary retreatment file, in achieving working length and apical patency was also to be evaluated. However, this latter aspect was eliminated after the pilot study, when it was found not to have an effect in regaining working length and apical patency.

No description available.

El retratamiento de canales radiculares es una alternativa ante el fracaso endodóntico. Este procedimiento tiene como objetivo reducir los síntomas que pueden presentarse o agravarse posterior al tratamiento de endodoncia. El procedimiento del retratamiento de canales sigue la premisa que aparentemente la calidad del material de obturación en todo el sistema de canales es deficiente, por consiguiente, todo el material debe ser retirado. Actualmente, con mejores técnicas de análisis imagenológico es posible identificar el origen de la lesión apical, por lo tanto, es posible seleccionar los canales pulpares con tratamiento deficiente y poder ser tratados de forma individual. De esta manera, el retratamiento selectivo de canales podría evitar el desgaste innecesario de canales en buen estado. / Root canal Retreatment is an alternative in the face off endodontic failure. This procedure aims to reduce the symptoms that may occur or worsen after the endodontic treatment. The root canal retreatment procedure follows the premise that apparently the quality of the filling material in the entire canal system is deficient, therefore, all the material must be removed. Currently, with better techniques of image analysis it is possible to identify the origin of the apical lesion, therefore, it is possible to select the pulp canals with poor treatment and be able to treat them individually. In this way, the selective root canal retreatment could avoid the unnecessary wear of root canals in good condition. / Trabajo académico

The purpose of this study was to determine what factors influence dentists when deciding whether to place an implant or perform endodontic retreatment. Null hypothesis: Dentists today are no more likely to place an implant than to perform endodontic retreatment. A twelve-item questionnaire was mailed to 525 general dentists and specialists who are members of the Richmond Dental Society. Response rate was 61.9%. The questionnaire included items on demographics, practice profile and cases of failing endodontic therapy which participants were asked to consider and chose between endodontic retreatment or implant placement. The relationship between the treatment choices and the characteristics of each dentist was assessed using a chi-square analyses and logistic regression analyses. Generally practitioners preferred retreatment (66%). This preference for retreatment varied between 25.5% and 85.9%. Associations were found between years of experience and implant use. In those practitioners with 10 years or less experience the odds of choosing an implant were higher than practitioners with more than 10 years of experience. Associations were also found between those who place implants vs. those who do not. The odds of choosing an implant verses retreatment were lower in those who did not place implants versus those who did. In conclusion, it appears that clinicians participating in this study in general still consider endodontic retreatment to be a viable treatment option prior to implant placement. However, this varies greatly with years of experience and the use of implants in practice.

A terapia laser é um excelente procedimento clínico coadjuvante no tratamento endodôntico pela sua capacidade de promoção e melhoria da limpeza e da desinfecção do sistema endodôntico, porém existem poucos estudos sobre a possível utilização desta nova tecnologia nas situações clínicas de desobturação. O objetivo deste estudo foi avaliar in vitro o uso do laser de diodo (810nm, no modo contínuo) na desobturação da guta percha e do cimento AH Plus, utilizando ou não solvente químico (eucaliptol). Canais radiculares obturados tiveram o seu material obturador irradiado pelo laser de diodo de 810 nm (ZAP SOFTLASE, ZAP LASERS). A temperatura externa radicular durante a irradiação foi verificada no terço apical de 12 amostras utilizando o sistema de medida de temperatura. Observou-se um aumento de temperatura que variou de 2,47 a 9,35 ºC. Raízes foram divididas aleatoriamente em 4 grupos com 10 espécimes, variando o parâmetro de irradiação laser e a utilização do eucaliptol. Os grupos foram: Grupo I = irradiação (1,0 W) sem a utilização de solvente, Grupo II = irradiação (1,5 W) sem o uso de solvente, Grupo III = irradiação (1,0 W) + solvente, Grupo IV = (1,5 W) + solvente. As amostras foram radiografadas no sentido V-L e M-D, antes e após o retratamento, digitalizadas, e as áreas remanescentes de guta percha foram calculadas com o auxílio de programas de computador: Adobe Photoshop e ImageLab. Os resultados dos espécimes dos grupos: G1xG3; G1xG4; G2xG4 apresentaram diferença estatística. O modelo experimental selecionado permitiu verificar que a propagação da temperatura durante o procedimento não excedeu 10ºC e que a presença do solvente possibilitou a remoção de maior quantidade de material obturador auxiliando o processo de desobturação quando do emprego da irradiação com laser de diodo. / The laser therapy is an excellent adjunct clinical procedure in endodontic treatment in order to improve the cleaning and disinfection of the root canal system; however few studies in the literature investigated the possible use of this new technology in the clinical situations of retreatment. The objective of this study was to evaluate in vitro the use of the diode laser (810nm, continuous mode) in the removal of gutta-percha and AH Plus sealer from the root canal, with or without the use of a chemical solvent (eucalyptol). Root canal filling materials were irradiated by 810 nm diode laser (ZAP SOFTLASE, ZAP LASERS). The temperature changes at the outer root surface were verified in the apical third of 12 samples during the irradiation. Temperature increase from 2.47 to 9.35 ºC was observed. The specimens were randomly divided in 4 groups of 10 roots each, varying the parameter of laser irradiation and the use of eucalyptol. The groups were assigned as follow: Group I = irradiation (1.0 W) without the solvent use, Group II = irradiation (1.5 W) without the solvent use, Group III = irradiation (1.0 W) + solvent, Group IV = (1.5 W) + solvent. Mesio-distal and buccolingual radiographs were taken before and after retreatment and the area of remaining gutta-percha in the root canals was determined with the aid of: Adobe Photoshop and ImageLab softwares. The groups: G1xG3; G1xG4; G2xG4 presented statistical differences.Based on the methodology used, it was verified that the temperature did not exceed 10ºC and that the presence of the solvent made it possible to remove large amounts of root canal filing material, aiding the desobturation process when used in association to the diode laser.

Introdução: Retratamentos endodônticos apresentam maior complexidade técnica e piores prognósticos quando comparados ao tratamento endodôntico inicial. Nesse contexto, uma investigação mais detalhada em relação aos fatores que afetam a exiquibilidade de se obter qualidade técnica satisfatória e reparo periapical é necessária. Técnicas empregadas para mineração de dados são pouco exploradas na área da Odontologia, ainda que apresentem potencial em contribuir com a descoberta do conhecimento. No presente estudo, padrões e fatores de risco relacionados à qualidade técnica e ao reparo periapical de retratamentos endodônticos foram investigados. Árvores de decisão foram geradas, sendo essa técnica complementada pela análise estatística convencional. Metodologia: Este estudo observacional incluiu 321 indivíduos com indicação de retratamento endodôntico atendidos por alunos de especialização em Endodontia. Foram coletados dados demográficos, referentes a história médica, ao diagnóstico, ao tratamento e a controles pós-operatórios, os quais foram transferidos para uma base de dados eletrônica. Após o preparo e pré-processamento de dados, foram selecionadas 32 variáveis independentes e 2 variáveis dependentes, as quais compreenderam os desfechos qualidade técnica do retratamento e reparo periapical. Estatísticas descritivas foram conduzidas a fim de determinar a frequência de dados ausentes, a distribuição das variáveis categóricas e a média e desvio-padrão de variáveis numéricas. Foram geradas árvores de decisão para a determinação de padrões relacionados aos desfechos, através do software de mineração de dados Weka (Waikato Environment of Knowledge Analysis, University of Waikato, New Zealand). Análises estatísticas convencionais foram conduzidas com auxílio do Software SPSS (SPSS Inc., Chicago, IL, USA), a fim de determinar fatores que poderiam interferir nos referidos desfechos. Resultados: Após o retratamento endodôntico, qualidade técnica satisfatória e reparo periapical foram obtidos em 65,20% e em 80,50% dos casos, respectivamente. A qualidade técnica do retratamento endodôntico foi afetada por vários fatores de risco, incluindo curvatura radicular severa (p < 0,001) e alterações na morfologia do canal radicular (p = 0,002). As árvores de decisão sugeriram padrões que combinam a ocorrência simultânea de raízes retas e reabsorções radiculares apicais com resultados tecnicamente insatisfatórios. O diâmetro da lesão periapical (p = 0,018), o grupo dentário (p = 0,015) e a presença de reabsorções apicais (p = 0,024) apresentaram associação significativa com o insucesso de retratamentos endodônticos. A análise de mineração de dados sugeriu que lesões periapicais extensas e qualidade da obturação insatisfatória no tratamento endodôntico inicial, apresentam mecanismos de interação entre a infecção intracanal e a resposta do hospedeiro que não foram totalmente elucidados, sendo necessários estudos complementares. Conclusão: Qualidade técnica satisfatória é afetada por diversos fatores de risco, entre eles, a presença de curvaturas radiculares severas e alterações na morfologia do canal radicular. A localização dos acidentes de procedimento exerce influência na obtenção da qualidade técnica. Fatores como o diâmetro da lesão periapical, o grupo dentário e as reabsorções radiculares apicais mostraram-se significativamente associados ao insucesso de retratamentos endodônticos. / Introduction: Non-surgical root canal retreatment presents higher technical complexity and poor prognosis compared to primary endodontic treatment. Within this context, a more detaild investigation on the factors affecting the feasibilty of achieving technical quality and periapical healing in teeth presenting secondary root canal infection is needed. Data mining approach is still little explored in the dentistry field, regardless of its potential to contribute to knowledge discovery. In the present study decision trees were complemented by conventional statistical analysis aiming to investigate patterns and risk factors related to technical quality and healing outcomes in non-surgical root canal retreatment. Methods: This observational study included 321 consecutive patients presenting for non-surgical root canal retreatment. Patients were treated by postgraduate students, following standard protocols. Data concerning demographic, medical, diagnostic, treatment and follow-up variables were transferred to an eletronic chart database (ECD). After data preprocessing and preparation a total of 32 independent variables and 2 dependent variables were defined. Basic statistics were tabled and provided the frequency of missing values, the distribution of categorical attributes and the mean and standard deviation values of numeric attributes. Decision trees were generated to predict patterns related to technical quality (satisfactory/unsatisfactory) and periapical healing (healed /failure), using J48 classification algorithm in Weka data mining software (Waikato Environment of Knowledge Analysis, University of Waikato, New Zealand). Statistical tests were performed using SPSS software (SPSS Inc., Chicago, IL, USA). Univariate and multivariate analytic methods were used to determine factors affecting endodontic retreatment technical quality and periapical healing. Results: After endodontic retreatment, technical outcome was satisfactory in 65.20%, and periapical healing was observed in 80.50% of the cases. Technical quality of endodontic retreatment was affected by several risk factors, including severity of root curvature (p < 0.001) and altered root canal morphology (p = 0.002). The decision trees suggested that patterns that combine straight root curvature and apical root resorption may prevent satisfactory technical outcomes. Periapical lesion area (p = 0.018), tooth type (p = 0.015) and apical resorption (p = 0.024) were shown to be significantly associated with endodontic retreatment failure. Data mining analysis suggested that large periapical lesions, as well as poor root filling quality in the initial endodontic treatment, present mechanisms that are not fully understood with regards to the interaction between intracanal infection and host response, which should be further investigated. Conclusions: Technical quality of endodontic retreatment is affected by several risk factors, including severity of root curvature and altered root canal morphology. The occurence of procedure accidents is especially relevant in the apical third of the roots, affecting the technical quality. Periapical lesion area, tooth type and apical resorption were shown to be significantly associated with endodontic retreatment failure.

Resumo: O presente trabalho se propôs a avaliar as características geométricas e dimensionais dos instrumentos de NiTi do sistema ProTaper Universal Retratamento bem como sua flexibilidade e resistência torcional. Um total de 102 instrumentos foram empregados neste estudo. Inicialmente, 12 instrumentos de cada formato foram submetidos a uma caracterização geométrica e dimensional por microscopia óptica. Foram avaliados os parâmetros ângulo, comprimento e diâmetro de ponta, comprimento de cada pitch ao longo das hastes e diâmetro do instrumento a cada milímetro da ponta. Após isto, todos os instrumentos foram aleatoriamente divididos em 3 grupos distintos: Grupo 1 contendo 36 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 12 unidades de cada formato para os ensaios de torção; Grupo 2 contendo 36 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 12 unidades de cada formato para os ensaios de flexibilidade; Grupo 3 contendo 30 instrumentos ProTaper Universal Retratamento D1, D2 e D3, sendo 10 unidades de cada formato para os ensaios de torção após estes instrumentos terem sido usados na desobturação de 15 canais radiculares. Tais ensaios de torção e flexibilidade foram executados de acordo com a especificação ISO 3630-1 em um dispositivo de bancada para testes utilizando um programa para aquisição e processamento dos dados especialmente desenvolvido para este fim. Os valores para torque máximo, deflexão angular até a fratura e momento de dobramento foram analisados estatisticamente pelo teste t de Student. Os resultados demonstraram que os instrumentos do Sistema ProTaper Universal Retratamento apresentaram boa padronização geométrica e características de superfície aceitáveis, embora tenham sido verificadas diferenças geométricas e dimensionais entre os instrumentos do sistema. O torque máximo e o momento de dobramento a 45o foram... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The present study has proposed to evaluate the geometric and dimensional features of NiTi ProTaper Universal Retreatment System's instruments as well as their flexibility and torsional resistance. It was used a total amount of 102 instruments. At the beginning, 12 instruments of each size were analyzed dimensional and geometrically by optical microscopy under parameters of angle, length and tip diameter, pitch's length along the blade and instrument's diameter from tip until the end of the active part. After that, all the instruments were randomly divided into 3 different groups: Group 1 having 36 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),12 samples from each size, to be submitted to torsion test; Group 2 having 36 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),12 samples from each size, to be submitted to bending test; Group 3 having 30 ProTaper Universal Retreatment instruments inside (D1, D2 and D3),10 samples from each size, to be submitted to torsion test after being used in 15 root canal unfilling. These torsion and bending tests were performed using a bench test device connected with a software to acquire and process data specially developed to this purpose, according to ISO 3630-1. Maximum torque, angular deflection until fracture and bending moment values were statistically analysed using Student's t test. The results showed that ProTaper Universal Retreatment System's instruments presented good geometric standardization and acceptable surface features, however differences were detected among the instruments. The maximum torque and the bending moment at 45º were higher for instruments with larger diameters (D1>D2>D3), even though angular deflection didn't show this same relationship. Besides, the new instruments showed a higher maximum torque value when compared to the ones who were used in 15 root canals unfilling. / Orientador: Fábio Luiz Camargo Villela Berbert / Coorientador: Maria Guiomar Azevedo Bahia / Banca: Celso Kenji Nishiyama / Banca: Carlos Eduardo da Silveira Bueno / Banca: Mário Tanomaru Filho / Banca: Idomeo Bonetti Filho / Doutor