Single-visit root canal treatment was first documented in 1887. The controversy and debate within the dental community has been ongoing for over a century without resolution. The concept of evidence-based health practice has provided a structure on which the clinically-relevant questions in this debate can be dealt with systematically. When clinicians are faced with choices of which treatment regimen should be offered to patients, the central issues that should be considered are effectiveness, complications, patient/operator preference/satisfaction, and cost. Systematic review and meta-analysis techniques were used to reach definitive conclusions where high quality primary studies are available. The issue of satisfaction was studied using a quality of life concept, while the issue of cost was addressed by an economic evaluation (cost-minimization analysis). Treatment effectiveness and complications of single- and multiple-visit approach were similar. Patients overwhelmingly preferred single- over multiple-visit treatment with high satisfaction scores for both regimens. Australian endodontists were reluctant to embrace single-visit root canal treatment. Single-visit root canal treatment costs society less than multiple-visit treatment. On balance single-visit treatment offers substantial advantages with no identified adverse effects.

Diagnosis and treatment of teeth with longitudinal fractures is challenging. Cracks are usually not visible radiographically; they require a thorough evaluation to aid in diagnosis. Patients may be asymptomatic, demanding the dentist rely on clinical findings to make a diagnosis. Early diagnosis of the presence and extent of a crack is essential for the successful management of a cracked tooth. There is limited information in the literature regarding the prevalence or predictive factors of cracks extending into the pulp chamber of teeth. The purpose of this study was to determine the prevalence of intrapulpal cracks in maxillary molars and to identify factors that may aid in diagnosing the existence of a crack. All maxillary molar teeth requiring non- surgical root canal therapy or retreatment at the Virginia Commonwealth University graduate endodontic clinic from June 2016 through December 2016 were included in the study after obtaining patient consent. Teeth were examined visually, transilluminated, stained, and examined microscopically for the presence of an intrapulpal crack. Demographic information, subjective data associated with the chief complaint, objective results of diagnostic testing (percussion, palpation, bite stick test, transillumination, probing depths, existing restorations, and diagnosis) were analyzed using chi-square and logistic regression (p<0.05) to identify associations of these findings with the existence of a crack. A total of 18% (15/82 teeth) of maxillary molars that were evaluated and had endodontic treatment initiated were cracked. There was a significant association between cracked teeth and pain on biting (P<.0001) and with probing depths greater than 4 millimeters (mm) (P < 0.003). Those positive on a tooth slooth test were more likely to have an intrapulpal crack (P<.001) and teeth with a positive transillumination test were also found to be associated with the presence of a crack(P < .001).

No description available.

Orientador: Brenda Paula Figueiredo de Almeida Gomes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-08T06:07:33Z (GMT). No. of bitstreams: 1 Quadros_Iadasade_D.pdf: 4876687 bytes, checksum: 8e557e91b84f929d6016a42935640384 (MD5) Previous issue date: 2007 / Resumo: O objetivo do presente trabalho foi avaliar os tratamentos endodônticos realizados nos anos de 1997 a 2001, por alunos do curso de especialização em Endodontia da Faculdade de Odontologia de Piracicaba, da Universidade Estadual de Campinas (FOP-UNICAMP). Os pacientes foram convocados para exames clínicos e radiográficos em 2003 e 2004. De um registro de 608 dentes tratados, 308 (50,7%) foram de pacientes que retornaram. Quarenta e cinco (7,4%), do total de 308 dentes tratados, foram extraídos, assim 263 dentes foram examinados. Análises univariada, bivariada e multivariada foram realizadas nos dentes examinados. O gênero feminino foi mais prevalente do que o masculino (65,4%). A maioria dos dentes tratados foi da maxila (53,9%), enquanto 28,1% foram molares inferiores. Dentes inferiores e unirradiculares mostraram 83,6% e 88% de sucesso, respectivamente. A faixa etária mais prevalente foi dos 21 a 29 anos, mas o sucesso maior dos tratamentos endodônticos foi entre 30-39 anos (p=0,008). O sucesso do tratamento endodôntico primário foi de 80,8% e do retratamento 88,9%. O sucesso relacionado com polpa normal foi de 83,3%, com necrose sem lesão foi de 88,9% e necrose com lesão, 79,1%. A regressão multivariada revelou que a presença de restauração foi o único fator significante envolvido no sucesso do tratamento endodôntico, sendo este de 86,5% quando os dentes foram restaurados (p<0,000). Conclui-se que a complexidade dos casos tratados na especialização não influenciou o sucesso do tratamento endodôntico realizado e que a presença de restauração é necessária para o bom prognóstico de dentes tratados endodonticamente / Abstract: The aim of this study was to evaluate the root canal treatments performed between 1997 and 2001 by post-graduate students in the Endodontics specialization course of the Dental School of Piracicaba, State University of Campinas, Piracicaba,SP, Brazil. Patients were recalled during 2003 and 2004 for clinical and radiographic examinations. Among 608 records of the endodontically treated teeth, 308 (50.7%) were from teeth of patients who had returned for the examination. Forty-five (7.4%) of the total 308 teeth had been extracted, therefore, 263 teeth were examined. Univariate, bivariate and multivariate analyses were performed examined teeth. The female gender was more prevalent than the male (65.4%). The majority of the treated teeth were from the maxilla (53.9%), while 28.1% were mandibular molars. Mandibular and unirradicular teeth showed 83.6% and 88% of success, respectively. The prevalent age group was 21-29, but the highest success rate of root canal treatments was among 30-39 years group (p=0.008). The success of root canal treatment was 80.8%, and of the retreatment, 88.9%. The success related to normal pulp was 83.3%, and to necrosis without lesion was 88.9%. The multivariate analyses revealed that the presence of restoration was the only significant factor involved in the success of the endodontic treatment. Therefore, the success was significantly greater (86.5%) when teeth were restored (p=0.000). It was concluded that the complexity of the cases treated in the specialization course did not influence the success of the endodontic treatments and that the restoration is the main factor for a good prognosis of the endodontically treated teeth / Doutorado / Endodontia / Doutor em Clínica Odontológica

Non-Surgical Root Canal Treatment (NSRCT) is performed to save the teeth with infected root canal system. A number of factors affect the long term survival of NSRCT. There is limited evidence correlating the survival rate of NSRCT in older adults with existing comorbid conditions and comparing them with the survival rate of NSRCT in younger adults. The primary objective of this study was to analyze the survival of non-surgical root canal therapy in older adults with comorbid conditions. Data was collected from patients' charts retrospectively to analyze the factors affecting the survival rate of NSRCT in permanent teeth in patients aged 18 and above and analyzed to compare the comorbid conditions in older adults and young adults. Factors including gender, prevailing coronary heart disease, diabetes, cancer, cancer therapy, and tobacco habits that may influence the long-term survival of endodontically treated teeth were analyzed statistically using a follow up data for five years. Survival analysis was the statistical method of choice to analyze the results given the focus of the clinical question on failure of endodontic treatment. Kaplan-Meier survival estimates were calculated for 5-year survival of endodontically treated teeth (with 95% confidence intervals). Teeth that had been retreatment, periapical surgery or extraction were considered as having had a complication, i.e., a failure. Analysis using the Kaplan-Meier method requires that actual date of failure (as indicated in description of project) as well as the date of initial endodontic treatment were available in the data set. The dates of re-treatment were considered as the date of failure for the purpose of statistical analysis. The statistical analysis showed that there was no significant association between age and root canal survival but there was a possible association between NSRCT failure and the presence of diabetes and tobacco habits.

No description available.

Este estudo teve como objetivo avaliar o grau de manchamento dental, ap¨®s o tratamento endodôntico, quando aplicada a terapia fotodinâmica, utilizando-se os corantes azuis de metileno e de orto toluidina como fotossensibilizadores, atrav¨¦s do sistema RGB e K de cores do programa Adobe Photoshop. Vinte dentes humanos unirradiculares tiveram seus canais preparados pela t¨¦cnica seriada com instrumentos endodônticos, Endo-PTC e liquido de Dakin. Constitu¨ªram-se tr¨ºs grupos experimentais, Grupo C: Corante em sua forma liquida, Grupo E: Substância qu¨ªmica Endo PTC associada ao corante em sua formulação e Grupo C+E: Corante em sua forma liquida com irrigação final de liquido de Dakin em conjunto com Endo PTC por 15 min. A leitura de cor foi executada antes (L0), imediatamente ap¨®s o preparo qu¨ªmico-cirurgico (L1) e dez dias depois da irradiação (L2). Analise estat¨ªstica pelo teste de Wilcoxon comprovou que os resultados dos esp¨¦cimes do Grupo E nas interações L1-L2 e L0-L2 não acarretaram diferenças significativas. Pelos resultados obtidos foi poss¨ªvel concluir que: com base no projeto experimental que executou a t¨¦cnica endodôntica tradicional, todos os corantes ativadores testados, alteraram os valores de K. Na an¨¢lise comprobat¨®ria dos resultados de alteração crom¨¢tica pelos valores de K os melhores resultados foram observados nos esp¨¦cimes dos grupos Metileno E e Toluidina E que na interação L0-L1 não apresentaram diferenças estatisticamente significantes a 5%. / The present study had as objective to evaluate the dental staining after the root canal treatment when it¡¯s used the photodynamic therapy, using the dies methylene blue and orto toluidina blue as photosensitizers, through the RGB and K color system from the software Adobe Photoshop. Twenty human single root teeth had its roots canals prepared by the seriated technique using the endodontic instruments plus Endo-PTC and Dakin. Three experimental groups were formed: Group C: dye in its liquid form; Group E: dye associated to the Endo-PTC cream and Group CE: dye in its liquid form with final irrigation of the Dakin plus Endo¨CPTC for 15 minutes. The color measure was taken before (L0), immediately after (L1) and ten days after the laser irradiation. The statistical analysis performed using the Wilcoxon text proves that the results of the specimens of the E Group on the interactions L1-L2 and L0-L2 didn¡¯t have any significant differences. Based on the results obtained it was possible to conclude that: based on the experimental design that performed the traditional endodontic technique, all the activating dyes tested altered the values of K. After carrying out an analysis of the chromatic alteration results according to K values, the best results were observed in specimens of group methylene E and group toluidine E, both of which presented no statistically significant difference for the interaction L0-L1 (p ¡Ü 5%).

Resumo: O presente estudo avaliou, ex vivo, atividade antimicrobiana do ozônio, associado ao veículo propilenoglicol e ao hidróxido de cálcio em canais radiculares contaminados com Enterococcus faecalis. Foram utilizados 50 dentes humanos unirradiculados, doados pelo Banco de Dentes da Faculdade de Odontologia de Araraquara. Após remoção das coroas dentárias, os canais radiculares foram instrumentados até uma lima endodôntica tipo kerr de número 50, e em seguida, os espécimes foram esterilizados, e os canais radiculares contaminados com E. faecalis e incubados a 37 ± 1°C por 21 dias. Os espécimes foram aleatoriamente divididos em cinco grupos experimentais, de acordo com a medicação utilizada: GI - Ozônio com propilenoglicol (n=11); GII - hidróxido de cálcio com paramonoclorofenolcanforado - PMCC (n=11), GIII - propilenoglicol com pó de hidróxido de cálcio ozonizado (n=11), GIV - grupo controle positivo - não foi colocada nenhuma medicação (n=11) e GV - grupo controle negativo - não foram contaminados (n=6). As coletas foram realizadas coletas após sete e quatorze dias e o crescimento microbiano verificado por meio da contagem de unidades formadoras de colônia (UFC) de E. faecalis. Os resultados que foram submetidos ao teste não paramétrico de Kruskal-Wallis, seguido pelo teste de Dunn e também pelo teste nãoparamétrico de Friedman sendo ambos com um nível de significância de 0,05, mostraram que o propilenoglicol ozonizado e o hidróxido de cálcio com PMCC reduziram estatisticamente o número de bactérias quando comparados ao grupo controle positivo em 7 e 14 dias, não apresentando diferenças estatísticas entre eles; o hidróxido de cálcio ozonizado não reduziu estatisticamente o número de bactérias quando comparados ao grupo controle positivo em 7 e 14 dias e o propilenoglicol ozonizado e o hidróxido de cálcio PMCC não apresentaram diferença... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study evaluated in vitro bactericidal effect of ozone associated with the vehicle propylene glycol and calcium hydroxide in root canals contaminated with Enterococcus faecalis. It used 50 single-rooted human teeth, donated by the teeth of the Faculty of Dentistry of Araraquara. After removal of dental crowns, root canals were instrumented to an endodontic kerr file number 50, and then the specimens were sterilized, and the root canals contaminated with Enterococcus faecalis and incubated at 37 ± 1 ° C for 21 days. The specimens were randomly divided into five experimental groups, according to the medication used: GI - ozone with propylene glycol (n = 11), group II - calcium hydroxide with paramonoclorofenolcanforado - PMCC (n = 11), GIII - propylene glycol added powder calcium hydroxide ozoized (n=11), GIV - positive control group - was not placed any medication (n = 11) and GV - negative control group - were not infected (n = 6). Microbiological samples were collected after seven and fourteen days and the microbial growth observed at the count of the number of colony forming units of E. faecalis. The results were analyzed using the nonparametric Kruskal-Wallis followed by Dunn's test and also by the non-parametric Friedman and both with a significance level of 0.05, showed that the propylene ozonized and calcium hydroxide with PMCC statistically reduced the number of bacteria when compared to positive control group at 7 and 14 days, calcium hydroxide ozonized not statistically reduced the number of bacteria when compared to positive control group at 7 and 14 days and propylene ozonized calcium hydroxide and CMCP showed no statistically significant differences in bacterial growth at 7 and 14 days.In a descending order of bactericidal action in the two study periods, is calcium hydroxide PMCC, followed by propylene ozonized and ozonized calcium hydroxide / Orientador: Idomeo Bonetti Filho / Coorientador: Antonio Carlos Pizzolitto / Banca: Marco Antonio Húngaro Duarte / Banca: Juliane Maria Guerreiro Tanomaru / Mestre

O objetivo deste estudo ex vivo foi avaliar as alterações químicas e morfológicas na dentina radicular tratada com diferentes lasers de alta potência. Foram selecionados cinquenta caninos superioresque tiveram suas coroas seccionadas transversalmente e os canais radiculares preparados com instrumentos rotatórios de NiTi até o instrumento #50.02. Após o preparo biomecânico, os dentes foram distribuídos em cinco grupos (n = 10) de acordo com o tratamento de superfície: GI - água, GII - NaOCl + EDTA, GIII - NaOCl + EDTA + laser Diodo (980nm), GIV - NaOCl + EDTA + laser Nd:YAG (1064nm) e GV - NaOCl + EDTA + laser Er,Cr:YSGG (2780nm). Os grupos submetidos ao tratamento com laser (GIII, GIV e GV) foram irradiados por 20 segundos em movimento helicoidal com velocidade aproximada de 1,5 mm/s. Em seguida, os dentes foram clivados e então submetidos à análise da composição orgânica e inorgânica por espectroscopia Raman (cts), quantificação de elementos químicos por espectroscopia de raios X por dispersão em energia (EDS) (wt%), e avaliação da morfologia por microscopia eletrônica de varredura (MEV). Os dados obtidos foram submetidos à análise estatística (ANOVA, p<0,05), considerando as variáveis tratamento de superfície e terço radicular. Nenhum dos tratamentos de superfície avaliados alterou a intensidade do pico de mineral (cts) (p=0,183). O grupo irradiado com Er,Cr:YSGG diminuiu significativamente a intensidade do pico de colágeno (cts) (290,7 ± 41,7) quando comparado aogrupo tratado com água (328,3 ± 63,5) e ao grupo tratado com NaOCl e EDTA (333,9 ± 55,8) (p<0,05). O grupo irradiado com Er,Cr:YSGG também apresentou maior razão mineral/colágeno (9,5 ± 1,1) quando comparado aos grupos tratados com água (7,7 ± 1,5), NaOCl + EDTA (8,0 ± 1,4) e Diodo (8,2 ± 1,6). Em relação aos terços radiculares, as intensidades do pico mineral e do pico de colágeno apresentaram aumento crescente de cervical para apical (p<0,05) em todos os grupos avaliados, resultando em razão mineral/colágeno menor para o terço cervical, quando comparado aos terços médio e apical. A análise por EDS não apresentou diferença entre os grupos estudados tanto para os elementos químicos avaliados individualmente, assim como para a razão Ca/P (p<0,05). A MEV mostrou que o grupo irradiado com Diodo apresentou superfície de matriz orgânica amorfa, enquanto queo laserEr,Cr:YSGG proporcionou maior remoção de dentina intertubular com formação de crateras, e o grupo irradiado com Nd:YAG promoveu fusão da dentinacom selamentodos túbulos dentinários. Conclui-se que nenhum dos tratamentos de superfície avaliados foi capaz de promover alterações no conteúdo inorgânico da dentina radicular; o tratamento com NaOCl, EDTA, e irradiação Er,Cr:YSGG alterou a estrutura de colágeno. O uso do laser promoveu alterações morfológicas, independentemente do tipo de laser utilizado, quando comparado aos grupos não irradiados / The aim of this ex vivo study was to evaluate the chemical and morphological changes in root dentin treated with different high power lasers. Fifty maxillary canines were selected and had their crowns sectioned transversely and the root canals prepared with NiTi rotary instruments to the instrument # 50.02.After biomechanical preparation, the teeth were distributed into five groups (n=10) according to the surface treatment: GI - water, GII - NaOCl + EDTA, GIII - NaOCl + EDTA + Diode (980nm), GIV - NaOCl + EDTA + Nd:YAG (1064nm) and GV - NaOCl + EDTA + Er,Cr:YSGG (2780nm). The groups subjected to laser treatment were irradiated for 20 seconds by performing helical motion along the rootwith a speed of approximately 1.5 mm/s. Samples were bisected, exposing the treated surface and were subjected to the analysis of organic and inorganic composition by Raman spectroscopy (cts), elements quantification by energy-dispersive x-ray spectroscopy (EDS) (%), and had the morphology evaluated by scanning electron microscope (SEM).Data were submitted to statistical analysis (ANOVA, p <0.05), considering the variables surface treatment and root third. None of the evaluated surface treatments alter the mineral peak intensity (cts) (p = 0.183).The group irradiated with Er,Cr:YSGG significantly reduced the intensity of collagen peak (cts) (290.7 ± 41.7) compared with the watertreated group (328.3 ± 63.5) and the group treated with NaOCl and EDTA (333.9 ± 55.8) (p <0.05). The group irradiated with Er,Cr:YSGG also showed higher mineral/collagen ratio (9.5 ± 1.1)compared to the group treated with water (7.7 ± 1.5), NaOCl and EDTA (8.0 ± 1.4) and diode 980 nm (8.2 ± 1.6). Both collagen and mineral peak intensities increased from cervical to apical root thirds (p<0.05)in all groups evaluated, resulting in lower mineral/collagen ratio to the cervical third when compared to middle and apical thirds. EDS analysis found no difference between the chemical elements as well as the Ca/P ratio between the studied groups (p <0.05). SEM showed that the group irradiated with 980 nm diode had an amorphous organic matrix surface, while the Er,Cr:YSGG provided greater removal ofintertubular dentin forming craters, and the group irradiated with Nd:YAG promoted fusion of dentin, sealing the dentinal tubules. It is concluded that none of the surface treatments evaluated were able to promote changes in the inorganic content of the root dentin; treatment with NaOCl, EDTA, and irradiated withEr,Cr:YSGG alter the collagenstructure. The use of laser promoted morphological changes, regardless the type of laser used, when compared to non-irradiated roots

Made available in DSpace on 2014-06-11T19:24:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-03-03Bitstream added on 2014-06-13T19:11:08Z : No. of bitstreams: 1 somenzarineto_h_me_arafo.pdf: 770431 bytes, checksum: ccfcddbbe84f78661018f873cf984b0d (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Foi realizada uma análise comparativa entre três técnicas de instrumentação distintas, utilizando-se instrumentos do sistema Endo-Eze, com movimentação oscilatória; instrumentos do sistema Pow-R, com movimentação rotatória e instrumentos Tipo K manuais, com técnica de forças balanceadas. Os instrumentos foram utilizados em uma sequência técnica pré-determinada em pré-molares superiores humanos, birradiculados, por cinco vezes. Para cada técnica utilizamos quatro jogos de instrumentos novos. Os instrumentos foram fotografados com o auxílio do microscópio eletrônico de varredura quando estavam sem uso, após uma vez de uso e após cinco vezes de uso. Para cada instrumento utilizado foi atribuído um escore de acordo com o grau de deformação apresentado. A correlação numérica para cada instrumento foi submetida a uma análise estatística (Teste de Kruskal-Wallis) para podermos determinar diferenças estatísticas significantes entre esses três grupos de instrumentos endodônticos. Os resultados obtidos foram tratados estatísticamente e permitiram concluir que não houve diferenças estatisticamente significantes entre os três grupos estudados para a situação de uma vez de uso. No entanto, para as situações sem uso e cinco vezes de uso os instrumentos do Grupo I (Endo-Eze) apresentaram melhores resultados quando comparados com os Grupos II e III (Pow-R e Manual). / It was comparatively analysed 3 different instrumentation techniques upon Endo-Eze, Pow-R and manual K-file instrument deformation Upper bicuspid teeth were instrumented 5 times, and the instruments were photographed before, and after 1 and 5 times of use. For each instrument, it was stablished one specific score, that when submmited to Kruskal-Wallis test showed better results to Endo-Eze group, followed by Pow-R and Manual respectivelly.