Aim: To assess the prevalence of apical periodontitis, root-filled teeth, and related covariates, considered potential risk factors for cardiovascular diseases in patients with a self-reported cardiovascular disease history, who first attended the Faculty of Dentistry, University of Porto, in 2018. Methodology: Out of 2,063 reviewed medical and dental records, 1,841 individuals met the inclusion criteria. Endodontic infections and oral status were assessed through orthopantomography. Cardiovascular disease classification was based on self-reported diagnosis. Medical history included dichotomous data on hypertension, diabetes mellitus, and smoking. Bivariate analyses were conducted using Student's t-test for quantitative variables and Pearson's Chisquare test for categorical variables (95% CI, alpha = 0.05). Multivariate logistic regression assessed the impact of confounders on the presence of apical periodontitis and root-filled teeth. Statistical significance was set at p < 0.05. Results: The prevalence of apical periodontitis and root-filled teeth was 72% and 57% in patients with cardiovascular diseases, and 45.6% and 47.8% in those without. Bivariate analysis revealed significant associations between cardiovascular disease and age, gender, number of teeth, apical periodontitis, hypertension, diabetes, and smoking. No significant association was found between cardiovascular disease and root-filled teeth. In the multivariate model, the association between apical periodontitis and cardiovascular disease was no longer statistically significant. Conclusion: Although the prevalence of apical periodontitis and root-filled teeth was higher in patients with self-reported cardiovascular disease, no significant association was observed. Hypertension and smoking emerged as key risk factors for cardiovascular disease. Further research is warranted to clarify the potential link between endodontic infections and cardiovascular conditions.
Aim: To investigate root dentin defects induced by different cast post removal techniques. Methodology: One hundred bovine incisors were standardized to 15 mm. Twenty roots served as unprepared controls; the remaining 80 were instrumented with the BioRace system (to size 40/.04), obturated using lateral condensation, and prepared for post space with #1-4 Largo drills. Of these, 60 received directly fabricated cast posts cemented with zinc phosphate. Post removal was performed using ultrasonic vibration, a carbide bur, or a spring-activated device. Roots were sectioned at 4, 8 and 12 mm from the apex and examined at 25 & times; magnification to assess the presence of fractures and other dentinal defects (partial cracks and craze lines). Data were analyzed with the Chi-square test (alpha = 0.05) and Bonferroni-adjusted pairwise z-tests. Results: Among 300 sections, 103 (34.3%) showed defects. The control group showed none. All removal techniques produced defects, with no significant difference among protocols for other defects (P>0.05). The spring-activated device was associated with a higher number of root fractures (P<0.05). Defects distribution was similar across root levels (4, 8 and 12 mm). Conclusions: All techniques caused dentin damage. Only the spring-activated device increased fractures. Careful selection of the removal strategy is advised.
Background: The anatomical relationship between posterior maxillary teeth and the maxillary sinus may predispose to intraoperative complications during endodontic treatment. While sodium hypochlorite extrusion into the sinus has been sporadically reported, no case series has described direct intraoperative endo-sinus communications. Methods: Fifteen cases of intraoperative endo-sinus communication were documented during root canal treatment or retreatment of maxillary premolars and molars. Clinical signs included profuse bleeding synchronous with respiration, the presence of nasal mucus in the pulp chamber, disappearance of sodium hypochlorite solution, and contamination of paper points. In all cases, a Valsalva maneuver was performed and confirmed the presence of communication. Management strategies included immediate obturation when the canal could be dried or hemostasis achieved, or provisional sealing with Teflon and IRM with or without calcium hydroxide dressing when immediate obturation was not possible. Patients were followed clinically and radiographically.. Results: In 4 cases (26.7%), endodontic obturation was completed in a single visit, while in 11 cases (73.3%) obturation was postponed. Among the latter, 4 cases received calcium hydroxide dressing and 7 had no intracanal medicament. In all cases, the communication resolved spontaneously within one week. At a mean follow-up of 3.9 years (range: 1-10 years), no patient developed persistent sinonasal symptoms or radiographic evidence of sinus pathology. Conclusions: This case series provides the first clinical description of intraoperative endo-sinus communications. When promptly recognized and appropriately managed, these events do not appear to compromise the long-term prognosis of endodontic treatment. Careful preoperative radiographic assessment, accurate working length determination at the first appointment, and controlled instrumentation are essential to prevent recurrence. Different obturation techniques may be successfully applied, with bioceramic sealers offering potential advantages in postoperative comfort.
Introduction: Endodontic treatment aims to clean and fill the root canals to maintain periapical health and alleviate pain, with postoperative pain influenced by multiple clinical factors. Sodium hypochlorite irrigation, although effective, can cause debris extrusion, with gel being an alternative that reduces this risk while maintaining antimicrobial efficiency. Objective: This study aimed to assess postoperative pain incidence in asymptomatic upper premolars with pulp necrosis and chronic periapical lesions undergoing endodontic intervention. Materials and Methods: Sixty-six patients were divided into three groups (n=22): Group SHG/SS used 3% sodium hypochlorite (SH) gel and saline solution (SS). Group SHG/S employed 3% SH gel and 2.5% SH solution (S). Group SHS/S used 2.5% SH solution for both purposes. Procedures lasted 40 to 60 minutes, conducted by the same operator in a single session. Clinical data was recorded, and postoperative pain was evaluated at 24, 48, and 72 hours using a modified Numeric Rating Scale. Statistical analysis was applied to the collected data. Results: Within the first 24 hours, auxiliary chemical substances significantly impacted postoperative pain (p = 0.021). SHS/S showed lower pain scores compared to SHG/S, while SHG/SS scores were intermediate. At 48 hours (p = 0.548) and 72 hours (p = 0.127), postoperative pain did not show statistical significance. SHS/S and SHG/SS did not significantly influence postoperative pain, but SHG/S had an impact. Conclusions: Postoperative pain did not significantly differ at 48 and 72 hours. SHG/S and SHG/SS did not markedly influence postoperative pain. Notably, the use of 3% SH gel with 2.5% SH solution increased postoperative pain levels. Clinical Relevance: The application of 3% sodium hypochlorite gel used as an auxiliary chemical associated with the 2.5% sodium hypochlorite solution used as an irrigant had an impact on postoperative pain, which resulted in higher levels of post-operative pain.
Aim: This study aimed to histologically evaluate dentin bridge formation and pulpal response following direct pulp capping using either mineral trioxide aggregate (MTA) or Well-Root PT, with and without adjunctive diode laser (DL) application, and to assess the independent effects of DL on pulpal tissues. Methodology: Ninety-six teeth from eight healthy adult mongrel dogs underwent Class V cavity preparation with mechanical pulp exposure. Specimens were randomly assigned to three primary groups: Group I (control) with Teflon disc placement; Group II with MTA; and Group III with Well-Root PT. Each group was further subdivided based on the application or absence of an 810 nm DL pretreatment. Histological samples were collected at 2-and 8-weeks post-treatment to assess pulpal response and dentin bridge formation. Results: Chi-square analysis showed statistically significant differences (P < 0.05) between the control group and both MTA and Well-Root PT groups at both time points. No significant differences (P > 0.05) were observed between the MTA and Well-Root PT groups, regardless of laser application. Similarly, DL pretreatment did not produce significant differences in histological outcomes within any group. Conclusion: From a clinical perspective, Well-Root PT represents a viable alternative to MTA for direct pulp capping. However, the application of an 810 nm diode laser did not significantly enhance regenerative outcomes for either bioceramic materials.
Aim: This study aimed to introduce and clinically validate a novel conservative technique, P.E.A.R.L. (Periapical Exudate Aspiration via Root canal Lumen), designed to manage acute periapical abscesses with associated facial swelling. The technique allows for direct aspiration of periapical exudate via the root canal system, potentially eliminating the need for surgical drainage or systemic antibiotic therapy. Materials and Methods: A clinical case involving a necrotic mandibular second premolar (tooth 4.5) presenting with acute facial swelling was treated using the P.E.A.R.L. technique. After establishing the working length, the canal was gently instrumented and irrigated. Apical patency was achieved with a small manual file to stimulate periapical exudate release. When exudate was not initially present within the canal, a fine endodontic suction tip (& Oslash; 0.30 mm) was connected to high-vacuum suction and positioned slightly beyond the apical foramen to allow negative pressure drainage. No systemic antibiotics were administered. Root canal obturation was performed in the same session. Results: Facial swelling and associated symptoms resolved within 36 hours following treatment. No postoperative complications occurred, and clinical and radiographic follow-up confirmed the infection's resolution. The case demonstrated successful management of an acute periapical abscess in a single visit without surgical incision or pharmacological support. Conclusions: The P.E.A.R.L. technique offers a conservative, efficient, and minimally invasive approach for managing periapical abscesses. It may reduce or eliminate the need for mucosal incision and antibiotic therapy, shorten treatment duration, and allow definitive root canal therapy to be completed in a single session. Further clinical studies are recommended to validate its broader applicability and long-term outcomes.
Aim: Enterococcus faecalis (E. faecalis) is a resilient endodontic pathogen associated with persistent root canal infections. The objective of this investigation was to assess and compare antibacterial efficacy of N-acetyl cysteine (NAC) alone and in combination with two photodynamic therapy (PDT) protocols utilizing methylene blue (MB) and indocyanine green (ICG) as photosensitizers. Methodology: Seventy-eight extracted human mandibular premolars were instrumented, sterilized, and inoculated with E. faecalis (MTCC 439). After 14 days of incubation, samples were randomly divided into 3 groups (n = 26 each): Group I-NAC alone; Group II-NAC + PDT with ICG (1 mg/mL, 810 nm diode laser); Group III-NAC + PDT with MB (20 mu g/mL, 660 nm diode laser). Bacterial samples were collected before and after disinfection using sterile paper points, and quantified via colony-forming unit (CFU) analysis on Brain Heart Infusion (BHI) agar. Data were log10-transformed and analyzed using paired t-tests and one-way ANOVA with Tukey's post hoc test (P<0.05). Results: All groups demonstrated significant CFU reduction post-treatment (P<0.0001). Mean CFU reductions were: Group I-0.84 +/- 0.29, Group II-1.52 +/- 0.54, and Group III-1.35 +/- 0.47. Group II & III showed significantly greater reductions than Group I (P < 0.0001 and P=0.0003, respectively). No significant difference was observed between Group II & Group III (P=0.3554). Conclusion: NAC combined with either MB-or ICG-mediated PDT significantly improved disinfection of E. faecalis-infected root canals compared to NAC alone. This combination offers a promising adjunctive approach for managing persistent endodontic infections.
Aim: This study aimed to assess the effectiveness of metal artifact reduction (MAR) algorithms in cone-beam computed tomography (CBCT) images, specifically for various common dental materials. Metal restorations, posts, and gutta-percha frequently cause artifacts due to their high density, impacting image quality. Methodology: Researchers used 11 extracted human mandibular teeth with different dental materials (amalgam, metal posts, porcelain-fused-to-metal (RFM) crowns, gutta-percha) and three intact teeth. CBCT scans were performed using a Galileos scanner on a mandible in water to simulate soft tissue. Images were acquired both with and without MAR activation across various tooth positions. Contrast-to-noise ratio (CNR) was calculated at multiple distances and angles. Statistical analysis was conducted using the Wilcoxon test. Results: The study found that activating the MAR algorithm had no significant impact on reducing metal artifacts across any of the evaluated dental materials, regardless of tooth type, position, or angle. Conclusion: The MAR algorithm, as tested, does not significantly reduce metal artifacts caused by dental materials like amalgam, metal posts, RFM crowns, or gutta-percha in CBCT images. In this context, clinical application of these algorithm does not provide justifiable added benefits.
Aim: Diabetic patients may exhibit altered responses to nerve stimulation due to diabetes-related neurological damage. This prospective, non-randomized, parallel, blinded clinical trial evaluated postoperative pain following endodontic treatment by comparing two groups of patients-with and without type 2 diabetes mellitus (T2DM). Methodology: Eighty adult patients were included: 40 with T2DM and 40 without T2DM. At baseline, glycated hemoglobin (HbA1c) levels were recorded. Endodontic treatment was performed, and root canals were irrigated with 2.5% sodium hypochlorite solution. Postoperative pain was assessed by a blinded researcher at 6, 12, 24, and 72 hours using a Numerical Rating Scale (NRS, 0-10). Results: Within the first 6 hours, 19 patients in the T2DM group and 24 in the control group reported pain (p = 0.429). After 12 hours, 11 T2DM patients and 19 control patients experienced pain (p = 0.165). At 24 hours, 9 patients with T2DM and 11 in the control group reported pain (p = 0.930). After 72 hours, 5 patients from each group reported pain (p = 0.186). No significant differences in pain intensity were observed between the groups at 6 hours (p = 0.139), 12 hours (p = 0.169), 24 hours (p = 0.387), or 72 hours (p = 0.687). However, regression analysis revealed that patients with T2DM had lower odds of experiencing postoperative pain (OR = 0.19; 95% CI = 0.04-0.77), regardless of sex, age, preoperative pain, tooth type, treatment modality, or sealer extrusion. Conclusions: Although no statistically significant differences in pain intensity were observed between groups, patients with T2DM exhibited lower odds of reporting postoperative pain. These exploratory findings may indicate a trend toward reduced postoperative discomfort in this population, warranting further investigation through larger randomized trials.
Aim: This report proposes a new, step-by-step workflow designed to safely manage the apical extent of root canal preparation. It utilizes advanced, motor-driven endodontic technology, specifically the enhanced Optimum Apical Stop (OAS2) function, to streamline and expedite traditional root canal procedures. Summary: In this case series, three patients underwent endodontic treatment, using a motor-driven protocol with the Morita Tri Auto ZX2+ device (J. Morita Corp., Osaka, Japan) and its OAS2 function activated. Root canal shaping was initiated with VDW.ROTATE instruments (VDW GmbH, Munich, Germany), followed by refinement using ProTaper Ultimate F2 and F3 files (Dentsply Sirona, Charlotte, NC, USA), and obturation with conform fit gutta-percha cones. Postoperative assessments included clinical evaluation, periapical radiographs, and patient-reported outcomes at 1, 3, 6, and 12 months. Outcome measures included pain, swelling, tooth function, need for reintervention, adverse effects, and radiographic signs of periapical healing. Immediate postoperative radiographs showed high-quality apical preparation and obturation. At one-year follow-up, all three cases demonstrated complete symptom resolution and radiographic absence of periapical radiolucency.
Aim: The aim of this study was to compare 4 different NiTi endodontic file systems [Pro-Taper Next (PTN), ProTaper Ultimate (PTU), VDW.Rotate (VR), and XP-Endo Shaper (XPS)] in terms of their instrumentation time (IT) and material removal capacity using standardized transparent acrylic root canal blocks (TABs). Methods: A total of 80 standardized TABs with canals of 17 mm length, a constant taper of 2%, and a curvature of 30 degrees were used. The root canals were randomly assigned to 4 experimental groups (n = 20 each), each of which used one of the tested file systems. All the instrumentation procedures were performed by a single operator following manufacturers' protocols using a torque-controlled endodontic motor. The weight of each TAB was measured before and after instrumentation using a precision scale, and the percentage of material loss was calculated. IT was also recorded using a digital stopwatch. Data was analyzed using one-way ANOVA, Kruskal-Wallis test, and Pearson correlation, with a significance level set at P < 0.05. Results: XPS demonstrated the highest material loss, significantly greater than PTN and VR (P < 0.001), while VR exhibited the most conservative material removal. XPS also showed the shortest IT, whereas PTU exhibited the longest (P < 0.001). A moderate positive correlation was found between IT and material loss (r = 0.579, P < 0.001). Conclusions: Endodontic file systems differ significantly in shaping efficiency and dentin preservation. The XPS offered superior time efficiency but removed more material, while VR preserved dentin more effectively. These findings may guide clinicians in selecting endodontic file systems based on clinical priorities. Future studies using natural teeth are recommended to validate these findings.
Aim: This study aimed to evaluate the antimicrobial efficacy of zinc oxide nanoparticles (ZnO NPs) and blue light, both individually and in combination, against Enterococcus faecalis (E. faecalis) in vitro. Their performance was compared to 1% sodium hypochlorite (NaOCl) to determine whether these adjuncts could enhance root canal disinfection. Methodology: A laboratory investigation was conducted using eight experimental groups: E. faecalis with phosphate-buffered saline (control), 1% NaOCl, ZnO NPs, blue light, 1% NaOCl/ZnO NPs, 1% NaOCl/blue light, ZnO NPs/blue light, and 1% NaOCl/ZnO NPs/blue light. Standardized E. faecalis inocula were exposed to each treatment under controlled conditions. Bacterial cells were then recovered, serially diluted, and plated on agar to determine colony-forming units (CFU). Reductions in CFU, compared to the control, were analyzed using Mann-Whitney tests. Statistical significance was set at p<0.05. Results: Most experimental groups exhibited significantly lower bacterial counts than the control (p=0.000), except for the blue light-only group, which was not statistically different. Among the single-agent treatments that reached significance, 1% NaOCl produced the greatest bacterial reduction, followed byZnO NPs. When combined, dual treatments reduced bacterial counts more than single agents. The triple combination achieved the highest reduction overall. Conclusions: This study highlights the potential of ZnO NPs and blue light as adjuncts to 1% NaOCl for more effective elimination of E. faecalis in planktonic cultures. The enhanced antimicrobial activity observed with combined treatments suggests that incorporating nanoparticles and photodisinfection could reduce the need for higher NaOCl concentrations while maintaining robust antibacterial efficacy.
Aim: The long-term success of endodontically treated teeth requires maintaining structural integrity, functionality, and aesthetics. The combined use of endodontic fiber posts with resin-based micro- and nano-composites seems to be an intriguing solution for the reinforcement of the damaged tooth structures. This in vitro study aimed to evaluate the mechanical behavior and fracture patterns of premolars restored with different combinations of endodontic fiber posts and composite resins, subjected to thermomechanical aging and masticatory force simulation. Methods: Fifty extracted maxillary premolars were divided into five groups, including a control group of healthy teeth and four experimental groups with two types of fiber posts (hollow and compact) and two composite resins with different elasticity (traditional and bulk-fill). After cyclic fatigue testing, fracture strength and failure modes were analyzed using statistical methods. Results: The control group exhibited significantly higher fracture resistance (1909 +/- 177) than the experimental groups, with no significant differences among experimental groups (p. value >0.05). However, teeth restored with bulk-fill composites demonstrated slightly higher fracture resistance and a higher percentage of favorable fractures than other samples. The combination of bulk-fill composite and hollow fiber posts was associated with more favorable fracture outcomes (n=8 favorable fractures). Conclusion: These findings suggest that bulk-fill composites, due to ease of use and favorable fracture behavior, may be a viable restorative option. Further studies with larger sample sizes are needed to confirm these results.
Aim: The aim of this case series is to introduce a new surgical template designed for static endodontic microsurgery using Piezosurgery (R). The template, created with computer-aided design/computer-aided manufacturing (CAD-CAM) technologies, aims to enhance the precision of root-end resections by providing individualized guidance for the surgical procedure. This approach seeks to reduce invasiveness, minimize bone loss, and improve surgical outcomes in cases of persistent apical periodontitis or other post-treatment endodontic complications. Summary Conventional endodontic treatments can fail in 14-16% of cases due to persistent infections within the root canal system or extraradicular factors. In such cases, endodontic microsurgery, especially when guided by advanced technologies, offers a high success rate of up to 89%. Recent innovations in piezoelectric devices and CAD-CAM-based surgical templates enable more precise, less invasive procedures. The new surgical template presented in this study allows for accurate root-end resections, ensuring optimal root sealing while minimizing damage to surrounding tissues. The template's design aims to improve accuracy and reduce the risk of surgical errors compared to freehand procedures, promoting better healing and fewer complications. Key Learning Point center dot Persistent apical periodontitis after root canal treatment can often be resolved with microsurgical techniques. center dot The integration of CAD-CAM technology with Piezosurgery (R) enhances surgical precision, reducing bone loss and tissue trauma. center dot Surgical templates designed for static endodontic microsurgery provide individualized, accurate guidance, leading to improved surgical outcomes. center dot The use of piezoelectric devices offers precise cutting with minimal damage to soft tissues, crucial for surgeries near sensitive structures. center dot Advances in guided endodontic surgery are improving success rates and minimizing post-operative complications.
Aim: This study aimed to evaluate in vitro the ability to remove pulp tissue from the mesial root canals of mandibular molars using three different protocols for the final activation time of irrigation with the Easy Clean (EC) rotary instrument. Materials and Methods: Thirty mandibular molars with vital pulp were instrumented with the ProDesign Logic rotary system and divided into three experimental groups according to the protocol for the final activation time of the irrigants (n=10). Group EC1: the final rinse was performed with 5 mL of 2.5% sodium hypochlorite (NaOCl), followed by 5 mL of 17% ethylenediaminetetraacetic acid (EDTA) and another 5 mL of 2.5% NaOCl solution, with each rinsing agent activated in 3 cycles of 20 seconds. Group EC2 used the same sequence of solutions as group EC1, with each irrigant activated in 6 cycles of 20 seconds. In group EC3, the operation technique and the sequence of solutions were the same as in groups EC1 and EC2, with each rinsing agent being activated in 9 cycles of 20 seconds. At the end, samples from all groups were washed with 20 mL of distilled water using a NavigTip 30-G syringe and needle. The samples were fixed in 10% formaldehyde, cut into micrometers, fixed on histology slides and stained with hematoxylin-eosin (HE). The total area of the canal and remaining tissue was determined using the Image J program to determine the percentage of remaining pulp. Results: In the cervical third, all groups had similar results. In the middle and apical thirds, EC1 and EC2 had similar percentages of pulp remnants and differed from EC3 (p<0.05). Conclusions: It can be concluded that the removal of pulp tissue increases with longer contact time of the NaOCl.
Recent development in the field of artificial intelligence has influenced dentistry, and particularly endodontics. Such AI-driven algorithms show great promise in improving the accuracy of diagnostics, treatment planning, and the actual conduct of endodontic treatment, as well as predicting treatment outcomes. AI has already started to prove itself useful in endodontics by improving the detection of periapical pathologies and root fractures, the estimation of root canal anatomy, the determination of working lengths, and the prediction of treatment outcomes. Further development and dissemination of this technology could significantly enhance endodontic practice and contribute to natural dentition conservation. However, despite AI bringing a better success rate and efficiency in the field of endodontic treatments, further studies are still needed to keep on validating their reliability and practicality for wider clinical integrations. This review is undertaken with the purpose of discussing recent advances in AI and describing their applications in the field of endodontics.
Aim: This study evaluated the effects of torque control settings and automatic stop functions on apical debris extrusion during root canal preparation using a continuous rotation file system. Methodology: Forty-eight extracted human lower premolars were randomly divided into four groups based on two torque control settings and two auto-stop functions. The extruded debris was collected in pre-weighed Eppendorf tubes and subsequently quantified. Results: Statistical analyses were conducted using SPSS, and the Kruskal-Wallis test and the Mann-Whitney U test revealed that the auto-stop mode significantly reduced debris extrusion, while the torque control settings did not. Conclusion: These findings suggest that clinicians can potentially minimise debris extrusion by utilising the auto-stop mode during root canal procedures.
Aim: This ex-vivo study aimed to evaluate the accuracy and efficacy of digitally designed 3D-printed endodontic guides (3DGs) in achieving a conservative endodontic access preparation on maxillary molars compared to a traditional endodontic access (TRAD). Methodology: Eighty extracted maxillary molars were divided into two groups: (1) TRAD access and (2) 3DG access. Two operators with varying levels of experience performed both approaches. Time allocated to perform each procedure was recorded. Volumetric analysis was done by comparing data from the pre- and the post-operative CBCTs. Results: Both operators with the 3DG cavity access located 100% of the canals present, while the TRAD groups missed 30.76-81.81% of second mesiobuccal canals. Time required and substance loss were significantly lower in the 3DG group vs. the TRAD group. Conclusions: Within the limitations of this study, the use of an endodontic 3DGs helped in preserving a significantly more dental structure in significantly less time.
Aim: To analyze the antimicrobial effect of different protocols using 2% chlorhexidine as an irrigating substance, and 2.5% sodium hypochlorite to decontaminate lower molars infected with Enterococcus faecalis. Methodology: 72 mesial roots were sectioned and contaminated with E. faecalis. The samples were randomly distributed into 4 groups (n=14) according to the protocols: 2 ml of 2% chlorhexidine gel and 10 ml of 9% saline solution (CHX G+SS); 2 ml of 2% chlorhexidine gel and 10 ml of 2% liquid chlorhexidine (CHX G+CHX L); 12 ml of 2% liquid chlorhexidine (CHX L); 12 ml of 2.5% liquid sodium hypochlorite (HIP L) (positive control). Bacteriological samples were collected before preparation and irrigation (S1), and after instrumentation and irrigation with different protocols (S2), for the ultimate purpose of quantifying the reduction in planktonic bacteria and intracanal biofilm. The samples were evaluated by using scanning electronic microscopy (SEM) to confirm the presence of biofilm. Bacterial quantification was performed using qPCR and the colony forming unit (CFU)/mL count. Statistical analysis was performed using the Kruskal-Wallis and Wilcoxon tests to compare the protocols of use for chlorhexidine as a according to the time points tested. The Student-Newman-Keuls test was used for multiple comparisons, with a significance level of 5%. Results: The SEM analysis allowed visualizing the biofilm structure. At S1, there was a significant difference among the teeth that made up each group (p<0.001) regarding the CFU count. At S2, there was no difference among the HIP L, CHX G+CHX L and only CHX L groups, but the CFU count was significantly higher in the CHX G+SS group (p<0.001). Significantly lower CFU counts were found after S2, for all the groups (p=0.010). Conclusion: The application of different 2% chlorhexidine protocols was effective in reducing bacterial contamination by E. faecalis. The 2% chlorhexidine application protocols proved to be good alternatives to 2.5% sodium hypochlorite, given the excellent antimicrobial efficacy.
Aim: To evaluate the root canal anatomy of mandibular incisors with Vertucci's type III configuration. Methodology: Forty mandibular incisors were scanned using a micro-CT to measure canal and dentin volume, bifurcation and merging levels, minor and major diameters, long-short diameter ratio, dentin thickness, degree of curvatures and number of foramens. Results: The apical third showed lower volume of canal and dentin. The bifurcation with the formation of buccal and lingual canals presented a mean of 3.75 mm extension. The cement-enamel junction, bifurcation and merging levels showed major diameter (P < 0.05). The round shaped canals were found in buccal (67.5%), lingual (85%) and apical sections (55%). In apical section dentin thickness ranged from 1.02 mm to 0.52 mm. No specimen showed root curvature and 82.5% of mandibular incisors presented single apical foramen. Conclusion: The morphologic aspects of root canal bifurcation and merging in mandibular incisors Vertucci's type III do not present a consistent pattern.
