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Doctoral Thesis
DOI
10.11606/T.23.2009.tde-28042009-100656
Document
Author
Full name
Eduardo Akisue
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2009
Supervisor
Committee
Gavini, Giulio (President)
Barletta, Fernando Branco
Caldeira, Celso Luiz
Figueiredo, Jose Antonio Poli de
Gioso, Marco Antonio
Title in Portuguese
Avaliação da resposta inflamatória periapical resultante da infiltração coronária em dentes de cães obturados com diferentes cimentos resinosos e técnicas obturadoras
Keywords in Portuguese
AH Plus
Infiltração dental
Obturação do canal radicular
Periodontite apical.
Real Seal
Abstract in Portuguese
Considerando-se a necessidade da obturação tridimensional e o adequado selamento marginal do sistema de canais radiculares, como fatores decisivos para o êxito da terapia endodôntica, este estudo objetivou avaliar as respostas inflamatórias periapicais resultantes da infiltração coronária em dentes de cães obturados com diferentes cimentos resinosos (AH Plus®, RealSeal® e RealSeal SE®) e técnicas obturadoras (condensação lateral e termoplástica). Para tanto, pré-molares e incisivos centrais e laterais de 5 cães tiveram o tratamento endodôntico realizado empregando-se limas de NiTi e creme de Endo PTC associado ao hipoclorito de sódio a 1%, estabelecendo-se como limite de instrumentação à distância de 1mm a 1.5mm aquém do vértice radiográfico. A seguir os condutos foram obturados de acordo com os grupos experimentais (n=12) e grupos controles (n=10): GI- AH Plus/condensação lateral, GII- AH Plus/termoplástificação, GIIIRealSeal/ condensação lateral, GIV- RealSeal/ termoplástificação, GV- RealSeal SE/condensação lateral, GVI- RealSeal SE/ termoplástificação, Grupo controle positivo e Grupo controle negativo. As cavidades coronárias ficaram expostas ao meio bucal por um período de 75 dias e, passado este período experimental, os cães foram eutanásiados por superdosagem de anestésico. Foi realizada a remoção cirúrgica das partes correspondentes aos pré-molares e incisivos da maxila e da mandíbula, fixação das mesmas em solução de formol a 10% por 72h e desmineralização em solução de ácido fórmico a 20% + citrato de sódio a 10% pelo período mínimo de 90 dias. Posteriormente, realizou-se a rotina histológica com cortes seriados com espessura de 6m e estes foram corados com hematoxilina e eosina (HE). Cada corte histológico foi digitalizado e analisado em relação à existência de patologia periapical por três avaliadores independentes. Os dados obtidos foram confrontados estatisticamente utilizando o teste de Kruskal-Wallis seguido do teste comparativo de Dunn, observando-se que em relação às técnicas, a termoplástificação por ondas contínuas de condensação associada à técnica de injeção mostrou melhores condições periapicais quando comparada à técnica de condensação lateral (p=0.0055), sendo que a utilização desta técnica resultou em reações inflamatórias mais intensas para o cimento RealSeal SE (p=0.002). Em relação aos cimentos avaliados, o RealSeal SE mostrou-se menos eficaz em evitar a percolação, produzindo maiores níveis de inflamação crônica independentemente do sistema de obturação (p=0.0088).
Title in English
Evaluation of periapical inflammation response from coronal leakage in dog´s teeth obturated using different resin-based sealers and different obturation techniques
Keywords in English
AH Plus
Dental leakage
Periapical periodontitis
Real Seal
Root canal obturation
Abstract in English
Considering the need for three-dimensional obturations and adequate marginal sealing of the radicular canal system as being decisive factors for successful endodontic therapy, this study had as its objective the evaluation of periapical inflammatory responses resulting from coronary infiltration in dog's teeth obturated using different resin sealers (AH Plus, RealSeal and RealSeal SE) and different obturation techniques (lateral condensation and thermoplastic). For this study, premolars, central and lateral incisors from five dogs had endodontic treatment employing NiTi files and Endo PTC cream associated with 1% sodium hypochlorite. The working length was established at a distance of 1.0 to 1.5mm short of the radiographic apex. After this, the teeth were obturated according to their experimental groups (n=12) and control groups (n=10). The groups were defined as follows: GI - AH Plus/lateral condensation, GII - AH Plus/thermoplastic, GIII - RealSeal/lateral condensation, GIV - RealSeal/thermoplastic, GV - RealSeal SE/lateral condensation, GVI - RealSeal SE/ thermoplastic, a positive control group and a negative control group. The coronal access were left exposed to the oral environment for a period of seventy-five days, and after this experimental period, the dogs were euthanized by anesthetic overdose. The parts corresponding to the premolars and the maxilar incisors were surgically removed. These were then submitted to a solution of 10% formol for 72 hours and then demineralized in a solution of 20% formic acid and 10% sodium citrate for a minimum period of ninety days. Before hand, a histological routine of serial cuts having a width of 6m was undertaken and these were colored with hematoxilin and eosin (HE). Each histological cut was digitalized and analyzed with respect to the existence of periapical inflammation by three independent evaluators. The data obtained was statistically compared, firstly using the Kruskal-Wallis test and then the comparative Dunn test, where it was noted that in relation to the techniques, thermoplastification by continuous wave of condensation associated with the injection technique showed better periapical conditions than what was seen for the lateral condensation technique (p=0.0055). On the other hand, for the sealers evaluated, the condensation technique resulted in more intense inflammatory reactions when the sealer RealSeal SE was used (p=0.002). In relation to the sealers evaluated, RealSeal SE was seen to be less effective against percolation, thus producing greater levels of chronic inflammation irrespective of the obturation system employed (p=0.0088).
 
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Publishing Date
2009-11-25
 
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