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XXII Congresso Nazionale Collegio dei Docenti Universitari di Discipline Odontostomatologiche Milano, 9-11 aprile 2015
MINERVA STOMATOLOGICA RIVISTA BIMESTRALE DI ODONTOSTOMATOLOGIA FONDATA NEL 1952 DA B. ROCCIA E T. OLIARO continuazione di: MINERVA ORTOGNATODONTICA ORGANO UFFICIALE DELLA SOCIETÀ ITALIANA DI ODONTOSTOMATOLOGIA E CHIRURGIA MAXILLO-FACCIALE REDATTORE CAPO
DIRETTORE SCIENTIFICO
C. Paganelli
P. L. Sapelli
COMITATO DI REDAZIONE
Biglioli F., Borracchini A., Brambilla E., Breschi L., Campisi G., Carossa S., Carrozzo M., Carmagnola D., Cerutti A., Chiapasco M., Cicciù D., Cicciù M., Cordasco G., Cortellini P., D’Aiuto F., Dalessandri D., Dalessandri M., Del Frabbro M., Di Rosario F., Dorigo E., Esposito M., Favia G., Ferrari M., Ferrario V., Fontana P., Francetti L., Gaffuri S., Gagliani M., Gastaldi G., Gherlone E., Laffranchi L., Levrini L., Lo Muzio L., Lodi G., Maggiore C., Maiorana C., Martina R., Montebugnoli L., Mortellaro C., Paganelli C., Pelo S., Perfetti G., Pini Prato G., Pizzo G., Prati C., Putignano A., Rimondini L., Roccuzzo M., Romeo E., Salgarello S., Sammartino G., Sanz M., Sardella A., Scarano A., Scully C., Sesenna E., Tian C., Tonni I., Trombelli L., Urbani G., Van Der Waal I., Warnakulasuriya S. CONSIGLIO DIRETTIVO S.I.O.C.M.F.
Presidente D. Cicciù
Vice Presidenti C. Maggiore, C. Paganelli
Segretario generale Segretario Tesoriere E. Rapisarda M. Procaccini Consiglieri M. Bosco, S. Caputi, A. Carrassi, U. Covani, C. De Bernardi, G. P. Farronato, E. Gherlone, C. Mortellaro, A. Polimeni, F. Zarone Revisori dei Conti A. Forabosco, G. Gallina, S. Pizzi Past President - Probi Viri E. Bertelli, R. Grandini, G. Nidoli, S. Pelo, P. L. Sapelli DIRETTORE RESPONSABILE A. Oliaro
This journal is PEER REVIEWED and is quoted in: CAB, EMBASE, Index to Dental Literature, PubMed/MEDLINE, Scopus Direzione, redazione, ufficio grafico, ufficio pubblicità, fotocomposizione, amministrazione - Edizioni Minerva Medica - Corso Bramante 83-85 - 10126 Torino Tel. (011) 67.82.82 - Fax (011) 67.45.02 - E-mail:
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[email protected] Segretario e Tesoriere Prof. M. Procaccini. Pubblicazione associata a
La Rivista aderisce al Codice di Autodisciplina degli Editori Medico Scientifici associati a FARMAMEDIA e può essere oggetto di pianificazione pubblicitaria
XXII Congresso Nazionale Collegio dei Docenti Universitari di Discipline Odontostomatologiche Milano, 9-11 aprile 2015
III
Vol. 60 - Suppl. 1 al N. 3
MINERVA GASTROENTEROLOGICA E DIETOLOGICA
ENDODONZIA
Effects of irrigating solutions on mineral content of root canal dentin A. Vinci, G. Gastaldo, N. Grasso, A. Cavada, M. Mirando Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia
Aim. The objective of the study was to evaluate and compare the decalcifying capability of different irrigating solutions by determining the concentration of calcium extracted from root canal dentin, at three immersion time periods, by inductively coupled plasma atomic emission spectrometry. The null hypothesis of the study was that there is no significant difference in concentration of calcium extracted among the various groups and among the successive 5-min immersion. Methods. Sixty maxillary central incisors, freshly extracted for periodontal reasons, not decayed, neither filled, nor endodontically treated, were stored in 0,1% thymol solution until use. Root canals were instrumented under abundant irrigation with Peeso burs n° 4 to 6 (Dentsply Maillefer, Ballaigues, Switzerland) using a contra-angle handpiece. After each instrument, the root canal was irrigated with 5 ml of distilled water. One transversal section of 2-mm thickness was obtained from the cervical third of each root using a preprogrammed automatic Accutom-50 diamond cutter (Accutom-50, Struers A/S, Ballerup, Denmark). Each slice was then sectioned in equal sections, obtaining a total of four (s1, s2, s3, s4) samples from each root. The specimens were assigned randomly to one of four experimental homogeneous groups (n = 60) for treatment with different irrigating solutions, as follows: Group 1: “EDTA 17%” (EDTA 17%), Ogna Laboratori Farmaceutici, Muggiò, Italy; Group 2: “Tetraclean” (citric acid 10.5% + Cetrimide 0.2% + 1% Doxycycline Hyclate + Polypropylene Glycol), Patent n. KR2004A000001; Group 3: “Tetraclean NA” (citric acid + Cetrimide + Polypropylene Glycol), Patent n. KR2012A000001; Group 4: saline solution as control. Each specimen was initially immersed in 15 ml of the correspondent irrigating solution and kept under constant stirring. At three interval immersion times (t = 5 min; t =10 min; t = 15 min), 5 ml of irrigant was 1 3 sampled with2 a graduated pipette and placed in labeled tubes. An inductively coupled plasma atomic emission spectrometer (ICPAES Perkin Elmer, Waltham, MA, USA) was used for calcium determination in each solution, by external standard calibration: linearity range between 0.5 and 100 mg/l; limit of detection (LOD) 0.1 mg/l, limit of quantification (LOQ) 0.5 mg/l. Data analysis was performed by Stata 12 (StataCorp LP, College Station, TX, USA). The assessment of normality was developed with Shapiro-Wilk test (P < 0.05), while comparison tests between groups were conducted with Mann-Whitney U test with a level of significance of P = 0.05. Results. The irrigating solutions tested promoted higher calcium release values from root canal dentin at 10 minutes exposition time than at 5 minutes; instead calcium release was not significantly different between 10 and 15 minutes, except for citric acid based agents (Tetraclean NA) which induced a higher and still increasing calcium release even after 10 minutes contact time
Vol. 64 - Suppl. 1 al No. 2
(P < 0.05). Moreover both the citric acid based agents (Tetraclean and Tetraclean NA) promote the highest calcium release at the three different contact times. Conclusion. The null hypothesis of the study has been rejected. A significantly higher release of Ca2+ was observed in samples submitted to citric acid based agents. Under the experimental conditions and restricting to the irrigating solutions considered in this investigation, to obtain an efficient decalcifying action on dentin (and subsequently the smear layer removal) and to facilitate the biomechanical procedures, citric acid based irrigants can be applied.
Cleaning effectiveness of single-use Ni-Ti systems: ultrastructural analysis G. Gastaldo 1, A. Vinci 1, M. Pigozzo 1, A. Dagna 1, R. Beltrami 2 1Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia 2Department of Brain and Behavioral Sciences, Section of Statistics, University of Pavia
Aim. One-file systems have recently appeared, with the aim of reducing the number of steps and files to reach a correct endodontic treatment. The aim of this in vitro study was to evaluate by SEM the root canal dentine surfaces after instrumentation with two different single-use Ni-Ti systems: OneShape and F6 Skytaper. The amount of debris and the morphology of smear layer at the coronal, middle, and apical third were parameters for the evaluation of the cleanliness of root canals. The null hypothesis of the study is that there is no significant difference in debris scores and smear layer scores between the two systems. Methods. 20 single-rooted human teeth freshly extracted for periodontal reasons were selected for this study and were divided into two groups. The crown of each tooth was removed at the level of the cementum-enamel junction (CEJ) in order to obtain root segments similar in length. The root canals were preliminary instrumented using stainless steel #08-10 K-files (Maillefer, Konstanz, Germany) and with two rotary Ni-Ti instruments, G1 file (12/.03) and G2 file (17/.03) (Micro Mega, Besancon, France), in order to create a glide path (engine settings: 300 rpm and 2.0 N/cm). Root canals were shaped with two different Ni-Ti instruments using 5,25% NaOCl and 17% EDTA solutions. The instruments are single-file technique and requires only one instrument to shape all the root canal; they were used with a digital endodontic engine (Silver Reciproc, VDW) in clockwise rotation respecting manufacturers’ instructions and protocols. Group A (n=10): OneShape (Micro Mega, Besancon, France); protocol requires file 25/06 with apical diameter 0.25 mm and 6% taper finishing preparation using in continuous motion (engine settings 400 rpm and 2,5 N/cm); Group B (n=10): F6 Skytaper (Komet Brasseler GmbH & Co., Lemgo, Germany); protocol requires file F6 25/06 with apical diameter 0.25 mm and 6% taper finishing preparation using in continuous motion (engine settings 300 rpm and 2,2 N/cm). Specimens were fractured longitudinally and prepared for scanning electron microscopy (SEM) analysis at a standard
MINERVA STOMATOLOGICA
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ABSTRACT
magnification of 1000x and 2500x. Photomicrographs were taken in three areas (coronal, middle and apical). The presence/absence of smear layer and the presence/absence of debris at the coronal, middle, and apical third of each canal were evaluated using two 5-step scale for scores, according to Hulsmann method. Numeric data were analyzed using Kruskall-Wallis and Mann-Whitney statistical tests and significance was predetermined at P0.05). The Mann-Whitney U test confirmed no significant differences in debris scores between the OneShape and F6 Skytaper groups when comparing coronal, middle and apical thirds (P>0.05). Conclusion. Within the limitation of this analysis, the Ni-Ti rotary instruments tested have been shown to produce moderate to heavy smear layer that need to be removed with the use of irrigating solutions. SEM analysis revealed that OneShape and F6 Skytaper associated to EDTA and NaOCl irrigation leave dentine surfaces substantially free from smear layer. Previous SEM studies investigated the effect of Ni-Ti rotary instruments on dentine and obtained similar conclusion: the present study also confirmed that the apical third is the area where more debris is still visible under SEM inspection.
Evaluation of postoperative pain after endodontic instrumentation technique performed with traditional rotary files or reciprocating G. Franciosi, P. F. Porciani, G. Corsentino, V. Spicciarelli, G. Nofri, S. Grandini Departement of Endodontics, University of Siena, Siena, Italy
Aim. The main purpose of root canal treatment is to prevent or eliminate pain. The purpose of this study was to evaluate postoperative pain, following root canal treatment, testing the null hypothesis that there are no statistically significant differences in postoperative pain after endodontic instrumentation techniques performed with traditional rotary files or reciprocating files. Methods. 10 patients in need for root canal treatment were selected. All treatments were performed on teeth not previously treated, with no lesion, using traditional irrigant solutions (Sodium Hypochlorite and EDTA), after a preoperative radiography. The patients were then divided randomly into two groups A and B. In group A root canal treatments were carried out using rotary files Flexmaster (VDW, Monaco, Germany), while in group B treaments were performed using reciprocating instrumentation Reciproc (VDW , Monaco, Germany). All treatments were carried out using the techniques chosen according to the manufacturer instructions (VDW, Monaco, Germany), by the same operator (Dentist with five years of experience) within a single session in our department. In each patient 2 vials of local anesthetic Citocartin 100 (Molteni Dental Srl, Milan, Italy) were used before the treatment. Each patient was then given Ibuprofen 600 mg granules to be taken as a single dose immediately after the treatment. Then each patient recorded his postoperative pain using a VAS scale over 24 hours after treatment. Results. Statistical tests on the VAS Scale show no
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statistically significant differences between the two groups (A e B). Conclusion. The null hypothesis is rejected as there are no statistically significant differences in postoperative pain after endodontic instrumentation performed with traditional rotary files or reciprocating files.
Quality of preparation by two nickel-titanium instruments activated by continuous rotation or adaptive motion: a micro-computed tomography study G. Avarotti 1, E. Pedullà 1, G. Plotino 2, N. M. Grande 2, P. Verzì 1, E. Rapisarda 1 1Dipartimento di Chirurgia Generale e Specialità MedicoChirurgiche, Università di Catania, Catania, 2 Dipartimento di Endodonzia, “La Sapienza” Università di Roma, Roma
Aim. To evaluate the shaping ability of curved root canals using Twisted FileAdaptive (TFA) files (SybronEndo, Orange, CA) and Mtwo (Sweden & Martina, Padova, Italy) activated by continuous rotation or Adaptive motion. Methods. Thirty-two mandibular molars with 2 separate mesial canals and severeangle of curvature were selected. Each canal was randomly assigned to 1 of the 4 experimentalgroups (n=16): TFA and Mtwo files used in continuous rotation (groups 1 and 3) or in Adaptive motion(groups 2 and 4). Root canals before and after preparation were assessed by micro-computed tomography. Volume, surface area, canal transportation, centering ability and preparation time were recordedand analyzed using 2 way analyses of variance. Results. Volume and surface area increased less with TFA files in continuous rotation than in other groups (P
