The aim of this study was to evaluate the influence of agitation techniques on bacterial reduction in curved root canals. Eighty human mandibular molars were prepared, inoculated with Enterococcus faecalis and incubated at 37°C for 60 days. Then, specimens were randomly separated into two test groups (n = 36) and two control groups (n = 04) according to agitation technique: Passive ultrasonic irrigation (PUI, Irrisonic) and XP‐endo Finisher (XPF). Microbial samples were collected before and after instrumentation and after final agitation using sterile paper points. Bacterial growth was analysed by turbidity of culture medium and UV spectrophotometry. The Wilcoxon rank test was used for the paired analysis, while the Mann–Whitney U‐test was used for the non‐paired analysis. The samples collected after final agitation were significantly different between test groups (p < 0.05). Bacterial reduction was greater in the PUI than in the XPF (p < 0.05) group. The irrigant agitation provided significant bacterial reduction. The use of the PUI showed better results.
External Root Resorption (ERR) is a pathological condition that can lead to tooth loss if not diagnosed and treated correctly. Calcium Hydroxide Ca(OH)2 is an intracanal medicament, which is used in cases of teeth with pulp necrosis, peri-radicular lesions and ERR. This paper describes the endodontic management of a tooth with severe ERR using injected non-setting Ca(OH)2 paste. A 28-year-old patient was referred for endodontic evaluation of tooth 47, which presented an extensive composite resin restoration and was negative to cold test. Panoramic and periapical radiographs revealed the presence of a filled pulp chamber, calcified root canals, ERR on the mesial and distal roots, and apical periodontitis in the mesial and distal roots. The diagnosis of asymptomatic apical periodontitis and severe ERR was established, and conventional root canal treatment combined with non-setting Ca(OH)2dressing was chosen. After five months, no more discharge from the root canal was observed, and a decrease in the size of the periapical lesion and arrest of ERR was detected. The root canal was filled, and the patient was referred for restoration. At the 6-months follow-up, radiographic examination evidenced periapical repair and containment of the ERR process. Chemomechanical root preparation in association with a non-setting Ca(OH)2 dressing protocol allows positive outcomes during the management of severe ERR associated with pulp necrosis and periapical inflammation.
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