This systematic review and meta-analysis investigated the influence of the number of files (full-sequence rotary-file versus reciprocating single-file systems) used during root canal preparation on the apical extrusion of debris and its biological relationship with the occurrence of symptomatic apical periodontitis. An extensive literature research was carried out in the Medline, ISI Web of Science and Cochrane databases, for relevant articles with the keyword search strategy. Based on inclusion and exclusion criteria, two reviewers independently rated the quality of each study determining the level of evidence of the articles selected. The primary outcome for the meta-analysis was determined by the amount of debris extruded into the periapical tissue during root canal preparation with multiple- or single-file systems in four laboratory studies. Analysis of in vivo release of neuropeptides (SP and CGRP) after root canal preparation with single- or multiple-file systems was also carried out. Amongst the 128 articles initially found, 113 were excluded for being nonrelevant or not fulfilling the selection criteria. Another four articles were excluded after methodology evaluation. Finally, nine laboratory studies and two in vivo studies were included in the systematic review. Four of the laboratory studies were further included for meta-analysis that revealed greater debris extrusion after the use of single-file techniques when compared to multiple-file systems. Analysis of in vivo neuropeptide expression in the periodontal ligament suggests that the design of the instrument is more important than the number of files used. Both rotary and reciprocating single-file systems generate apical extrusion of debris in laboratory studies, or expression of neuropeptides in vivo. Available evidence is limited, but supports the fact that this inflammatory reaction is not influenced by the number of files but the type of movement and the instrument design.

Control de la placa dental en pacientes con ortodoncia. Una revisión de la literatura Control of the dental plate in patients with orthodontics. A review of literature Nelly Liliana Sánchez Vásquez 1a RESUMEN Conforme los tratamientos ortodonticos han ido incrementándose también han ido en aumento las patologias producto del mal control de placa durante el tratamiento ,se ha observado un considerable incremento en la aparición de caries o manchas blancas después de los tratamientos ortodonticos asi como la enfermedad periodontal. El control de placa es sumamente importante puesto que al presentar aditamentos ortodonticos disminuye la capacidad autolimpieza asi como se incrementan las zonas retentivas y propensas a la formación del biofilm. Para evitar que los pacientes presenten este problema se decide hacer una revisión bibliografica y asi plantear una alternativa para el clínico l