Bacteriemia during endodontic treatment in relation to the technique of biomechanical preparation: randomized clinical trial

Abstract

bjective:The aim of this randomized clinical trial was to evaluate the frequency of bacteriemia during endodontic treatment, with comparison between two techniques for biomechanical preparation of the root canal system. Materials and methods: The sample comprised 50 patients aged 16 to 52 years, of both genders, which were divided into 2 groups with 25 patients each. Group I underwent biomechanical preparation by the step-back technique, and Group II was treated by the rotary technique with nickel-titanium instruments (K3). Patients were submitted to antisepsis of the oral cavity with chlorhexidine digluconate and three samples of blood were collected for blood culture: preoperatively, immediately after the biomechanical preparation and 10 minutes later. The significance level adopted was 5.0%, and analysis was performed by descriptive and inferential statistics by means of the Fisher's exact test, Fisher-Freeman-Halton test and Student's t test. Data were analyzed on the Statexact and SPSS softwares. Results: All blood cultures achieved before and immediately after preparation were negative. On the other hand, with regard to the blood cultures collected 10 minutes after preparation, one (4%) positive case was found for Group I. However, this difference was not statistically significant (p = 0.50). Conclusion: The frequency of bacteriemia was low and observed just for Group I. Uniterms: Bacteremia; Endocarditis, bacterial; Antibiotic prophylaxis; Root canal therapy.bjetivo: O objetivo deste ensaio clínico randomizado foi avaliar a freqüência de bacteriemia durante o tratamento endodôntico comparando duas técnicas de preparo biomecânico do sistema de canais radiculares. Materiais e métodos: A amostra constou de 50 pacientes, com idade variando entre 16 e 52 anos e de ambos os sexos, sendo dividida em 2 grupos de 25 pacientes. No Grupo I, realizou-se o preparo biomecânico através da técnica escalonada com recuo progressivo programado, e, no Grupo II, por meio técnica rotatória, empregando instrumentos de níquel-titânio (K3). Os pacientes realizaram anti-sepsia da cavidade bucal com gluconato de clorexidina e foram realizadas três coletas de sangue para hemoculturas: no pré-operatório, imediatamente após o preparo biomecânico e 10 minutos depois. O nível de significância foi de 5,0%, e foram utilizadas técnicas de estatística descritiva e inferencial através dos testes exato de Fisher, Fisher-Freeman-Halton e "T" de Student. A análise dos dados foi realizada através do programa Statexact e SPSS. Resultados: As hemoculturas tomadas antes e imediatamente após o preparo, foram todas negativas. Já nas hemoculturas, realizadas 10 minutos após o preparo, foi encontrado um caso (4%) positivo no Grupo I. Esta diferença, entretanto, não foi estatisticamente significante (p = 0,50). Conclusão: Concluiu-se que a freqüência de bacteriemia foi baixa e observada apenas no Grupo I. Unitermos: Bacteriemia; Endocardite bacteriana; Antibioticoprofilaxia; Tratamento do canal radicular. 334J Appl Oral Sci. 2005;13(4):334-9

Compliance of RCTs in endodontic instrumentation with the CONSORT Statement: A systematic review

“…In relation to study design, most studies were parallel, and they were performed at university settings. The mean age reported was 36.1 years (Arslan et al 2016, Gathani et al 2016, Jain et al 2016, Neves et al 2016, Aqrabawi & Jamani 2006, Çiçec et al 2017, Dourado et al 2005, Gomes et al 2017, Kashefinejad et al 2016, Kherlakian et al 2016, Mollashahi et al 2017, Neelakantan et al 2015, Peters et al 2004, Relvas et al 2016, Shokraneh et al 2017, Topcuoglu et al 2017, Wei et al 2006; and female patients prevailed in 13 studies (Comparin et al 2017, Neves et al 2016, Pasqualini et al 2016, Aqrabawi & Jamani 2006, Dourado et al 2005, Gomes et al 2017, Dourado et al 2005, Gomes et al 2017, Peters et al 2004, Wei et al 2006, Aminsobhani et al 2017, Krithikadatta et al 2016, Saumya-Rajesh et al 2017.…”

“…The 2% lidocaine was the anesthetic salt most used in the studies (Comparin et al 2017, Jain et al 2016, Nekoofar et al 2015, Aqrabawi & Jamani 2006, Gomes et al 2017, Kashefinejad et al 2016, Kherlakian et al 2016, Mollashahi et al 2017, Neelakantan et al 2015, Relvas et al 2016, Shokraneh et al 2017, Aminsobhani et al 2017, Krithikadatta et al 2016, Saumya-Rajesh et al 2017, Saha et al 2018, Shahi et al 2016, Arias et al 2015. Only 9 studies out of 33 performed the endodontic treatment in 2 sessions (Gathani et al 2016, Nekoofar et al 2015, Neves et al 2016, Dourado et al 2005, Peters et al 2004, Topcuoglu et al 2017, Wei et al 2006, Saumya-Rajesh et al 2017, Pettiette et al 2001, and most of them used calcium hydroxide as intracanal medication.…”