Publications by authors named "Marina C Prado"

7 Publications

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Clinical and Radiographic Outcomes of Regenerative Endodontic Procedures in Traumatized Immature Permanent Teeth: Inter-appointment dressing or Single-Visit?

J Endod 2021 Jul 23. Epub 2021 Jul 23.

Department of Restorative Dentistry - Endodontic Division, State University of Campinas - Piracicaba Dental School (FOP-UNICAMP). Piracicaba, SP, Brazil. Electronic address:

Introduction: More data are needed before affirming that single-visit approaches are effective and safe for regenerative endodontic procedures (REPs). This study compared clinical and radiographic outcomes of REPs between inter-appointment dressing or single-visit protocols.

Methods: Twenty young patients presenting traumatized immature teeth with pulp necrosis were divided into 2 groups. Teeth were submitted to 6% NaOCl and 2% chlorhexidine irrigation and to 17% EDTA use prior to blood clot induction. In the inter-appointment dressing group (n=11), calcium hydroxide was used with 2% chlorhexidine gel for 21 days before scaffold induction. In the single-visit group (n=9), the scaffold was induced during the only appointment. Patients were followed-up for 24 months. Primary, secondary and tertiary outcomes were assessed by 3 independent evaluators. Preoperative and follow-up radiographs were assessed for quantitative measurements of apical diameter, root width, root length, and cervical barrier placement and compared between groups by t test or Mann-Whitney test. Categorical variables were assessed with G test and Fisher exact test, and continuous variables with Mann-Whitney test. Statistical significance was set at 5%.

Results: One tooth showed persistence of infection. No difference was observed in cervical barrier placement (p>0.05), and between groups regarding primary, secondary, and tertiary outcomes (p>0.05) and in parameters of quantitative radiographic outcomes (p>0.05).

Conclusion: Completing REPs with an inter-appointment dressing or in a single-visit protocol presented similar clinical and radiographic outcomes. Single-visit protocol of REPs using 6% NaOCl, 2% chlorhexidine and 17% EDTA permitted satisfactory outcomes in necrotic immature permanent teeth.
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http://dx.doi.org/10.1016/j.joen.2021.07.013DOI Listing
July 2021

Comparison of Postobturation Pain Experience after Apical Extrusion of Calcium Silicate- and Resin-Based Root Canal Sealers.

J Endod 2021 Aug 29;47(8):1278-1284. Epub 2021 May 29.

Department of Restorative Dentistry, Division of Endodontics, São Leopoldo Mandic Dental School, Campinas, São Paulo, Brazil.

Introduction: This study compared the intensity of postobturation pain after unintentional apical extrusion of calcium silicate-based root canal sealers (EndoSequence BC Sealer [Brasseler USA, Savannah, GA] and Bio-C Sealer [Angelus, Londrina, PR, Brazil]) with a resin-based sealer (AH Plus; Dentsply Sirona, York, PA).

Methods: A total of 330 patients referred for root canal treatment on molar teeth with asymptomatic irreversible pulpitis were recruited. Root canals were prepared using WaveOne Gold instruments (Dentsply Sirona) in a crown-down technique and irrigated with 2% chlorhexidine gel and saline solution. Next, patients were randomly distributed into 3 groups according to the root canal sealer used (n = 110): AH Plus, BC Sealer, and Bio-C Sealer. Root canal filling was then accomplished with a vertical compaction technique. Patients presenting with an unintentional extrusion of sealers (n = 13/group) were assessed for postobturation pain experience using a visual descriptor scale ranging from 0-10 at 6-, 12-, 24-, and 48-hour and 1-week intervals after treatment. Mixed analysis of variance repeated measures were used to assess the results (α = 0.05).

Results: The extrusion rate was similar for all sealers (~12%). There was no significant difference in the postobturation pain results between the root canal sealers evaluated (P > .05). However, after the time interval of 12 hours, AH Plus (P = .04073) and Bio-C Sealer (P = .04327) demonstrated a significant reduction in pain, whereas BC Sealer did not show differences in pain intensity, even in the maximum period evaluated of 1 week (P > .05).

Conclusions: The occurrence of unintentional apical extrusion of calcium silicate-based root canal sealers presents similar postoperative pain results compared with resin-based sealers with low-intensity pain.
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http://dx.doi.org/10.1016/j.joen.2021.05.008DOI Listing
August 2021

Clinical and Molecular Microbiological Evaluation of Regenerative Endodontic Procedures in Immature Permanent Teeth.

J Endod 2020 Oct 16;46(10):1448-1454. Epub 2020 Jul 16.

Department of Dentistry, Discipline of Endodontics, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil. Electronic address:

Introduction: This study evaluated the bacterial levels after regenerative endodontic procedures and their correlation with the treatment outcome using molecular microbiology methods.

Methods: Root canal samples of 15 necrotic immature teeth were analyzed by quantitative polymerase chain reaction. Bacteria were counted before treatment (S1), after irrigation with 6% sodium hypochlorite (S2), and after intracanal dressing (S3) using either triple antibiotic paste (n = 7) or calcium hydroxide with chlorhexidine (n = 8). The Wilcoxon test for related samples and the Mann-Whitney test were used for statistical analysis (P < .05). After a follow-up period of 12-48 months, clinical and radiographic findings were correlated with microbiological data using a linear regression model (P < .05).

Results: All S1 and S2 samples were positive for bacteria, but the number of positive S3 samples decreased to 53.3% (P = .001). Overall, there was a significant reduction of bacterial levels after each treatment step (S1-S2, P = .001; S2-S3, P = .02). In the triple antibiotic paste and chlorhexidine groups, 57.1% and 50% of S3 samples were positive with median numbers of 6.97 × 10 and 3.59 × 10 bacterial cells, respectively. No significant differences were found between the groups. Periapical healing occurred in all cases despite the presence of low levels of residual bacteria. However, the latter had a negative impact on the thickness of dentinal walls (R = 0.0043).

Conclusions: Although the bacterial levels were drastically reduced after the regenerative endodontic procedures, the residual bacteria influenced the thickness of the dentinal walls.
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http://dx.doi.org/10.1016/j.joen.2020.07.005DOI Listing
October 2020

Effects of auxiliary device use on smear layer removal.

J Oral Sci 2016 ;58(4):561-567

Proclin Department, School of Dentistry, Rio de Janeiro State University.

This study evaluated the effects of different auxiliary irrigation devices on smear layer removal with a chelating solution (QMix). Fifty single-rooted permanent human teeth were shaped with a sequence of nickel-titanium instruments. A 2% chlorhexidine gel was used as a chemical auxiliary substance during preparation. Samples were assigned to five groups (n = 10 each) according to final irrigation protocol, namely, distilled water (control group), QMix 1 min, QMix + passive ultrasonic irrigation (PUI), QMix + plastic endodontic finishing file (EC), and QMix 3 min. Teeth were prepared and evaluated by scanning electron microscopy, and three photomicrographs (magnification, 1,000×) were obtained for each root third. Two blinded and precalibrated evaluators analyzed and scored the images, and the data were statistically analyzed by the Kruskal-Wallis and Dunn tests (P < 0.05). Groups were ranked according to the extent of smear layer removal. The total area of the root canal walls and apical root thirds was calculated, and the groups ranked PUI > EC = QMix 3 min > QMix 1 min > control. QMix 1 min was effective for smear layer removal only when used with auxiliary devices, and QMix + passive ultrasonic irrigation yielded the best results, particularly for the apical third.(J Oral Sci 58, 561-567, 2016).
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http://dx.doi.org/10.2334/josnusd.16-0216DOI Listing
November 2017

Assessing pulp stones by cone-beam computed tomography.

Clin Oral Investig 2017 Sep 9;21(7):2327-2333. Epub 2016 Dec 9.

Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil.

Objectives: The aim of this study was to evaluate the occurrence of pulp stones by cone-beam computed tomography (CBCT) and to correlate their prevalence with patient's gender, location of tooth (right or left of maxillary or mandibular arch), group of teeth, and restorations.

Materials And Methods: CBCT images of 382 patients randomly selected from the database of the University Oral Radiology Department were retrospectively examined. A total of 2833 tooth images obtained using the i-CAT 3D Imaging System were evaluated. Image analysis was performed with the i-CAT software, and all teeth were evaluated in sagittal, axial, and coronal views. All the measurements were subjected to chi square test, odds ratio, and Fisher's exact tests (p < 0.05).

Results: The prevalence of pulp stones was similar between patient's genders and tooth locations. Pulp stones were detected in 31.9% of patients and 9.5% of teeth. Maxillary and mandibular molars were the groups of teeth with the highest frequency of pulp stones. The presence of restorations increased the chance of occurrence of pulp stones by 2.1 times in all teeth examined (p < 0.0001) and by 4.7 times in maxillary teeth (p < 0.0001).

Conclusions: Pulp stones had a high prevalence with molar teeth showing the highest prevalence. The presence of restorations increased the chance of occurrence of these calcifications, specifically in maxillary teeth.

Clinical Relevance: CBCT provides accurate anatomical details in three dimensions, offering the possibility to view an individual tooth in axial, sagittal, and coronal views. This study performed an investigation of the occurrence of pulp stones by CBCT.
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http://dx.doi.org/10.1007/s00784-016-2027-5DOI Listing
September 2017

Push-out Bond Strength of Injectable Pozzolan-based Root Canal Sealer.

J Endod 2016 Nov 15;42(11):1656-1659. Epub 2016 Sep 15.

Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.

Introduction: The present study aimed to rank the bond strength to root dentin of a new injectable pozzolan-based root canal sealer, EndoSeal MTA, as compared with MTA Fillapex and AH Plus.

Methods: Eighteen dentinal slices (1 ± 0.1 mm) were obtained from the middle third of 6 maxillary incisors previously selected. Three canal-like holes with 0.8 mm diameter were drilled perpendicularly on the axial surface of each slice. Then, a standardized irrigation was applied for all holes that were subsequently filled with 1 of 3 test root canal sealers. After that, slices were stored in contact with phosphate-buffered saline solution (pH 7.2) for 7 days at 37°C before the push-out assay. Friedman test and Wilcoxon signed rank test with a Bonferroni correction were used to rank the results. Significance boundary was set at α = 5%.

Results: Friedman test confirmed a significant dissimilarity in push-out ranks among the tested cements (P < .01). Wilcoxon signed rank test demonstrated AH Plus had significant superior resistance to dislodgment compared with Endo Seal (P < .01) or MTA Fillapex (P < .01), whereas MTA Fillapex presented the lowest push-out values as compared with Endo Seal (P < .01) or AH Plus (P < .01).

Conclusions: EndoSeal presents satisfactory bond strength performance for application in endodontic therapy compared with MTA Fillapex, and although it displays a new alternative of injectable bio-tight root canal sealer, it is not able to improve adhesion compared with AH Plus.
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http://dx.doi.org/10.1016/j.joen.2016.08.009DOI Listing
November 2016

Effectiveness of three methods for evaluating root canal anatomy of mandibular incisors.

J Oral Sci 2016 ;58(3):347-51

Proclin Department, School of Dentistry, Rio de Janeiro State University.

This study compared the effectiveness of clinical observation, clinical microscopic observation, and tooth-clearing technique in determining the number of canals in mandibular incisors. Root canal ramifications were also analyzed. Using clinical and microscopic analyses, we determined the number of canal entrances in 277 mandibular incisors. In addition, tooth-clearing technique was used to determine the number of canals and frequency of ramifications in the samples. The kappa coefficient was used to compare the different methods with regard to frequency of canals. Most teeth had one canal entrance. The proportion of teeth with two canals was 23.5% by tooth-clearing analysis, 5.8% by clinical microscopy, and 1.1% by clinical analysis. A large number of samples had some type of ramification (40.1%), and most ramifications were present in teeth with two canals. The most frequent ramification was lateral canals (8.3%). Clinical microscopy improved identification of a second canal in mandibular incisors. However, it did not identify second canals in all teeth with two canals. (J Oral Sci 58, 347-351, 2016).
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http://dx.doi.org/10.2334/josnusd.15-0730DOI Listing
April 2017
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