Comparação in vivo de HyFlex CM e ProTaper Next na remoção de bactérias e endotoxinas de infecções endodônticas
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Data
2018-12-06
Autores
Machado, Camila Ambrósio Dias [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo deste estudo clínico foi avaliar a eficácia de dois sistemas rotatórios: HyFlex CM e ProTaper Next na remoção de bactérias cultiváveis e endotoxinas de canais radiculares infectados. Vinte e quatro canais radiculares de molares e pré-molares com necrose pulpar e lesão periapical foram selecionados e divididos aleatoriamente em 2 grupos: HyFlex CM (n = 12); e ProTaper Next (n = 12). As amostras foram coletadas antes e após o preparo biomecânico e inoculadas em frascos específicos. A irrigação foi realizada com hipoclorito de sódio a 2,5%. Um teste turbidimétrico LAL (Pyrogent 5000 – Lonza, Walkersville, MD, EUA) foi utilizado para quantificar endotoxinas. Cultura microbiológica foi utilizada para determinar a contagem de unidades formadoras de colônias bacterianas (UFC/mL). Os dados coletados foram analisados estatisticamente usando SigmaPlot 12.0 para Windows (Systat Software Inc., San Jose, CA). Foi realizado o teste estatístico de Two-Way ANOVA e o nível de significância foi de 5%. Nas coletas antes do preparo biomecânico, bactérias cultiváveis e endotoxinas foram evidenciadas em 100% das amostras. A análise de cultura revelou que não houve uma diferença estatisticamente significativa na redução bacteriana entre os dois sistemas de instrumentação. As endotoxinas estavam presentes em 100% dos canais após a instrumentação e não houve diferença estatística entre os dois sistemas na redução de endotoxinas. Assim, concluímos que ambos os sistemas de instrumentação foram eficazes na redução de bactérias e endotoxinas de canais radiculares com infecção endodôntica primária e que não houve diferença estatística entre eles. Contudo, nenhum sistema foi capaz de eliminar 100% das bactérias e seus subprodutos.
The aim of this clinical study was to compare the effectiveness of two rotary systems: HyFlex CM and ProTaper Next on the removal of cultivable bacteria and endotoxins from primarily infected root canals. Twenty-four root canals of molars and premolars with pulp necrosis were selected and randomly divided into 2 groups: HyFlex CM (n = 12); and ProTaper Next (n = 12). Samples were collected before and after the biomechanical preparation and inoculated in specific flasks. Irrigation was performed using 2.5% sodium hypochlorite. A kinetic turbidimetric lysate assay of limulus amoebocytes was used to quantify endotoxins. Microbiological culture was used to determine the count of bacterial colony forming units (CFU/mL). Data collected were statistically analyzed using SigmaPlot 12.0 for Windows (Systat Software Inc, San Jose, CA). The Two-Way ANOVA statistical test was performed and the level of significance was 5%. In the samples before the biomechanical preparation, cultivable bacteria and endotoxins were evidenced in 100% of the cases. The culture analysis revealed that there was no statistically significant difference in the bacterial reduction between the two instrumentation systems. Endotoxins were present in 100% of the canals after instrumentation, and there was no statistical difference between the two systems in endotoxin reduction. Thus, it was concluded that both instrumentation systems were effective in reducing root canal bacteria and endotoxins with primary endodontic infection and that there was no statistical difference between them. However, no system was able to eliminate 100% of the bacteria and their by-products.
The aim of this clinical study was to compare the effectiveness of two rotary systems: HyFlex CM and ProTaper Next on the removal of cultivable bacteria and endotoxins from primarily infected root canals. Twenty-four root canals of molars and premolars with pulp necrosis were selected and randomly divided into 2 groups: HyFlex CM (n = 12); and ProTaper Next (n = 12). Samples were collected before and after the biomechanical preparation and inoculated in specific flasks. Irrigation was performed using 2.5% sodium hypochlorite. A kinetic turbidimetric lysate assay of limulus amoebocytes was used to quantify endotoxins. Microbiological culture was used to determine the count of bacterial colony forming units (CFU/mL). Data collected were statistically analyzed using SigmaPlot 12.0 for Windows (Systat Software Inc, San Jose, CA). The Two-Way ANOVA statistical test was performed and the level of significance was 5%. In the samples before the biomechanical preparation, cultivable bacteria and endotoxins were evidenced in 100% of the cases. The culture analysis revealed that there was no statistically significant difference in the bacterial reduction between the two instrumentation systems. Endotoxins were present in 100% of the canals after instrumentation, and there was no statistical difference between the two systems in endotoxin reduction. Thus, it was concluded that both instrumentation systems were effective in reducing root canal bacteria and endotoxins with primary endodontic infection and that there was no statistical difference between them. However, no system was able to eliminate 100% of the bacteria and their by-products.
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Palavras-chave
Endotoxinas, Bactérias, Endodontia, Desinfecção, Endotoxins, Bacteria, Endodontics, Disinfection