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Ricardo Machado 5 Articles
Persistent pain after successful endodontic treatment in a patient with Wegener’s granulomatosis: a case report
Ricardo Machado, Jorge Aleixo Pereira, Filipe Colombo Vitali, Michele Bolan, Elena Riet Correa Rivero
Restor Dent Endod 2022;47(3):e26.   Published online June 9, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e26
AbstractAbstract PDFPubReaderePub

Wegener’s granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

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Difficulties experienced by endodontics researchers in conducting studies and writing papers
Betul Aycan Alim-Uysal, Selin Goker-Kamali, Ricardo Machado
Restor Dent Endod 2022;47(2):e20.   Published online March 15, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e20
AbstractAbstract PDFPubReaderePub
Objectives

The study investigated the difficulties experienced by endodontics researchers around the world in conducting studies and writing papers.

Materials and Methods

A survey consisting of 18 questions on the difficulties experienced by endodontics researchers in performing studies and writing papers was e-mailed to academics in the field of endodontics working at 202 universities. The independent risk factors were analyzed using binary logistic regression at a significance level of 0.05.

Results

A total of 581 individuals (10.7%) agreed to participate in the study. Almost half the participants (48.2%) reported that they had received some type of training in conducting studies and writing papers. In response to the question, “Do you get help from a statistician to perform the statistical analyses of your studies?,” 77.1% answered “yes.” Around 40% of the participants stated that the need to obtain ethical approval negatively affected their desire to conduct studies. The participants’ regions had no effect on the reported difficulties associated with writing papers in English or conducting statistical analyses (p > 0.05). Most participants (81.8%) reported difficulties in writing the Discussion section, regardless of their region, academic degrees, or years of experience.

Conclusions

The participants stated they experienced difficulties in many areas, such as conducting statistical analyses, finding new ideas, and writing in English. Engaging in a detailed examination of ethics committee rules, expanding biostatistics education, increasing the number of institutions providing research funding, and increasing the number of endodontics journals can increase the enthusiasm of endodontics researchers to publish papers.

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Postoperative pain after endodontic treatment of necrotic teeth with large intentional foraminal enlargement
Ricardo Machado, Daniel Comparin, Sérgio Aparecido Ignácio, Ulisses Xavier da Silva Neto
Restor Dent Endod 2021;46(3):e31.   Published online May 31, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e31
AbstractAbstract PDFPubReaderePub
Objectives

To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE).

Materials and Methods

The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%.

Results

Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05).

Conclusions

Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.

Trial Registration

The Brazilian Clinical Trials Registry Identifier: RBR-3r967t

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Smear layer removal by passive ultrasonic irrigation and 2 new mechanical methods for activation of the chelating solution
Ricardo Machado, Isadora da Silva, Daniel Comparin, Bianca Araujo Marques de Mattos, Luiz Rômulo Alberton, Ulisses Xavier da Silva Neto
Restor Dent Endod 2021;46(1):e11.   Published online January 26, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e11
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to compare smear layer removal by conventional application (CA), passive ultrasonic irrigation (PUI), EasyClean (EC), and XP-Endo Finisher (XPF), using 17% ethylenediaminetetraacetic acid (EDTA) after chemomechanical preparation, as evaluated with scanning electron microscopy (SEM).

Materials and Methods

Forty-five single-rooted human mandibular premolars were selected for this study. After chemomechanical preparation, the teeth were randomly divided into 5 groups according to the protocol for smear layer removal, as follows: G1 (control): CA of distilled water; G2 (CA): CA of 17% EDTA; G3 (PUI): 17% EDTA activated by PUI; G4 (EC): 17% EDTA activated by EC; and G5 (XPF): 17% EDTA activated by XPF. SEM images (×1,000) were obtained from each root third and scored by 3 examiners. Data were evaluated using the Kruskal-Wallis and Dunn tests (p < 0.05).

Results

In the apical third, there were no statistically significant differences among the groups (p > 0.05). In the cervical and middle thirds, the experimental groups performed better than the control group (p < 0.05); however, G2 presented better results than G3, G4, and G5 (p < 0.05), which showed no differences among one another (p > 0.05).

Conclusions

No irrigation method was able to completely remove the smear layer, especially in the apical third. Using CA for the chelating solution performed better than any form of activation.

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Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation
Daniel Poletto, Ana Claudia Poletto, Andressa Cavalaro, Ricardo Machado, Leopoldo Cosme-Silva, Cássia Cilene Dezan Garbelini, Márcio Grama Hoeppner
Restor Dent Endod 2017;42(4):324-331.   Published online November 1, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.324
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation.

Materials and Methods

Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope.

Results

EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05).

Conclusions

Ultrasonic activation did not significantly influence smear layer removal.

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