Effects of coronal leakage on concentration of hydrogen ions and calcium hydroxide release of several calcium hydroxide pastes over different periods of time

Purpose: To evaluate the effects of coronal leakage on concentration of hydrogen ions (pH) and calcium release of several calcium hydroxide pastes, over different periods of time. Material and Methods: Fifty extracted human mandibular central incisors (n=10) were instrumented up to the F2 instrument and assigned to the following intracanal dressing: G1- Calen, G2- Calen with 0.4% chlorhexidine (CHX), G3- Calcium hydroxide with camphorated paramonochlorophenol (CPMC) and glycerin, G4- Calen, but temporary filling material maintained during all test (positive control) and G5- Root canal without intracanal dressing (negative control). All groups were immersed in distilled water for 7 days. In sequence, the temporary filling materials were removed, except in controls groups. All specimens were individually mounted on a specific device and only its root again immersed in distilled water. Concentration of hydrogen ions and calcium release by calcium hydroxide pastes in distilled water were evaluated in 24h, 7, 14 and 28 days. The results were submitted to ANOVA test (p = 0.05). After 28 days, root canals from experimental groups were examined in SEM. Results: G1, G2, G3 and G4 presented similar pH values and calcium release and did not differ from each other (p>0.05), up to 7 days. After this time G1, G2 and G3 presented values lower values than G4 (p<0.05). In SEM analysis, calcium hydroxide residues were observed in all experimental groups. Conclusions: After 7 days, coronal leakage decreased the concentration of hydrogen ions and calcium ion release provided by all calcium hydroxide pastes.

Effect of calcium chloride on the pH values of several formulations of calcium hydroxide mixed with chlorhexidine digluconate

This study evaluated the effect of the addition of 5% calcium chlorite (CaCl2) on pH values in calcium hydroxide pastes (CH), with or without 2% chlorhexidine digluconate (CHX) used as vehicle, in several periods analysis. Polyethylene tubes were filled with CH mixed with water (G1), 2% CHX solution (G2) or gel (G3), or CHX solution or gel with 5% CaCl2 (G4 and G5, respectively). All tubes were individually immersed in distilled water. After 12, 24 hours, 7, 14 and 28 days, pH value was evaluated directly in water which the tubes were stored. Data were submitted to ANOVA and Tukey tests (α=0.05). In 24 hs and 14 days, pH values were similar to all groups. In 12 hs, the G1 presented lower pH value than other groups except to G4 (p < 0.05), and G4 presented lower pH value than G5 (p < 0.05). In 7 days, G1 presented lower pH value than G4 and G5 (p < 0.05). In 28 days, G1 and G5 presented lower pH values than G2 and G4 (p < 0.05) and among other groups there are no statistical differences (p > 0.05). The pH values increased in long-term analysis to all CH pastes. The association of 5% calcium chloride with 2% CHX solution as vehicle of CH paste provided a pH value increase in relation to CH mixed with distilled water. The CHX gel interfered negatively on pH value in comparison to CHX solution when mixed with CaCl2.

Effect of zirconium oxide and zinc oxide nanoparticles on physicochemical properties and antibiofilm activity of a calcium silicate-based material

The aim of the present study was to evaluate the antibiofilm activity against Enterococcus faecalis, compressive strength. and radiopacity of Portland cement (PC) added to zirconium oxide (ZrO2), as radiopacifier, with or without nanoparticulated zinc oxide (ZnO).The following experimental materials were evaluated: PC, PC + ZrO2, PC + ZrO2 + ZnO (5%), and PC + ZrO2 + ZnO (10%). Antibiofilm activity was analyzed by using direct contact test (DCT) on Enterococcus faecalis biofilm, for 5 h or 15 h. The analysis was conducted by using the number of colony-forming units (CFU/mL). The compressive strength was performed in a mechanical testing machine. For the radiopacity tests, the specimens were radiographed together with an aluminium stepwedge. The results were submitted to ANOVA and Tukey tests, with level of significance at 5%. The results showed that all materials presented similar antibiofilm activity (

Hydrogen ion and calcium releasing of MTA Fillapex® and MTA-based formulations

MTA is composed of various metal oxides, calcium oxide and bismuth. It has good biological properties and is indicated in cases of endodontic complications. Several commercial formulations are available and further studies are necessary to evaluate these materials. Objective: To evaluate pH and calcium releasing of MTA Fillapex® compared with gray and white MTA. Material and methods: Gray and white MTA (Angelus) and MTA Fillapex® (Angelus) were manipulated and placed into polyethylene tubes and immersed in distilled water. The pH of these solutions was measured at 24 hours, 7 days and 14 days. Simultaneously, at these same aforementioned periods, these materials' calcium releasing was quantified, through atomic absorption spectrophotometry. The results were submitted to ANOVA, with level of significance at 5%. Results: Concerning to pH, the materials present similar behaviors among each other at 24 hours (p > 0.05). At 7 and 14 days, MTA Fillapex® provided significantly lower pH values than the other materials (p < 0.05). Regarding to calcium releasing, at 24 hours and 7 days, MTA Fillapex® provided lower releasing than the other materials (p < 0.05). After 14 days, differences were found between MTA Fillapex® and gray MTA (p < 0.05). Conclusion: All materials showed alkaline pH and calcium releasing, with significantly lower values for MTA Fillapex® sealer.

Influence of the addition of calcium hydroxide powder on some physical and chemical properties of the sealer MTA fillapex

Objective: This study evaluated the flow, pH and calcium release of MTA Fillapex (G1) or Fillapex plus 10% in weight of calcium hydroxide powder (G2), compared to AH Plus (G3) and Sealapex (G4). Materials and methods:The flow test was performed according to ISO 6876:2001 requirements. The sealers were placed into plastic tubes and immersed in deionized water. After 24 hours, 7, 14 and 28 days, the water of each tube was removed and tested to evaluate the pH values and the level of released calcium. Calcium release values were analyzed statistically by Kruskal Wallis and Dunn tests and pH values analyzed by ANOVA and Tukey tests (? = 5%). Results:G1 presented higher flow among all sealers. The addition of 10% calcium hydroxide into MTA Fillapex reduced the flow (p < 0.05) but, in a level, that is lower than the one recommended for ISO norms. G2 and G4 presented pH values and calcium release higher than G3 (p < 0.05) in all periods. G1 presented pH value higher than G3 (p < 0.05), except in 7 days period (p > 0.05). G4 presented higher pH values than G1 and G2, but the calcium release was similar for all periods (p > 0.05). G3 presented lower calcium release among all groups (p < 0.05). Conclusion: The addition of 10% calcium hydroxide in MTA Fillapex caused reduction in flow and no negative interference in pH and/or calcium release. However, the obtained flow is different from ISO requirements. Clinical relevance: MTA Fillapex presents levels of flow above the ISO norms. The addition of calcium hydroxide is a suggestion for solving this problem, but the impact of these procedures should be carefully evaluated.

Influence of addition of calcium oxide on physicochemical properties of Portland cement with zirconium or niobium oxide

Context: Calcium oxide (CaO) may be added to mineral trioxide aggregate (MTA) or Portland cement (PC) to improve physicochemical and biological properties. Aims: To evaluate the physicochemical properties of PC associated with radiopacifiers and CaO. Materials and Methods: MTA Angelus, PC + 30% zirconium oxide (Zr), or 30% niobium oxide (Nb) associated with 10 or 20% of CaO were evaluated. Gilmore needles were used to evaluate initial and final setting time. Compressive strength was evaluated after the periods of 24 hours and 21 days. pH was analyzed after 3, 12, 24 hours, 7, 14, 21 days. Solubility and flow tests were performed based on the ISO 6876. The data obtained were submitted to analysis of variance and Tukey tests (P ≤ 0.05). Results: The associations with 10% CaO showed greater strength that the associations with 20% CaO. The shortest initial setting time was observed for the association PC + Zr + 20% CaO and MTA. All the cements presented alkaline pH. The flow of all cements was similar. The highest solubility was found in the associations with 20% CaO. Conclusion: The addition of CaO to PC favored the alkaline property and the PC + Zr + 20% CaO presented setting time similar to MTA.

The association of chlorhexidine digluconate and calcium chloride to use as vehicle of a silicate calcium-based cement

Objective: The purpose of this study was to evaluate the influence of the addition of 2% chlorhexidine digluconate (CHX) associated with 5% calcium chloride (CaCl2 ) on antimicrobial activity, setting time, pH and calcium release of gray mineral trioxide aggregate (GMTA). Materials and Methods: GMTA powder was mixed with water, 2% CHX alone or 2% CHX combined with 5% CaCl2 . Antimicrobial activity was determined against Enterococcus faecalis (ATCC 29212) strains by agar diffusion test. Data obtained were submitted to kruskal wallis tests. Analysis of the setting time was evaluated by American society for testing and materials C266-03 requirements. The pH and calcium release analysis were evaluated, in 24 h, 7, 14 and 28 days using pH meter equipment and atomic absorption spectrophotometer, respectively. Data obtained were analyzed by ANOVA, in 5% significance level. Results: Significant differences were seen (P < 0.01) among the zones of bacterial growth inhibition produced by 5% CaCl2 + 2% CHX combination against E. faecalis when compared with water (P < 0.05). Regarding the setting time, that combination had the shortest setting time (P < 0.05). All associations were alkaline and released calcium. No statistical difference was observed between the experimental groups at the different periods of analysis (P > 0.05). Conclusion: Combination of 5% CaCl2 + 2% CHX reduced the setting time and enhanced the antimicrobial activity of GMTA without changing the pH and calcium release.

Biocompatibility of Intracanal Medications Based on Calcium Hydroxide

The aim of this study was to evaluate the rat subcutaneous tissue reaction to calcium hydroxide-based intracanal medicaments, UltraCal XS (calcium hydroxide, barium sulphate, aqueous matrix), Hydropast (calcium hydroxide, barium sulphate, and propyleneglycol), and Calen (Calcium hydroxide, zinc oxide, colophony, and polyethyleneglycol), used as a control. Methods. Forty-eight rats (Rattus Norvegicus Holtzman) were distributed in three groups: Calen, UltraCal XS, and Hydropast. Polyethylene tubes filled with one of the medicaments were implanted in the dorsal subcutaneous. After 7 and 30 days, the implants were removed and the specimens were fixed and embedded in paraffin. Morphological and quantitative analyses were carried out in the HE-stained sections. The numerical density of inflammatory cells in the capsule was evaluated and statistical analyses were performed (P>/0.05). Results. At 7 days, all materials induced an inflammatory reaction in the subcutaneous tissue adjacent to the implants. In all groups, a significant reduction in the number of inflammatory cells and giant cells was verified in the period of 30 days. Conclusion. These results indicate that the calcium hydroxide-based medicaments evaluated present biocompatibility similar to Calen.

A new calcium silicate-based material (Biodentine) for filling radicular perforation in an endodontic-periodontal lesion: a case report

This case report presents an apical radicular perforation management using new calcium silicate-based cement (Biodentine) in a combined endodontic-periodontal lesion. The presence of apical radicular perforation may interfere in the endodontic treatment prognosis. Radicular perforation filling with bioactive cement through endodontic surgery is a possible treatment. This study presents an apical radicular perforation with periodontal involvement, due to alveolar bone loss on the buccal radicular surface from an incorrect intracanal preparation for the fiber post placing. The chosen alternative was a periapical surgery, the perforation was filled with a silicate and calcium chloride bioactive cement (Biodentine; Septodont, Saint-Maur-des-Fosses Cedex, France), and the radicular surface was etched with citric acid, because the access from root canal was impossible. The follow-up was for 8 months, through clinical and radiographic analysis. At the end of the follow-up, radiographic analyses showed the bone healing, and no clinical changes in periodontal probing depth, gingival recession, and the height of the interproximal mesial and distal papillae were observed. The root perforation treatment has a difficult management, especially when the dental root has a simultaneous periodontal commitment. The Biodentine proves to be a promising material for use in these situations.

Calcium silicate-based cements associated with micro-and nanoparticle radiopacifiers: physicochemical properties and bioactivity

The aim of this study was to evaluate the physicochemical properties and bioactivity of two formulations of calcium silicate-based cements containing additives (CSCM) or resin (CSCR), associated with radiopacifying agents zirconium oxide (ZrO2) and niobium oxide (Nb2O5) as micro- and nanoparticles; calcium tungstate (CaWO4); and bismuth oxide (Bi2O3). MTA Angelus was used as control. Methods. Surface features and bioactivity were evaluated by scanning electron microscopy and the chemical composition by energy dispersive X-ray spectrometry (EDS-X). Results. CSCM and CSCR presented larger particle sizes than MTA. Hydroxyapatite deposits were found on the surface of some materials, especially when associated with the radiopacifier with ZrO2 nanoparticles. All the cements presented calcium, silicon, and aluminum in their composition. Conclusion. Both calcium silicate-based cements presented composition and bioactivity similar to MTA when associated with the radiopacifiers evaluated.

Niobium pentoxide as radiopacifying agent of calcium silicate-based material: evaluation of physicochemical and biological properties

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Push-out bond strength of calcium hydroxide and mineral trioxide aggregate based sealers

The adhesiveness of six root canal sealers: Acroseal, Endo CPM, Epiphany, White MTA, Sealapex and Sealer 26 to dentin, was evaluated in a push-out test design. Methods: Twenty eight roots of freshly extracted teeth were gauged with a size 5 Largo drill. With a cutting machine slices of 2 mm were prepared, rinsed with 5.25% NaOCl and a final rinse with 17% EDTA, dried and filled with one of the sealers. After setting their bond strength was measured in a mechanical testing machine. The data were statistically analyzed by using a One Way ANOVA and post hoc Tukey test. Results: The mean and standard deviation from values of bond strength was: Sealapex 2.2±0.4; Endo CPM 3.8±1.3; White MTA 6.0±1.4; Epiphany 10.9±2.6; Sealer 26 12.3±2.3; and Acroseal 12.2±1.4. Acroseal, Sealer 26 and Epiphany presented a significantly (P<0.01) greater bond strength compared with the other sealers. Also White MTA showed higher adhesiveness compared with Endo CPM and Sealapex (P<0.01). Conclusion: The bond strength between endodontic sealers and root dentin was maximal when Acroseal, Sealer 26 and Epiphany were used; Sealapex e Endo CPM, in turn, presented the lowest bond strength mean values.

Evaluation of the pH, calcium release and antibacterial activity of MTA Fillapex

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of calcium hydroxide dressing on push-out bond strength of endodontic sealers to root canal dentin

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of surface application of dolomitic limestone and calcium-magnesium silicate on soybean and maize in rotation with green manure in a tropical region

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)