Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning.

The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning. A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained. Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples. Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning.

Blood cells attachment after root conditioning and PRP application: An in vitro study

Aim: Root conditioning is aimed at smear layer removal and at dental matrix collagen exposure, which may promote periodontal regeneration. This in vitro study assessed smear layer removal, collagen fiber exposure and the influence of PRP (platelet-rich plasma) application on adhesion of blood cells to the root surface using scanning electron microscopy (SEM). Materials and methods: Scaled root samples (n = 160) were set in five groups and conditioned with: group I - control group (saline solution); group II (EDTA 24%); group III (citric acid 25%); group IV (tetracycline hydrochloride 50 mg/ml); group V (sodium citrate 30%). Eighty samples were assessed using the root surface modification index (RSMI). The other eighty samples were set in two groups. The first group (n = 40) received PRP gel application with a soft brush and the second group (n = 40) received PRP application and then a blood drop. The fibrin clot formation was assessed in the first group and the blood cells adhesion was assessed in the second group using the BEAI (blood elements adhesion index). A previously trained, calibrated, and blind examiner evaluated photomicrographs. Statistical analysis was performed using the Kruskal-Wallis's and Dunn's tests. Results: Group III attained the best results for RSMI and BEAI. Moreover, it was the only group showing fibrin clot formation. Conclusion: Citric acid was the most efficient conditioner for smear layer removal, collagen fiber exposure and blood cell adhesion. Moreover, it was the only group showing fibrin clot formation after PRP application. Clinical significance: This study demonstrated that root conditioning followed by PRP application may favor blood cell adhesion on root surface which may optimize periodontal healing.

Effectiveness of castor oil extract on Escherichia coli and its endotoxins in root canals

The results of the present study showed a significant decrease in the number of E. coli in root canals (first collection) after irrigation with castor oil extract during biomechanical preparation. All medications tested in this study were able to eliminate E. coli in root canals; however, they could not neutralize endotoxins completely.

Adhesion of real seal to human root dentin treated with different solutions

The aim of this study was to evaluate the effects of different irrigants on sealer-dentin bond strength when using Real Seal. Thirty single-rooted teeth were divided into 3 groups. In one group, the teeth were irrigated with 3 mL of 2.5% NaOCl after each file change, flushed with 17% EDTA for 3 min and finally rinsed with 3 mL of 2.5% NaOCl. In the other two groups, rinse with NaOCl was replaced with 2% chlorhexidine gluconate (CHX) and 0.9% saline, respectively. Each root was sectioned transversally into apical, middle and coronal thirds to obtain 2-mm-thick slices. Each slice was filled with Real Seal and Resilon. Push-out test was used to analyze bond strength and failure modes were classified as adhesive, cohesive or mixed, according to SEM observations. The push-out test did not reveal any statistically significant difference (p>0.05) between the irrigants. However, the groups exhibited significantly different (p<0.05) bond strengths in terms of the root canal third. Higher bond strength was observed at the apical third when compared with coronal third, while middle third presented intermediary values. Fifteen specimens were analyzed by SEM (5 per group). Eleven specimens exhibited adhesive failures (5 in saline, 4 in NaOCl and 2 in CHX group); 2 cohesive failures were observed in the CHX group, and 1 mixed failure each was observed in the CHX and NaOCl groups. The tested irrigants did not influence the bond strength of Resilon and Real Seal to dentin. The apical third exhibited higher mean bond strengths and adhesive failures were predominant.

Effect of acid fruit juices combined with electric or sonic toothbrushing on root dentin permeability - An in vitro study

The purpose of this in vitro study was to quantify the alterations on human root dentin permeability after exposure to different acid fruit juices and to evaluate the effect of toothbrushing with electric or sonic toothbrush after acid exposure. The root dentin of 50 extracted third molars was exposed with a high speed bur. Crowns were sectioned above the cementoenamel junction and root fragments were used to prepare dentin specimens. Specimens were randomly assigned to 5 groups according to the fruit juice (kiwifruit, starfruit, green apple, pineapple and acerolla). Each specimen was connected to a hydraulic pressure apparatus to measure root dentin permeability using fluid filtration method after the following sequential steps: I) conditioning with 37% phosphoric acid for 30 s, II) root scaling, III) exposure to acid fruit juices for 5 min and IV) electric or sonic toothbrushing without dentifrice for 3 min. Data were analyzed statistically by the Wilcoxon and Mann-Whitney tests at 5% significance level. All fruit juices promoted a significant increase of dentin permeability while toothbrushing decreased it significantly (p<0.05). It may be concluded that all acid fruit juices increased root dentin permeability, while toothbrushing without dentifrice after acid exposure decreased the permeability. The toothbrush mechanism (electric or sonic) had no influence on the decrease of root dentin permeability.

Combination of orthodontic movement and periodontal therapy for full root coverage in a miller class iii recession: A case report with 12 years of follow-up

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

Wound healing of dehiscence defects following different root conditioning modalities: An experimental study in dogs

Objective: The purpose of this study was to investigate the periodontal healing pattern of dehiscence-type defects following different chemical root conditioning modalities. Materials and methods: Buccal osseous dehiscence defects were created on six teeth of seven dogs. After dental plaque accumulation, defects were treated with sterile saline solution (control group) or one chemical conditioning modality: citric acid (CA group), ethylenediaminetetraacetic acid (EDTA group), tetracycline (TTC group), citric acid + tetracycline (CA + TTC group), or tetracycline + citric acid (TTC + CA group). After 3 months of healing, clinical parameters were evaluated, and the animals were killed. Histological sections were processed, and a computer-assisted histometric analysis was used to evaluate the formation of new cementum, new bone, and epithelial apical migration. Results: All treatments yielded significant improvements in terms of probing depth decrease and clinical attachment level gain compared to baseline values; however, without significant differences among the groups (p > 0.05; one-way ANOVA). The highest amount of new cementum was noted in the EDTA group (3.72 ± 0.83 mm, 77.6 %), while the lowest amount of new bone was observed in the TTC group (0.7 ± 0.94 mm, 14.3 %). However, no statistically significant differences could be observed among the groups regarding epithelial apical migration, new cementum, and alveolar bone formation (p > 0.05). Conclusion: Chemical root surface conditioning did not promote any significant improvement in periodontal healing pattern of dehiscence-type defects in dogs. Clinical Relevance: Chemical root surface conditioning after surgical debridement did not promote positive or negative effects on periodontal healing pattern of dehiscence-type defects. © 2012 Springer-Verlag Berlin Heidelberg.

Mechanized instrumentation of root canals oscillating systems

Cleaning and shaping are important steps in the root canal treatment. Despite the technological advances in endodontics, K and Hedströen files are still widely used. In an attempt to be more effective in preparing the root canals, faster and more cutting efficient kinematic, alloys and design alternatives utilizing mechanically oscillating or rotary files are proposed. Even with all these technological innovating alternatives, the preparation of root canals remains a challenge.

Root distribution, nutrient uptake, and yield of two upland rice cultivars under two water regimes

Upland rice (Oryza sativa L.) cultivation has been increasing in global importance due to the decreasing water availability for flood- irrigated rice. The use of sprinkler irrigation to supplement rainfall and the identification of cultivars more adapted to lower water availability could be effective alternatives for producing upland rice without yield losses while using less water. The objective of this field study was to evaluate the root distribution, plant nutrition, and grain yield of two drought tolerant upland rice cultivars under two water regimes in the Cerrado Region of Brazil during two growing seasons. The main plots were two water regimes (rainfed and sprinkler-irrigation plus rainfall). Subplots were two upland rice cultivars Carajás and IAC 201. Low water availability reduced root growth by 7% and grain yields were from 2644 to 4002 kg ha-1 on average for rainfed and sprinkler irrigation treatments, respectively. Carajás had a significantly better root distribution, nutrient uptake, and higher grain yield (3732 kg ha-1) compared with IAC 201 (2914 kg ha-1) averaged over two growing seasons and water regimes. There were no treatment interactions. Our results suggest that, even when cultivars with a higher tolerance to less water availability are used, using sprinkler irrigation to augment limited rainfall during dry periods may be a viable method to increase upland rice grain yields. © 2013 by the American Society of Agronomy.

Root coverage stability of the subepithelial connective tissue graft and guided tissue regeneration: A 30-month follow-up clinical trial

Objectives: The aim of this study was to compare the long-term clinical effects produced by subepithelial connective tissue graft (SCTG) and guided tissue regeneration combined with demineralized freeze-dried bone allograft (GTR-DFDBA) in the treatment of gingival recessions in a 30-month follow-up clinical trial. Methods: Twenty-four defects were treated in 12 patients who presented canine or pre-molar Miller class I and/or II bilateral gingival recessions. GTR-DFDBA and SCTG treatments were performed in a randomized selection in a split-mouth design. The clinical measurements included root coverage (RC), gingival recession (GR), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KTW). These clinical parameters were evaluated at baseline and after 6, 18 and 30 months post-surgery. Results: The changes in RC, GR, PD and CAL did not show significant differences between groups (p > 0.05). Both procedures promoted similar RC (GTR-DFDBA: 87% and SCTG: 95.5%) and similar reduction in GR (GTR-DFDBA: 3.25 mm and SCTG: 3.9 mm), PD (GTR-DFDBA: 1.6 mm and SCTG: 1.2 mm) and CAL (GTR-DFDBA: 4.9 mm and SCTG: 5.0 mm). The increase in KTW was significantly higher (p = 0.02) in the SCTG group (3.5 mm) than in the GTR-DFDBA group (2.4 mm). Conclusions: Both techniques for treatment of gingival recession (SCTG and GTR-DFDBA) lead to favourable and long-term stable results, but SCTG promoted a more favourable increase in keratinized tissue. © 2012 Elsevier Ltd. All rights reserved.

Sealing ability of MTA used as a root end filling material: Effect of the sonic and ultrasonic condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Ex-vivo Effect of Intracanal Medications Based on Ozone and Calcium Hydroxide in Root Canals Contaminated with Enterococcus faecalis

This ex vivo study evaluated the antibacterial effect of intracanal medications in root canals contaminated with Enterococcus faecalis. Fifty single-rooted human teeth were contaminated with E. faecalis (ATCC 29212) and incubated at 37°C for 21 days. The specimens were randomly divided into 5 groups according to the intracanal medication used: OZ-PG: ozonized propylene glycol; CH/CPMC: calcium hydroxide/camphorated paramonochlorophenol; OZ-PG/CH ozonized PG/CH; PC: positive control group (no medication); and NC: negative control group (no contamination). The samples were collected after 7 days (post-medication) and 14 days (final). Bacterial growth was checked by counting the colony-forming units (CFU). OZ-PG and CH/CPMC reduced significantly the CFU counts compared with PC in the post-medication and final samples, with no statistically significant differences among them. On the other hand, OZ-PG/CH did not reduce significantly the number of bacteria compared with PC. In conclusion, among the evaluated medications OZ-PG and CH/CPMC were the most effective against E. faecalis.

In vitro antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis in root canals

Objective: The aim of this study was to evaluate the antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecali's inoculated in root canals. Material and Methods: Seventy-two human tooth roots were contaminated with C. albicans and E. faecalis for 21 days. The groups were divided according to the auxiliary chemical substance into: G1) 2.5% sodium hypochlorite (NaOCl), G2) 2% chlorhexidine gel (CHX), G3) castor oil, G4) glycolic Aloe vera extract, g5) glycolic ginger extract, and G6) sterile saline (control). The samples of the root canal were collected at different intervals: confirmation collection, at 21 days after contamination; 1st collection, after instrumentation; and 2nd collection, seven days after instrumentation. Microbiological samples were grown in culture medium and incubated at 37°C for 48 hours. Results: The results were submitted to the Kruskal-Wallis and Dunn (5%) statistical tests. NaOCl and CHX completely eliminated the microorganisms of the root canals. Castor oil and ginger significantly reduced the number of CFU of the tested bacteria. Reduction of CFU/mL at the 1st and 2nd collections for groups G1, G2, G3 and G4 was greater in comparison to groups G5 and G6. Conclusion: It was concluded that 2.5% sodium hypochlorite and 2% chlorhexidine gel were more effective in eliminating C. albicans and E. faecalis, followed by the castor oil and glycolic ginger extract. The Aloe vera extract showed no antimicrobial activity.

Biomarkers in mangrove root crab Goniopsis cruentata for evaluating quality of tropical estuaries

The present study reports the use of biomarkers analyzes in mangrove root crab Goniopsis cruentata tissues to assess the environmental quality of two tropical estuarine areas. Animals from Ceará River estuary presented inhibition of ChE and GST enzymatic activities and higher rates of DNA damage with respect to those sampled in a pristine environment. G. cruentata appears to represent a proper species to monitor the quality of tropical estuaries. Since Ceará River is a legally protected area, this survey highlight the needs to implement actions to control pollution loads and improve the protection of natural ecosystems and resources. © 2013 Elsevier Ltd. All rights reserved.

Biocompatibility and biomineralization assessment of a new root canal sealer and root-end filling material

Objective: This study investigated the short-term subcutaneous tissue reaction and biomineralization ability of two epoxy-based root canal sealers containing calcium hydroxide (MBP and MBPc) and ProRoot MTA. Materials and methods: Polyethylene tubes containing the materials were implanted into the dorsal connective tissue of Wistar rats (n = 52) for 7 or 30 days; empty implanted tubes served as controls. Specimens were stained with hematoxylin-eosin and von Kossa stain or left unstained for observation under polarized light. Qualitative and quantitative evaluations of all tissue reactions were performed. One-way anova and the Kruskal-Wallis test were used for statistical analysis (P < 0.05). Results: No significant differences were observed among the groups. All three materials induced mild-to-moderate tissue reactions at 7 days, which decreased over time. Dystrophic mineralization and birefringent structures were observed only in the ProRoot MTA ® group. Conclusion: Both MBP and MBPc appear to be biocompatible but do not stimulate biomineralization. © 2012 John Wiley & Sons A/S.