Analysis of four gutta-percha techniques used to fill mesial root canals of mandibular molars

P>Aim To compare the percentage of gutta-percha, sealer and voids and the influence of isthmuses in mesial root canals of mandibular molars filled with different techniques. Methodology Canals in 60 mesial roots of mandibular first molars were prepared with ProTaper instruments to size F2 (size 25, 0.08 taper) and filled using a single-cone, lateral compaction, System B or Thermafil techniques. An epoxy resin sealer was labelled with Rhodamine-B dye to allow analysis under a confocal microscope. The percentage of gutta-percha, sealer and area of voids was calculated at 2, 4 and 6 mm from the apex, using Image Tool 3.0 software. Statistical analysis was performed using nonparametric Kruskal-Wallis and Dunn tests (P < 0.05). The influence of isthmuses on the presence or absence of voids was evaluated using the Fisher test. Results At the 2 mm level, the percentage of gutta-percha, sealer and voids was similar amongst the System B, lateral compaction and single-cone techniques. The single-cone technique revealed significantly less gutta-percha, more sealer and voids in comparison with the Thermafil technique at the 2 and 4 mm level (P < 0.05). The analysis of all sections (2, 4 and 6 mm) revealed that more gutta-percha and less sealer and voids were found in root canals filled with Thermafil and System B techniques (P < 0.05). The Fisher test revealed that the presence of isthmuses increased the occurence of voids in the lateral compaction group only (P < 0.05). Conclusion Gutta-percha, sealer filled area and voids were dependent on the canal-filling technique. The presence of isthmuses may influence the quality of root filling.

Coupling of composite resin cements to quartz fiber posts: A comparison of industrial and ""chairside"" treatments of the post surface

Purpose: To evaluate the influence of surface treatments on microtensile bond strength of luting resin cements to fiber posts. Materials and Methods: Forty-two quartz fiber posts (Light Post, RTD) were divided into 7 groups (n = 6) according to the surface treatment. I and 11: experimental patented industrial treatment consisting of zirconium oxide coating and silanization (RTD); III: industrial treatment followed by adhesive application (XPBond, Dentsply Caulk); IV: adhesive (XPBond); V: adhesive (Prime&Bond NT, Dentsply Caulk); VI: silane (Calibra Silane, Dentsply Caulk); VII: no treatment. Adhesives were used in the self-curing mode. Two cements (Sealbond, RTD - group 1, and Calibra, Dentsply Caulk - groups 11 to VII) were applied on the posts to produce cylindrical specimens. Post/cement interfaces were evaluated under SEM. The surface of the industrially coated posts was examined using energy dispersive analysis by x-ray. Cylinders were cut to obtain microtensile sticks that were loaded in tension at a crosshead speed of 0.5 mm/min until failure. Statistical analysis was performed using Kruskal-Wallis analysis of variance followed by Dunn`s multiple range test for post-hoc comparisons (p < 0.05). Weibull analysis was also performed. Results: The post/cement bond strength was significantly higher on fiber posts treated industrially (I: 23.14 +/- 8.05 MPa; II: 21.56 +/- 7.07 MPa; III: 22.37 +/- 7.00 MPa) or treated with XPBond adhesive (IV: 21.03 +/- 5.34 MPa) when compared to Prime&Bond NT application (V: 14.05 +/- 5.06 MPa), silanization (VI: 6.31 +/- 4.60 MPa) or no treatment (VII: 4.62 +/- 4.31) of conventional fiber posts (p < 0.001). Conclusion: The experimental industrial surface treatment and the adhesive application enhanced fiber post to resin cement interfacial strength. Industrial pretreatment may simplify the clinical luting procedure.

Influence of Filling Materials on the Bonding Interface of Thin-walled Roots Reinforced with Resin and Quartz Fiber Posts

Introduction: A common complication during the restoration of severely destroyed teeth is the loss of coronal root dentine. The aim of this study was to evaluate the influence of different sealers on the bonding interface of weakened roots reinforced with resin and fiber posts. Methods: Sixty extracted maxillary canines were used. The crowns were removed, and the thickness of root dentine was reduced in the experimental (n = 40) and positive control (n = 10) groups. The specimens of experimental group were assigned to four subgroups (n = 10) according to the filling material: gutta-percha + Grossmann`s sealer, gutta-percha + AH Plus (Dentsply De Trey Gmbh, Konstanz, Germany), gutta-percha + Epiphany (Pentron Clinical Technologies, Wallingford, CT), and Resilon (Resilon Research LLC, Madison, CT) + Epiphany. In the negative control group (n = 10), canals were not filled. After post space preparation, the roots were restored with composite resin light-activated through a translucent fiber post. After 24 hours, specimens were transversally sectioned into 1-mm-thick slices. Push-out test and scanning electron microscopic (SEM) analyses of different regions were performed. Data from push-out test were analyzed by using Tukey post hoc multiple comparison tests. The percentage of failure type was calculated. Data from SEM analysis were compared by Friedman and Kruskal-Wallis tests (alpha = 0.05). Results: The mean bond strength was significantly higher in the negative control group as compared with the other groups (P < .05). In all groups, the most frequent type of failure was adhesive. Overall, apical and middle regions presented a lower density of resin tags than the coronal region (P < .05). Conclusions: The push-out bond strength was not affected by sealer or region. The canal region affected significantly the resin tag morphology and density at the bonding interface. (J Endod 2011;37:531-537)

SEM analysis of enamel surface treated by Er : YAG laser: Influence of irradiation distance

Background: Depending on the distance of laser tip to dental surface a specific morphological pattern should be expected. However, there have been limited reports that correlate the Er:YAG irradiation distance with dental morphology. Purpose: To assess the influence of Er:YAG laser irradiation distance on enamel morphology, by means of scanning electron microscopy (SEM). Methods: Sixty human third molars were employed to obtain discs (congruent to 1 mm thick) that were randomly assigned to six groups (n = 10). Five groups received Er:YAG laser irradiation (80 mJ/2 Hz) for 20 s, according to the irradiation distance: 11, 12, 14, 16, or 17 mm. and the control group was treated with 37% phosphoric acid for 15 s. The laser-irradiated discs were bisected. One hemi-disc was separated for superficial analysis without subsequent acid etching, and the other one, received the phosphoric acid for 15 s. Samples were prepared for SEM. Results: Laser irradiation at 11 and 12 min provided an evident ablation of enamel, with evident fissures and some fused areas. At 14, 16 and 17 mm the superficial topography was flatter than in the other distances. The subsequent acid etching on the lased-surface partially removed the disorganized tissue. Conclusions: Er:YAG laser in defocused mode promoted slight morphological alterations and seems more suitable for enamel conditioning than focused irradiation. The application of phosphoric acid on lased-enamel surface, regardless of the irradiation distance, decreased the superficial irregularities.

Influence of energy and pulse repetition rate of Er : YAG laser on enamel ablation ability and morphological analysis of the laser-irradiated surface

Objective: To assess the influence of energy and pulse repetition rate of Er:YAG laser on the enamel ablation ability and substrate morphology. Methods: Fifteen crowns of molars were sectioned in four fragments, providing 60 samples, which were ground to flatten the enamel surface. The initial mass was obtained by weighing the fragments. The specimens were hydrated for I h, fixed, and a 3-mm-diameter area was delimited. Twelve groups were randomly formed according to the combination of laser energies (200, 250, 300, or 350 mJ) and pulse repetition rates (2, 3, or 4 Hz). The final mass was obtained and mass loss was calculated by the difference between the initial and final mass. The specimens were prepared for SEM. Data were submitted to ANOVA and Scheffe test. Results: The 4 Hz frequency resulted in higher mass loss and was statistically different from 2 and 3 Hz (p < 0.05). The increase of frequency produced more melted areas, cracks, and unselective and deeper ablation. The 350 mJ energy promoted greater mass loss, similar to 300 mJ. Conclusions: The pulse repetition rate influenced more intensively the mass loss and morphological alteration. Among the tested parameters, 350 mJ/3 Hz improved the ability of enamel ablation with less surface morphological alterations. (C) 2007 Wiley Periodicals, Inc. J Biomed Mater Res.

A bivariate regression model for matched paired survival data: local influence and residual analysis

The use of bivariate distributions plays a fundamental role in survival and reliability studies. In this paper, we consider a location scale model for bivariate survival times based on the proposal of a copula to model the dependence of bivariate survival data. For the proposed model, we consider inferential procedures based on maximum likelihood. Gains in efficiency from bivariate models are also examined in the censored data setting. For different parameter settings, sample sizes and censoring percentages, various simulation studies are performed and compared to the performance of the bivariate regression model for matched paired survival data. Sensitivity analysis methods such as local and total influence are presented and derived under three perturbation schemes. The martingale marginal and the deviance marginal residual measures are used to check the adequacy of the model. Furthermore, we propose a new measure which we call modified deviance component residual. The methodology in the paper is illustrated on a lifetime data set for kidney patients.

On estimation and influence diagnostics for log-Birnbaum-Saunders Student-t regression models: Full Bayesian analysis

The purpose of this paper is to develop a Bayesian approach for log-Birnbaum-Saunders Student-t regression models under right-censored survival data. Markov chain Monte Carlo (MCMC) methods are used to develop a Bayesian procedure for the considered model. In order to attenuate the influence of the outlying observations on the parameter estimates, we present in this paper Birnbaum-Saunders models in which a Student-t distribution is assumed to explain the cumulative damage. Also, some discussions on the model selection to compare the fitted models are given and case deletion influence diagnostics are developed for the joint posterior distribution based on the Kullback-Leibler divergence. The developed procedures are illustrated with a real data set. (C) 2010 Elsevier B.V. All rights reserved.

Local Influence Analysis for Skew-Normal Linear Mixed Models

In this article, we consider local influence analysis for the skew-normal linear mixed model (SN-LMM). As the observed data log-likelihood associated with the SN-LMM is intractable, Cook`s well-known approach cannot be applied to obtain measures of local influence. Instead, we develop local influence measures following the approach of Zhu and Lee (2001). This approach is based on the use of an EM-type algorithm and is measurement invariant under reparametrizations. Four specific perturbation schemes are discussed. Results obtained for a simulated data set and a real data set are reported, illustrating the usefulness of the proposed methodology.

DIAGNOSTIC TECHNIQUES OF LOCAL INFLUENCE IN SPATIAL ANALYSIS OF SOYBEAN YIELD

Modeling of spatial dependence structure, concerning geoestatistics approach, is an indispensable tool for fixing parameters that define this structure, applied on interpolation of values in places that are not sampled, by kriging techniques. However, the estimation of parameters can be greatly affected by the presence of atypical observations on sampled data. Thus, this trial aimed at using diagnostics techniques of local influence in spatial linear Gaussians models, applied at geoestatistics in order to evaluate sensitivity of maximum likelihood estimators and restrict maximum likelihood to small perturbations in these data. So, studies with simulated and experimental data were performed. Those results, obtained from the study of real data, allowed us to conclude that the presence of atypical values among the sampled data can have a strong influence on thematic maps, changing, therefore, the spatial dependence. The application of diagnostics techniques of local influence should be part of any geoestatistic analysis, ensuring that the information from thematic maps has better quality and can be used with greater security by farmers.

Monodisperse lignin fractions as standards in size-exclusion analysis Comparison with polystyrene standards

The difficulty of preparing monodisperse lignin fractions on a large scale is a limiting factor in many applications. The present paper addresses this problem by examining the properties and size-exclusion behavior of lignin isolated by the acetosolv pulping process from post-extraction crushed sugarcane bagasse. The isolated lignin was subjected to a solvent pretreatment, followed by preparative gel permeation chromatography fractionation. The fractions were analyzed by high-performance size-exclusion chromatography (HPSEC) and these samples showed a great decrease in polydispersity, compared to the original acetosolv lignin. Several fractions of very low polydispersity, close to unity, were employed as calibration curve standards in HPSEC analysis. This original analytical approach allowed calibration with these lignin fractions to be compared with the polystyrene standards that are universally employed for lignin molecular mass determination. This led to a noteworthy result, namely that the lignin fractions and polystyrene standards showed very similar behavior over a large range of molecular masses in a typical HPSEC analysis of acetosolv lignin. (C) 2009 Elsevier B.V. All rights reserved.

The influence of residual salivary fluoride from dentifrice on enamel erosion: an in situ study

The objective of this study was to assess the salivary residual effect of fluoride dentifrice on human enamel subjected to an erosive challenge. This crossover in situ study was performed in two phases (A and B), involving ten volunteers. In each phase, they wore acrylic palatal appliances, each containing 3 human enamel blocks, during 7 days. The blocks were subjected to erosion by immersion of the appliances in a cola drink for 5 minutes, 4 times a day. Dentifrice was used to brush the volunteers’ teeth, 4 times a day, during 1 minute, before the appliance was replaced into the mouth. In phases A and B the dentifrices used had the same formulation, except for the absence (PD) or presence (FD) of fluoride, respectively. Enamel alterations were determined using profilometry, microhardness (%SMHC), acid- and alkali-soluble F analysis. The data were tested using ANOVA (p < 0.05). The concentrations (mean ± SD) of alkali- and acid-soluble F (µgF/cm²) were, respectively, PD: 1.27ª ± 0.70/2.24A ± 0.36 and FD: 1.49ª ± 0.44/2.24A ± 0.67 (p > 0.05). The mean wear values (± SD, µm) were PD: 3.63ª ± 1.54 and FD: 3.54ª ± 0.90 (p > 0.05). The mean %SMHC values (± SD) were PD: 89.63ª ± 4.73 and FD: 87.28ª ± 4.01 (p > 0.05). Thus, we concluded that the residual fluoride from the fluoride-containing dentifrice did not protect enamel against erosion.

Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

OBJECTIVES: This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. MATERIAL AND METHODS: Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized pre-surgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). RESULTS: As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm² in the test group and 2 mm² in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). CONCLUSIONS: The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions.

Comparison of periodontal parameters in individuals with syndromic craniosynostosis

Craniosynostosis syndromes are characterized by premature closure of one or more cranial sutures, associated with other malformations, the most frequent of which are the Crouzon and Apert syndromes. Few studies in the literature have addressed the oral health of these individuals. The purpose of this study was to compare the periodontal status of individuals with Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes before toothbrushing and compare the efficiency of plaque removal before and after mechanical toothbrushing. The probing depth, plaque index (according to Löe and O'Leary), clinical attachment level, gingival index (according to Silness and Löe) and amount of keratinized mucosa were evaluated before toothbrushing, and the O'Leary plaque index was assessed before and immediately after toothbrushing, on the same day, in 27 individuals aged 11 to 36 years. There was statistically significant difference in the mean probing depth and clinical attachment level among regions (p=0.00; p=0.01, respectively). The gingival index did not reveal statistically significant differences. With regard to the plaque index, the left region exhibited higher plaque index values than the right and anterior regions. No significant results were found in the analysis of keratinized mucosa. Comparison of the O'Leary plaque index before and after toothbrushing revealed statistically significant difference for all syndromes except for the Pfeiffer syndrome (p<0.05). In conclusion, there was no difference in the periodontal status among individuals with syndromic craniosynostosis. The posterior region was more affected than the anterior region as to the presence of plaque, loss of insertion and probing depth. Individuals with Pfeiffer syndrome exhibited greater toothbrushing efficiency than individuals with the other craniosynostosis syndromes.

Influence of different catilever extensions and glass or polyamaramid reinforcement fibers on fracture strength of implant-supported temporary

In long-term oral rehabilitation treatments, resistance of provisional crowns is a very important factor, especially in cases of an extensive edentulous distal space. The aim of this laboratorial study was to evaluate an acrylic resin cantilever-type prosthesis regarding the flexural strength of its in-balance portion as a function of its extension variation and reinforcement by two types of fibers (glass and polyaramid), considering that literature is not conclusive on this subject. Each specimen was composed by 3 total crowns at its mesial portion, each one attached to an implant component (abutment), while the distal portion (cantilever) had two crowns. Each specimen was constructed by injecting acrylic resin into a two-part silicone matrix placed on a metallic base. In each specimen, the crowns were fabricated with either acrylic resin (control group) or acrylic resin reinforced by glass (Fibrante, Angelus) or polyaramide (Kevlar 49, Du Pont) fibers. Compression load was applied on the cantilever, in a point located 7, 14 or 21 mm from the distal surface of the nearest crown with abutment, to simulate different extensions. The specimen was fixed on the metallic base and the force was applied until fracture in a universal test machine. Each one of the 9 sub-groups was composed by 10 specimens. Flexural strength means (in kgf) for the distances of 7, 14 and 21 mm were, respectively, 28.07, 8.27 and 6.39 for control group, 31.89, 9.18 and 5.16 for Kevlar 49 and 30.90, 9.31 and 6.86 for Fibrante. Data analysis ANOVA showed statistically significant difference (p<0.05) only regarding cantilever extension. Tukey's test detected significantly higher flexural strength for the 7 mm-distance, followed by 14 and 21 mm. Fracture was complete only on specimens of non-reinforced groups.

Influence of different adhesive systems on the pull-out bond strength of glass fiber posts

This in vitro study evaluated the tensile bond strength of glass fiber posts (Reforpost - Angelus-Brazil) cemented to root dentin with a resin cement (RelyX ARC - 3M/ESPE) associated with two different adhesive systems (Adper Single Bond - 3M/ESPE and Adper Scotchbond Multi Purpose (MP) Plus - 3M/ESPE), using the pull-out test. Twenty single-rooted human teeth with standardized root canals were randomly assigned to 2 groups (n=10): G1- etching with 37% phosphoric acid gel (3M/ESPE) + Adper Single Bond + #1 post (Reforpost - Angelus) + four #1 accessory posts (Reforpin - Angelus) + resin cement; G2- etching with 37% phosphoric acid gel + Adper Scotchbond MP Plus + #1 post + four #1 accessory posts + resin cement. The specimens were stored in distilled water at 37°C for 7 days and submitted to the pull-out test in a universal testing machine (EMIC) at a crosshead speed of 0.5 mm/min. The mean values of bond strength (kgf) and standard deviation were: G1- 29.163 ± 7.123; G2- 37.752 ±13.054. Statistical analysis (Student's t-test; a=0.05 showed no statistically significant difference (p<0.05) between the groups. Adhesive bonding failures between resin cement and root canal dentin surface were observed in both groups, with non-polymerized resin cement in the apical portion of the post space when Single Bond was used (G1). The type of adhesive system employed on the fiber post cementation did not influence the pull-out bond strength.