Análise histomorfológica de dentes decíduos de cães com rizogênese incompleta, após biopulpectomia e obturação dos canais radiculares com hidróxido de cálcio em diferentes veículos

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

The impact of the addition of iodoform on the physicochemical properties of an epoxy-based endodontic sealer

Due to the low radiopacity of Sealer 26, iodoform is frequently empirically added to this sealer. Thus, the interference of this procedure with the physicochemical properties of Sealer 26 must be evaluated. Objective: This study evaluated the influence of the addition of iodoform on setting time, flow, solubility, pH, and calcium release of an epoxy-based sealer. Material and Methods: The control group was pure Sealer 26, and the experimental groups were Sealer 26 added with 1.1 g, 0.55 g or 0.275 g of iodoform. Setting time evaluation was performed in accordance with the ASTM C266-03 speciflcation. The analysis of flow and solubility was in accordance with the ISO 6876-2001 speciflcation. For the evaluation of pH and calcium ion release, polyethylene tubes were filled with the materials and immersed in flasks with 10 ml of deionized water. After 24 h, 7, 14, 21, 28, and 45 days pH was measured. In 45 days, the calcium released was evaluated with an atomic absorption spectrophotometer. Results: The addition of iodoform increased setting time in comparison with pure sealer (P < 0.05). As for flow, solubility, and calcium release, the mixtures presented results similar to pure sealer (p > 0.05). In the 24 h period, the mixture with 1.1 g and 0.55 g of iodoform showed lower pH than pure sealer and than sealer added with 0.275 g of iodoform (P < 0.05). Conclusions: The iodoform added to Sealer 26 interferes with its setting time and solubility properties. Further studies are needed to address the clinical signiflcance of this interference.

Effects of calcium hydroxide addition on the physical and chemical properties of a calcium silicate-based sealer

Recently, various calcium silicate-based sealers have been introduced for use in root canal filling. The MTA Fillapex is one of these sealers, but some of its physicochemical properties are not in accordance with the ISO requirements. Objective: The aim of this study was to evaluate the flowability, pH level and calcium release of pure MTA Fillapex (MTAF) or containing 5% (MTAF5) or 10% (MTAF10) calcium hydroxide (CH), in weight, in comparison with AH Plus sealer. Material and Methods: The flowability test was performed according to the ISO 6876: 2001 requirements. For the pH level and calcium ion release analyses, the sealers were placed individually (n=10) in plastic tubes and immersed in deionized water. After 24 hours, 7 and 14 days, the water in which each specimen had been immersed was evaluated to determine the pH level changes and calcium released. Flowability, pH level and calcium release data were analyzed statistically by the ANOVA test (alpha=5%). Results: In relation to flowability: MTAF>AH Plus>MTAF5>MTAF10. In relation to the pH level, for 24 h: MTAF5=MTAF10=MTAF>AH Plus; for 7 and 14 days: MTAF5=MTAF10>MTAF>AH Plus. For the calcium release, for all periods: MTAF>MTAF5=MTAF10>AH Plus. Conclusions: The addition of 5% CH to the MTA Fillapex (in weight) is an alternative to reduce the high flowability presented by the sealer, without interfering in its alkalization potential.

CLSM assessment of tubule penetration and bacterial leakage evaluation of two resin-based sealer

Aim: The aims of this study were to assess the penetration of two endodontic sealers (salicylate and epoxy resin-based sealers) into dentinal tubules using CLSM; and to evaluate the bacterial leakage of roots filled with the same sealers associated with gutta-percha. Material and Methods: For sealer penetrability assessment, thirty bovine roots were instrumented and divided into three groups: AHP: EDTA + filling with AH Plus and gutta-percha (n=10), MTAF: EDTA + filling with MTA Fillapex and gutta-percha (n=10), control group: canals were not irrigated with EDTA and were filled with gutta-percha and AH Plus (n=5) or MTA Fillapex (n=5). Rhodamine B was added to the sealers in order to provide adequate fluorescence. The roots were transversely sectioned 3mm from the apex to enable CLSM analysis. Leakage was evaluated for turbidity of the broth in a split chamber model system for 30 days, using Enterococcus faecalis as a microbial marker. Thirty roots were instrumented and divided in four grupos: AHP: filling with AH Plus and gutta-percha (n=10); MTAF: filling with MTA Fillapex and gutta-percha (n=10); positive control: filling with gutta-percha without sealer (n = 5); negative control: sealing with cyanoacrylate to test the seal of the system (n = 5). Results: The medians for dentinal tubule penetration were 6.8% (AHP) and 6.6% (MTAF) (P = 0.82). The average time for bacterial leakage was 8 days in both experimental groups (P = 0.79). Conclusion: MTA Fillapex and AH Plus presented similar behavior regarding dentinal tubule penetration and bacterial leakage.

Evaluación del comportamiento biológico de tres cementos obturadores endodónticos en tejido subcutáneo de ratones

The aim of this study was to evaluate the biological behavior of the root canal filling sealers: Endofill, Endomethasone and Sealer 26 when in contact with the subcutaneous connective tissue of rat. For the study one control and three experimental groups were used. A total of 15 animals were divided into 5 for each period: 7, 21, and 60 days. The obtained histological sections were processed and stained using the hematoxiline & eosine technique. The histological sections were subjective and comparatively analyzed using optic microscopy. The intensity of the inflammatory reaction and the level of fibrosis of the tissue were registered. The results were registered in scores and statistical analysis by KRUSKAL-WALLIS p<0,05 and MILLER methods. The statistical analysis revealed that in the period of 60 days, there was statistical significance to group II (Endofill) between group (control) and III (Endomethasone) with mononuclear cells into connective tissue. All materials promoted inflammatory reaction more intense at 7 and 21 days with the Endomethasone showing the best results.

Influência da reinstrumentação do degrau apical radicular após o posicionamento primário do cone principal de guta-percha noselamento apical

The aim of this study was to evaluate in vitro the apical leakage after the apical re-preparation and replacement of the principal gutta-percha point plus endodontic sealer (Sealer 26TM). Sixty extracted human canines were prepared by using a step back technique up to size 50 K type file apically. At each change of instrument the canals were irrigated with distilled water. After that step, the external surface roots were coated and subdivided into six groups with ten roots each: I – single gutta percha point technique; II – lateral condensation and III – hybrid technique. The IV, V and VI groups were similar to others groups but after to place the principal gutta percha point, it was removed, re-prepared up to size 60K file and in sequence replaced the principal gutta percha point and the root canal filling finished. The specimens were immersed in 2% Rhodamine BTM for 7 days at 37 oC. The apical leakage was measured by Image ToolsTM program. With Kruskal Wallis test statistical analysis showed that there was no significant difference between the techniques (p > 0.05).

Influência do cimento obturador e agente de irrigação final na infiltração marginal em situações de sobreobturações endodônticas

Objective: The objective of this paper was to verify if the final irrigation at 17% EDTA, separately or followed by chlorhexidine digluconate at 2% interferes on the apical marginal leakage in root canal overfilling, due to the use of two root canal filling materials (Sealer 26TM or SealapexTM). Methods: Forty lower incisors extracted, with a single root canal, were biomechanically prepared, at 2.0mm beyond the radicular apex, with ProTaper SystemTM, finishing it with the F3 instrument. Irrigation was accomplished with 1.0 mL NaOCl at 2.5% at each change of equipment caliper and, in the end, with 5.0 mL normal saline solution. After achieving this procedure, the foraminal channels was standardized with a file K 25 until its DO appears in the foraminal opening. From this moment, the teeth were subdivided into two groups of 20 specimens each, because of the final irrigation method used: I – irrigation with EDTA at 17% for 3min and II – identical protocol, thus, after EDTA aspiration at17%, it was again irrigated with chlorhexidine digluconate at 2%, also kept intra-canal for 3min. Each group was again sub-divided into two sub-groups (ten teeth each), according to the cement used (Sealer 26TM or SealapexTM), and filled by using a single gutta-percha F1 (ProTaperTM, Universal Filling), in such a manner that it goes 2.0 mm beyond the radicular apex. Soon after that, the teeth were immersed in Rhodamine BTM for 72h, vacuum and after the roots have been bucolingually grooved, the leakages marked were measured with program Image ToolTM. Results and Conclusions: The leakage magnitude was similar among themselves (p > 0.05), except for group Sealapex®, thus the final use with chlorhexidine reduced apical leakage (p < 0.05).

Avaliação do pH, da solubilidade e da infiltração marginal em retrobturações com o Sealer 26 puro ou acrescido de iodofórmio

Sealer 26® cement contains bisphenol epoxy resin associated with calcium hydroxide, presenting smaller radiopacity than other endodontic cements. Aiming to improve this property, iodoform has been added in its composition. However, this addition's possible changes in physical and chemical properties still need to be studied. OBJECTIVE: To evaluate the apical sealing ability, solubility, and pH of Sealer 26® alone or with iodoform, at several proportions. MATERIAL AND METHODS: Three experimental mixtures of Sealer 26®, alone or with iodoform, were prepared and subjected to solubility test. Additionally, these combinations were inserted into polyethylene tubes and immersed in distilled water, and, their pH was evaluated after 24-h and 7-day periods. Subsequently, forty roots of extracted lower incisors subdivided into four groups of 10 specimens each, were retrograde filled with one of the previously described mixtures and gutta-percha points. The roots were immersed in Rhodamine B, under vacuum, for 72 hours. After this period, the specimens were longitudinally sectioned, root fragments photographed, these images scanned, and apical infiltration measured by Image tool software. The obtained data were subjected to statistical analysis, at a significance level of 5%. RESULTS: Marginal leakage and solubility tests did not show any difference among the experimental groups (p > 0.05). pH analysis was only statistically different at 24-h period and between Sealer 26® alone and 1.1g iodoform group (p < 0.05). CONCLUSION: The presence of iodoform in Sealer 26®, at the used proportions, did not alter the solubility, apical marginal leakage and pH properties of the original cement.

Resolução por retratamento não cirúrgico de dente com lesão periapical: relato de caso clínico

The development and maintenance of periapical lesion occurs as a result of bacterial infection of the root canal system. Faced with the failure of endodontic treatment, retreatment is the first option with great potential for success, when performed with proper disinfection of the root canal system. Case report: Patient aged 39 years needing dental care show at clinical examination moderate gingival bleeding in the region of tooth 22 and the presence of radiographic periapical bone rarefaction due to unsatisfactory endodontic treatment. It was indicated the endodontic retreatment. We performed procedures to remove the filling material, root canal preparation using manual and mechanical techniques and completion with the use of root canal medication based on calcium hydroxide. After root canal filling, clinical and radiographic success were demonstrated for the case. Conclusion: We conclude that the non-surgical retreatment with disinfection and proper use of medication to the base of calcium hydroxide promoted success after outcome monitoring for 2 years and 8 months (AU)

MTA versus Portland cement: review of literature

Introduction: Both Mineral Trioxide Aggregate (MTA) and Portland cement (PC) have been highlighted because of their favorable biological properties, with extensive applications in Endodontics, including the possibility of using into root canal filling. Objective: This article reviews literature related to MTA and PC comparing their physical, chemical and biological properties, as well as their indications. Literature review: Literature reports studies revealing the similarities between these materials’ properties, including both biocompatibility and bone repair induction. Moreover, there is the need for the development of a root canal sealer based on these materials (MTA and PC). Conclusion: MTA and CP show promissory perspective both in Dentistry and Endodontics.

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.

Citocompatibilidade, propriedades antibiofilme e físicas e cimentos endodônticos associados à amoxilina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação dos fatores críticos para a seleção e aplicação clínica dos pinos de fibra: relato de caso cliínico

Teeth that have lost much of their coronal tooth structure need intraradical devices to achieve a desired retention of the restorative material, restoring aesthetics and function to the patient. For this purpose, various types of intracanal posts have been studied, of wich the fiber posts have been highlighted with its increasing use in the dental market. The purpose of this study was to present a clinical case of using fiberglass post. As well as critically analyze the published works and points of controversy described by different authors related to factors such as different protocols cementation, surface treatments pins, fracture toughness and compression, the possibility of microleakage, diameter and length of the pin, and the various materials used in conjunction with the intracanal retainers. Thus, we concluded that fiber posts showed as an excellent alternative for anterior teeth, since have least 2 mm of tooth remaining.

The effects of canal preparation and filling on the incidence of dentinal defects

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Radiographic and microbiologic evaluation of posttreatment apical and periapical repair of root canals of dogs' teeth with experimentally induced chronic lesion

The objective of the present study was to evaluate radiographically and bacteriologically apical and periapical repair in dogs' teeth with induced chronic periapical lesions with the use of two different operative techniques (techniques 1 and 2). The study was conducted on 40 root canals of upper and lower premolars from two dogs aged approximately 12 months. Periapical lesions were induced by leaving the root canals exposed to the oral environment for 5 days and then sealing them with zinc oxide-eugenol for 45 days. After this period, radiographic examination revealed the occurrence of a radiolucent lesion and endodontic treatment was started. The two techniques did not differ in terms of chemomechanical preparation, final filling, or type of cement, but differed in terms of irrigating solution and the presence of an antibacterial dressing. Thus 4% to 6% hypochlorite and hydrogen peroxide (10 volumes) were used in technique 1 during chemomechanical preparation and an antibacterial dressing based on calcium hydroxide was applied between sessions, whereas Dakin's fluid (0.5% sodium hypochlorite solution) and a final filling with no antibacterial dressing were used in technique 2. After chemomechanical preparation, the root canals were filled with gutta-percha cones and Sealapex (Sealapex-Sybron, Kerr, Sao Paulo, Brazil), and the animals were killed 270 days after the final filling. Blocks were cut into 6-μm sections and stained by the Brown and Brenn method. Radiographic, histomicrobiologic and statistical analysis permitted us to conclude the following: radiographically there was a marked reduction or even the disappearance of the radiolucent area present before treatment with greater success in the group treated with technique 1 (group I) than in the group treated with technique 2 (group II); the extent of bacterial invasion of dentinal tubules was greater and more intense in group II than in group I; and the amount of microorganisms detected in the ramifications of the apical delta and in the lumen of the root canal was intense in group II and mild or absent in group I. © 1994.