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.

Restoration of endodontically treated teeth

The restoration of endodontically treated teeth is one of the most challenging situations of the dentist`s clinical practice, because it involves procedures related to several areas, such as Endodontics, Operative Dentistry, and Prosthetics. These restorations aim to replace the structures lost during endodontic surgery and access to both the pulp chamber and root canal system during the instrumentation, as well as the removal of the carious tissue and temporary restorations. It is also important to remember that the prognosis of endodontically treated teeth depends not only on endodontic treatment success itself, but also on the amount of remnant tooth tissue and the definitive restoration that will be placed onto the dental element.

Evaluación comparativa in vitro de la capacidad de sellado del sistema de conductos radiculares por diferentes técnicas

The aim of this study was to evaluate in vitro the sealing ability of the root canal using different techniques: cold lateral compaction, modified Hybrid Tagger, Thermafil and System B. Material and methods. Were used 116 human single-roots, included in resin blocks, sectioned longitudinally, attached to a device with screws and divided into four groups (n=29). After instrumentation using a bur, depression was made in each third of the root canal in each of the halves. Teeth were filled upon the different techniques. For evaluation of the quality, pictures were taken with a 1.5X magnification, photos and radiographs were utilized. After statistical analysis, were performed both macroscopic and radiographic evaluation, by Chi-square test (χ2). Results. The Thermafil technique showed better results in terms of sealing capacity, failures and homogeneity followed by modified Hybrid Tagger, the System B and cold lateral compaction. Conclusions. Thermafil was the technique that shown to be macroscopic, radiographic and homogeneously best over the other techniques evaluated in regard to the filling of the depressions made (AU)

Visão contemporânea sobre pinos anatômicos

As an alternative to improve the adaptation of prefabricated posts in flared canals and weakened roots, the option is for relining prefabricated pin, known as a technique of anatomical post. This technique, which can be made with composite resin increases the adjustment post to the walls of the canal and reduces the cementing line, causing the retaining post is less dependent on the mechanical properties of the cementing agent. This article aims to provide an overview of anatomical posts, specifically in the last two decades, based on studies extracted from Scielo, Scopus and Pubmed, referring to the following terms of MeSH Data Base: custom made fiber post, indirect fiber glass posts, root canal therapy and post and core tecnique. According to the literature review in this article, it can be concluded that this technique has been used by several authors and has been shown effective and promising, it creates an individualized retainer with better adaptation and decreased mechanical imbrication cementing line .

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.

Capacidade de termoplastificação da guta-percha com diferentes conicidades

jObjective: The objective of this study was to evaluate the thermoplasticity of the gutta-percha cones used for root canal obturation: Dentsply convencional (Dentsply Ind. e Com., Petrópolis, RJ, Brazil), Dentsply 0.04, (Dentsply Ind. e Com., Petrópolis, RJ, Brazil), Antaeos 0.04 (VDW GmbH, Munich, Germany), ProTaper (Dentsply Ind. e Com., Petrópolis, RJ, Brazil) and Alfa 0.06 (VDW GmbH, Munich, Germany). Material and method: Specimens of each material (n = 10) were prepared after heating. After 24 hours were again heated to 70 °C and placed between two glass plates and subjected to a compression of 5 kg for 2 minutes. The scanned image of the groups before and after the compression was analyzed with the software Image Tool (UTHSCSA Image Tool for Windows version 3.0, San Antonio, TX, USA). The flow capacity of the different materials was determined by the difference between the initial and final area of each specimen. The results were submitted to ANOVA and Tukey test with significance level of 5%. Result: Among the material evaluated, the gutta-percha cones Alpha 0.06 and ProTaper presented more thermoplasticity than other groups (p < 0.05). The Dentsply gutta-percha presented thermoplasticity intermediate. The groups Dentsply 0.04 and 0.04 showed lower thermoplasticity after heating (p > 0.05). Conclusion: The gutta-percha present different property of thermoplasticity, which is important to selection of thermoplastic obturation techniques.

Cirugía endodóntica con obturación simultánea del conducto radicular: caso atípico

The apical surgery with simultaneous root filling consists in the elimination of the local etiologic factors concomitant with the shaping and obturation of the root canal system. This technique is indicated when there is no possibility of obturating the root canal by conventional methods. Some adverse factors may difficult the clinical procedures, such as the radiographic interpretation. Periapical radiographs must not be used as the main diagnostic resource due to their inherent disadvantages, such as distortion and superimposition with other anatomical structures. The aim of this clinical case report is to show the limitations of radiographic examination in an apical surgery in which a root perforation was not visible in the radiographic image, as well as the gutta-percha was not related to its real clinical location.

Chemical characterization and bioactivity of epoxy resin and Portland cement-based sealers with niobium and zirconium oxide radiopacifiers

The purpose of this study was to characterize and to evaluate the bioactivity potential of experimental root canal sealers (ES) based on Portland cement, epoxy resin with nano- and micro-particles of niobium or zirconium oxide used as radiopacifiers in comparison to AH Plus and MTA Fillapex. Methods Specimens of the sealers (10 mm in diameter × 1 mm thick) were prepared and the radiopacity was evaluated according to ISO 6876 (2012) specifications. Characterization of the sealers was performed under the scanning electron microscope (SEM) immediately after setting and after immersion for 28 days in Hank's balanced salt solution (HBSS). In addition X-ray energy dispersive spectroscopy (EDS), X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy were also performed. The pH and calcium ion release were measured after 1, 7, 14, 21 and 28 days after completion of seating using a digital pH meter and an atomic absorption spectrophotometer, respectively. Results The experimental sealers exhibited an average radiopacity of 2.5 mm thickness of aluminum, which was similar to MTA Fillapex (P > 0.05) and inferior to AH Plus (P < 0.05). AH Plus did not show bioactivity. Although the experimental sealers did not exhibit the formation of hydration product, they encouraged the deposition of crystalline spherical structures of calcium deficient phosphate. The highest pH and calcium release values were observed with the experimental sealers (P < 0.01). ES-Nb-micro was the only sealer to present hexagonal shaped crystal deposition. Significance Novel root canal sealers based on a mixture of Portland cement, epoxy resin and radiopacifier exhibited a degree of bioactivity although no evidence of cement hydration was demonstrated on material characterization. The radiopacifier particle size had limited effect on the sealer microstructure and chemical properties.

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.

Filling of simulated lateral canals with gutta-percha or thermoplastic polymer by warm vertical compaction

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

Estudo da diversidade microbiana e níveis de endotoxinas em lesões endo-periodontais

Pós-graduação em Odontologia Restauradora - ICT

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

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of Ciprofloxacin-containing Scaffolds on Enterococcus faecalis Biofilms

Introduction: Antibiotic-containing polymer-based nanofibers (hereafter referred to as scaffolds) have demonstrated great potential for their use in regenerative endodontics from both an antimicrobial and cytocompatibility perspective. This study sought to evaluate in vitro the effects of ciprofloxacin (CIP)-containing polymer scaffolds against Enterococcus faecalis biofilms. Methods: Human mandibular incisors were longitudinally sectioned to prepare radicular dentin specimens. Sterile dentin specimens were distributed in 24-well plates and inoculated with E. faecalisfor biofilm formation. Infected dentin specimens were exposed to 3 groups of scaffolds, namely polydioxanone (PDS) (control), PDS + 5 wt% CIP, and PDS + 25 wt% CIP for 2 days. Colony-forming units (CFU/mL) (n = 10) and scanning electron microscopy (SEM) (n -= 2) were performed to quantitatively and qualitatively assess the antimicrobial effectiveness, respectively. Results: PDS scaffold containing CIP at 25 wt% showed maximum bacteria elimination with no microbial growth, differing statistically (P < .05) from the control (PDS) and from PDS scaffold containing CIP at 5 wt%. Statistical differences (P < .05) were also seen for the CFU/mL data between pure PDS (5.92-6.02 log CFU/mL) and the PDS scaffold containing CIP at 5 wt% (5.39 5.87 log CFU/mL). SEM images revealed a greater concentration of bacteria on the middle third of the dentin specimen. after 5 days of biofilm formation. On scaffold exposures, SEM images showed similar results when compared with the CFU/mL data. Dentin specimens exposed to PDS + 25 wt% CIP scaffolds displayed a practically bacteria-free surface. Conclusions: On the basis of the data presented, newly developed antibiotic-containing electrospun scaffolds hold promise as an intracanal medicament to eliminate biofilm/infection before regenerative procedures.

Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections

Introduction: This clinical study aimed to determine the microbiological profile resistant to different intracanal medications in primary endodontic infections by using both microbiological culture and the checkerboard DNA-DNA hybridization technique. Methods: Twenty primarily infected root canals were selected and then instrumented before being randomly divided into 2 groups according to the intracanal medications: calcium hydroxide (Ca[OH](2)) or Ca(OH)(2) + chlorhexidine (CHX). Samples were collected before and after root canal procedures, which consisted in submitting them to microbiological culture and processing them for checkerboard DNA-DNA hybridization. Results: No differences were found between the Ca(OH)(2) (99.98%) and Ca(OH)(2) + CHX groups (99.76%) regarding the median percentage values for the reduction of cultivable bacteria. The most frequently detected species were Capnocytophaga ochracea (70%) and Fusobacterium nucleatum ssp. vincentii (70%) in the initial samples. After instrumentation, the most frequently detected species were E. faecium (60%). After root canal treatments using either Ca(OH)(2) or Ca(OH)(2) + CHX as intracanal medications, the most frequently detected species were E nucleatum ssp. vincentii (90%) and Enterococcus faecium (40%), respectively. Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, this reduction was significantly greater in the Ca(OH)(2) + CHX group (P < .05). This difference was also observed when evaluating the total bacterial load (P < .05). Conclusions: The use of Ca(OH)(2) associated with CHX as an intracanal medication showed better results by acting on gram-positive and gram-negative microorganisms although such an action to eradicate enterococci should also be sought.

Clinical Influence of Different Intracanal Medications on Th1-type and Th2-type Cytokine Responses in Apical Periodontitis

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