The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study

Introduction The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. Methods Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n=20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. Results QG and EG presented similar amounts of sealer penetration (P>.05). MG and CG presented the lowest penetrability values (P<.05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P<.05). Conclusions Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. Clinical relevance Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike guttapercha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

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)

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)

Filling of simulated lateral canals with gutta percha or resilon when using thermomechanical compaction

Aims: To evaluate the filling of simulated lateral canals with gutta-percha or Resilon when using thermomechanical compaction. Setting and Design: Forty-five human single-rooted teeth were subjected to tooth decalcification and clearing. Materials and Methods: After root canal preparation, artificial lateral canals were made at 2, 5, and 8 mm from the working length (WL), corresponding to the apical, middle, and cervical thirds, respectively. The specimens were divided (n = 15) according to the filling material: Dentsply gutta-percha (GD), Odous gutta-percha (GO), and Resilon cones (RE). Root canals were obturated by thermomechanical compaction using a #45 compactor and no sealer. Lateral canals were analyzed by digital radiography and digital images after tooth decalcification and clearing using the Image Tool software. Statistical Analysis Used: Data were subjected to the Kruskal-Wallis and Dunn tests at 5% significance. Results: In the coronal third, RE and GO presented more filling ability than GD (P < 0.05). In the middle and apical thirds, RE presented the best results. Conclusions: Resilon demonstrated filling ability as material for root canal obturation by using thermomechanical compaction.

Residues of different gel formulations on dentinal walls: a SEM/EDS analysis

The aim of this study was to evaluate the presence of residues of sodium hypo-chlorite gel, chlorhexidine gel, and EDTA gel on dentina l walls after canal preparat ion throughchemical SEM- elemental chemical microanal ys is (EDS) analysis. Forty-eight single-rootedteeth were selected. They had their crowns sectioned and were instrumented with a reciprocat-ing system. The canals were irrigated with 5 mL of saline solution during root canal preparation.After instrumentation, the root canals were irrigated with 3 mL 17% EDTA followed by 1 min ofultrasonic passive activation (33 20 sec) to remove the smear layer, and then irrigated with3 mL of saline solution. The specimens were randomized into three groups (n 5 12) accord ing tothe chemical substance that filled the root canal for 30 min: GI: 5.5% sodium hypochlorite gel;GII: 2% chlorhexidine gel; GIII: 24% EDTA gel; Negative c ontrol group: no substance was used.Then, the root canals were irrigated with 6 mL of saline solution followed by 1 min of ultrasonicpassive activation (33 20 sec). After ultrasonic activation , the canals were irrigated with 2 mLsaline. The roots were sect ioned, and the perce ntage of each chemical element present in thesamples was analyzed through chemi cal SEM-EDS microanalysis. All expe rimental groupsshowed a significantly higher percentage of chemical elements (Na and/or Cl) than the controlgroup (P < 0.03). This in vitro study has shown that, regardless of chemical solutions used evenafter the final irrigation protocol, chemical residues of d ifferent substances remained attached tothe r oot c anal wa lls. Microsc. Res. Tech. 78:495–49 9, 2015.

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 .

Influence of the gutta-percha taper and finger spreader on lateral consensation effectiveness

Introduction: Lateral condensation effectiveness may be influenced by the gutta-percha and finger spreader taper used during root canal obturation. Objective: To evaluate the penetration ability of finger spreader into simulated root canals prepared using MTwo rotary system and filled with different gutta-percha and finger spreader tapers. Material and methods: Resin blocks with curved root canals had the apical diameter enlarged up to #25.06 and distributed into groups (n = 6) according to the gutta-percha taper (#25.02, #25.04, and #25.06) and the finger spreader (#30 and #35 NiTi, and stainless steel B) used to perform cold lateral condensation. After applying a load of 1.5 Kg over the finger spreaders’ head, the distance between the finger spread tip and the apical limit of the root canal preparation were obtained. The data were submitted to Anova and Tukey-Krammer’s test, with 5% of significance. Results: The gutta-percha cones with 0.02 taper enabled higher finger spreader penetration when compared to 0.04 and 0.06 tapers (p < 0.05), which were similar between each other (p > 0.05), regardless of the type and diameter of the finger spreader used. When different finger spreaders were compared among themselves, stainless steel B showed higher penetration ability (p < 0.05). Conclusion: It was concluded that the stainless-steel finger spreaders showed superior penetration ability and gutta-percha with lower tapers enabled a more effective lateral condensation at the apical third.

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.

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)

Fracture resistance of simulated immature teeth after different intra-radicular treatments

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after different intra-radicular treatments. Crowns and roots of bovine incisors were cut transversally and removed to simulate immature teeth. Root canal preparation and flaring were performed using a bur in crown-apex and apex-crown direction. The samples were distributed into 5 groups (n=10): Positive control (PoC) - no root canal flaring or filling; Negative control (NeC) - teeth were sectioned and their root canals were flared; Direct anatomical glass fiber post (RaP) - #2 Reforpost main glass fiber post relined with composite resin; Double tapered conical glass fiber posts (ExP) - #3 Exacto glass fiber post; and #2 Reforpost main glass fiber + Reforpin accessory glass fiber posts (RrP). In RaP, ExP and RrP, 4.0-mm apical plugs were done with MTA Angelus. The specimens were embedded in polystyrene resin inside cylinders and the periodontal ligament was simulated with a polyether-based impression material. The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° relative to the long axis of the tooth) in a servo-hydraulic mechanical testing machine MTS 810. Data were subjected to one-way ANOVA and Dunnett's C or Tukey's tests (α=0.05). The control groups (PoC and NeC) showed lower fracture strength than the experimental groups. NeC presented the lowest resistance and ExP presented the highest resistance among the experimental groups. The flaring procedures produced a detrimental effect on the fracture resistance of the bovine teeth. Glass fiber intra-radicular posts increased significantly the fracture resistance of simulated immature teeth.

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

Pós-graduação em Odontologia Restauradora - ICT

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.