Comportamento dos tecidos periapicais de dentes de cães após a obturação de canal com Sealapex acrescido ou não de iodoformio.

Some endodontists use iodoform in Sealapex in order to rend it more radiopac. This procedure is empiric and for this reason we decided to observe, histologically, if the iodoform introduces some modification in the biological properties of Sealapex. Thirty root canals of dogs' teeth were overinstrumented and filled, by lateral condensation technique, with gutta percha points and Sealapex, with or without iodoform. The iodoform was added in two different proportions: 30 mg or 112 mg for one centimeter of the base and one centimeter of the catalyst of Sealapex. The pieces were removed for histological studies, 6 months after the treatment. The histological results showed that Sealapex encourages apical closure by cementum deposition and that the addition of iodoform does not change that biological property.

Apical leakage following root canal dressing with calcium hydroxide.

The purpose of this study was to analyse the apical leakage in teeth filled by the lateral condensation technique following medication with calcium hydroxide. One hundred and twenty extracted human teeth were biomechanically prepared by using exclusively reaming motion with files up to #40. Half of the teeth received a calcium hydroxide dressing for 3 days. The medication was removed by irrigation and reaming motion with files #40 up to #70. The teeth were divided in 6 experimental groups, according to the dimension of the utilized instrument. The root canals were filled and posteriorly the teeth were placed into a 2% methylene blue dye solution inside a flask, which was attached to a vacuum pump. Leakage was measured linearly, and the results showed significantly (p<0.01) less leakage in the experimental groups that received calcium hydroxide dressings than in the control groups. The results persisted even after the removal of 300 micrometers of dentin from the root canal dentinal walls.

pH changes at the surface of root dentin when using root canal sealers containing calcium hydroxide

The purpose of this study was to investigate long-term pH changes in cavities prepared in root surface dentin of extracted teeth after obturation of the root canal with gutta-percha and a variety of sealers containing calcium hydroxide. After cleaning and shaping, root canals in 50 recently extracted, human single-rooted teeth were divided into five groups. Each of four groups was obturated with gutta-percha and either Sealapex, Sealer 26, Apexit, or CRCS, all of which contain calcium hydroxide. The remaining group served as the control and was not obturated with gutta-percha or sealer. Cavities were prepared in the facial surface of the roots in the cervical and middle regions. The pH was measured in these dentinal cavities at the initiation of the experiment, and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days after obturation. Results indicate that the pH at the surface of the root does not become alkaline when calcium hydroxide cements are used as root canal sealers. Regardless of the sealer used, the observed pattern of pH change was not different from that seen in the control group of roots that were not treated with sealer. It is concluded that calcium hydroxide-containing cements, although suitable for use as root canal sealants, do not produce an alkaline pH at the root surface. If such a pH change is related to treatment of root resorption, these sealants do not contribute to this treatment. Copyright © 1996 by The American Association of Endodontists.

Apical leakage after root canal filling with an experimental calcium hydroxide gutta-percha point

This study was an in vitro analysis of the apical seal of root canals filled with an experimental calcium hydroxide gutta-percha point. One hundred and ten recently extracted human permanent teeth with a single root were used. The root canals were biomechanically prepared, and some received a dressing of calcium hydroxide for 7 days. Root canals not dressed were filled by the lateral condensation technique with either regular gutta-percha or calcium hydroxide gutta-percha points. The dressed root canals were filled with the same sealers and regular gutta-percha points. The specimens were placed into a 2% methylene blue dye solution under vacuum, and the apical leakage was linearly evaluated. The experimental groups with calcium hydroxide dressing and the one with calcium hydroxide gutta-percha points exhibited significantly (p < 0.05) less leakage than the groups filled with regular gutta-percha points. The results obtained indicated that calcium hydroxide guttapercha points produced an improvement in the apical sealing quality of the root canal filling. Copyright © 1996 by The American Association of Endodontists.

Calcium hydroxide root canal sealers: Evaluation of pH, calcium ion concentration and conductivity

The calcium hydroxide ionization of four root canal sealers (Sealapex, CRCS, Sealer 26, and Apexit) was studied by measuring conductivity and pH and by conducting atomic absorption spectrophotometry. Samples 6 mm in diameter and 15 mm long were prepared from these sealers. After setting and 48 h storage in a desiccator, five samples of each material were placed in 50 mL distilled water and analysed after 0,1,2,4, 6 and 24 h and 5, 15 and 30 days. The results showed that Sealapex was the root canal sealer showing the highest pH, ionic calcium and total calcium values (P<0.05) throughout the experimental period, followed by CRCS, Apexit and Sealer 26.

Effect of different root canal sealers on periapical repair of teeth with chronic periradicular periodontitis

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and periapical repair in the teeth obturated with Sealapex (P < 0.05).

In vivo antimicrobial activity of 2% chlorhexidine used as a root canal irrigating solution

The aim of the present study was to evaluate the in vivo antimicrobial activity of 2% chlorhexidine gluconate (FCFRP-USP) used as a root canal irrigating solution in teeth with pulp necrosis and radiographically visible chronic periapical reactions. Culture techniques and measurement of the inhibition zone were used. Twenty-two root canals of incisors and molars of 12 patients were used. After accessing the canal, the first root canal sample was collected with two sterile paper points that were transferred to a tube containing reduced transport fluid. The root canal was instrumented using chlorhexidine solution. A small sterile cotton pellet was placed at the root canal entrance, and the cavity was sealed with zinc oxide-eugenol cement. The canals were maintained empty for 48 h. Three sterile paper points were then introduced to absorb the root canal fluid (second sample). One paper point was placed on an agar plate inoculated with Micrococcus luteus ATCC 9341 and incubated for 24 h at 37°C, and the other two were submitted to microbiological evaluation. Present in 10 cases at baseline, mutans streptococci was reduced by 100% at the second assessment. Treatment showed an efficiency of 77.78% for anaerobic microorganisms at the second assessment. These data suggest that chlorhexidine prevents microbial activity in vivo with residual effects in the root canal system up to 48 h. Copyright © 1999 by The American Association of Endodontists.

Connective tissue responses to calcium hydroxide-based root canal medicaments

Aim: The objective of the present study was to evaluate the tissue inflammatory response induced by calcium hydroxide pastes, with or without paramonochlorophenol and camphor. Methodology: Isogenic BALB/c mice were inoculated into the subcutaneous tissue with either 0.1 mL of a suspension of Calen, Calen with camphorated paramonochlorophenol, Calen with paramonochlorophenol, Calasept paste or phosphate-buffered saline (control). After 6, 12 and 24 h and 2, 3, 5, 7 and 15 days, three animals in each group were sacrificed and the excised lesions processed for histopathological evaluation of the inflammatory response. Events monitored and graded included the assessment of vascular congestion, oedema, haemorrhage, inflammatory infiltrate, necrosis and tissue repair. Results: The pastes induced an inflammatory response at every observation period, although the intensity, duration and extension of inflammation varied. Calen paste always produced an initial short-term inflammatory response whilst the other pastes produced extended reactions. All pastes allowed repair to take place by the end of the experimental period, although the speed of this process varied between the materials. Calen presented the best biocompatibility; the phenolic compound caused greater tissue response, which was even more severe in the absence of camphor. Calasept paste was damaging and the repair process slower. Conclusions: All calcium hydroxide formulations caused an inflammatory response. The severity and longevity of the responses varied between pastes as a result of the various antiseptic agents. Although irritating, repair was apparent with all formulations.

Reaction of dogs' teeth to root canal filling with mineral trioxide aggregate or a glass ionomer sealer

This study was conducted to observe the reaction of apical tissues of dogs' teeth after root canal filling with gutta-percha and mineral trioxide aggregate (MTA) or a glass ionomer (Ketac-Endo) as a sealer. The root canals were instrumented and filled by the lateral condensation technique with the sealers studied. Animals were killed 6 months later, and the specimens were removed and prepared for histological analysis. Results showed no inflammatory reaction of apical tissue and total closure of the apical foramen of all the teeth sealed with MTA. The teeth sealed with Ketac-Endo showed two cases of partial closure and different degrees of chronic inflammatory reaction. In conclusion, MTA exhibited better biological properties than Ketac-Endo. Copyright © 1999 by The American Association of Endodontists.

A comparison of molar root canal preparation using stainless-steel and nickel-titanium instruments

Fifty-four extracted human mandibular molars were embedded and sectioned at two levels. The reassembled mesial root canals were prepared with stainless-steel hand K-files (Flexofiles) and either Nitiflex or Mity nickel-titanium hand K-files using a push-pull anticurvature filing technique. Each of the three experimental groups contained 36 mesial canals randomly distributed. Superimposed pre- and postinstrumentation cross-sectional root images were magnified using a stereomicroscope and transferred to a computer for measurement and statistical analysis. The direction and extent of canal center movement were evaluated. At the apical level, the groups produced no significant difference of direction of canal center movement. In cervical sections, all groups tended to move in a distolingual direction. The three groups, however, produced no significant difference in the cervical sections in the extent of canal center movement. In apical sections, Nitiflex produced the least canal center movement. Copyright © 1999 by The American Association of Endodontists.

Evaluation of cell culture cytotoxicity of five root canal sealers

The cytotoxicity of four calcium hydroxide-based root canal sealers (Sealapex, CRCS, Apexit, and Sealer 26) and one zinc oxide-eugenol-based sealer (Fill Canal) was evaluated microscopically for morphological changes in rat peritoneal macrophages. The least cytotoxic sealer was Fill Canal, followed in increasing order of cytotoxicity by CRCS, Sealer 26, Apexit, and Sealapex. Copyright © 2000 by The American Association of Endodontists.

Calcium hydroxide root canal dressing. Histopathological evaluation of periapical repair at different time periods.

The objective of this study was to evaluate periapical and apical repair using calcium hydroxide root canal dressings for different lengths of times in teeth with induced chronic periapical lesions. A total of 61 root canals of maxillary and mandibular premolars from 4 dogs were used. After mechanical preparation of the root canals using the crown-down technique, and 5.25% NaOCl as irrigating solution, the apical foramen was enlarged in all cases. A calcium hydroxide root canal dressing was applied. The control group did not receive a root canal dressing. The animals were killed at 7, 15 or 30 days. After histological preparation, serial sections were stained with hematoxylin-eosin and Mallory's trichrome. The best histopathological results occurred at 15 and 30 days, and the worst results occurred at 7 days and in the control group.

Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers.

The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC) was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p < 0.05) than the group filled with Sealer Plus, that had unsatisfactory results.

Diagnostic agreement of conventional and inverted scanned panoramic radiographs in the detection of the mandibular canal and the mental foramen.

The aim of this study was to evaluate the diagnostic agreement of conventional panoramic radiographs and their inverted scanned images in the detection of the mandibular canal and mental foramen. A total of 77 panoramic radiographs obtained from the files of totally edentulous patients were used. Digitization was done by means of a scanner with brightness and contrast adjustment, as well as image inversion. The extension of mandibular canal was divided into anterior, middle, and posterior regions, and the presence of a radiopaque line that characterized the mandibular canal was classified according to a 5-point confidence scale. The mental foramen was classified in 4 types: continuous, separated, diffuse, and unidentified. Both conventional and inverted scanned panoramic radiographs were evaluated by 3 calibrated implantologists at 2 distinct moments with a minimum interval of 10 days between them. Intraexaminer agreement was evaluated by Kappa statistics by point and by 95% confidence interval. Because the intraexaminer level of agreement was low, interexaminer agreements could not be carried out. The results showed a substantial (in 2 situations), moderate (in 16 situations), and fair (in 18 situations) intraexaminer agreement for mandibular canal and a substantial (in 1 situation), fair (in 1 situation), and moderate (in 10 situations) intraeaminer agreement for mental foramen. There were no statistically significant differences in most instances. In conclusion, the diagnostic agreement of conventional and inverted scanned panoramic radiographs for detection of mandibular canal and mental foramen was low.