Coronal and apical leakage analysis of two different root canal obturation systems

This study compared the coronal and apical leakage of AH Plus with gutta-percha to that of Epiphany with Resilon. Twenty-four single rooted teeth were instrumented and divided into 2 groups according to the solutions for smear layer removal and the obturation materials employed: Group A - 17% EDTA-T and AH Plus with gutta-percha; Group B - primer and Epiphany with Resilon. The Group B specimens were light-cured in the coronal area for 20 s. The external root surfaces were covered with a double layer of ethyl cyanoacrylate, except for the apical foramen and the cavity access. The teeth were immersed in 0.5% methylene blue for 48 h. The specimens were rinsed, dried and axially split for dye penetration measurement with the ImageLab 2.3 software. The t-test showed no significant differences for coronal leakage between the groups, but there were significant differences for apical leakage between the groups (P < 0.05). AH Plus with gutta-percha and Epiphany with Resilon provided the same coronal seal, whereas Epiphany with Resilon provided the best apical seal.

Analysis of Permeability and Morphology of Root Canal Dentin After Er,Cr:YSGG Laser Irradiation

Objective: The aim of this study was to evaluate the morphology and permeability of root canal walls irradiated with Er,Cr:YSGG laser after conventional endodontic treatment. Background: Laser irradiation can be used for dentinal tubule exposure, smear layer removal, and disinfection. Another potential, interesting application is as an adjunct to endodontic treatment, especially in the intracanal medication phase. Methods: Fifty-two single-rooted teeth had their crowns sectioned at the cementoenamel junction and were randomly divided into four groups (n = 13): G1: conventional preparation (CP) + irrigation with EDTA-T+rhodamine B dye solution associated with NDP (dexamethasone phosphate, paramonochlorophenol, polyethylenoglycol) (Rhod-NDP); G2: CP+EDTA-T + Er,Cr:YSGG laser irradiation 0.75W+Rhod-NDP; G3: CP + EDTA-T + Er,Cr:YSGG 1.5W+Rhod-NDP; G4: CP + EDTA-T + Er,Cr:YSGG 2.5W + Rhod-NDP. For the permeability analysis (n = 9), teeth were transversely cut and two slices of each third were selected. The images were analyzed by ImageLab software (Softium Informatica Ltda., Sao Paulo, SP, Brazil). Additional samples (n = 4) were examined by scanning electron microscopy. Results: Data were analyzed statistically using the Kruskal-Wallis and Student-Newman-Keuls tests for the following areas: apical third (H = 23.4651): G1 (14.25)(a), G2 (17.66)(ab), G3 (26.50)(b), G4 (39.58)(c); medium (H = 23.1611): G1 (14.16)(a), G2 (16.66)(ab), G3 (28.83)(b), G4 (38.33)(b); and cervical (H = 32.4810): G1 (9.66)(a), G2 (20.00)(ab), G3 (27.00)(b), G4 (41.33)(c), (p<0.01). Despite the irregular aspect of laser irradiation along the canal walls, the parameters of 1.5W and 2.5W allowed morphologic modifications that increased dentinal permeability. Conclusions: Irradiation with Er, Cr: YSGG laser could be effective in endodontic treatment for increasing dentinal permeability.

Ultrastructural analysis of root canal dentine irradiated with 980-nm diode laser energy at different parameters

Objective: The purpose of this in vitro study was to investigate using the scanning electron microscope (SEM) the ultrastructural morphological changes of the radicular dentine surface after irradiation with 980-nm diode laser energy at different parameters and angles of incidence. Background Data: There have been limited reports on the effects of diode laser irradiation at 980 nm on radicular dentin morphology. Materials and Methods: Seventy-two maxillary canines were sectioned and roots were biomechanically prepared using K3 rotary instruments. The teeth were irrigated with 2 mL of distilled water between files and final irrigation was performed with 10 mL of distilled water. The teeth were then randomly divided into five groups (n = 8 each) according to their diode laser parameters: Group 1: no irradiation (control); group 2: 1.5 W/continuous wave (CW) emission (the manufacturer's parameters); group 3: 1.5 W/100 Hz; group 4: 3 W/CW; and group 5: 3 W/100 Hz. Laser energy was applied with helicoid movements (parallel to the canal walls) for 20 sec. Eight additional teeth for each group were endodontically prepared and split longitudinally and irradiation was applied perpendicularly to the root surface. Results: Statistical analysis showed no difference between the root canal thirds irradiated with the 980-nm diode laser, and similar results between the parameters 1.5 W/CW and 3 W/100 Hz (p > 0.05). Conclusion: When considering different output powers and delivery modes our results showed that changes varied from smear layer removal to dentine fusion.

Knoop Microhardness and FT-Raman Spectroscopic Evaluation of a Resin-Based Dental Material Light-Cured by an Argon Ion Laser and Halogen Lamp: An in Vitro Study

Objective: The purpose of this study was to evaluate in vitro the Knoop microhardness (Knoop hardness number [KHN]) and the degree of conversion using FT-Raman spectroscopy of a light-cured microhybrid resin composite (Z350-3M-ESPE) Vita shade A3 photopolymerized with a halogen lamp or an argon ion laser. Background Data: Optimal polymerization of resin-based dental materials is important for longevity of restorations in dentistry. Materials and Methods: Thirty specimens were prepared and inserted into a disc-shaped polytetrafluoroethylene mold that was 2.0 mm thick and 3 mm in diameter. The specimens were divided into three groups (n = 10 each). Group 1 (G1) was light-cured for 20 sec with an Optilux 501 halogen light with an intensity of 1000 mW/cm(2). Group 2 (G2) was photopolymerized with an argon laser with a power of 150 mW for 10 sec, and group 3 (G3) was photopolymerized with an argon laser at 200 mW of power for 10 sec. All specimens were stored in distilled water for 24 h at 37 degrees C and kept in lightproof containers. For the KHN test five indentations were made and a depth of 100 mu m was maintained in each specimen. One hundred and fifty readings were obtained using a 25-g load for 45 sec. The degree of conversion values were measured by Raman spectroscopy. KHN and degree of conversion values were obtained on opposite sides of the irradiated surface. KHN and degree of conversion data were analyzed by one-way ANOVA and Tukey tests with statistical significance set at p < 0.05. Results: The results of KHN testing were G1 = 37.428 +/- 4.765; G2 = 23.588 +/- 6.269; and G3 = 21.652 +/- 4.393. The calculated degrees of conversion (DC%) were G1 = 48.57 +/- 2.11; G2 = 43.71 +/- 3.93; and G3 = 44.19 +/- 2.71. Conclusions: Polymerization with the halogen lamp ( G1) attained higher microhardness values than polymerization with the argon laser at power levels of 150 and 200 mW; there was no difference in hardness between the two argon laser groups. The results showed no statistically significant different degrees of conversion for the polymerization of composite samples with the two light sources tested.

Comparison of dentin root canal permeability and morphology after irradiation with Nd:YAG, Er:YAG, and diode lasers

The aim of this study was to compare the effects of Nd:YAG, Er:YAG, and diode lasers on the morphology and permeability of root canal walls. The three laser wavelengths mentioned interact differently with dentin and therefore it is possible that the permeability changes caused will determine different indications during endodontic treatment. Twenty-eight human single-rooted teeth were instrumented up to ISO 40 and divided into four groups: group C, control (GC), non-laser irradiated; group N (GN), irradiated with Nd:YAG laser; group E (GE), with Er:YAG laser and group D (GD) with diode laser. After that, the roots were filled with a 2% methylene blue dye, divided into two halves and then photographed. The images were analyzed using Image J software and the percentage of dye penetration in the cervical, middle, and apical root thirds were calculated. Additional scanning electron microscopy (SEM) analyses were also performed. The analysis of variance (ANOVA) showed significant permeability differences between all groups in the middle and cervical thirds (p < 0.05). The Tukey test showed that in the cervical third, GN presented means of dye penetration statistically significantly lower than all of the other groups. In the middle third, GE and GD showed statistically higher dye penetration means than GC and GN. SEM analysis showed melted surfaces for GN, clean wall surfaces with open dentinal tubules for GE, and mostly obliterated dentinal tubules for GD. Er:YAG (2,094 nm) laser and diode laser (808 nm) root canal irradiation increase dentinal permeability and Nd:YAG (1,064 nm) laser decreases dentin permeability, within the studied parameters.

An ex vivo comparison of root canal length determination by three electronic apex locators at positions short of the apical foramen

Objective. The aim of this study was to evaluate the precision of working length determination of 3 electronic apex locators (EALs): Root ZX, RomiApex D-30, and Ipex at 0.0 mm, at the apical foramen (AF), and at 1.0 mm short of the AF. Methodology. Thirty-eight mandibular premolars had their real lengths previously determined. Electronic measurements were determined at 1.0 mm, followed by measurements at 0.0 mm, performed in triplicate. Results. Precision of devices at 1.0 mm and 0.0 mm were: 94.7% and 97.4%, respectively (Root ZX); 78.9% and 97.4% (RomiApex D-30); and 76.3% and 97.4% (Ipex). Although no statistical differences were observed between the EALs at 0.0, at 1.0 mm Root ZX performed significantly better than the others. Conclusion. The EALs had acceptable precision when measuring the working length at the AF. However, when used at levels short of the AF, only Root ZX did not suffer a significant negative effect on precision. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e57-e61)

Root Canal Area Increase Promoted by the EndoSequence and ProTaper Systems: Comparison by Computed Tomography

Introduction: The aim of this study was to compare the increase of the root canal area after instrumentation with EndoSequence or ProTaper rotary systems. Methods: Twenty-two mesial root canals from mandibular molars were instrumented. Teeth were mounted on a base, numbered, and divided into 2 groups; teeth from 1-11 (PT group) were instrumented by using the ProTaper system, and teeth from 12-22 (ES group) were instrumented by using the EndoSequence system. Cone beam computed tomography was performed on all teeth before and after instrumentation. Measurements at 3,5, and 7 mm as well as differences in instrument performance were statistically compared by the Student t test at 5% significance level. Results: Both systems increased significantly the root canal area (P < .05) at all levels. Comparison between the rotary systems showed significantly greater increase (P < .05) for EndoSequence at 3 mm, with no statistically significant difference (P < .05) at the other levels. Conclusions: Both rotary systems increased significantly the root canal area. (J Endod 2010;36:1179-1182)

Efficacy of Profile .04 taper series 29 in removing filling materials during root canal retreatment-an in vitro study

Objective. The aim of this study was to compare Profile .04 taper series 29 instruments and hand files for gutta-percha removal. Study design. Twenty maxillary central incisors with a single straight canal were instrumented and filled. The teeth were divided into 2 groups of 10 specimens each, according to gutta-percha removal techniques: Group 1- Profile series 29 and Group 2- hand files and solvent. The amount of time for gutta-percha removal and the number of fractured instruments were evaluated. Radiographs were taken and the teeth were grooved longitudinally and split. The area of residual debris was measured using computer software. Results. The time for filling material removal was significantly shorter when Profile series 29 was used (P = .00). Regarding cleanliness, there were no statistical differences in the teeth halves evaluations (P = .05). Hand instruments cleaned the canals significantly better than Profiles, in the radiographic analysis considering the whole canal. Overall, the radiographic analysis showed a smaller percentage of residual debris than the teeth halves analysis. Conclusion. The Profile series 29 instruments proved to be faster than hand instruments in removing root filling materials; however, hand instruments yielded better root canal cleanliness. Some residual debris was not visualized by radiographs. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e46-e50)

Cytotoxicity of resin-based light-cured liners

Purpose: To evaluate the cytotoxic effects of resin-based light-cured liners on culture of pulp cells. Methods: Discs measuring 4 mill in diameter and 2 mm thick were fabricated from TheraCal (TCMTA), Vitrebond (VIT), and Ultrablend Plus (UBP). These specimens were immersed in serum-free culture medium (DMEM) for 24 hours or 7 days to produce the extracts. After incubating the pulp cells for 72 hours, the extracts were applied on the cells and the cytotoxic effects were determined based on the cell metabolism (MTT), total protein expression and cell morphology (SEM). In the control group, fresh DMEM was used. Data from MTT analysis and protein expression were submitted to Kruskal-Wallis and Mann-Whitney tests at the preset level of significance of 5%. Results: When in contact with the 24-hour extract, TCMTA, VIT, and UBP decreased the cell metabolism by 31.5%, 73.5% and 71.0%, respectively. The total protein expressed by the cells in contact with VIT and UBP was lower than TCMTA and DMEM (Mann-Whitney, P< 0.05). When in contact with the 7-day extract, TCMTA, VIT, and UBP decreased the metabolic activity by 45.9%, 77.1% and 64.4%, respectively. All the liners expressed statistically lower amounts of proteins when compared to the control. A reduction in the number of cells was observed for all liners. The remaining cells from TCMTA group resembled those from the control group while for VIT and UBP the cells presented significant morphological alterations. (Ani J Dent 2009;22:137-142).

Caries-preventive Efficacy and Retention of a Resin-modified Glass lonomer Cement and a Resin-based Fissure Sealant: A 3-year Split-mouth Randomised Clinical Trial

Purpose: This prospective clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period. Materials and Methods: Using a split-mouth randomised design, 1280 sealants were randomly applied on sound permanent second molars of 320 young patients aged between 12 and 16 years. Half of the teeth (n = 640) were sealed with a resin-modified glass ionomer cement (RMGIC) (Vitremer (TM), 3M ESPE) and the other half (n = 640) with a conventional light-cure, resin-based fissure sealant (LCRB) (Fluoroshield (R), Dentsply Caulk). Teeth were evaluated at baseline, 6-, 12-, 18-, 24-, 30- and 36-month intervals with regard to retention and new caries development. Results: On the sealed occlusal surfaces after 3 years, 5.10% of RMGIC and 91.08% of LCRB sealants were totally intact and 6.37% of RMGIC and 7.65% of LCRB sealants were partially intact. New caries lesions were found in 20.06% of RMGIC sealed occlusal surfaces, compared to 8.91% for LCRB sealants. Conclusions: The findings of the present clinical study suggest that RMGIC should be used only as a transitional sealant that can be applied to newly erupting teeth throughout the eruptive process, whereas LCRB sealants are used to successfully prevent occlusal caries lesions once an effective rubber dam can be achieved. It can be concluded that there are differences between the RMGIC and LCRB sealants over a 3-year period in terms of the retention rate and caries-preventive efficacy. RMGIC can serve as a simple and economic sealing solution, however provisional. Due to its poor retention rate, periodic recalls are necessary, even after 6 months, to eventually replace the lost sealant.

Flat-Oval Root Canal Preparation with Self-Adjusting File Instrument: A Micro-Computed Tomography Study

Introduction: The aim of this study was to evaluate the root canal preparation in flat-oval canals treated with either rotary or self-adjusting file (SAF) by using micro-tomography analysis. Methods: Forty mandibular incisors were scanned before and after root canal instrumentation with rotary instruments (n = 20) or SAF (n = 20). Changes in canal volume, surface area, and cross-sectional geometry were compared with preoperative values. Data were compared by independent sample t test and chi(2) test between groups and paired sample t test within the group (alpha = 0.05). Results: Overall, area, perimeter, roundness, and major and minor diameters revealed no statistical difference between groups (P > .05). In the coronal third, percentage of prepared root canal walls and mean increases of volume and area were significantly higher with SAF (92.0%, 1.44 +/- 0.49 mm(3), 0.40 +/- 0.14 mm(2), respectively) than rotary instrumentation (62.0%, 0.81 +/- 0.45 mm(3), 0.23 +/- 0.15 mm2, respectively) (P < .05). SAF removed dentin layer from all around the canal, whereas rotary instrumentation showed substantial untouched areas. Conclusions: In the coronal third, mean increases of area and volume of the canal as well as the percentage of prepared walls were significantly higher with SAF than with rotary instrumentation. By using SAF instruments, flat-oval canals were homogenously and circumferentially prepared. The size of the SAF preparation in the apical third of the canal was equivalent to those prepared with #40 rotary file with a 0.02 taper. (J Endod 2011;37:1002-1007)

Apical limit of root canal filling and its relationship with success on endodontic treatment of a mandibular molar: 11-year follow-up

Objective. This article discusses the relationship between apical limit of root canal filling and success on endodontic treatment of a mandibular molar. Study design. A mandibular right first molar with vital pulp was endodontically treated, and 3 years later periapical lesions on mesial and distal roots were detected. The canals were retreated and obturated to the same levels as in the previous treatment. Results. An 8-year radiographic follow-up showed repair of the periapical lesions on both roots. Conclusions. Results suggest that the apical limit of obturation seems to have no influence in the repair of periapical tissues in mandibular molars. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: e48-e50)

Effect of a bleaching agent on abrasion of resin-based restoratives

Purpose: To evaluate the effect of a 10% carbamide peroxide-containing bleaching agent on brushing abrasion of esthetic restorative materials. Methods: Using a randomized complete block design, 150 specimens (n = 15) measuring 3 x 3 x 2 mm were fabricated into acrylic resin cylinders, using one of the restorative materials: a microfilled resin composite (At), a hybrid resin composite (Ch), a flowable resin composite (Wa), a resin-modified glass-ionomer cement (Fj) and a polyacid-modified resin composite (Dy). The bleaching agent or artificial saliva (control) was applied for 2 hours/day. After that, 120 brushing strokes were simulated automatically and the samples were kept in artificial saliva. Such bleaching/brushing cycle was performed daily for 21 days. Wear depth was assessed using profilometry. Results: Bleaching did not show significant effect on wear depth. There was a significant difference among the restorative materials. Tukey`s test showed that (Al=Ch) < (Wa) < (Fj) and that Dy was only different from Fj. (Am J Dent 2009;22:171-174).

Atomic Absorption Spectrometry and Scanning Electron Microscopy Evaluation of Concentration of Calcium Ions and Smear Layer Removal With Root Canal Chelators

Aim. The aim of this study was to evaluate the concentration of calcium ions and smear layer removal by using root canal chelators according to flame atomic absorption spectrophotometry and scanning electron microscopy. Forty-two human maxillary central incisors were irrigated with 15% ethylenediaminetetraacetic acid (EDTA), 10% citric acid, 10% sodium citrate, apple vinegar, 5% acetic acid, 5% malic acid, and sodium hypochlorite. The concentration of calcium ions was measured by using flame atomic absorption spectrometry, and smear layer removal was determined by scanning electron microscopy. Mean +/- standard deviation, one-way analysis of variance, Tukey-Kramer, Kruskal-Wallis, Dunn, and kappa tests were used for statistical analysis. The use of 15% EDTA resulted in the greatest concentration of calcium ions followed by 10% citric acid; 15% EDTA and 10% citric acid were the most efficient solutions for removal of smear layer. (J Endod 2009;35:727-730)

Temperature variation at the external root surface during 980-nm diode laser irradiation in the root canal

Objective: To assess the temperature variation in the cervical, middle and apical thirds of root external wall, caused by 980-nm diode laser irradiation with different parameters. Methods: The roots of 90 canines, had their canals instrumented and were randomly distributed into 3 groups (n = 30) according to the laser potency (1.5 W, 3.0 W and 5.0 W). Each group was subdivided into 3 (n = 10) according to the frequency (CM, 100 Hz and 1000 Hz), and each subgroup divided into 2 (n = S): dried canal or filled with distilled water. The maximum temperature values were collected by 3 thermocouples located at each third of the root external wall and recorded by digital thermometers. Results: The groups irradiated in the continuous mode (CM) presented the highest values (11.82 +/- 5.78), regardless of the canals were dry or not, which were statistically different (p < 0.01) from those obtained with 100 Hz (6.22 +/- 3.64) and 1000 Hz (6.00 +/- 3.36), which presented no statistical difference between them (p > 0.01). The groups irradiated with 5.0 W presented the greatest temperature variation (12.15 +/- 5.14), followed by 3.0 W (7.88 +/- 3.92) and 1.5 W (4.02 +/- 2.16), differing between them (p < 0.01). The cervical third of the root presented the highest temperature rises (9.68 +/- 5.80), followed by the middle (7.66 +/- 4.87) and apical (6.70 +/- 4.23), with statistical difference among them (p < 0.01). After 30 s from the end of irradiation, all the specimens presented temperature variation lower than 10 degrees C. Conclusions: Application of 980-nm diode laser in the root, at 1.5 W in all operating modes, and 3.0 W, in the pulsed mode, for 20 s, can safely be used in endodontic treatment, irrespective of the presence of humidity. (C) 2008 Elsevier Ltd. All rights reserved.