Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers

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

Calcium hydroxide root canal sealers - Histopathologic evaluation of apical and periapical repair after endodontic treatment

Eighty root canals of the premolars of 4 dogs, with vital pulp, were instrumented and filled during the same session with the Sealapex, CRCS, Sealer 26, and Apexit sealers, the animals were sacrificed 180 days after root canal filling and their maxillae and mandibles were removed and fixed in 10% formalin, After routine histologic processing, the sections were stained with hematoxylin-eosin and Mallory trichrome, Histopathologic analysis showed that Sealapex was the sealer that best permitted the deposition of mineralized tissue at the apical level and was the only sealer that provided complete sealing (37.5% of cases), With the use of Sealapex, no inflammatory infiltrate occurred and there was no reabsorption of mineralized tissues, In contrast, partial sealing and a moderate inflammatory infiltrate occurred with the use of CRCS, When Apexit and Sealer 26 were used the absence of sealing was frequent and active reabsorption of mineralized tissues occurred in most cases, the inflammatory infiltrate predominating with the use of Apexit was of the severe type, whereas with the use of Sealer 26 the inflammatory infiltrate was mild or absent.

Root canal filling: fracture strength of fiber-reinforced composite-restored roots and finite element analysis

The aims of this study were to evaluate the effect of root canal filling techniques on root fracture resistance and to analyze, by finite element analysis (FEA), the expansion of the endodontic sealer in two different root canal techniques. Thirty single-rooted human teeth were instrumented with rotary files to a standardized working length of 14 mm. The specimens were embedded in acrylic resin using plastic cylinders as molds, and allocated into 3 groups (n=10): G(lateral) - lateral condensation; G(single-cone) - single cone; G(tagger) - Tagger's hybrid technique. The root canals were prepared to a length of 11 mm with the #3 preparation bur of a tapered glass fiber-reinforced composite post system. All roots received glass fiber posts, which were adhesively cemented and a composite resin core was built. All groups were subjected to a fracture strength test (1 mm/min, 45°). Data were analyzed statistically by one-way ANOVA with a significance level of 5%. FEA was performed using two models: one simulated lateral condensation and Tagger's hybrid technique, and the other one simulated the single-cone technique. The second model was designed with an amount of gutta-percha two times smaller and a sealer layer two times thicker than the first model. The results were analyzed using von Mises stress criteria. One-way ANOVA indicated that the root canal filling technique affected the fracture strength (p=0.004). The G(lateral) and G(tagger) produced similar fracture strength values, while G(single-cone) showed the lowest values. The FEA showed that the single-cone model generated higher stress in the root canal walls. Sealer thickness seems to influence the fracture strength of restored endodontically treated teeth.

Retromolar canal associated with age, side, sex, bifid mandibular canal, and accessory mental foramen in panoramic radiographs of Brazilians

Background. The retromolar canal (RMC) is an anatomical variation that can cause complications in dental procedures. Method. The RMC was evaluated according to age, sex, and presence of accessory mandibular canal and accessory mental foramen, on both sides in 500 panoramic radiographs, belonging to individuals at the age of 7 to 20 years. The associations of interest were studied through Fisher's Exact Test and Pearson's Chi-Square Test, and the correlation was studied through Pearson's Correlation Coefficient (r). The significance level used was 5%. Results. The RMC was observed in 44 radiographs (8.8%), and out of those 24 were females. There was no statistically significant association between the RMC and age (p > 0.05; Fisher's Exact Test), sex (p = 0.787; Pearson's Chi-Square Test), amount of mandibular canals and mental foramina, on both sides (p > 0.05; Pearson's Chi-Square Test). There was a significant association between RMC and side, the higher frequency of the canal being on the right side (p < 0.05; Fisher's Exact Test). Conclusions. Despite the low occurrence of the RMC, its identification and the verification of its dimensions and path are relevant, mainly in cases when anesthetic and surgical procedures can present failures or difficulties.

Correlation between volume of apical periodontitis determined by cone-beam computed tomography analysis and endotoxin levels found in primary root canal infection

This clinical study was conducted to correlate the levels of endotoxins and bacterial counts found in primary endodontic infection with the volume of periapical bone destruction determined by cone-beam computed tomography (CBCT) analysis. Moreover, the levels of bacteria and endotoxins were correlated with the development of clinical features. Twenty-four root canals with primary endodontic disease and apical periodontitis were selected. Clinical features such as pain on palpation, pain on percussion, and previous episode of pain were recorded. The volume (cubic millimeters) of periapical bone destruction was determined by CBCT analysis. Endotoxins and bacterial samplings were collected by using sterile/apyrogenic paper points. Endotoxins were quantified by using limulus amebocyte lysate assay (KQCL test), and bacterial count (colony-forming units [CFU]/mL) was determined by using anaerobic culture techniques. Data were analyzed by Pearson correlation and multiple logistic regression (P < .05). Endotoxins and bacteria were detected in 100% of the root canal samples (24 of 24), with median values of 10.92 endotoxin units (EU)/mL (1.75-128 EU/mL) and 7.5 × 10(5) CFU/mL (3.20 × 10(5)-8.16 × 10(6) CFU/mL), respectively. The median volume of bone destruction determined by CBCT analysis was 100 mm(3) (10-450 mm(3)). The multiple regression analysis revealed a positive correlation between higher levels of endotoxins present in root canal infection and larger volume of bone destruction (P < .05). Moreover, higher levels of endotoxins were also correlated with the presence of previous pain (P < .05). Our findings revealed that the levels of endotoxins found in root canal infection are related to the volume of periapical bone destruction determined by CBCT analysis. Moreover, the levels of endotoxin are related to the presence of previous pain.

Delayed tooth replantation following root canal filling with calcium hydroxide and MTA: Histomorphometric study in rats

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

Environmental and Farm Management Factors Associated with Tuberculosis on Cattle Farms in Northeastern Michigan

Objective—To identify major environmental and farm management factors associated with the occurrence of tuberculosis (TB) on cattle farms in northeastern Michigan. Design—Case-control study. Sample Population—17 cattle farms with infected cattle and 51 control farms. Procedure—Each case farm (laboratory confirmed diagnosis of Mycobacterium bovis infection) was matched with 2 to 4 control farms (negative whole-herd test results within previous 12 months) on the basis of type of farm (dairy or beef) and location. Cattle farm data were collected from in-person interviews and mailed questionnaires. Wildlife TB data were gathered through state wildlife surveillance. Environmental data were gathered from a satellite image-based geographic information system. Multivariable conditional logistic regression for matched analysis was performed. Results—Major factors associated with increased farm risk of TB were higher TB prevalence among wild deer and cattle farms in the area, herd size, and ponds or creeks in cattle housing areas. Factors associated with reduced farm risk of TB were greater amounts of natural open lands in the surrounding area and reducing deer access to cattle housing areas by housing cattle in barns, barnyards, or feedlots and use of electrified wire or barbed wire for livestock fencing. Conclusions and Clinical Relevance—Results suggest that certain environmental and management factors may be associated with risk of TB on cattle farms.

Spatial and Temporal Spread of Bovine Tuberculosis in Wild White-Tailed Deer in Michigan

In 1975, a wild white-tailed deer infected with bovine tuberculosis was shot in the northeastern Lower Peninsula, Michigan. The shooting of a second infected deer in the same area in 1994 triggered ongoing disease surveillance in the region. By 2002, bovine tuberculosis had been confirmed in 12 Michigan counties: from 449 deer; two elk; 41 non-cervid wildlife; one captive cervid facility and 28 cattle herds. We analyzed geographic spread of disease since the surveillance began and investigated factors influencing the prevalence of disease within the infected area. These analyses reveal that 78 percent of tuberculous deer came from within a 1560 km2 'core' area, within which the prevalence of apparent disease averaged 2.5 percent. Prevalence declined dramatically outside of the core and was an order of magnitude lower 30 km from its boundary. This prevalence gradient was highly significant (P<0.0001) and did not alter over the 6 year surveillance period (P= 0.98). Within the core, deer density and supplemental feeding by hunters were positively and independently correlated with tuberculosis prevalence in deer. Together, these two factors explained 55 percent of the variation in prevalence. We conclude that bovine tuberculosis was already well established in the deer population in 1994, that the infected area has not expanded significantly since that time, and that deer over-abundance and food supplementation have both contributed to ongoing transmission of disease. Managers are currently enforcing prohibitions on deer feeding in the core and are working to lower deer numbers there through increased hunting pressure.

Bovine Tuberculosis in Michigan Wildlife and Livestock

Since 1994, the state of Michigan has recognized a problem with bovine tuberculosis (TB), caused by Mycobacterium bovis, in wild white-tailed deer from a 12-county area in northeastern Lower Michigan. A total of 65,000 free-ranging deer have been tested, and 340 have been found to be positive for M. bovis. The disease has been found in other wildlife species, and, in 1998, in domestic cattle, where to date 13 beef cattle and 2 dairy cattle herds have been diagnosed with bovine TB. Unfortunately, the situation is unique in that there have never been reports of self-sustaining bovine TB in a wild, free-ranging cervid population in North America. Scientists, biologists, epidemiologists, and veterinarians who have studied this situation have concluded that the most logical theory is that high deer densities and the focal concentration caused by baiting (the practice of hunting deer over feed) and feeding are the factors most likely responsible for the establishment of self-sustaining TB in free-ranging Michigan deer. Baiting and feeding have been banned since 1998 in counties where the disease has been found. In addition, the deer herd has been reduced by 50% in the endemic area with the use of unlimited antlerless permits. The measures of apparent TB prevalence have been decreased by half since 1997, providing hopeful preliminary evidence that eradication strategies are succeeding.

Epizootiologic Survey of Mycobacterium Bovis in Wildlife and Farm Environments in Northern Michigan

Bovine tuberculosis (bovine TB), caused by Mycobacterium bovis, has reemerged in northern Michigan, USA, with detections in white-tailed deer (Odocoileus virginianus) in 1994 and in cattle in 1998. Since then, significant efforts have been directed toward reducing deer densities in the area in the hopes of reducing the bovine TB prevalence rate in deer and eliminating spillover of the disease into cattle. Despite the success of the efforts to reduce deer densities, additional cattle herds have become infected. Other mammals can be infected with M. bovis, and some carnivores and omnivores had been found to be infected with the disease in northern Michigan, USA. We conducted a multiyear surveillance effort to detect bovine TB in wild species of mammals in the Michigan, USA, outbreak area. From 2002 to 2004, tissue samples from 1,031 individual animals of 32 species were collected, processed, and cultured for M. bovis. Only 10 (1.0%) were culture-positive for M. bovis (five raccoons [Procyon lotor], four opossums [Didelphis virginiana], and one grey fox [Urocyon cinereoargenteus]). We also found two raccoons and four opossums to be positive for Mycobacterium avium. We collected 503 environmental samples from cattle farms recently identified as bovine TB positive; none yielded positive M. bovis culture results. Finally, we used infrared cameras to document wildlife use of four barns in the area. Many avian and mammalian species of wildlife were observed, with raccoons being the most commonly observed species. This surveillance study identified no new wildlife species that should be considered significant reservoirs of bovine TB in the outbreak area in northern Michigan, USA. However, the relatively high, apparent bovine TB prevalence rates in some carnivorous and omnivorous species, their relatively long life spans, and their frequent use of barns, suggests that removal of raccoons, opossums, foxes, and coyotes (Canis latrans) should be considered when a newly infected farm is depopulated of cattle.

Situational and Driver Characteristics Associated With Deervehicle Collisions in Southeastern Michigan

Deer-vehicle collisions (DVCs) create societal impacts throughout the range of white-tailed deer (Odocoileus virginanus). In Michigan reported DVCs increased by nearly 60% between 1992-2003, with current estimates at more than 65,000 DVCs per year and a mean of $2,300 vehicle damage. To better understand where to direct education and information programs, we used Office of Highway Safety Planning (OHSP) data, 2001-2003, to profile driver characteristics and accident situations of DVCs in Washtenaw, Oakland, and Monroe Counties in Michigan. Each county varies in intensity of land use, human and deer densities, and available deer habitat. Deer density in Washtenaw, Oakland, and Monroe Counties was 49.5, 21.9 and 8.9 per mi2, respectively, and the annual rate of DVCs in these counties was 5.3, 2.6 and 1.8 per 1,000 licensed drivers. Drivers are at particular risk of being involved in DVCs between 6pm- 6am, which includes dawn and dusk commuting hours, and night. Single lane roads and roads with higher posted speed limits provided greater risk to drivers of involvement in a DVC. Middle-aged drivers, particularly males, were at increased risk deer-related collisions. Results from this study will be combined with survey research to determine how best to educate drivers about risk factors that make occurrence of a DVC more likely.

Evaluation of Radiopacity, pH, Release of Calcium Ions, and Flow of a Bioceramic Root Canal Sealer

Introduction: The aim of the present study was to evaluate the physicochemical properties of a bioceramic root canal sealer, Endosequence BC Sealer. Radiopacity, pH, release of calcium ions (Ca2+), and flow were analyzed, and the results were compared with AH Plus cement. Methods: Radiopacity and flow were evaluated according to ISO 6876/2001 standards. For the radiopacity analysis, metallic rings with 10-mm diameter and 1-mm thickness were filled with cements. The radiopacity value was determined according to radiographic density (mm Al). The flow test was performed with 0.05 mL of cement placed on a glass plate. A 120-g weight was carefully placed over the cement. The largest and smallest diameters of the disks formed were measured by using a digital caliper. The release of Ca2+ and pH were measured at periods of 3, 24, 72, 168, and 240 hours with spectrophotometer and pH meter, respectively. Data were analyzed by analysis of variance and Tukey test (P < .05). Results: The bioceramic endodontic cement showed radiopacity (3.84 mm Al) significantly lower than that of AH Plus (6.90 mm Al). The pH analysis showed that Endosequence BC Sealer showed pH and release of Ca2+ greater than those of AH Plus (P < .05) during the experimental periods. The flow test revealed that BC Sealer and AH Plus presented flow of 26.96 mm and 21.17 mm, respectively (P < .05). Conclusions: Endosequence BC Sealer showed radiopacity and flow according to ISO 6876/2001 recommendations. The other physicochemical properties analyzed demonstrated favorable values for a root canal sealer. (J Endod 2012;38:842-845)

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

Objective: This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure. Material and Methods: One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blot-dried. A trial adhesive (base to catalyst on a 1: 1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TEGDMA, 0.5% EDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1: 2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturer's instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy. Results: Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (Exp 1 - ethanol-wet bonding technique)=Group 2 (Exp 2 - ethanol-wet bonding technique)= Group 3 (OSP - ethanol-wet bonding technique)= Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface. Conclusions: The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

In vivo accuracy of conventional and digital radiographic methods in confirming root canal working length determination by Root ZX

Objectives: To compare, in vivo, the accuracy of conventional and digital radiographic methods in determining root canal working length. Material and Methods: Twenty-five maxillary incisor or canine teeth from 22 patients were used in this study. Considering the preoperative radiographs as the baseline, a 25 K file was inserted into the root canal to the point where the Root ZX electronic apex locator indicated the APEX measurement in the screen. From this measurement, 1 mm was subtracted for positioning the file. The radiographic measurements were made using a digital sensor (Digora 1.51) or conventional type-E films, size 2, following the paralleling technique, to determine the distance of the file tip and the radiographic apex. Results: The Student "t" test indicated mean distances of 1.11 mm to conventional and 1.20 mm for the digital method and indicated a significant statistical difference (p<0.05). Conclusions: The conventional radiographic method was found to be superior to the digital one in determining the working length of the root canal.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

Objective: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods: The operators prepared one canal with RaCe rotary instruments and another with Flexofiles. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radial's, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.