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)

Delayed tooth replantation: MTA as root canal filling

MTA has been investigated as a root-end filling material. Its mechanism of action has some similarities to that of Ca(OH())2. The purpose of this study was to evaluate the repair process taking place in the delayed replantation of monkey teeth using calcium hydroxide and MTA as root canal filling materials. Five monkeys had their lateral incisors extracted and bench-dried for 60 minutes. After root canal preparation, the teeth were assigned to two groups according to root canal filling material: I, calcium hydroxide; and II, MTA. The same treatment sequence was followed for both groups: coronal seal, periodontal ligament removal, immersion of the tooth in 2% acidulated-phosphate sodium fluoride, irrigation of the socket with saline and replantation. Both groups exhibited replacement resorption, areas of ankylosis and absence of inflammatory root resorption. Statistically similar results (p > 0.05) were observed for both groups regarding replacement root resorption, but the groups differed significantly (p < 0.05) regarding the occurrence of ankylosis. MTA may be a viable clinical option for filling teeth submitted to delayed replantation, and is an acceptable option for treating replanted permanent teeth in order to prevent tooth resorption, particularly when dressing changes are not possible.

Effect of root canal status on periodontal healing after surgical injury in dogs.

This study was carried out to observe if the status of the root canal might influence the healing process of surgically prepared experimental periodontal lesions. Forty tooth roots from four dogs were divided into four different groups: a) root canals with vital pulps, b) root canals open to the oral environment, c) root canals infected and filled with zinc oxide eugenol cement, and d) root canals infected and filled with calcium hydroxide. By means of a surgical intervention, a cavity was prepared in the medium portion of the roots. Six months later, the specimens were removed and prepared for histological analysis. The results, which were submitted to statistical analysis, showed that the status of the root canals influenced the healing process of the experimental periodontal lesions. In the groups where the root canals were filled, calcium hydroxide gave the best results. In the group with root canals left open to the oral environment, resorption of the dentin of the experimental cavities, was the most obvious observation. However, it did not prevent the repair process, only slowed it down.

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.

Uncommon crown-root fracture treated with adhesive tooth fragment reattachment: 7 years of follow-up

Crown-root fractures account for 5% of all fractures in permanent teeth and can involve enamel, dentin, and cementum. Depending on whether there is pulpal involvement, these problems may be classified as complicated (which are more common) or noncomplicated. The treatment depends on the level of the fracture line, root length and/or morphology, and esthetic needs. Several treatment strategies are available for esthetic and functional rehabilitation in crown-root fractures. Adhesive tooth fragment reattachment is the most conservative restorative option when the tooth fragment is available and the biological width has no or minimal violation. This article reports a case of an uncomplicated crown-root fracture in the permanent maxillary right central incisor of a young patient who received treatment with adhesive tooth fragment reattachment, preserving the anatomic characteristics of the fractured tooth after periodontal intervention. The fracture line of the fragment had an unusual shape, starting on the palatal side and extending to the buccal side subgingivally. After 7 years, the attached coronal fragment remained in position with good esthetics, as well as clinical and radiographic signs of pulpal vitality, periodontal health, and root integrity, thus indicating success.

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.

Root-supported overdentures associated with temporary immediate prostheses: a case-report

Complete denture fabrication can be a treatment challenge for many dentists, especially when the patient has remaining teeth. So, planning for use of clinical alternatives to improve the treatment prognosis and to enable greater comfort to patient must be considered. This case report describes the use of remaining roots to aid in the stability, support and retention of root-supported overdentures. Thus, immediate prostheses were planned for temporary rehabilitation prior to definitive overdentures. The aim of this study was to demonstrate the planning of root-supported overdentures attached with a ball system for retention associated with immediate dentures between the periods of preparation to fabrication of the definitive overdentures. The proposed treatment met the patient's needs such as being able to carry on normal activities during the sequencing of procedures to be performed over a period of time. The treatment had longevity with patient's knowledge about the necessity of oral hygiene and periodic controls.

The effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root thirds

The purpose of this study was to evaluate the effect of self-adhesive and self-etching resin cements on the bond strength of nonmetallic posts in different root regions. Sixty single-rooted human teeth were decoronated, endodontically treated, post-space prepared, and divided into six groups. Glass-fiber (GF) posts (Exacto, Angelus) and fiber-reinforced composite (FRC) posts (EverStick, StickTeck) were cemented with self-adhesive resin cement (Breeze) (SA) (Pentral Clinical) and self-etching resin cement (Panavia-F) (SE) (Kuraray). Six 1-mm-thick rods were obtained from the cervical (C), middle (M), and apical (A) regions of the roots. The specimens were then subjected to microtensile testing in a special machine (BISCO; Schaumburg, IL, USA) at a crosshead speed of 0.5 mm/min. Microtensile bond strength data were analyzed with two-way ANOVA and Tukey's tests. Means (and SD) of the MPa were: GF/SA/C: 14.32 (2.84), GF/SA/M: 10.69 (2.72), GF/SA/A: 6.77 (2.17), GF/SE/C: 11.56 (4.13), GF/SE/M: 6.49 (2.54), GF/SE/A: 3.60 (1.29), FRC/SA/C: 16.89 (2.66), FRC/SA/M: 13.18 (2.19), FRC/SA/A: 8.45 (1.77), FRC/SE/C: 13.69 (3.26), FRC/SE/M: 9.58 (2.23), FRC/SE/A: 5.62 (2.12). The difference among the regions was statistically significant for all groups (p < 0.05). The self-adhesive resin cement showed better results than the self-etching resin cement when compared to each post (p < 0.05). No statistically significant differences in bond strengths of the resin cements when comparable to each post (p > 0.05). The bond strength values were significantly affected by the resin cement and the highest values were found for self-adhesive resin cement.

Fracture resistance of weakened bovine teeth after long-term use of calcium hydroxide

In some parts of the world, revascularization may not be the most feasible treatment option for necrotic immature teeth. Therefore, apexification remains the most widely utilized treatment option for these cases. This study aimed to evaluate the fracture resistance of weakened bovine tooth roots treated with various irrigant solutions as well as long-term application of calcium hydroxide intracanal medication (ICM). One hundred seventy bovine teeth were randomly divided into three experimental groups (n = 50) and two control groups (n = 10). Group SS was irrigated with physiologic solution; group CHX was treated with 2% chlorhexidine gel and group NaOCl was irrigated with 1% sodium hypochlorite. After instrumentation, root canals were dressed with calcium hydroxide and evaluated at different periods (15, 60, 90, 180, and 360 days). The specimens were loaded at a 45° angle to measure fracture resistance through the use of an EMIC test machine. A decrease in fracture resistance was observed during the time of ICM dressing. The highest values of fracture resistance were observed in group SS with 15 days of ICM, not differing from the control group. Irrigation with NaOCl associated with ICM for 15 days presented the lowest fracture resistance; however, a statistically significant difference was not observed when compared with SS and CHX in the same time period. In longer periods of exposure to ICM (180 and 360 days), root canals irrigated with NaOCl and CHX showed significantly lower fracture resistance than SS (P < 0.05). Apexification with periodic changes of calcium hydroxide medicament leads to weakness of the teeth independent of the irrigation solution used.

Avaliação da capacidade seladora apical de um adesivo dentinário, acrescido ou não de hidróxido de cálcio, comparada à de um cimento endodôntico à base de hidróxido de cálcio, na obturação de canais radiculares

Pós-graduação em Odontologia Restauradora - ICT

Efeito dos lasers de Nd:YAG e de Er:YAG na adaptação das obturações de canais radiculares: análise do selamento marginal apical

Pós-graduação em Odontologia Restauradora - ICT

Determination of the p-monochlorophenol residue in the calcium hydroxide plus p-monochlorophenol combination used as an intracanal dressing in pulpless teeth of dogs with induced chronic periapical lesion

To determine the presence of p-monochlorophenol in the calcium hydroxide (Calen) + p-monochlorophenol combination after its use as intracanal dressing, periapical lesions were induced in 60 root canals of upper and lower premolars of four dogs, After biomechanical preparation, the root canals received the intracanal medication, which was removed from the apical third after 2, 4, 7, and 14 days for chemical analysis by spectrophotometry, the results showed a p-monochlorophenol loss of approximately 50.0% in the dressing after 48 h, with no further significant loss after longer periods of times, p-Monochlorophenol was still present in the medication after 14 days.

Delayed tooth repalantetion after treatment of necrotic periodontal ligament with citric acid

Objective: to evaluated the effect of treating root-adhered necrotic periodontal ligament (PDL) with citric acid on the healing process in delayed rat tooth replantation. Material and Methods: Forty Wistar rats, assigned to 4 groups (n=10), had their upper right incisor extracted and kept dry on a workbench. For Group I (control), the teeth were replanted after a 5 min extra-alveolar time. For the other groups, replantation was done after 60 min. In Group II, the root canals were filled with a calcium hydroxide-based paste and the teeth were replanted with no root surface treatment. In Group III, the teeth were immersed in citric acid (pH 1) for 3 min, the canals were filled with calcium hydroxide and the teeth were replanted. In Group IV, instead of the immersion, the roots were scrubbed with gauze soaked in citric acid and the teeth were replanted. The animals were sacrificed 60 days postoperatively. Results: Regarding replacement resorption, there was statistically significant difference (p < 0.05) between the control group and the other three groups. No statistically significant difference (p > 0.05) was found among the groups regarding the areas of inflammatory resorption. There was also a statistically significant difference (p < 0.05) between the control group and Group IV regarding ankylosis. The control group showed the least replacement resorption percent means compared to the other groups (p < 0.05). The root structure was more affected by replacement resorption and ankylosis in Group IV compared to the Groups II and III, but this difference was not significant statistically (p > 0.05). Conclusion: the treatment of root surface-adhered necrotic periodontal ligament with citric acid was not able to prevent the occurrence of ankylosis, root resorption and inflammatory resorption in delayed rat tooth replantation.

Storage media for avulsed teeth: a literature review

Dental avulsion is the most severe type of traumatic tooth injuries because it causes damageto several structures and results in the complete displacement of the tooth from its socketin the alveolar bone. The ideal situation is to replant an exarticulated tooth immediatelyafter avulsion because the extraoral time is a determinant factor for treatment successand for a good prognosis. However, it is not always possible. The success of replantationdepends on a number of factors that may contribute to accelerate or minimize theoccurrence of root resorption or ankylosis, among which is the type and characteristicsof the medium used for temporary storage during the time elapsed between avulsionand replantation. Maintaining the tooth in an adequate wet medium that can preserve,as longer as possible, the vitality of the periodontal ligament cells that remain on rootsurface is the key to success of replantation. Recent research has led to the developmentof storage media that produce conditions that closely resemble the original socketenvironment, with adequate osmolality (cell pressure), pH, nutritional metabolites andglucose, and thus create the best possible conditions for storage. Although these storagemedia can now be purchased in the form of retail products, the most common scenariois that such a product will not be readily available at the moment of the accident Thispaper reviews the literature on the different storage media that have been investigatedfor avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBOand SciELO electronic databases using the key words storage medium , transportationmedium , avulsion , tooth avulsion , replantation , tooth replantation , milk and propolis .After application of inclusion and exclusion criteria, 39 papers were selected and criticallyreviewed with respect to the characteristics, efficacy and ease of access of the storagemedium. The review of the lite