Effect of the association between the tray and impression techniques on angulated implants using the All-on-Four system

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

Efeitos da aplicação de resina hidrofóbica sobre a resistência de união de adesivos autocondicionantes de frasco único

Introduction: It is known that self-etching adhesive systems can act as semi-permeable membranes. Objective: Evaluate the effects of additional layer of hydrophobic resin on the microtensile bond strength of self-etching one-bottle adhesives. Material and method: Sixty bovine incisors were used in this study. The facial enamel surfaces of the crowns were abraded with silicon carbide paper to expose flat, mid-coronal dentin surfaces. The following adhesives were used: Clearfil Tri S Bond (CTSB), AdheSE One (ADH) and One Coat  7.0 (OC). Each material was tested with and without applying an additional layer of hydrophobic material from the same manufacturer. Z-350 composite resin was inserted in three 1 mm increments. All adhesive restorative procedure was performed under simulated pulpal pressure and the microtensile test was performed immediately after curing the composite resin. Data were submitted to ANOVA and Tukey test (p < 0.05). Result: For all adhesives tested, the worst results were observed in groups which the additional layer of hydrophobic resin was not applied. Conclusion: The application of additional layer of hydrophobic material can improve the adhesion of self-etching all-in-one adhesive systems.

Effects of coronal leakage on concentration of hydrogen ions and calcium hydroxide release of several calcium hydroxide pastes over different periods of time

Purpose: To evaluate the effects of coronal leakage on concentration of hydrogen ions (pH) and calcium release of several calcium hydroxide pastes, over different periods of time. Material and Methods: Fifty extracted human mandibular central incisors (n=10) were instrumented up to the F2 instrument and assigned to the following intracanal dressing: G1- Calen, G2- Calen with 0.4% chlorhexidine (CHX), G3- Calcium hydroxide with camphorated paramonochlorophenol (CPMC) and glycerin, G4- Calen, but temporary filling material maintained during all test (positive control) and G5- Root canal without intracanal dressing (negative control). All groups were immersed in distilled water for 7 days. In sequence, the temporary filling materials were removed, except in controls groups. All specimens were individually mounted on a specific device and only its root again immersed in distilled water. Concentration of hydrogen ions and calcium release by calcium hydroxide pastes in distilled water were evaluated in 24h, 7, 14 and 28 days. The results were submitted to ANOVA test (p = 0.05). After 28 days, root canals from experimental groups were examined in SEM. Results: G1, G2, G3 and G4 presented similar pH values and calcium release and did not differ from each other (p>0.05), up to 7 days. After this time G1, G2 and G3 presented values lower values than G4 (p<0.05). In SEM analysis, calcium hydroxide residues were observed in all experimental groups. Conclusions: After 7 days, coronal leakage decreased the concentration of hydrogen ions and calcium ion release provided by all calcium hydroxide pastes.

Effect of calcium chloride on the pH values of several formulations of calcium hydroxide mixed with chlorhexidine digluconate

This study evaluated the effect of the addition of 5% calcium chlorite (CaCl2) on pH values in calcium hydroxide pastes (CH), with or without 2% chlorhexidine digluconate (CHX) used as vehicle, in several periods analysis. Polyethylene tubes were filled with CH mixed with water (G1), 2% CHX solution (G2) or gel (G3), or CHX solution or gel with 5% CaCl2 (G4 and G5, respectively). All tubes were individually immersed in distilled water. After 12, 24 hours, 7, 14 and 28 days, pH value was evaluated directly in water which the tubes were stored. Data were submitted to ANOVA and Tukey tests (α=0.05). In 24 hs and 14 days, pH values were similar to all groups. In 12 hs, the G1 presented lower pH value than other groups except to G4 (p < 0.05), and G4 presented lower pH value than G5 (p < 0.05). In 7 days, G1 presented lower pH value than G4 and G5 (p < 0.05). In 28 days, G1 and G5 presented lower pH values than G2 and G4 (p < 0.05) and among other groups there are no statistical differences (p > 0.05). The pH values increased in long-term analysis to all CH pastes. The association of 5% calcium chloride with 2% CHX solution as vehicle of CH paste provided a pH value increase in relation to CH mixed with distilled water. The CHX gel interfered negatively on pH value in comparison to CHX solution when mixed with CaCl2.

Effect of two formulations of 10% sodium ascorbate on fracture resistance of endodontically treated tooth submitted to dental bleaching with hydrogen peroxide associated titanium dioxide nanoparticles

Purpose: This study evaluated the effect of 10% sodium ascorbate (10SA), in gel (10SAg) or aqueous solution (10SAs) formulations, on fracture resistance of endodontically treated tooth submitted to dental bleaching procedures with 15% hydrogen peroxide associated with titanium dioxide (15HP-TiO2) nanoparticles and photoactivated by LED-laser. Material and methods: Forty maxillary premolars were endodontically-treated and embedded in acrylic resin up to the cement-enamel junction. The specimens were divided into four groups (n=10): G1 (negative control): no bleaching, coronal access restored with composite resin; G2 (positive control): three dental bleaching sessions using 15HP-TiO2 and LED-laser photoactivation and restored with composite resin (positive control); G3 (10SAg): similar procedures to G2, but applied 10SA, in gel formulation, for 24 hours before restoration; G4 (10SAs): similar procedures to G3, but applied 10SA, in aqueous solution formulation. The 15HP-TiO2 was applied on buccal and lingual surfaces of the crown tooth and inside the pulp chamber and photoactivated by LED-laser. Between each bleaching session, the teeth were maintained in artificial saliva, at 37oC, for 7 days. In sequence, the teeth were submitted to fracture resistance testing using an eletromechanical machine test. The data was analyzed using Kruskal Wallis test (p = 0.05) Results: There are no differences significant among the groups in relation to fracture resistance of endodontically treated teeth (p>0.05). Conclusions: The use of 10% sodium ascorbate, in gel or aqueous solution formulations, did not interfered on the fracture resistance teeth after dental bleaching using 15HP-TiO2 and LED-laser photoactivation.

Influencia de diferentes intensidades de luz en la resistencia de unión de un sistema adhesivo utilizando un colorante fluorescente para su observación

The purpose of this study was to use a fluorescent dye and CLSM microscope to observe the effect of different light intensities on dentin tensile bond strength. Flat dentin surfaces were created on 16 intact human third molars and divided in 4 groups: Group G1 - halogen - KM -200R®; Group G2 - LED - Ultraled®; Group G3 - LED - UltraLume LED5® and Group G4 - LED - Biolux Single V®. For all the groups, the restoration procedure used Single Bond® adhesive, mixed with rodamin B and InTen-S® composite resin. Then, they were cut on serial sections to obtain 1 mm2 area and submitted to micro tensile test and after words, the fractures were analyzed with a digital microscope and CLSM. The statistical analysis showed that all in all groups, except Group G2, which had a significant smaller tensile bond strength ratio. The fracture mode analysis showed that there were significant differences when comparing groups G1 / G2, and G2 / G4. There is no evidence of relevant differences among the other groups. With these results, we conclude that the use of fluorescent dye and CLSM demonstrated to be a simple and nondestructive technique, and that there are evidences that light intensities influenced the dentine tensile.

Ethanol is inefficient to remove endodontic sealer residues of dentinal surface

Endodontic sealer residues on dentinal surface have negative effects on adhesion of adhesives system and/or can cause discoloration of the dental crown. Objective: To evaluate the efficacy of 95% ethanol in removal of residues of epoxy-based (AH Plus), methacrylate-based (Epiphany SE) or calcium-based (Sealapex) sealers on dentinal surface. Material and methods: Thirty-two bovine incisor dental crown fragments (0.5 mm x 0.5 mm) were treated with 17% EDTA and 2.5% NaOCl. The specimens were divided into three experimental groups (n = 10): G1 (AH Plus), G2 (Epiphany SE) and G3 (Sealapex). In each group was applied a coating of one endodontic sealer type and were left undisturbed for 5 minutes. After this period, the specimens were cleaned with 95% ethanol. The control group was composed by two specimens that did not receive any sealer or cleaning treatment. The sealer residues persistence after cleaning with 95% ethanol was evaluated by scanning electron microscopy (x500) and a score system was applied. Data obtained were analyzed by Kruskal-Wallis and Dunn tests (α = 5%). Results: Moderate amount of endodontic sealer residues were observed in all groups, regardless of the endodontic sealer compositions. G1, G2 and G3 presented similar amount of sealer residues on dentinal surface after cleaning with 95% ethanol (p > 0.05). Conclusion: 95% ethanol was inefficiency to remove completely AH Plus, Epiphany SE and Sealapex residues of sealer-contaminated dentin.

Análise comparativa da rugosidade superficial de resinas compostas de alta densidade

The success achieved by the use of composite resins in anterior teeth precipitately leads their use in posterior teeth. However, the indiscriminate application of these materials in cavities with several diverse sizes rapidly pointed out their lack of resistance to oclusal and proximal wear. OBJECTIVE: To evaluate the surface roughness of composite resin in relation to finishing and polishing technique. MATERIAL AND METHODS: Eight experimental groups (n = 15) were divided according to finishing and polishing technique: G1 – Z250TM composite resin without surface finishing and polishing; G2 – Z250TM composite resin plus surface finishing and polishing; G3 – P60TM composite resin without surface finishing and polishing; G4 – P60TM composite resin plus surface finishing and polishing; G5 – Prodigy CondensableTM composite resin without surface finishing and polishing; G6 – Prodigy CondensableTM composite resin plus surface finishing and polishing; G7 – SurefillTM composite resin without surface finishing and polishing; G8 – SurefillTM composite resin plus surface finishing and polishing. Three packable and one microhybrid (control group) composite resin was used. The surface roughness was measured using a profilometer at three points in each sample. The results were evaluated by ANOVA and Tukey test (p < 0.05). RESULTS: Prodigy CondensableTM composite resin showed the lowest surface roughness, while SurefillTM showed the highest surface roughness. Comparing the resins used, only between P60TM and SurefillTM there were no statistically significant differences (p > 0,05). CONCLUSION: Surface roughness was lower in all types of resin composites surfaces in contact with Mylar matrix strip than in areas submitted to finishing and polishing procedure.

Avaliação da eficácia de limpeza de quatro agulhas irrigadoras endodônticas

The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. OBJECTIVE: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. MATERIAL AND METHODS: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file), root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution) and after irrigation (remnant of contrast solution), were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed by using Anova and Tukey's test. The level of significance was set at P < 0.05. RESULTS: For all root canal enlargements, 30G needles (G3 e G4) presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. CONCLUSION: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

Effect of staining agents on color change of composites

Composite resins are materials that can present color changing when exposed to pigments. Objective: The aim of this study was to evaluate, in vitro, the color changing of composites after immersion in different substances for different periods. Material and methods: Two microhybrid composite resins: Charisma (Heraeus – Kulzer) and Opallis (FGM) were used. Red wine and acai pulp were also used as immersion medium. For this study, 32 specimens with 10 mm of diameter and 2 mm of thickness were used, divided into 4 groups: Group 1 – Opallis composite immersed in red wine solution; Group 2 – Opallis composite immersed in acai berry pulp solution; Group 3 – Charisma composite immersed in red wine solution; Group 4 – Charisma composite immersed in acai berry pulp solution. The specimens were evaluated in the following time periods: T0 – baseline, T1 – 24 hours, T2 – 48 hours, T3 – 72 hours and T4 – 96 hours. For the assessment of staining, a spectrophotometer for colorimetry was used (Color Guide 45 / 0, PCB 6807 BYK-Gardner Gerestsried GmBH, Germany), and the values obtained were transferred to a computer and recorded according to CIELAB system. Results: The data were evaluated using Kruskal- Wallis non-parametric tests with the following mean values for the immersion periods of 24, 48, 72 and 96 hours, respectively: G1 – 7.35, 7.84, 9.04,10.48; G2 – 2.92, 4.15, 4.30, 4.64; G3 – 3.14, 7.35, 8.13, 8.43, G4 – 4.49, 5.99, 6.92, 6.76. Conclusion: Red wine showed a higher tendency toward altering the composite color than acai berry pulp. In addition, no significant difference was found concerning to the behavior of the two composite resins. Concerning to the immersion time periods, significant differences were only observed among the groups in the 24 hour time period.

Influência da agulha irrigadora e da dilatação do canal radicular na eficácia da irrigação endodôntica

Introduction: The irrigation of root canals aims to their cleaning and disinfection, improving endodontic treatment success. Objective: To investigate the influence of the diameter and type of irrigation needle and the root canal enlargement on the mechanical efficacy of endodontic irrigation. Material and methods: Twelve human single-rooted mandibular incisors were used. During some instrumentation stages (enlargement by #20, #30, and #40 K file), root canals were filled with radiographic contrast solution mixed to propyleneglycol and zinc oxide. Needles with different diameters and designs were employed: G1 – 23G and lateral opening; G2 – 22G and apical opening; G3 – 30G and lateral opening; G4 – 30G and apical opening. The needles were inserted up to resistance, with 1 mm step-back to avoid root canal obliteration. The irrigation was performed with 2 mL of distilled water. Before and after irrigation/aspiration, teeth were radiographed at bucco-lingual and mesiodistal direction, using a digital radiographic system. Then, root canal areas, before (filled by contrast solution) and after irrigation (remnant of contrast solution), were submitted to image subtraction with Adobe Photoshop CS4 software. Subsequently, the areas were measured by Image Tool 3.0 software, allowing the obtaining of the cleaning percentage for each modality. Data were analysed by using Anova and Tukey’s test. The level of significance was set at P < 0.05. Results: For all root canal enlargements, 30G needles (G3 e G4) presented a better cleaning efficacy. In all groups, higher cleaning efficacy percentage was observed at #30 and #40 K file enlargement. Conclusion: Regardless their design, thinner needles were more effective; a better cleaning efficacy occurred in more enlarged root canals.

Ethanol is inneficient to remove endodontic sealer residues of dentinal surface

Introduction: Endodontic sealer residues on dentinal surface have negative effects on adhesion of adhesives system and/or can cause discoloration of the dental crown. Objective: To evaluate the efficacy of 95% ethanol in removal of residues of epoxy-based (AH Plus), methacrylate-based (Epiphany SE) or calcium-based (Sealapex) sealers on dentinal surface. Material and methods: Thirty-two bovine incisor dental crown fragments (0.5 mm x 0.5 mm) were treated with 17% EDTA and 2.5% NaOCl. The specimens were divided into three experimental groups (n = 10): G1 (AH Plus), G2 (Epiphany SE) and G3 (Sealapex). In each group was applied a coating of one endodontic sealer type and were left undisturbed for 5 minutes. After this period, the specimens were cleaned with 95% ethanol. The control group was composed by two specimens that did not receive any sealer or cleaning treatment. The sealer residues persistence after cleaning with 95% ethanol was evaluated by scanning electron microscopy (x500) and a score system was applied. Data obtained were analyzed by Kruskal-Wallis and Dunn tests (α = 5%). Results: Moderate amount of endodontic sealer residues were observed in all groups, regardless of the endodontic sealer compositions. G1, G2 and G3 presented similar amount of sealer residues on dentinal surface after cleaning with 95% ethanol (p > 0.05). Conclusion: 95% ethanol was inefficiency to remove completely AH Plus, Epiphany SE and Sealapex residues of sealercontaminated dentin.

Fracture resistance of teeth submitted to several internal bleaching protocols

Aim: The aim of this study was to evaluate the fracture resistance of teeth submitted to several internal bleaching protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP), 15% hydrogen peroxide with titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser or sodium perborate (SP). Materials and methods: After endodontic treatment, fifty bovine extracted teeth were divided into five groups (n = 10): G1-unbleached; G2-35HP; G3-37CP; G4-15HPTiO2 photoactivated by LED-laser and G5-SP. In the G2 and G4, the bleaching protocol was applied in 4 sessions, with 7 days intervals between each session. In the G3 and G5, the materials were kept in the pulp teeth for 21 days, but replaced every 7 days. After 21 days, the teeth were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until teeth fracture. The data were submitted to ANOVA and Tukey tests (α = 5%). Results: The 35HP, 37CP, 15HPTiO2 and SP showed similar fracture resistance teeth reduction (p > 0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p < 0.05). Conclusion: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other. Clinical significance: There are several internal bleaching protocols using hydrogen peroxide in different concentrations and activation methods. This study evaluated its effects on fracture resistance in endodontically-treated teeth.

Influence of the addition of calcium hydroxide powder on some physical and chemical properties of the sealer MTA fillapex

Objective: This study evaluated the flow, pH and calcium release of MTA Fillapex (G1) or Fillapex plus 10% in weight of calcium hydroxide powder (G2), compared to AH Plus (G3) and Sealapex (G4). Materials and methods:The flow test was performed according to ISO 6876:2001 requirements. The sealers were placed into plastic tubes and immersed in deionized water. After 24 hours, 7, 14 and 28 days, the water of each tube was removed and tested to evaluate the pH values and the level of released calcium. Calcium release values were analyzed statistically by Kruskal Wallis and Dunn tests and pH values analyzed by ANOVA and Tukey tests (? = 5%). Results:G1 presented higher flow among all sealers. The addition of 10% calcium hydroxide into MTA Fillapex reduced the flow (p < 0.05) but, in a level, that is lower than the one recommended for ISO norms. G2 and G4 presented pH values and calcium release higher than G3 (p < 0.05) in all periods. G1 presented pH value higher than G3 (p < 0.05), except in 7 days period (p > 0.05). G4 presented higher pH values than G1 and G2, but the calcium release was similar for all periods (p > 0.05). G3 presented lower calcium release among all groups (p < 0.05). Conclusion: The addition of 10% calcium hydroxide in MTA Fillapex caused reduction in flow and no negative interference in pH and/or calcium release. However, the obtained flow is different from ISO requirements. Clinical relevance: MTA Fillapex presents levels of flow above the ISO norms. The addition of calcium hydroxide is a suggestion for solving this problem, but the impact of these procedures should be carefully evaluated.

Effectiveness of ProTaper retreatment system associated with organic solvents in the removal of root canal filling material

Aim: To evaluate the effectiveness of ProTaper universal retreatment system in the removal of root canal filling material with thermomechanical compaction, in comparison to manualmechanical technique, associated with orange oil or eucalyptol. Materials and methods: Forty extracted lower incisors were filled with thermomechanical compaction technique. After 3 years, the root canal filling was removed by: G1 - manualmechanical technique with orange oil; G2 - manual-mechanical technique with eucalyptol; G3 - ProTaper universal retreatment system with orange oil and G4 - ProTaper universal retreatment system with eucalyptol. In sequence, all root canals were instrumented to F5 instrument. The teeth were longitudinally grooved, images of buccal half were obtained in stereomicroscope and covered area by root canal filling material was measured using image tool software, in cervical, middle and apical radicular thirds. The results were subjected ANOVA and Tukey test (p = 0.05). Results: In all thirds, the manual-mechanical technique showed lower presence of root canal filling material on root canal dentin in comparison to ProTaper retreatment universal system, regardless of organic solvent used (p < 0.05). There is no difference between organic solvents in removal root canal filling material (p > 0.05). Conclusion: The ProTaper universal retreatment system showed lower effectiveness in removal root canal filling material than manual-mechanical technique, regardless of organic solvents (orange oil or eucalyptol oil) used. Clinical significance: Recently rotary instruments have been proposed to removal of root canal filling material. However, there are no studies evaluating its effectiveness in removal root canal filling material in association with orange oil or eucalyptol oil.