Photoelastic Analysis of Biomechanical Behavior of Single and Multiple Fixed Partial Prostheses With Different Prosthetic Connections

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

Influence of the type of vehicle and limit of obturation on apical and periapical tissue response in dogs' teeth after root canal filling with mineral trioxide aggregate

The purpose of this study was to investigate the influence of the type of vehicle (distilled water or propyleneglycol) on the response of apical tissues of dogs' teeth after root canal filling with mineral trioxide aggregate (MTA) at two different limits. Forty roots of incisors and premolars of two adult dogs were used. After pulpectomy, the root canals were prepared biomechanically, and the roots had the apical cemental barrier penetrated with a #15 K-file and widened to a #25 K-file. The root canals were assigned to four groups according to the vehicle used for MTA (ProRoot-MTA; Tulsa Dental, Tulsa, OK) preparation and the limit of root canal filling: group 1, filling with MTA/distilled water to the limit of the cemental canal; group 2, overfilling with MTA/distilled water, group 3, filling with MTA/propyleneglycol to the limit of the cemental canal; and group 4, overfilling with MTAlpropyleneglycol. The animals were killed by anesthetic overdose 90 days after endodontic treatment and the anatomic pieces were prepared for histomorphological analysis. The sections were stained with hematoxylin and eosin and Brown and Brenn techniques. The results showed that MTA pastes prepared with either distilled water or propyleneglycol as vehicles had similar biological behavior (p > 0.05); root fillings placed at the cemental canal limit showed better results than the overfillings (p = 0.01), and MTA/propyleneglycol paste was more easily placed into the root canals than MTA/distilled water paste.

Influence of apical patency and filling material on healing process of dogs' teeth with vital pulp after root canal therapy

Foi propósito deste trabalho observar o processo de reparo de dentes de cães após obturação dos canais com dois cimentos diferentes, fazendo ou não a patência apical. Após uma sobreinstrumentação, os canais receberam um curativo de uma solução de corticosteróide-antibiótico por 7 dias, com o objetivo de obter invaginação de tecido conjuntivo para dentro dos canais. Após esse período, esse tecido foi totalmente removido em metade dos casos (grupos com patência apical) e preservados no restante dos casos (grupos sem patência apical). Os canais foram obturados pela técnica da condensação lateral empregando um cimento a base de hidróxido de cálcio (Sealer Plus) ou um cimento de Grossman (Fill Canal). Os animais foram sacrificados por overdose anestésica 60 dias após o tratamento endodôntico e as peças anatômicas foram obtidas e preparadas para análise histológica. Os dados obtidos foram analisados com base em diversos parâmetros histomorfológicos. Os resultados foram melhores nos grupos sem patência apical (p=0,01) do que nos grupos com patência. Dentre os cimentos estudados, os melhores resultados foram observados com o cimento Sealer Plus (p=0,01). em conclusão, tanto a patência apical (presença ou ausência) quanto o tipo de material obturador de canal influíram no processo de reparo apical de dentes de cães com polpas vitais após tratamento endodôntico. O emprego de um cimento a base de hidróxido de cálcio em dentes sem patência apical promoveu os melhores resultados, dentre as condições experimentais propostas.

Tissue reaction to Endométhasone sealer in root canal fillings short of or beyond the apical foramen

Objective: This study evaluated the response of periapical tissues to the endodontic sealer Endomethasone in root canal fillings short of or beyond the apical foramen. Material and Methods: Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to obtain a main apical foramen, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramen by the lateral condensation of gutta-percha and Endomethasone, originating 2 experimental groups: G1: Endomethasone/short of the apical foramen; G2: Endomethasone/beyond the apical foramen. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown & Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramen of the main root canal and apical opening of accessory canals, apical cementum resorption, intensity of the inflammatory infiltrate, presence of giant cells and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (p=0.05). Results: Comparing the 2 groups, the best result (p<0.05) was obtained with root canal filling with Endomethasone short of the apical foramen but a chronic inflammatory infiltrate was present in all specimens. Conclusions: Limiting the filling material to the root canal space apically is important to determine the best treatment outcome when Endomethasone is used as sealer.

Tissue reaction of the EndoREZ in root canal fillings short of or beyond an apical foramenlike communication

This study evaluated the response of periapical tissues to the endodontic sealer EndoREZ in root canal fillings short of or beyond the apical foramenlike communication. Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to create an apical foramenlike communication, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramenlike opening by the lateral condensation of gutta-percha and EndoREZ, originating 2 experimental groups: G1, EndoREZ/short of the apical foramenlike opening, and G2, EndoREZ/beyond the apical foramenlike opening. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown and Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramenlike communication and apical opening of accessory canals, apical cementum resorptions, intensity of the inflammatory infiltrate, presence of giant cells, and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (P = .05). Comparing the 2 groups, the best result (P = .05) was obtained with root canal filling with EndoREZ short of the apical foramenlike opening. In conclusion, limiting the filling material to the root canal space apically was important to determine the best treatment outcome when EndoREZ was used as the sealer. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e94-e99)

Effect of Drilling Technique on the Early Integration of Plateau Root Form Endosteal Implants: An Experimental Study in Dogs

Purpose: This study tested the hypothesis that early integration of plateau root form endosseous implants is significantly affected by surgical drilling technique.Materials and Methods: Sixty-four implants were bilaterally placed in the diaphysial radius of 8 beagles and remained 2 and 4 weeks in vivo. Half the implants had an alumina-blasted/acid-etched surface and the other half a surface coated with calcium phosphate. Half the implants with the 2 surface types were drilled at 50 rpm without saline irrigation and the other half were drilled at 900 rpm under abundant irrigation. After euthanasia, the implants in bone were nondecalcified and referred for histologic analysis. Bone-to-implant contact, bone area fraction occupancy, and the distance from the tip of the plateau to pristine cortical bone were measured. Statistical analyses were performed by analysis of variance at a 95% level of significance considering implant surface, time in vivo, and drilling speed as independent variables and bone-to-implant contact, bone area fraction occupancy, and distance from the tip of the plateau to pristine cortical bone as dependent variables.Results: The results showed that both techniques led to implant integration and intimate contact between bone and the 2 implant surfaces. A significant increase in bone-to-implant contact and bone area fraction occupancy was observed as time elapsed at 2 and 4 weeks and for the calcium phosphate-coated implant surface compared with the alumina-blasted/acid-etched surface.Conclusions: Because the surgical drilling technique did not affect the early integration of plateau root form implants, the hypothesis was refuted. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69: 2158-2163, 2011

Short-term clinical and immunologic effects of scaling and root planing with Er : YAG laser in chronic periodontitis

Background: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been used for periodontal therapy. This study compared Er:YAG laser irradiation (100 mJ/pulse, 10 Hz, 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for the treatment of periodontal pockets affected with chronic periodontitis.Methods: Twenty-one subjects with pockets from 5 to 9 mm in non-adjacent sites were studied. In a split-mouth design, each site was randomly allocated to a treatment group: SRP and laser (SRPL), laser only (L), SRP only (SRP), or no treatment (C). The plaque index (PI), gingival index (GI), bleeding on probing (BOP), and interleukin (IL)-1 beta levels in crevicular fluid were evaluated at baseline and at 12 and 30 days postoperatively, whereas probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were evaluated at baseline and 30 days after treatment. A statistical analysis was conducted (P<0.05).Results: Twelve days postoperatively, the PI decreased for SRPL and SRP groups (P<0.05); the GI increased for L, SRP, and C groups but decreased for the SRPL group (P<0.05); and BOP decreased for SRPL, L, and SRP groups (P<0.01). Thirty days postoperatively, BOP decreased for treated groups and was lower than the C group (P<0.05). PD decreased in treated groups (P<0.001), and differences were found between SRPL and C groups (P<0.05). CAL gain was significant only for the SRP group (P<0.01). GR increased for SRPL and L groups (P<0.05). No difference in IL-1 beta was detected among groups and periods.Conclusion: Er:YAG laser irradiation may be used as an adjunctive aid for the treatment of periodontal pockets, although a significant CAL gain was observed with SRP alone and not with laser treatment.

A scanning electron microscopy study of diseased root surfaces conditioned with EDTA gel plus Cetavlon after scaling and root planing

In the present investigation, a scanning electron microscopy analysis was performed to evaluate the effects of the topical application of ethylenediaminetetraacetic acid (EDTA) gel associated with Cetavlon (EDTAC) in removing the smear layer and exposing collagen fibers following root surface instrumentation. Twenty-eight teeth from adult humans, single rooted and scheduled for extraction due to periodontal reasons, were selected. Each tooth was submitted to manual (scaling and root planing) instrumentation alone or combined with ultrasonic instruments, with or without etching using a 24% EDTAC gel. Following extraction, specimens were processed and examined under a scanning electron microscope. A comparative morphological semi-quantitative analysis was performed; the intensity of the smear layer and the decalcification of cementum and dentinal surfaces were graded in 12 sets using an arbitrary scale ranging from 1 (area covered by a smear layer) to 4 (no smear layer). Root debridement with hand instruments alone or combined with ultrasonic instruments resulted in a similar smear layer covering the root surfaces. The smear layer was successfully removed from the surfaces treated with EDTAC, which exhibited numerous exposed dentinal tubules and collagen fibers. This study supports the hypothesis that manual instrumentation alone or instrumentation combined with ultrasonic instrumentation is unable to remove the smear layer, whereas the subsequent topical application of EDTAC gel effectively removes the smear layer, uncovers dentinal openings and exposes collagen fibers.

Influence of the Angle of Irradiation of the Er,Cr:YSGG Laser on the Morphology, Attachment of Blood Components, Roughness, and Root Wear: In Vitro Study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparative study on the effect of ultrasonic instruments on the root surface in vivo

The present study was designed to investigate the effectiveness of different ultrasonic instruments on the root surface. Fourteen patients with 35 single root teeth designated for extraction were recruited to the present study. Teeth were assigned to four experimental groups: group 1, piezoelectric ultrasonic device; group 2, magnetostrictive ultrasonic device; group 3, hand instrumentation; and group 4, untreated teeth (control). After instrumentation, the teeth were extracted and the presence of residual deposits (roughness and root surfaces characteristics) were analyzed. The results showed that residual deposits were similar in all tested groups: piezoelectric, 8.7%; magnetostrictive, 9.7%; hand instrumentation, 11.1% and control, 76.4%. There were statistically significant differences between control and all the experimental groups (p < 0.0001). With respect to roughness parameters evaluation, R(a) and R(z) of the roots treated with the different instruments showed a similar pattern (p > 0.05), but for R(t) and R(y), a significant difference was observed (p < 0.05) among hand instrumentation and ultrasonic devices. SEM analysis revealed a similar root surface pattern for the ultrasonic devices, but curettes showed many instrumental scratches, deep gouges, and a relatively large amount of dentin was removed. Within the limits of the study, although the instruments produced similar results, root surfaces instrumentated with curettes were rougher and had more root surface tissue removed than with the ultrasonic device.

Evaluation of the radiopacity of calcium hydroxide- and glass-ionomer-based root canal sealers

Aim To evaluate the radiopacity of calcium hydroxide-based root canal sealers (Acroseal, Sealapex and Sealer 26), a glass-ionomer-based sealer (Activ GP Sealer) and a zinc oxide and eugenol-based sealer (Intrafill).Methodology Five disc-shaped specimens (10 x 1 mm) were fabricated from each material, according to the International Organization for Standardization (ISO) 6876/2001 standard. After setting of the materials, radiographs were taken using occlusal films and a graduated aluminum step-wedge varying from 2 to 16 mm in thickness. The dental X-ray unit (GE1000) was set at 50 Kvp, 10 mA, 18 pulses s(-1) and distance of 33.5 cm. The radiographs were digitized and the radiopacity compared with that of the aluminum step-wedge, using WIXWIN-2000 software (Gendex). Data (mm Al) were submitted to ANOVA and Tukey test.Results Intrafill was the most radiopaque material (7.67 mm Al) followed by Sealer 26 (6.33 mm Al), Sealapex (6.05 mm Al) and Acroseal (4.03 mm Al). Activ GP was the least radiopaque material (1.95 mm Al, P < 0.05).Conclusions The sealers evaluated in this study had different radiopacities. However, except for the glass-ionomer-based sealer, all materials had radiopacity values above the minimum recommended by the ISO standard.

Effects of Er,Cr:YSGG Laser Irradiation on Root Surfaces for Adhesion of Blood Components and Morphology

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Radiopacity evaluation of new root canal filling materials by digitalization of images

The aim of this study was to evaluate the radiopacity of five root canal filling materials (AH Plus, Intrafill, Roeko Seal, Epiphany, and EndoRez). Following the International Organization of Standardization 687612001, five circular specimens (10 X 1 mm) were made from each material. After the material set, radiographs were made using occlusal film and a graduated aluminum step-wedge varying in thickness from 2 to 16 mm. The dental X-ray unit (GE1000) was set at 50 Kvp, 10 mA, 18 pulses/second, and distance of 33.5 cm. The radiographs were digitized, and the radiopacity was compared with the aluminum step-wedge, using WIXWIN-2000 software (Gendex). Data (mm Al) were analyzed using ANOVA and Tukey tests. AH Plus and Epiphany were the most radiopaque materials (9.8 and 8.8 mm Al, respectively), followed by EndoRez (7.2 mm Al). Roeko Seal and Intrafill presented the lowest radiopacity values (5.7 and 6.1 mm Al, respectively). Although the materials evaluated demonstrated different radiopacities, all had values above the minimum recommended by the international Organization of Standardization.

Bacterial leakage evaluation of root canals filled with different endodontic sealers

Objective. The objective of this study was to evaluate the sealing ability of AH Plus, Epiphany, Acroseal, Endofill, and Polifil after active lateral condensation technique, by using a bacterial test, during 64 days.Study design. One hundred bovine incisors were cleaned and shaped; then they were filled with the endodontic sealers and adapted into a microcentrifuge tube. The setup root/microcentrifuge tube was added to glass flasks containing Brain Heart Infusion broth. A culture of Enterococcus faecalis was inserted into the upper chamber of each assembly. Daily leakage was evaluated through the broth turbidity.Results. The results were submitted to statistical analysis (Kaplan-Meier method, Kruskal-Wallis and Dunn tests).Conclusions. AH Plus and Endofill had the worst sealing ability when compared with Polifil, which showed the least leakage. Acroseal and Epiphany showed a tendency toward having an intermediate behavior; however, there was no significant difference among Acroseal, Epiphany, and the other sealers. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e56-e60)

pH, Calcium Ion Release, and Setting Time of an Experimental Mineral Trioxide Aggregate-based Root Canal Sealer

Introduction: An experimental mineral trioxide aggregate sealer (MTAS) has been developed for use as a root canal sealer. The aim of this study was to evaluate the setting time, pH, and calcium ion release of MTAS compared with white Portland cement (CPB-40; Votorantin Cimentos, Camargo Correa SA, Pedro Leopoldo, MG, Brazil), white MTA Angelus (MTA; Angelus, Londrina, PR, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany). Methods: For the evaluation of setting time, each material was analyzed using Gilmore-type needles. Polyethylene tubes with the materials were immersed in distilled water for the measurement of pH (digital pH meter) and calcium release (atomic absorption spectrophotometry). The evaluations were performed at 3, 6, 12, 24, and 48 hours and 7, 14, and 28 days. Data were analyzed by analysis of variance and the Tukey test at 5% significance level. Results: MTAS showed higher calcium release at all experimental periods, a greater increase in pH up to 48 hours and the longest setting time. Conclusions: MTAS presented favorable properties for its indication as a root canal sealer. (J Endod 2011;37:844-846)