Avaliação do PH e da densidade óptica do corante azul de metileno tamponado e não tamponado após o contato com diferentes cimentos endodônticos

O objetivo deste trabalho foi avaliar o pH e a densidade óptica das soluções de azul de metileno a 1% e 2% (tamponadas e não tamponadas) após a imersão de três cimentos endodônticos. Foram preparados oitenta espécimes de cada cimento endodôntico (Endofill, AH Plus e Sealapex), os quais foram imersos nas soluções corantes. As soluções foram analisadas antes e após a imersão dos materiais nos períodos de tempo de 0, 24, 48 e 72h. Foram realizadas avaliações do pH utilizando um pHmetro e da densidade óptica utilizando um espectofotômetro ajustado em 596nm. Os dados de pH foram analisados através de estatística descritiva e os dados da densidade óptica foram analisados pela ANOVA e teste de Tukey 5%. Pôde-se verificar que as soluções corantes de azul de metileno tamponadas e não tamponadas apresentaram pequena variação nos valores de pH e densidade óptica antes do contato com os cimentos endodônticos. As soluções corantes não tamponadas apresentaram valores de pH menores que as tamponadas, independentemente do contato com qualquer cimento endodôntico. Os cimentos endodônticos promoveram alterações nos valores de pH das soluções corantes, sendo que as maiores alterações ocorreram nas soluções não tamponadas. Ocorreram alterações nos valores da densidade óptica das soluções corantes tamponadas e não tamponadas nos diferentes períodos de tempo de análise, sendo diferentes para cada cimento endodôntico utilizado

Investigation of chemical changes in sealers during application of the warm vertical compaction technique

Aim To assess (i) heat generated by pluggers during warm vertical compaction of gutta-percha and investigation of temperature changes on the external root surface during canal filling, and (ii) the chemical changes of root canal sealers induced by heat.Methodology Four sealers, namely AH Plus, MTA Plus and two other experimental sealers based on tricalcium silicate, were characterised. External temperatures generated on the root surface during warm vertical compaction of gutta-percha with different sealers inside the root canal were monitored using an infrared thermography camera. Chemical changes induced by heating the sealers were assessed by Fourier transform infrared (FT-IR) spectroscopy.Results MTA Plus and the experimental sealers were composed of a cement and radiopacifier, with epoxy resin or a water-soluble polymer as dispersant, whilst AH Plus was epoxy resin-based. The heat generated at the tips of the continuous wave pluggers was found to be lower than the temperature set and indicated on the device LCD display. The sealers reduced the heat generated on the external root surfaces during the heating phase. AH Plus sustained changes to its chemical structure after exposure to heat, whilst the other sealers were unaffected.Conclusions The temperatures recorded at the tips of continuous wave pluggers varied with their taper and were lower than the temperature set on the System B LCD display. Root canal sealers reduced the dissipation of heat generated during warm vertical compaction, with the temperature at the external root surface maintained at 37-41 degrees C, a temperature below that is necessary to cause irreversible damage to bone and periodontium. The use of AH Plus sealer during warm vertical compaction techniques results in chemical changes in the sealer. The effect on sealer properties needs to be further investigated.

Citotoxicidade de cimentos retrobturados experimentais em fibroblastos V79: [recurso eletrônico]

Combining the characteristics of good adhesion and sealing of the AH Plus sealer the biological properties of the MTA, zinc oxide and calcium hydroxide, the purpose of this study was to evaluate the cytotoxicity of these associations. The specimens of the sealers and their associations were mixed and exposure to culture medium (82.4 mm2surface/mL) after the manipulation and incubated in a humidified incubator (37°C and 100% humidity) for 24 h. Chinese hamster lung fibroblasts (V79) were exposed to different dilutions of this extracts for 24 h and cell viability was measured by MTT test. The differences between the cell survival rates were statistically analyzed for Kruskal-Wallis and Dunn (p≤0.05). All sealers showed a significant difference with the group control, except the MTA. Cytotoxicity with the control group increased in the following order: AH Plus < AH Plus + Ca(OH) 2 < AH Plus + OxZn< AH Plus + MTA < MTA (p≤ 0,05). It was concluded that the addition of biological materials in order to improve the consistency of AH Plus for use in retro cavities its toxicity has not decreased significantly

Infiltração coronária microbiana em canais radiculares obturados pela técnica do cone único com diferentes cimentos endodônticos

With the emergence of new filling materials with different properties and behaviors, the approach of endodontic treatment must be readjusted so that the appropriate result can be achieved. New endodontic sealers include methacrylate resin-based, plant resin-based and the evolution of epoxy-based sealers. This study verified the behavior of new materials that presents controversial results in the literature, about coronal bacterial leakage. That for, 56 single-rooted human teeth were prepared in the direction crown-apex and filled with gutta-percha points with taper of 4% using the single cone technique. Roots were divided randomly into 4 groups according to the sealer (Apexit Plus, AH Plus, EndoREZ and Polifil). After filling, the roots were incorporated in a leakage model, which upper chamber contained a suspension of Streptococcus mutans, and lower chamber a broth, leaving 3 mm of root apical portion immersed. Leakage was assessed for turbidity in lower chamber every day for 60 days. Survival analysis was performed using the nonparametric Kaplan- Meier method (p<0,05). All experimental groups presented leakage during the study’s period, however the maximum time achieve was 22 days. The medium time of leakage was: Apexit Plus 6,3 days, AH Plus 6,3 days and Polifil 5,1 days, but in EndoREZ all specimens infiltrated in the first day, presenting shorter capacity of impermeabilization compared to the other groups. Concluding that none of the sealers tested was able to prevent coronal bacterial leakage

Adaptação marginal do agregado de trióxido mineral com e sem cloreto de cálcio em retrocavidades

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

CLSM assessment of tubule penetration and bacterial leakage evaluation of two resin-based sealer

Aim: The aims of this study were to assess the penetration of two endodontic sealers (salicylate and epoxy resin-based sealers) into dentinal tubules using CLSM; and to evaluate the bacterial leakage of roots filled with the same sealers associated with gutta-percha. Material and Methods: For sealer penetrability assessment, thirty bovine roots were instrumented and divided into three groups: AHP: EDTA + filling with AH Plus and gutta-percha (n=10), MTAF: EDTA + filling with MTA Fillapex and gutta-percha (n=10), control group: canals were not irrigated with EDTA and were filled with gutta-percha and AH Plus (n=5) or MTA Fillapex (n=5). Rhodamine B was added to the sealers in order to provide adequate fluorescence. The roots were transversely sectioned 3mm from the apex to enable CLSM analysis. Leakage was evaluated for turbidity of the broth in a split chamber model system for 30 days, using Enterococcus faecalis as a microbial marker. Thirty roots were instrumented and divided in four grupos: AHP: filling with AH Plus and gutta-percha (n=10); MTAF: filling with MTA Fillapex and gutta-percha (n=10); positive control: filling with gutta-percha without sealer (n = 5); negative control: sealing with cyanoacrylate to test the seal of the system (n = 5). Results: The medians for dentinal tubule penetration were 6.8% (AHP) and 6.6% (MTAF) (P = 0.82). The average time for bacterial leakage was 8 days in both experimental groups (P = 0.79). Conclusion: MTA Fillapex and AH Plus presented similar behavior regarding dentinal tubule penetration and bacterial leakage.

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.

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.

Evaluation of the physicochemical properties and push-out bond strength of mta-based root canal cement

Aim: This study investigated the flowability, setting time, pH, calcium release and bond strength of a MTA-based cement (MTA Fillapex®) compared to AH Plus and Sealapex. Materials and methods: For the flowability test, the ISO 6876:2001 specification was utilized and for the setting time test, the ASTM C266-03 specification was utilized. For the pH and calcium release measurements, 10 samples were prepared for each group and analyzed for several different periods. For the push-out test, dentin disks were distributed into three groups, according to the cement utilized and into three subgroups, according to the root third (n = 10). After obturation, the specimens underwent push-out testing. The data were compared statistically using a significance level of 5%. Results: The flowability of all materials was found to be similar (p > 0.05). The setting times were different among the groups tested (MTA Fillapex < Sealapex < AH Plus) (p < 0.05). At days 7 and 28, the MTA Fillapex presented the higher pH values (p < 0.05). At 24 hours and at 14 days, the calcium release of the MTA Fillapex was similar to that of Sealapex (p > 0.05). AH Plus presented the lowest pH and calcium release values (p < 0.05). In all root thirds, the adhesion to the dentin of the MTA Fillapex and Sealapex were significantly lower than that of AH Plus (p < 0.05). Conclusion: MTA Fillapex and Sealapex presented several similar properties and both were found to be different than AH Plus. Clinical significance: This study evaluated the physicochemical and mechanical properties of new MTA-based root canal cement, in order to use this scaler in root canal fillings. MTA Fillapex showed satisfactory properties for clinical use.

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.

The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study

Introduction The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. Methods Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n=20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. Results QG and EG presented similar amounts of sealer penetration (P>.05). MG and CG presented the lowest penetrability values (P<.05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P<.05). Conclusions Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. Clinical relevance Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike guttapercha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

Radiopacity and flow of different endodontic sealers

The present study evaluated the radiopacity and flow of different endodontic sealers: AH Plus, Endo CPM, MTA Fillapex, Sealapex, Epiphany, and Epiphany SE. For the radiopacity test, six specimens measuring 10mm in diameter and 1mm in thickness were fabricated from each material. They were radiographed on an occlusal film alongside an aluminum step wedge. Radiographs were digitized to determine the radiopacity equivalence in millimeters of aluminum. To evaluate the flow, a 120 g load was placed on top of a glass slab containing 0.05 } 0.005ml of sealer. The diameters of each material were measured (mm) with a caliper and samples were photographed. Digitized images were analyzed using the UTHSCSA Image Tool for Windows software, to determine the sealer area (mm2). Data were submitted to ANOVA and Tukey's test at 5% significance. AH Plus and Epiphany SE presented the greatest radiopacity (12.5 mm Al and 12.0 mm Al, respectively) (p>0.05), followed by Epiphany (9.6 mm Al) and Fillapex (8.9 mm Al). Endo CPM (5.46 mm Al) and Sealapex (5.51 mm Al) presented lower radiopacity. MTA Fillapex presented significantly higher values of flow than other sealers (33.11 mm and 844.9 mm2). AH Plus, Epiphany, and Epiphany SE had similar values. Endo CPM (21.05 mm and 342.8 mm2) and Sealapex (19.98 mm and 352.5 mm2) presented the lowest flow values (p>0.05). All sealers presented radiopacity and flow values according to ISO and ANSI/ADA recommendations.

Chemical characterization and bioactivity of epoxy resin and Portland cement-based sealers with niobium and zirconium oxide radiopacifiers

The purpose of this study was to characterize and to evaluate the bioactivity potential of experimental root canal sealers (ES) based on Portland cement, epoxy resin with nano- and micro-particles of niobium or zirconium oxide used as radiopacifiers in comparison to AH Plus and MTA Fillapex. Methods Specimens of the sealers (10 mm in diameter × 1 mm thick) were prepared and the radiopacity was evaluated according to ISO 6876 (2012) specifications. Characterization of the sealers was performed under the scanning electron microscope (SEM) immediately after setting and after immersion for 28 days in Hank's balanced salt solution (HBSS). In addition X-ray energy dispersive spectroscopy (EDS), X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy were also performed. The pH and calcium ion release were measured after 1, 7, 14, 21 and 28 days after completion of seating using a digital pH meter and an atomic absorption spectrophotometer, respectively. Results The experimental sealers exhibited an average radiopacity of 2.5 mm thickness of aluminum, which was similar to MTA Fillapex (P > 0.05) and inferior to AH Plus (P < 0.05). AH Plus did not show bioactivity. Although the experimental sealers did not exhibit the formation of hydration product, they encouraged the deposition of crystalline spherical structures of calcium deficient phosphate. The highest pH and calcium release values were observed with the experimental sealers (P < 0.01). ES-Nb-micro was the only sealer to present hexagonal shaped crystal deposition. Significance Novel root canal sealers based on a mixture of Portland cement, epoxy resin and radiopacifier exhibited a degree of bioactivity although no evidence of cement hydration was demonstrated on material characterization. The radiopacifier particle size had limited effect on the sealer microstructure and chemical properties.

Evaluation of the pH, calcium release and antibacterial activity of MTA Fillapex

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of calcium hydroxide dressing on push-out bond strength of endodontic sealers to root canal dentin

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)