Bacterial leakage in root canals filled with conventional and MTA-based sealers

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

Antibacterial efficacy of endodontic irrigating solutions and their combinations in root canals contaminated with Enterococcus faecalis

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

Effect of temporary cements on the shear bond strength of luting cements

Objective: The purpose of this study was to evaluate, by shear bond strength (SBS) testing, the influence of different types of temporary cements on the final cementation using conventional and self-etching resin-based luting cements. Material and Methods: Forty human teeth divided in two halves were assigned to 8 groups (n=10): I and V (no temporary cementation); II and VI: Ca(OH)(2)-based cement; III and VII: zinc oxide (ZO)based cement; IV and VIII: ZO-eugenol (ZOE)-based cement. Final cementation was done with RelyX ARC cement (groups I to IV) and RelyX Unicem cement (groups V to VIII). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. Results: Means were (MPa): I - 3.80 (+/- 1.481); II - 5.24 (+/- 2.297); III - 6.98 (+/- 1.885); IV - 6.54 (+/- 1.459); V - 5.22 (+/- 2.465); VI - 4.48 (+/- 1.705); VII - 6.29 (+/- 2.280); VIII - 2.47 (+/- 2.076). Comparison of the groups that had the same temporary cementation (Groups II and VI; III and VII; IV and VIII) showed statistically significant difference (p<0.001) only between Groups IV and VIII, in which ZOE-based cements were used. The use of either Ca(OH) 2 based (Groups II and VI) or ZO-based (Groups III and VII) cements showed no statistically significant difference (p>0.05) for the different luting cements (RelyX (TM) ARC and RelyX (TM) Unicem). The groups that had no temporary cementation (Groups I and V) did not differ significantly from each other either (p>0.05). Conclusion: When temporary cementation was done with ZO- or ZOE-based cements and final cementation was done with RelyX ARC, there was an increase in the SBS compared to the control. In the groups cemented with RelyX Unicem, however, the use of a ZOE-based temporary cement affected negatively the SBS of the luting agent used for final cementation.

Temperature Changes in Gutta-Percha and Resilon Cones Induced by a Thermomechanical Compaction Technique

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

Apical Sealing Quality of In Vitro Apicectomy Procedures After Using Both Er:YAG and Nd:YAG

The aim of this study was to evaluate the apical sealing of dentinal tubules after root-end surface cutting by using Er:YAG and Nd:YAG lasers. After root-canal instrumentation and filling, apices of 50 extracted maxillary canine human teeth were resected by Er: YAG with 400 mJ, 10 Hz, for 30 sec. The samples were randomly assigned to five groups (n = 10): (GI) treated without root-end cavity, but with Nd: YAG (1.0W, 10 Hz, 20 sec) for dentinal tubules sealing; (GII) treated with root-end cavity without the use of Nd: YAG; (GIII) treated with root-end cavity and Nd: YAG application; (GIV) treated with root-end cavity made by Er: YAG with no focus and without Nd: YAG application; and (GV) treated without root-end cavity and without Nd: YAG application. The root-end cavities were performed by using Er: YAG at 300 mJ, 10 Hz, for 20 sec. Subsequently, all teeth were waterproofed and immersed in 2% methylene blue for 48 h in a vacuum environment. The samples were longitudinally sectioned, and microleakage was measured. ANOVA and the Fisher LSD test showed that GIV was less susceptible to microleakage than were the other groups (p < 0.05). Interestingly, the use of the Er: YAG with no focus showed superior dentinal tubule sealing in comparison with the other groups, even with or without root-end cavity and Nd: YAG application.

Effects of chlorhexidine and sodium hypochlorite on the microhardness of root canal dentin

Objective. The purpose of this study was to evaluate the effects of endodontic irrigants on the microhardness of root canal dentin.Study design. Thirty extracted single-rooted human teeth were used. The crowns were sectioned at the cementoenamel junction. Each root was transversely sectioned into cervical, middle, and apical segments, resulting in 90 specimens. The 3 sections of each root were separately mounted in an individual silicon device with acrylic resin. The specimens were randomly divided into the following 3 groups (n = 30), according to the irrigant solution used: (1) group 1, control (saline solution); (2) group 2, 2% chlorhexidine gluconate solution; and (3) group 3, 1% sodium hypochlorite (NaOCl). After 15 minutes of irrigation, dentin microhardness was measured on each section at 500 mu m and 1000 mu m from the pulp-dentin interface with a Vickers diamond microhardness tester in Vickers hardness number (VHN).Results. Data obtained were analyzed using analysis of variance and the Tukey test (5%). Specimens irrigated with 2% chlorhexidine (group 2) or 1% NaOCl (group 3) presented lower values of dentin microhardness, with significant difference in relation to the control group (P < .05).Conclusion. It could be concluded that chlorhexidine and NaOCl solutions significantly reduced the microhardness of root canal dentin at 500 mu m and 1000 mu m from the pulp-dentin interface.

SEALING ABILITY of CASTOR OIL POLYMER AS A ROOT-END FILLING MATERIAL

Objective: The purpose of this study was to evaluate the sealing ability of castor oil polymer (COP), mineral trioxide aggregate (MTA) and glass ionomer cement (GIC) as root-end filling materials. Forty-five single-rooted human teeth were cleaned and prepared using a step-back technique. The apical third of each root was resected perpendicularly to the long axis direction. All teeth were obturated with gutta-percha and an endodontic sealer. After, a root-end cavity with 1.25-mm depth was prepared using a diamond bur. The specimens were randomly divided into three experimental groups (n = 15), according to the root-end filling material used: G1) COP; G2) MTA; G3) GIC. The external surfaces of the specimens were covered with epoxy adhesive, except the root-end filling. The teeth were immersed in rhodamine B dye for 24 hours. Then, the roots were sectioned longitudinally and the linear dye penetration at the dentin/material interface was determined using a stereomicroscope. ANOVA and Tukey's tests were used to compare the three groups. The G1 group (COP) presented smaller dye penetration, statistically different than the G2 (MTA) and G3 (GIC) groups (p < 0.05). No statistically significant difference in microleakage was observed between G2 and G3 groups (p > 0.05). The results of this study indicate that the COP presented efficient sealing ability when used as a root-end filling material showing results significantly better than MTA and GIC.

Effectiveness of ozonated water on Candida albicans, Enterococcus faecalis, and endotoxins in root canals

The aim of this study was to evaluate the effectiveness of ozonated water in the elimination of Candida albicans, Enterococcus faecalis, and endotoxins from root canals. Twenty-four single-rooted human teeth were inoculated with C. albicans and E. faecalis, and 24 specimens were inoculated with Escherichia coli endotoxin. Ozonated water (experimental group) or physiologic solution (control group) was used as irrigant agent. Antimicrobial effectiveness was evaluated by the reduction of microbial counts. Lipopolissacharide complex presence was assessed by limulus amebocyte lysate test and B-lymphocyte stimulation. Data were analyzed by Wilcoxon and Mann-Whitney tests (5%). Ozonated water significantly reduced the number of C. albicans and E. faecalis at the immediate sampling, but increased values were detected after 7 days. Ozonated water did not neutralize endotoxin. It could be concluded that ozonated water was effective against C. albicans and E. faecalis but showed no residual effect. No activity on endotoxin was observed.

INTRAPULPAL TEMPERATURE VARIATION DURING BLEACHING WITH VARIOUS ACTIVATION MECHANISMS

Objectives: The aim of this study was to evaluate the intrapulpal temperature variation after bleaching treatment with 35% hydrogen peroxide using different sources of activation. Material and Methods: Twenty-four human teeth were sectioned in the mesiodistal direction providing 48 specimens, and were divided into 4 groups (n=12): (G1) Control - Bleaching gel without light activation, (G2) Bleaching gel + halogen light, (G3) Bleaching gel + LED, (G4) Bleaching gel + Nd: YAG Laser. The temperatures were recorded using a digital thermometer at 4 time points: before bleaching gel application, 1 min after bleaching gel application, during activation of the bleaching gel, and after the bleaching agent turned from a dark-red into a clear gel. Data were analyzed statistically by the Dunnet's test, ANOVA and Tukey's test (alpha=0.05). Results: The mean intrapulpal temperature values (degrees C) in the groups were: G1: 0.617 +/- 0.41; G2: 1.800 +/- 0.68; G3: 0.975 +/- 0.51; and G4: 4.325 +/- 1.09. The mean maximum temperature variation (MTV) values were: 1.5 degrees C (G1), 2.9 degrees C (G2), 1.7 degrees C (G3) and 6.9 degrees C (G4). When comparing the experimental groups to the control group, G3 was not statistically different from G1 (p>0.05), but G2 and G4 presented significantly higher (p<0.05) intrapulpal temperatures and MTV. The three experimental groups differed significantly (p<0.05) from each other. Conclusions: The Nd: YAG laser was the activation method that presented the highest values of intrapulpal temperature variation when compared with LED and halogen light. The group activated by LED light presented the lowest values of temperature variation, which were similar to that of the control group.

Scanning electron microscope evaluation of chlorhexidine gel and liquid associated with sodium hypochlorite cleaning on the root canal walls

Objective. The aim of this study was to evaluate, by scanning electronic microscopy (SEM), the cleaning of the root canal walls after instrumentation and irrigation with 2.5% sodium hypochlorite (NaOCl) associated with 2% chlorhexidine (CHX) gel or liquid, combined or not with 17% ethylenediamine tetra-acetic acid (EDTA).Study design. Sixty single-root human teeth were subjected to standardized root canal instrumentation with different irrigants (n = 10): G1) NaOCl + CHX liquid; G2) NaOCl + CHX liquid + EDTA + saline solution; G3) NaOCl + CHX gel; G4) NaOCl + CHX gel + EDTA + saline solution; G5) saline solution; G6) saline solution + EDTA. After instrumentation, the teeth were prepared for SEM analysis (x500 and x2,000) to evaluate the cleaning of the cervical, middle, and apical thirds. The area analyzed was quantified according to the percentage of open and closed tubules, and data were statistically analyzed by analysis of variance and Tukey tests (P = .05).Results. The number of open tubules was highest in G4 in all root thirds, showing statistically significant difference from G1, G2, and G5 (P < .05). G1 presented higher quantity of closed tubules significant than G2.Conclusion. Irrigation with NaOCl and CHX gel followed by EDTA and saline solution produced greater cleaning of the root canal walls. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e82-e87)

Assessment of external root temperature during root canal irradiation by Nd:YAG and Er:YAG lasers

Different types of laser have been widely studied for applicability in the oral health area. In the endodontic area, investigations with some types of laser have been conducted to establish safe parameters for clinical application in root canals. However, it has not been duly explained whether the temperature increase caused by laser irradiation could cause alteration in the temperature on the external surface of the root and, consequently, alterations in the cells of the periodontal ligament, causing resorption and even loss of the dental element. The proposal in this paper was to gauge the external root temperature in the apical and cervical regions of the roots of human teeth during root canal irradiation with Nd:yttrium aluminum garnet (YAG) and Er:YAG lasers using different parameters. The novel approach of this paper is the use of the technique of laser applications along the total length of the root canal with series of repetitive irradiation, however, using time of 1 s of irradiation associated with 1 s off to avoid cumulative thermal effects. Experimental results confirm the accuracy of the parameters and exposure regimen obtained. All the parameters used in this paper are acceptable from a clinical as well as a biological point of view. (C) 2009 Laser Institute of America.

Cimentos endodônticos: análise morfológica imediata e após seis meses utilizando microscopia de força atômica

O objetivo deste trabalho foi analisar a morfologia dos cimentos Sealapex, Apexit, Sealer 26 (cimentos a base de hidróxido de cálcio) e Ketac Endo (cimento de ionômero de vidro), através da microscopia de força atômica, verificando-se as características de suas partículas após a obturação dos canais radiculares e após um período de seis meses de contato com o plasma sanguíneo humano. Utilizaram-se 16 dentes unirradiculares humanos extraídos e incluídos em blocos de resina após o preparo biomecânico. As raízes foram divididas em quatro grupos de quatro raízes cada e os canais radiculares obturados pela técnica de condensação lateral passiva com os cimentos em estudo. Verificou-se que o cimento Apexit foi o que mais sofreu desintegração após seis meses de imersão em plasma sanguíneo humano, seguido pelo Ketac Endo e Sealapex. Dentre todos os cimentos estudados, o Sealer 26 mostrou-se o mais uniforme e com a menor desintegração.

O movimento ortodôntico não induz reabsorção cervical externa ou O movimento ortodôntico não altera cor, volume e nem induz inflamação gengival

Nesse trabalho, procurou-se explicar - anatômica e funcionalmente - como se estrutura e se organiza a região cervical dos dentes, para fundamentar os seguintes questionamentos: 1) Por que ocorre Reabsorção Cervical Externa na dentição humana?; 2) Por que na gengivite e na periodontite não se tem Reabsorção Cervical Externa?; 3) Por que depois do traumatismo dentário e da clareação interna pode ocorrer a Reabsorção Cervical Externa?; 4) Por que o movimento ortodôntico não altera a cor e o volume gengival durante o tratamento?; 5) Por que o movimento ortodôntico não induz Reabsorção Cervical Externa, mesmo sabendo-se que a região cervical pode ser muito exigida? A existência de antígenos sequestrados na dentina, a presença de janelas de dentina na região cervical de todos os dentes, a reação do epitélio juncional e a distribuição dos vasos sanguíneos gengivais podem justificar por que a Reabsorção Cervical Externa não ocorre e nem a cor e o volume gengival são alterados no movimento ortodôntico.

Spectroscopic study of ejected dental tissue after Er : YAG laser ablation

By means of IR spectroscopy, we determined the teeth ablation mechanism by an Er:YAG laser oscillating at 2.94 mum. Ejected dental material, ablated by the laser from human teeth, was deposited on an IR window and the absorption spectra were measured in the range 2500-20,000 nm. Sound teeth were used, and the corresponding film spectra were compared to spectra obtained by traditional methods. The films spectra obtained do not differ appreciably from those obtained by the traditional method for sound teeth, indicating that the material ejected by an Er:YAG represents the tooth condition.The obtained results confirm that a spectroscopic analysis of a tooth treated with an Er:YAG laser can be done measuring the absorbance of a film composed of ejected material without the need to slice it. In addition, we could determine that the laser absorption occurs mainly by the interstitial water, and the temperature elevation of the ejected material does not exceed 60degreesC. (C) 2002 Elsevier B.V. B.V. All rights reserved.

Scanning electron microscopic study of the cleaning ability of chlorhexidine as a root-canal irrigant

Aim To evaluate in vitro the cleaning of root-canal walls after irrigation with different irrigants.Methodology A total of 36 recently extracted human teeth were divided into four experimental groups according to the irrigating solution used: saline; 2% chlorhexidine; 2.5% sodium hypochlorite; and 2.5% sodium hypochlorite + EDTA. The cleaning of the apical, middle and coronal thirds of the root canals was evaluated by scanning electron microscope examination using a 4-point scoring system.Results the best cleaning was obtained using 2.5% sodium hypochlorite and EDTA, followed by 2.5% sodium hypochlorite only (P < 0.05), whose cleaning was similar to chlorhexidine only in the cervical third. Cleaning by saline and 2% chlorhexidine was worse than the other two groups and was similar in all thirds. Better cleaning was found in the cervical and middle thirds for all groups with the worst results in the apical third.Conclusions the apical third of the root canals was not cleaned as well as the middle and coronal thirds. Cleaning by chlorhexidine and saline was inferior compared to the cleaning by sodium hypochlorite with and without EDTA.