Radiopacity of Portland Cement Associated With Different Radiopacifying Agents

This study evaluated the radiopacity of Portland cement associated with the following radiopacifying agents: bismuth oxide, zinc oxide, lead oxide, bismuth subnitrate, bismuth carbonate, barium sulfate, iodoform, calcium tungstate, and zirconium oxide. A ratio of 20% radiopacifier and 80% white Portland cement by weight was used for analysis. Pure Portland cement and dentin served as controls. Cement/radiopacifier and dentin disc-shaped specimens were fabricated, and radiopacity testing was performed according to the ISO 6876/2001 standard for dental root sealing materials. Using Insight occlusal films, the specimens were radiographed near to a graduated aluminum stepwedge varying from 2 to 16 mm in thickness. The radiographs were digitized and radiopacity compared with the aluminum stepwedge using Digora software (Orion Corporation Soredex, Helsinki, Finland). The radiographic density data were converted into mmAl and analyzed statistically by analysis of variance and Tukey-Kramer test (alpha = 0.05). The radiopacity of pure Portland cement was significantly lower (p < 0.05) than that of dentin, whereas all cement/radiopacifier mixtures were significantly more radiopaque than dentin and Portland cement alone (p < 0.05). Portland cement/bismuth oxide and Portland cement/lead oxide presented the highest radiopacity values and differed significantly from the other materials (p < 0.05), whereas Portland cement/zinc oxide presented the lowest radiopacity values of all mixtures (p < 0.05). All tested substances presented higher radiopacity than that of dentin and may potentially be added to the Portland cement as radiopacifying agents. However, the possible interference of the radiopacifiers with the setting chemistry, biocompatibility, and physical properties of the Portland cement should be further investigated before any clinical recommendation can be done. (J Endod 2009,35:737-740)

Influence of glutaraldehyde priming on bond strength of an experimental adhesive system applied to wet and dry dentine

Objectives: This study tested the following null hypotheses: (1) there is no difference in resin-dentine bond strength when an experimental glutaraldehyde primer solution is added prior to bonding procedures and (2) there is no difference in resin-dentine bond strength when experimental glutaraldehyde/adhesive system is applied under dry or wet demineralized dentine conditions. Methods: Extracted human maxillary third molars were selected. Flat, mid-coronal dentine was exposed for bonding and four groups were formed. Two groups were designated for the dry and two for the wet dentine technique: DRY: (1) Group GD: acid etching + glutaraldehyde primer (primer A) + HEMA/ethanol primer (primer B)-under dried dentine + unfilled resin; (2) Group D: the same as GD, except for primer A application; WET: (3) Group GW: the same as GD, but primer B was applied under wet dentine condition; (4) Group W: the same as GW, except for primer A application. The bonding resin was light-cured and a resin core was built up on the adhesive layer. Teeth were then prepared for microtensile bond testing to evaluate bond strength. The data obtained were submitted to ANOVA and Tukey`s test (alpha = 0.05). Results: Glutaraldehyde primer application significantly improved resin-dentine bond strength. No significant difference was observed when the same experimental adhesive system was applied under either dry or wet dentine conditions. These results allow the first null hypothesis to be rejected and the second to be accepted. Conclusion: Glutaraldehyde may affect demineralized dentine properties leading to improved resin bonding to wet and dry substrates. (C) 2008 Elsevier Ltd. All rights reserved.

Evaluation of the temperature of different refrigerant sprays used as a pulpal test

The temperature of different refrigerant sprays (Endo-Ice, Endo-Frost, Coolermatic and Sprayon Contact and Tuner Cleaner) used as pulpal tests were evaluated in vitro. A thermocouple placed inside the pulp chamber of a maxillary central incisor was used to register the temperature changes when the refrigerant sprays were applied with a cotton swab, for 10 s. Results indicate that Endo-Ice and Endo-Frost presented the lowest temperatures among the refrigerant sprays tested. Temperatures measured inside the pulp chamber, however, were statistically similar in all groups.

Presence of arsenic in different types of MTA and white and gray Portland cement

Objective. The presence of arsenic in various types of mineral trioxide aggregate (MTA) and Portland cements were evaluated to verify if they comply with the ISO-recommended limit for water-based cements of 2 mg arsenic/kg material. Study design. An amount of 5 mL of hydrochloric acid was added to 2 g each of MTA and Portland cement to be analyzed. After 15 minutes, the material was filtered and the volume of supernatant was diluted with reagent-grade water up to 40 mL. Atomic absorption spectrophotometry readings were performed in triplicate. Results. The following mean values were obtained: CPM (Egeo, Buenos Aires, Argentina) 11.06 mg/kg; CPM sealer (Egeo) 10.30 mg/kg; MTA- Obtura (Angelus, Londrina, PR, Brazil) 0.39 mg/kg; Experimental MTA: 10.30 mg/kg; White MTA- Angelus (Angelus) 1.03 mg/kg; Gray MTA- Angelus (Angelus) 5.91 mg/kg; ProRoot-MTA (Dentsply/Tulsa Dental Specialties, Tulsa, OK) 5.25 mg/kg; Gray Portland cement (Votorantim Cimentos, Cubatao, SP, Brazil): 34.27 mg/kg; and White Portland cement (Cimento Rio Branco, Rio de Janeiro, RJ, Brazil) 0.52 mg/kg. Conclusion. All tested materials presented arsenic in their composition. The form of arsenic was not analyzed nor the toxicity of the arsenic found. Only MTA- Obtura, White MTA- Angelus, and White Portland cement presented arsenic levels below the limit set in the ISO 9917-1 standard. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 909-913)

Fracture resistance of Class II glass-ionomer cement restorations

Purpose: To investigate in vitro the effect of retentive grooves, GIC type and insertion method on the fracture resistance of Class II glass-ionomer cement (GIC) restorations. Methods: Premolars were divided into 12 groups (n=10) according to three variables: retentive grooves [presence (PR) or absence AR)], GICs type [Ketac-Molar (KM), Fuji VIII (F8) and RelyX Luting (RX)], and insertion method [syringe injector (SI) or spoon excavator (SE)]. The specimens were subjected to fracture resistance test. Data were submitted to three-way ANOVA and multiple comparisons were performed using a Tukey test (P < 0.05). Results: Mean fracture resistance values (Kgf) +/- standard deviations (SD) were: KM (PR+SI) 65.66 +/- 2.5; KM (PR+SE) = 62.58 +/- 2.1; KM (AR+SI) = 57.11 +/- 1.9; KM (AR+SE) = 51.94 +/- 2.3; F8 (PR+SI) = 63.05 +/- 2.1; F8 (PR+SE) = 60.12 +/- 2.3; F8 (AR+SI) = 55.11 +/- 1.9; F8(AR+SE)=49.20 +/- 1.6; RX (PR+SI)=50.99 +/- 2.4; RX (PR+SE)=48.81 +/- 2.5; RX (AR+SI)=45.53 +/- 2.6; RX (AR+SE)=41.88 +/- 3.0. Statistically significant differences were observed among all the groups tested (P=0.001). There was significant difference when pooled means for GIC type were compared with retentive grooves (P=0.01) and when pooled means for retentive grooves were compared with insertion method (P=0.01).

Effect of different surface treatments on the repair bond strength of indirect composites

Purpose: To evaluate the tensile bond strength of indirect composites repaired with different surface treatments and direct composites. Methods: 180 specimens were prepared with Targis, belleGlass HP and Sculpture indirect composites, light-activated and post-cured according to the manufacturers` recommendations. The specimens were stored in distilled water for 24 hours at 37 degrees C. The bonding surfaces were prepared with air abrasion, hydrofluoric acid or hydrofluoric acid followed by a neutralizing solution. All the treated surfaces were subject to the application of a silane and a bonding agent before the repair procedures with Tetric Ceram and Tetric Flow for the Targis specimens, Herculite XRV and Revolution for the belleGlass HP specimens and Sculp-It and Flow-It for Sculpture specimens. The tensile bond strength tests were carried out using a universal testing machine at cross-head speed of 0.5 mm/minute. The type of fracture was observed under a light microscope at x40 magnification. Data were analyzed by a two-way ANOVA and Tukey`s post-hoc tests (P<0.05). Results: Targis showed a statistically higher repair bond strength than belleGlass HP and Sculpture, which were not significantly different from each other. Air abrasion increased the repair bond strength of belleGlass HP and Sculpture. For Targis, all the surface treatments resulted in similar repair bond strength. The different viscosity of repair composites did not affect the repair of indirect composites. Fractured surfaces showed mostly adhesive failures, mainly with hydrofluoric acid treatment.

Mineral trioxide aggregate with or without calcium chloride in pulpotomy

The aim of this study was to evaluate the reaction of the pulp tissue against mineral trioxide aggregate (MTA) with or without 10% calcium chloride (CaCl2). Pulpotomies were performed in 4 canines and 8 premolars of two 8-month-old dogs. MTA with or without CaCl2 was applied on the pulp tissue. The animals were killed after 90 days, and the specimens were processed for the microscopic analysis. Pulp tissue response was similar for MTA with and without CaCl2 Pulp vitality was present in all specimens, along with pulp repair with formation of mineralized tissue bridging. The addition of CaCl2 to MTA did not change its biologic properties in formation of mineralized barrier after pulpotomy.

Enamel Wetness Effects on Bond Strength Using Different Adhesive Systems

Objective: To evaluate, through the application of different dentin bonding systems, the influence of wetness on shear bond strength in enamel. Methods: This study evaluated three etch-and-rinse adhesive systems (Scotchbond MP [used with and without primer]; Singlebond; and Prime&Bond 2.1) and two self-etching adhesive systems (Clearfil SE Bond; and Xeno IV). Flat bovine enamel surfaces were either air-dried for 30 seconds or blotted with absorbent paper after acid-etching for the conventional bonding agents or before the application of self-etching bonding agents. The resin composite EsthetX was bonded to flat surfaces that had been treated with one of the adhesives, following the manufacturer`s instructions. After being stored in water at 37 degrees C for one week, bonded specimens were broken in shear. Data were evaluated with two-way analysis of variance (ANOVA) and Student-Newman-Keuls tests (alpha=0.05). For comparing each condition individually, regardless of the adhesive or wetness condition, a one-way ANOVA and a Student-Newman-Keuls test (alpha=0.05) were applied. Results: The two-way ANOVA showed significant differences among adhesive systems. An interaction effect was also observed (p < 0.05), but wetness did not influence shear bond strength (p=0.98). The one-way ANOVA showed that the all-in-one adhesive was the only material influenced by the presence of water at the enamel`s surface. Conclusion: The all-in-one adhesive behaved differently depending on whether the enamel surface was dry or wet.

Influence of curing rate on softening in ethanol, degree of conversion, and wear of resin composite

Purpose: To investigate the effect of curing rate on softening in ethanol, degree of conversion, and wear of resin composites. Methods: With a given energy density and for each of two different light-curing units (QTH or LED), the curing rate was reduced by modulating the curing mode. Thus, the irradiation of resin composite specimens (Filtek Z250, Tetric Ceram, Esthet-X) was performed in a continuous curing mode and in a pulse-delay curing mode. Wallace hardness was used to determine the softening of resin composite after storage in ethanol. Degree of conversion was determined by infrared spectroscopy (FTIR). Wear was assessed by a three-body test. Data were submitted to Levene`s test, one and three-way ANOVA, and Tukey HSD test (alpha= 0.05). Results: Immersion in ethanol, curing mode, and material all had significant effects on Wallace hardness. After ethanol storage, resin composites exposed to the pulse-delay curing mode were softer than resin composites exposed to continuous cure (P< 0.0001). Tetric Ceram was the softest material followed by Esthet-X and Filtek Z250 (P< 0.001). Only the restorative material had a significant effect on degree of conversion (P< 0.001): Esthet-X had the lowest degree of conversion followed by Filtek Z250 and Tetric Ceram. Curing mode (P= 0.007) and material (P< 0.001) had significant effect on wear. Higher wear resulted from the pulse-delay curing mode when compared to continuous curing, and Filtek Z250 showed the lowest wear followed by Esthet-X and Tetric Ceram. (Am J Dent 2011;24:115-118).

Bone crestal height and bone density after third-molar extraction and grafting: a long-term follow-up study

The objective of this study was to evaluate the long-term influence of xenogenic grafts on bone crestal height and radiographic density following extraction of teeth. The right and left third lower molars of 22 patients were surgically extracted, and one randomly chosen socket was filled with a xenogenic graft (Gent-Tech). The contralateral molar was left to heal naturally, serving as a paired control. Digital intraoral radiographies were taken at surgery and 2, 6, and 24 months after, to evaluate bone density (BD) and alveolar bone crest to cementoenamel junction distance. The data obtained were subjected to two-way analysis of variance and Tukey`s test (alpha = 0.05). The significant decrease in cementoenamel junction distance observed for both groups was limited to the first 6 months. BD values increased significantly in the first 6 months, with no alterations observed up to 24 months for both groups. BD was higher for the experimental group at all time points (p < 0.05). Socket grafting with the xenogenic materials tested did not changed bone crestal height and bone radiographic density in the long term.

Monostotic fibrous dysplasia: a 23-year follow-up of a patient with spontaneous bone remodeling

Fibrous dysplasia is a benign fibro-osseous disease that affects one or more bones. Although its etiology has been defined, the mechanism of spontaneous resolution is still unclear. There is strong evidence indicating the occurrence of stabilization when bone maturation is completed. Deformities that lead to esthetic and functional disorders are observed in almost all cases. Plastic surgery is often recommended when the maxilla and mandible are involved. In the case of mild deformities, careful follow-up during skeletal growth is recommended. We describe here the 23-year follow-up of a patient with monostotic fibrous dysplasia whose disease had stabilized by 13 years of follow-up. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 229-234)

Tooth abnormalities and soft tissue alterations in patients with G/BBB syndrome

OBJECTIVE: The G/BBB syndrome is an X-linked recessive disorder characterized by eye anomalies, laryngotracheoesophageal cleft, congenital heart disease, genitourinary anomalies and gastrointestinal disorders. Patients may also present cleft lip and palate, high-arched palate and thin upper lip. This study aimed to investigate the occurrence of tooth abnormalities and soft tissue changes in patients with G/BBB syndrome. DESIGN: Cross-sectional. SUBJECTS AND METHODS: Twenty-one patients with G/BBB syndrome were analyzed as to the presence of tooth abnormalities and soft tissue alterations. MAIN OUTCOME MEASURES: The prevalence of tooth agenesis and supernumerary teeth was compared to patients without morphofunctional alterations, matched for gender and age. RESULTS: All patients had complete cleft lip and palate; 95.23% of patients presented tooth abnormalities, mainly hypoplastic alterations, with predominance of alterations of number, followed by alterations of structure, shape and position. The frequency of tooth agenesis and supernumerary teeth was significantly higher compared with the control group; 11 patients presented incisiform supernumerary teeth in the mandibular anterior region. Ankyloglossia was observed in 11 of 21 patients. CONCLUSION: The presence of mandibular anterior supernumerary teeth and ankyloglossia should be investigated in the clinical evaluation of patients with suspected diagnosis of the G/BBB syndrome. Oral Diseases (2008) 14, 747-753

Expression of bone resorption regulators (RANK, RANKL, and OPG) in odontogenic tumors

Objective. To investigate the expression of bone resorption regulators (receptor activator of nuclear factor kappa B [RANK], RANK ligand [RANKL], and osteoprotegerin [OPG]) in calcifying cystic odontogenic tumor (CCOT), adenomatoid odontogenic tumor (AOT), calcifying epithelial odontogenic tumor (CEOT), odontogenic myxoma (OM), and ameloblastic fibroma (AF). Study design. The expression of these mediators was evaluated by means of immunohistochemistry. Results. All specimens demonstrated positive immunoreactivity to RANK, RANKL, and OPG. The quantification of these mediators in epithelium revealed a similar pattern of expression for RANKL and OPG in CCOT, AOT, CEOT, and AF. With regard to stromal/mesenchymal cells, the majority of AOT and CCOT cases showed a higher content of OPG than RANKL, whereas CEOT, OM, and especially AF had a tendency to present a greater content of RANKL than OPG. Conclusion. Our data indicate that the CCOT, AOT, CEOT, OM, and AF cell constituents express key regulators of bone metabolism that might locally modulate tumor-associated bone resorption. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:548-55)