Glucose reactivity with filling materials as a limitation for using the glucose leakage model

Aim To evaluate the reactivity of different endodontic materials and sealers with glucose and to asses the reliability of the glucose leakage model in measuring penetration of glucose through these materials.Methodology Ten uniform discs (radius 5 mm, thickness 2 mm) were made of each of the following materials: Portland cement, MTA (grey and white), sealer 26, calcium sulphate, calcium hydroxide [Ca(OH)(2)], AH26,Epiphany, Resilon, gutta-percha and dentine. After storing the discs for 1 week at 37 degrees C and humid conditions, they were immersed in 0.2 mg mL(-1) glucose solution in a test tube. The concentration of glucose was evaluated using an enzymatic reaction after 1 week. Statistical analysis was performed with the ANOVA and Dunnett tests at a significant level of P < 0.05.Results Portland cement, MTA, Ca(OH)(2) and sealer 26 reduced the concentration in the test tube of glucose significantly after 1 week (P < 0.05). Calcium sulphate reduced the concentration of glucose, but the difference in concentrations was not significant (P = 0.054).Conclusions Portland cement, MTA, Ca(OH)(2) and sealer 26 react with a 0.2 mg mL(-1) glucose solution. Therefore, these materials should not be evaluated for sealing ability with the glucose leakage model.

Morphological assessment of dentine and cementum following apicectomy with Zekrya burs and Er:YAG laser associated with direct and indirect Nd:YAG laser irradiation

Objectives. This study aimed to assess the apical surface morphology of maxillary central incisors resected 3.0 mm from the tooth apex using Zekrya burs or Er:YAG laser, with or without subsequent direct Nd:YAG laser irradiation (apical and buccal surfaces) and indirect irradiation (palatal surface).Study design. Forty maxillary central incisors were instrumented and obturated. The roots were divided into 4 groups according to the root resection method (Zekrya bur or Er: YAG laser -1.8 W, 450 mJ, 4 Hz, 113 J/cm(2)) and further surface treatment (none or Nd: YAG laser -2.0 W, 100 mJ, 20 Hz, 124 J/cm(2)). The teeth were prepared for SEM analysis. Scores ranging from 1 to 4 were attributed to cut quality and morphological changes. The data were analyzed by the Kruskal-Wallis test and by Dunn's test.Results. SEM images showed irregular surfaces on the apical portions resected with Zekrya burs, with smear layer and grooves in the resected dentine and slight gutta-percha displacement and plasticization. on the other hand, apicectomies carried out with Er: YAG laser showed morphological changes compatible with ablated dentine, with rough surfaces and craters. In spite of the presence of plasticized gutta-percha, with the presence of bubbles, an irregular adaptation of the filling material to the root walls was also observed. Direct Nd: YAG laser irradiation of the apical and buccal surfaces of the resected roots resulted in areas of resolidification and fusion in the dentine and cementum, with a vitrified aspect; indirect Nd: YAG laser irradiation of the palatal surfaces yielded a lower number of changes in the cementum, with irregular resolidification areas.Conclusions. There were no differences in terms of cut quality between the use of burs and Er: YAG laser or between the 2 surfaces (apical and buccal) treated with Nd: YAG laser with direct irradiation. However, morphological changes were significantly less frequent on surfaces submitted to indirect irradiation (palatal) when compared with those directly irradiated. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e77-e82)

Comportamento dos tecidos periapicais de dentes de cães após a obturação de canal com Sealapex acrescido ou não de iodoformio.

Some endodontists use iodoform in Sealapex in order to rend it more radiopac. This procedure is empiric and for this reason we decided to observe, histologically, if the iodoform introduces some modification in the biological properties of Sealapex. Thirty root canals of dogs' teeth were overinstrumented and filled, by lateral condensation technique, with gutta percha points and Sealapex, with or without iodoform. The iodoform was added in two different proportions: 30 mg or 112 mg for one centimeter of the base and one centimeter of the catalyst of Sealapex. The pieces were removed for histological studies, 6 months after the treatment. The histological results showed that Sealapex encourages apical closure by cementum deposition and that the addition of iodoform does not change that biological property.

Radiographic and microbiologic evaluation of posttreatment apical and periapical repair of root canals of dogs' teeth with experimentally induced chronic lesion

The objective of the present study was to evaluate radiographically and bacteriologically apical and periapical repair in dogs' teeth with induced chronic periapical lesions with the use of two different operative techniques (techniques 1 and 2). The study was conducted on 40 root canals of upper and lower premolars from two dogs aged approximately 12 months. Periapical lesions were induced by leaving the root canals exposed to the oral environment for 5 days and then sealing them with zinc oxide-eugenol for 45 days. After this period, radiographic examination revealed the occurrence of a radiolucent lesion and endodontic treatment was started. The two techniques did not differ in terms of chemomechanical preparation, final filling, or type of cement, but differed in terms of irrigating solution and the presence of an antibacterial dressing. Thus 4% to 6% hypochlorite and hydrogen peroxide (10 volumes) were used in technique 1 during chemomechanical preparation and an antibacterial dressing based on calcium hydroxide was applied between sessions, whereas Dakin's fluid (0.5% sodium hypochlorite solution) and a final filling with no antibacterial dressing were used in technique 2. After chemomechanical preparation, the root canals were filled with gutta-percha cones and Sealapex (Sealapex-Sybron, Kerr, Sao Paulo, Brazil), and the animals were killed 270 days after the final filling. Blocks were cut into 6-μm sections and stained by the Brown and Brenn method. Radiographic, histomicrobiologic and statistical analysis permitted us to conclude the following: radiographically there was a marked reduction or even the disappearance of the radiolucent area present before treatment with greater success in the group treated with technique 1 (group I) than in the group treated with technique 2 (group II); the extent of bacterial invasion of dentinal tubules was greater and more intense in group II than in group I; and the amount of microorganisms detected in the ramifications of the apical delta and in the lumen of the root canal was intense in group II and mild or absent in group I. © 1994.

Effect of dentine surface treatment on leakage of root fillings with a glass ionomer sealer.

The purpose of this study was to observe the quality of seal of the glass ionomer cement, Ketac-Endo, after treatment of the root canal wall. The root canals of 140 extracted human teeth were prepared biomechanically. The root canals were treated with either EDTA or received an intracanal dressing of calcium hydroxide or camphorated paramonochlorphenol. The root canals were filled by the lateral condensation technique with gutta-percha points and the sealer Ketac-Endo, or zinc oxide-eugenol cement or Sealapex. The teeth were placed into a 2% methylene blue dye solution inside a flask, which was attached to a vacuum pump. Leakage was measured linearly. Sealapex exhibited significantly less leakage than Ketac-Endo or zinc oxide-eugenol cement (P<0.01). The use of EDTA and intermediary dressings reduced significantly (P<0.01) the leakage observed with the zinc oxide-eugenol sealer and Ketac-Endo.

pH changes at the surface of root dentin when using root canal sealers containing calcium hydroxide

The purpose of this study was to investigate long-term pH changes in cavities prepared in root surface dentin of extracted teeth after obturation of the root canal with gutta-percha and a variety of sealers containing calcium hydroxide. After cleaning and shaping, root canals in 50 recently extracted, human single-rooted teeth were divided into five groups. Each of four groups was obturated with gutta-percha and either Sealapex, Sealer 26, Apexit, or CRCS, all of which contain calcium hydroxide. The remaining group served as the control and was not obturated with gutta-percha or sealer. Cavities were prepared in the facial surface of the roots in the cervical and middle regions. The pH was measured in these dentinal cavities at the initiation of the experiment, and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days after obturation. Results indicate that the pH at the surface of the root does not become alkaline when calcium hydroxide cements are used as root canal sealers. Regardless of the sealer used, the observed pattern of pH change was not different from that seen in the control group of roots that were not treated with sealer. It is concluded that calcium hydroxide-containing cements, although suitable for use as root canal sealants, do not produce an alkaline pH at the root surface. If such a pH change is related to treatment of root resorption, these sealants do not contribute to this treatment. Copyright © 1996 by The American Association of Endodontists.

Effect of different root canal sealers on periapical repair of teeth with chronic periradicular periodontitis

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and periapical repair in the teeth obturated with Sealapex (P < 0.05).

Reaction of dogs' teeth to root canal filling with mineral trioxide aggregate or a glass ionomer sealer

This study was conducted to observe the reaction of apical tissues of dogs' teeth after root canal filling with gutta-percha and mineral trioxide aggregate (MTA) or a glass ionomer (Ketac-Endo) as a sealer. The root canals were instrumented and filled by the lateral condensation technique with the sealers studied. Animals were killed 6 months later, and the specimens were removed and prepared for histological analysis. Results showed no inflammatory reaction of apical tissue and total closure of the apical foramen of all the teeth sealed with MTA. The teeth sealed with Ketac-Endo showed two cases of partial closure and different degrees of chronic inflammatory reaction. In conclusion, MTA exhibited better biological properties than Ketac-Endo. Copyright © 1999 by The American Association of Endodontists.

Evaluation of apical sealing of three endodontic sealers

Aim: The apical sealing ability of three different endodontic sealers was evaluated in extracted teeth using dye penetration. Methodology: The root canals of 99 extracted human maxillary central incisors were prepared sequentially 2 mm beyond the apical foramen with a size 55 Nitiflex file. The teeth were divided into three experimental groups and obturated by lateral condensation of cold gutta-percha and one of the following sealers: group 1, zinc oxide and eugenol sealer (Fill Canal); group 2, glass ionomer sealer (Ketac-Endo) and group 3, epoxy resin sealer (AH Plus). The teeth were covered with nail varnish to within 1 mm of the apical foramen and immersed in 2% methylene blue in a reduced pressure environment for 24h. After this period, the teeth were washed and cut longitudinally for apical leakage analysis. The values were obtained from the maximum depth of leakage as well as the average between the maximum and minimum values observed for each group. Results: Statistical evaluation of the results showed no significant difference in the leakage between Fill Canal and Ketac-Endo (P > 0.05). Leakage with AH Plus was significantly less (P < 0.01) than with the other sealers. Conclusions: All three sealers allowed some leakage to occur. Leakage with AH Plus was significantly different than with Fill Canal or Ketac-Endo.

Radiographic evaluation of periradicular repair after endodontic treatment of dog's teeth with induced periradicular periodontitis

Eighty-four root canals of premolars from six dogs were left open for 7 days, and then sealed and followed for 45 days until periradicular periodontitis developed. The root canals were then treated endodontically using 5.25% sodium hypochlorite as the irrigating solution. After instrumentation, all root canals were filled with a calcium hydroxide-based antibacterial dressing (Calen PMCC or Calasept) that was left in place for 30 days. After this period the root canals were filled with gutta-percha cones and a root canal sealer (Sealapex or AH Plus)-group I: Calen PMCC + Sealapex; group II: Calasept + Sealapex; group III: Calen PMCC + AH Plus; and group IV: Calasept + AH Plus. Periapical radiographs of the teeth were made after root canal filling and after 90, 180, 270, and 360 days. Radiographic images were digitalized by scanning, and the Mocha program was used to measure the periapical lesions. Analysis showed that the lesions of groups I to III were statistically similar reduction in size, whereas group IV had a smaller reduction in lesion size (p < 0.05). Copyright © 2001 by The American Association of Endodontists.

Apical and periapical repair of dogs' teeth with periapical lesions after endodontic treatment with different root canal sealers.

The aim of this study was to evaluate the apical and periapical repair after root canal treatment of dogs' teeth with pulp necrosis and chronic periapical lesion using different root canal sealers. After periapical lesion induction, forty-four root canals of 3 dogs were submitted to biomechanical preparation using 5.25% sodium hypochlorite as an irrigating solution. A calcium hydroxide dressing (Calen PMCC) was applied for 15 days and the root canals were filled using the lateral condensation technique with gutta-percha points and Sealapex, AH Plus or Sealer Plus for sealing. After 180 days, the animals were sacrificed by anesthetic overdose and the obtained histological sections were stained with hematoxylin-eosin for optical microscopic analysis of the apical and periapical repair. The groups filled with Sealapex and AH Plus had better histological repair (p < 0.05) than the group filled with Sealer Plus, that had unsatisfactory results.

Anatomic and radiograph study of the persistence of Foramen of Huschke

Aim: the aim of this study is to assess and locate the Foramen of Huschke. Study design: anatomical. Material and Method: using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected saggital linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. Results: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

In vitro evaluation of apical microleakage using different root-end filling materials

The objective of this study was to evaluate the apical leakage of retrograde cavities filled with Portland Cement (Concrebrás S/A-MG-Brazil), ProRoot MTA™ (Dentsply International, Johnson City, TN, USA) and Sealapex (Kerr Corporation, Orange, California, USA) with addition of zinc oxide (Odahcam Herpo Produtos Dentários Ltda, Rio de Janeiro, RJ, Brazil). Forty-two extracted single-rooted human teeth were decoronated and used for this study. The root canals were instrumented at 1.0mm short of the apical foramen using the step-back technique to an apical ISO size 60. The roots were obturated with gutta-percha points and sealer Sealapex (Kerr Corporation-USA) and then 3mm of each root apex was sectioned at a 90° angle. Ultrasonic retrograde preparation was performed with a diamond tip to 3mm depth and the roots were randomly divided into 3 groups according to the filling material: G1-Portland, G2-ProRoot MTA, G3- Sealapex zinc oxide-added cement. The root surfaces were covered with nail varnish up to 2mm from the apical foramen, immersed in simulated tissue fluid for 30 days, and then immersed in 0.2% Rhodamine B solution for 24 hours for evaluation of marginal leakage. The results showed mean leakage of 0.75, 0.35 and 0.35 for groups 1, 2 and 3, respectively; however, Kruskal-Wallis test revealed that there was no statistically significant difference among the results (p>0.05).

Periapical tissue healing after post space preparation with or without use of a protection plug and root canal exposure to the oral environment. Study in dogs

The purpose of this study was to evaluate the influence of coronal leakage on the healing of dogs' periapical tissues after root canal filling, post space preparation and protection or not with a temporary sealer plug. Forty root canals of dogs' teeth were instrumented and filled by the lateral condensation technique with gutta-percha points and Endomethasone or CRCS sealers. After post space preparation, the remaining filling material was protected or not with a plug of temporary Coltosol sealer and exposed to the oral environment for 90 days. Thereafter, the animals were sacrificed and the specimens were removed and prepared for histomorphological and histobacteriological analysis. The findings revealed 35% of microbial leakage in the groups without plugs and 15% of leakage in the groups with plugs. Statistical analysis showed that the use of a Coltosol plug improved significantly the histomorphological results regardless of the type of root canal sealer (p=0.05) and that CRCS and Endomethasone sealers showed similar results (p>0.05).

Biocompatibility of acetazolamide pastes in the subcutaneous tissue of rats

This aim of this study was to investigate the biocompatibility of two experimental acetazolamide (AZ)-based pastes in the subcutaneous tissue of rats. Both pastes contained AZ as the main component in similar concentration. The vehicle in experimental paste 1 was saline, while experimental paste 2 was prepared with propylene glycol. Sixty polyethylene tubes were sealed at one end with gutta-percha (GP), which served as a control. Half of the tubes were flled with paste 1 and half with paste 2. The tubes were implanted in the subcutaneous tissue of 15 rats, being 4 tubes for each animal. The animals were killed 7, 15 and 45 days after surgery and the specimens were processed in laboratory. The histological sections were stained with hematoxylin and eosin and were analyzed by light microscopy. Scores were assigned to level of infammatory process: 1- none; 2- mild; 3- moderate; 4- severe. The data were analyzed statistically by the Kruskal-Wallis test (p≤0.05). Paste 1 produced an infammatory process at 7 days. However, the intensity of this infammation decreased with time and was nearly absent at 45 days. No statistically signifcant difference (p>0.05) was observed between the control (GP) and paste 1. However, paste 2 produced infammatory response at all study periods and differed signifcantly (p<0.05) from the control. In conclusion, in the present study, the experimental AZ-based paste 1 was considered as biocompatible as the control matrial (GP), while experimental paste 2 was irritating to rat subcutaneous tissue.