Capacidade de selamento de três materiais retrobturadores frente à infiltração microbiana por Enterococcus faecalis

O objetivo deste estudo foi comparar a capacidade de selamento apical de três materiais retrobturadores em dentes submetidos à infiltração microbiana por Enterococcus faecalis. Além de analisar a ocorrência da infiltração microbiana em relação à variável tempo. Para tal, foram utilizados 80 caninos superiores permanentes humanos extraídos, instrumentados com o sistema rotatório ProTaper Universal (MAILLEFER) e obturados pela técnica de compactação lateral, com dois tipos de cimento endodôntico: Endofill (DENTSPLY) e AH Plus (DENTSPLY). A apicetomia foi realizada com a remoção de 3mm do terço apical e o retropreparo confeccionado com pontas ultrasônicas. As amostras foram subdivididas, aleatoriamente, em 6 grupos com 10 dentes cada, e 2 grupos controles. Os materiais utilizados para a retrobturação foram MTA branco (ANGELUS), IBC BioAggregate (INNOVATIVE BIOCERAMIX INC.) e Acroseal (SEPTODONT). Foram confeccionados dispositivos para fixação dos dentes aos tubos Eppendorfs. As amostras foram inoculadas com cepas de E. faecalis e incubadas a 37C, por um período de 90 dias, para análise da presença de turvação do meio Enterococcosel. Para a realização da análise estatística foram utilizados os seguintes testes: Qui-quadrado com Prova Exata de Fisher e Kruskal-Wallis. Os resultados mostraram que todos os grupos nos quais foi realizada a obturação e a posterior retrobturação apresentaram infiltração. Comparando todos os grupos, não houve diferença significativa entre os materiais testados. Em relação apenas aos materiais retrobturadores, o Acroseal obteve a menor infiltração, seguido do MTA branco e do IBC BioAggregate. As amostras obturadas com o cimento Endofill não apresentaram diferença estatística em relação à variável tempo. Porém, nas amostras obturadas com o cimento AH Plus, houve maior ocorrência de infiltração nas amostras retrobturadas com o IBC BioAggregate e menor infiltração nas amostras retrobturadas com Acroseal, com diferença estatisticamente significante ao nível de 10%.

Resistência de três materiais retrobturadores frente à infiltração microbiana por Enterococcus faecalis

O objetivo deste estudo foi comparar a capacidade de selamento apical de três materiais retrobturadores em dentes submetidos à infiltração microbiana por Enterococcus faecalis. Além de analisar a ocorrência da infiltração microbiana em relação à variável tempo. Para tal, foram utilizados 45 incisivos superiores permanentes humanos extraídos, instrumentados com o sistema rotatório ProTaper Universal (MAILLEFER) e obturados pela técnica Híbrida de Tagger, com cimento endodôntico: AH Plus (DENTSPLY). A apicetomia foi realizada com a remoção de 3mm do terço apical e o retropreparo confeccionado com pontas ultrasônicas. As amostras foram subdivididas, aleatoriamente, em três grupos com 15 dentes cada, e dois grupos controles. Os materiais utilizados para a retrobturação foram MTA branco (ANGELUS), Sealer 26 (Dentsply), Palacos-R (HERAEUS KULZER). Foram confeccionados dispositivos para fixação dos dentes aos tubos Eppendorfs. As amostras foram inoculadas com cepas de E. faecalis e incubadas a 37C, por um período de 60 dias, para análise da presença de turvação do meio Enterococosel. Para a realização da análise estatística foram utilizados os seguintes testes: Quiquadrado pela correção de Yates, Prova Exata de Fisher e pela curva de sobrevivência com os testes Mantel-Cox e o Gehan-Breslow-Wilcoxon. Os resultados mostraram que todos os grupos nos quais foi realizada a obturação e a posterior retrobturação apresentaram infiltração. Comparando todos os grupos, houve diferença significativa entre o Palacos-R e o Sealer 26. Mas não houve diferença significativa entre o Palacos-R e o MTA e nem do MTA com o Sealer 26. Em relação aos materiais retrobturadores, o Palacos-R obteve a menor infiltração, seguido do MTA branco e do Sealer 26.

Biocompatibility in vitro tests of mineral trioxide aggregate and regular and white Portland cements

Mineral trioxide aggregate (MTA) and Portland cement are being used in dentistry as root end-filling materials. However, biocompatibility data concerning genotoxicity and cytotoxicity are needed for complete risk assessment of these compounds. In the present study, genotoxic and cytotoxic effects of MTA and Portland cements were evaluated in vitro using the alkaline single cell gel (comet) assay and trypan blue exclusion test, respectively, on mouse lymphoma cells. The results demonstrated that the single cell gel (comet) assay failed to detect DNA damage after a treatment of cells by MTA and Portland cements for concentrations up to 1000 mu g/ml. Similarly, results showed that none of the compounds tested were cytotoxic. Taken together, these results seem to indicate that MTA and Portland cements are not genotoxins and do not induce cellular death.

Sealability of MTA and calcium hydroxide-containing sealers

Objectives: The aim of this study was to evaluate the apical sealability of Fillapex (R), Endo-CPM-Sealer (R) and Sealapex (R). Material and Methods: Ninety-four freshly extracted single-rooted teeth were selected and decoronated. All teeth were radiographed to confirm the existence of a single and straight root canal, which was prepared using Protaper Universal and 2.5% sodium hypochlorite. The teeth were randomly divided in groups of 10 specimens each according to the sealer, and the canals were filled using the single cone technique and one of the sealers. Four additional teeth were used as controls. The teeth were submitted to dye leakage with Rhodamine B for 24 h but using vacuum on the initial 15 min. Thereafter, they were cut longitudinally and the leakage was measured in a linear fashion from apex to crown. Data were analyzed by ANOVA and Tukey's tests at 5% significance level. Results: Fillapex (R) and Sealapex (R) showed significantly less dye leakage than Endo-CPM-Sealer (R) (p<0.05). Conclusions: It was concluded that Fillapex (R) and Sealapex (R) were able to prevent apical dye leakage differently from Endo-CPM-Sealer (R).

Histologic evaluation of the use of membrane, bone graft, and MTA in apical surgery

The aim of this study was to evaluate the periapical healing after the use of membrane, bone graft, and mineral trioxide aggregate (MTA) in apical surgery of dogs' teeth. Apical lesions were induced in 48 roots of 6 dogs after coronal access and pulpal removal. Apical surgery consisted of osteotomy with trephine bur for the standardization of the critical surgical cavities, followed by apicoectomy, curettage, preparation of the root-end cavities with the aid of the ultrasonic device, and retrofilling with MTA. The surgical sites were divided into: group 1-filled with blood; group 2-filled with blood and recovered with membrane; group 3-filled with bone graft; and group 4-filled with bone graft and recovered with membrane. The results showed that the inflammatory infiltrate, the periapical healing process, and the behavior of MTA was the same in all groups, including the mineralization stimulation. It was concluded that the use of membranes and bone graft materials isolated or associated in apical surgery did not alter the periapical healing process after the root-end filling with MTA. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 309-314)

Bond strength of different endodontic sealers to dentin: push-out test

Objective: The aim of this in vitro study was to evaluate the bond strength of different root canal sealers to dentin. Material and Methods: Forty extracted single-rooted human teeth were examined and the coronal and middle thirds of the canals were prepared with a 1.50 mm post drill (FibreKor Post System, Pentron). The teeth were allocated in two experimental groups, irrigated with 2.5% NaOCl+17% EDTA or saline solution (control group) and instrumented using Race rotary files (FKG) to a size #40 at the working length. Then, the groups were divided into four subgroups and filled with Epiphany sealer (Group 1), EndoREZ (Group 2), AH26 (Group 3) and Grossman's Sealer (Group 4). After 2 weeks of storage in 100% humidity at 37 degrees C, all teeth were sectioned transversally into 2-mm-thick discs. Push-out tests were performed at a cross-head speed of 1 mm/min using a universal testing machine. The maximum load at failure was recorded and expressed in MPa. Results: Means (+/- SD) in root canals irrigated with 2.5% NaOCl and 17% EDTA were: G1 (21.6 +/- 6.0), G2 (15.2 +/- 3.7), G3 (14.6 +/- 4.5) and G4 (11.7 +/- 4.1). Two-way ANOVA and Tukey's test showed the highest bond strength for the Epiphany's group (p < 0.01) when compared to the other tested sealers. Saline solution decreased the values of bond-strength (p < 0.05) for all sealers. Conclusion: Epiphany sealer presented higher bond strength values to dentin in both irrigating protocols, and the use of 2.5% NaOCl and 17% EDTA increased the bond strength values for all sealers.

Ability of Gutta-Percha and Resilon to Fill Simulated Lateral Canals by Using the Obtura II System

Introduction: The aim of this study was to evaluate the ability of Resilon (Resilon Research, LLC, North Branford, CT) and 2 types of gutta-percha to fill simulated lateral canals when using the Obtura II system (Model 823-700; Obtura Spartan, Fenton, MO). Methods: Forty-five human single-rooted teeth were selected and subjected to root canal preparation. After that, simulated lateral canals were made at 2, 5, and 8 mm from the working length (WL). The specimens were divided into 3 groups (n = 15) according to the filling material used: Obtura Flow 150 gutta-percha (Obtura flow), Odous Endo Flow gutta-percha (Odous; Odous de Deus Ind e Corn. Ltda Belo Horizonte, MG, Brazil), and Resilon pellets (Resilon). Root canals were filled using the Obtura II system with the tip inserted to 3 mm from the WL. No sealer was used for root canal obturation. Specimens were subjected to a tooth decalcification and clearing method, and filling of the lateral canals was analyzed by digital radiography and photographs. The measurement of lateral canal filling was done using Image Tool software (UTHSCSA Image Tool for Windows version 3.0, San Antonio, TX). Data were statistically analyzed with the Kruskal-Wallis test at 5% significance. Results: All materials showed an ability to penetrate into the simulated lateral canals, with a minimum percentage of 73% in all thirds of the root canal. Conclusions: It was concluded that gutta-percha and Resilon are solid core materials with a lateral canal filling ability when used with the Obtura II system. (J Endod 2012;38:676-679)

Genotoxicity and cytotoxicity of mineral trioxide aggregate and regular and white Portland cements on Chinese hamster ovary (CHO) cells in vitro

Objective. Recently, mineral trioxide aggregate (MTA) and Portland cement have been used in dentistry as root-end-filling materials. However, the reported results concerning the biocompatibility of these materials are inconsistent. The goal of this study was to examine the genotoxicity and cytotoxicity of MTA and Portland cements in vitro by the single-cell gel (comet) assay and trypan blue exclusion test.Study design. Chinese hamster ovary (CHO) cells were exposed to MTA and regular and white Portland cements at final concentration ranging from 1 to 1000 mu g/mL for 1 h at 37 degrees C.Results. All compounds tested did not show genotoxic effects in all concentrations evaluated. No significant differences (P > .05) in cytotoxicity were observed for all compounds tested.Conclusions. Taken together, our results suggest that MTA and Portland cements are not genotoxins and are not able to induce cellular death.

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.

Changes in pH at the dentin surface in roots obturated with calcium hydroxide pastes

The purpose of this study was to determine the pH, after defined periods of time, in cavities prepared in the facial surface of the cervical, middle, and apical regions of roots obturated with calcium hydroxide pastes. Root canal instrumentation was performed on 40 recently extracted, single-rooted human teeth. Cavities 1.5 mm in diameter and 0.75 mm in depth were prepared in the cervical, middle, and apical regions of the facial surface of each root. Teeth were randomly divided into four groups. One group was left unobturated and served as a control. The three remaining groups were obturated with either aqueous calcium hydroxide, calcium hydroxide mixed with camphorated monochlorophenol, or Pulpdent pastes. Access cavities and apical foramina were closed with Cavit. Each tooth was stored individually in a vial containing unbuffered isotonic saline. pH at the surface was measured in the cervical, middle, and apical cavities at 0 and 3, 7, 14, 21, 28, 45, 60, 90, and 120 days. Results indicate that hydroxyl ions derived from calcium hydroxide pastes diffused through root dentin at all regions over the experimental period of 120 days. The pattern of pH change at the tooth surface was similar in all regions of the root, regardless of the type of calcium hydroxide paste used. This was a rapid rise in pH from a control value of pH 7.6, to greater than pH 9.5 by 3 days, followed by a small decline to pH 9.0 over the next 18 days, before finally rising and remaining at, or above pH 10.0 for the remainder of the experimental period. Pulpdent paste in the apical region was the only exception in this pattern, producing a pH rise nearly one full unit below the other pastes, pH 9.3. These results indicate that, for all pastes tested, a high pH is maintained at the root surface for at least 120 days. Copyright © 1996 by The American Association of Endodontists.

Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydroxide

This study was conducted to observe the rat subcutaneous connective tissue reaction to the implanted dentin tubes filled with calcium hydroxide or mineral trioxide aggregate. The animals were sacrificed after 7 and 30 days, and the specimens were prepared for morphological study. Some undecalcified specimens were prepared for histological analysis with polarized light and Von Kossa technique for calcium. The results were similar for both studied materials. At the tube openings, there were Von Kossa-positive granules that were birefringent to polarized light. Next to these granulations, there was an irregular tissue like a bridge that was Von Kossa-positive. The dentin walls of the tubes exhibited in the tubules a structure highly birefringent to polarized light, usually like a layer and at different depths. It is possible that the mechanism of action of both materials has some similarity. Copyright © 1999 by The American Association of Endodontists.

Release of formaldehyde by 4 endodontic sealers

Objective. The purpose of this study was to evaluate the release of formaldehyde by some root canal filling materials. Study design. Two older endodontic sealers, AH 26 and Endomethasone, and 2 recently available sealers, AH Plus and Top Seal, were analyzed. Infrared and electronic spectroscopy were used to determine formaldehyde content after set of the materials. Results. Analysis showed that the AH 26 and Endomethasone sealers released formaldehyde. Although the AH Plus and Top Seal sealers have similar chemical composition, they released formaldehyde in a minimal concentration. Conclusions. The AH 26 and Endomethasone sealers released formaldehyde after setting; however, a minimum release was observed for the AH Plus and Top Seal sealers. Copyright © 1999 by Mosby, Inc.

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.

Calcium salts deposition in rat connective tissue after the implantation of calcium hydroxide-containing sealers

This study was conducted to observe the rat subcutaneous connective tissue reaction to implanted dentin tubes that were filled with mineral trioxide aggregate, Sealapex, Calciobiotic Root Canal Sealer (CRCS), Sealer 26, and the experimental material, Sealer Plus. The animals were sacrificed after 7 and 30 days, and the specimens were prepared for histological analysis after serial sections with a hard-tissue microtome. The undecalcified sections were examined with polarized light after staining according to the Von Kossa technique for calcium. At the tube openings, there were Von Kossa-positive granules that were birefringent to polarized light. Next to these granulations, there was irregular tissue, like a bridge, that was Von Kossa-positive. The dentin walls of the tubes exhibited a structure highly birefringent to polarized light, usually like a layer, in the tubules. These results were observed with all the studied materials, except the CRCS, which didn't exhibit any kind of mineralized structure. The results suggest that among the materials studied, the CRCS could have the least possibility of encouraging hard tissue deposition.