Comparative study of MTA and other materials in retrofilling of pulpless dogs' teeth

This in vivo study compared the effect of mineral trioxide aggregate (MTA), IRM, Super EBA and ZOE in a puttylike consistency, used as retrofilling materials, in the healing process of periapical tissue of pulpless dogs' teeth submitted to a conventional retrofilling technique. Twenty-four premolars obtained from three dogs were used. At the first intervention, the animals were anesthetized, coronal access was obtained and pulpectomy was done. Root canals were kept open to the oral environment for 180 days to induce the formation of apical lesions. After surgical removal of the lesions with curettes, 2 mm of the apical root was cut out perpendicular to the long axis of the teeth, and root-end cavities were shaped with a low-speed round bur. The bone cavities were irrigated and dried, and the root-end cavities were filled with MTA, IRM, Super EBA and ZOE in a puttylike consistency. The bone cavities were passively filled with blood and flaps were sutured. The coronal access openings were cleaned and double-sealed with ZOE and amalgam. After 180 days, the animals were killed by anesthetic overdose, maxilla and mandible were removed and the pieces were processed for histomorphologic analysis. Data were evaluated blindly on the basis of several histopathologic events and the scores obtained were analyzed statistically using the Kruskal Wallis test. No significant differences were observed among MTA, Super EBA and IRM (p>0.05). However, ZOE had a significantly more negative influence on the apical healing (p<0.05). In conclusion, MTA, Super EBA and IRM had similar histopathologic effects among each other and better performance than ZOE used in a puttylike consistency. Furthermore, only MTA stimulated hard tissue deposition in direct contact with the retrofilling material, even when it was inserted under critical conditions.

Back-scattered electron imaging for leakage analysis of four retrofilling materials

This study aimed to evaluate, ex vivo, the nanoleakage in dentinal tubules, the linear infiltration of silver nitrate in the dentin wall/root-end filling material interface, and the presence of gaps in this interface in root-end cavities filled with 4 filling materials. Forty-eight disto-buccal root canals of maxillary molars were instrumented and filled. Retrograde cavities were prepared with ultrasonic points (apical 2 mm). The samples were divided into 2 control groups (n = 4) and 4 experimental groups (n = 10): Group I white mineral trioxide aggregate (MTA); Group II Super EBA; Group III Portland cement; and Group IV Sealer 26. After 1 week, the specimens were subjected to silver nitrate and prepared for SEM (backscattered electrons). In the apical-apical segment, an area with significantly higher leakage was observed for Super EBA, followed by Portland cement, MTA, and Sealer 26 (P = 0.0054). In the medium and cervical segments, all materials showed the same leakage behavior (P = 0.1815 and P = 0.1723, respectively). The linear infiltration at the dentin wall/root-end filling material interface was higher with Super EBA than the other groups. No differences in the percentage of gaps along the 3 mm of dentin wall/root-end filling material interface between the 4 materials were evident (P > 0.05). Nanoleakage occurred mainly in the apical segment of the samples, and Super EBA showed the highest values. The area and linear leakage were lower in the middle and coronal segments, regardless of the root-end filling material. No material perfectly sealed the root-end cavities, which allowed for the leakage occurrence. Microsc. Res. Tech. 75:796800, 2012. (C) 2011 Wiley Periodicals, Inc.

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)

pH and calcium ion release evaluation of pure and calcium hydroxide-containing Epiphany for use in retrograde filling

Objective: Hydroxyl (OH(-)) and calcium (Ca(++)) ion release was evaluated in six materials: G1) Sealer 26, G2) White mineral trioxide aggregate (MTA), G3) Epiphany, G4) Epiphany + 10% calcium hydroxide (CH), G5) Epiphany + 20% CH, and G6) zinc oxide and eugenol. Material and Methods: Specimens were placed in polyethylene tubes and immersed in distilled water. After 3, 6, 12, 24, and 48 h, 7, 14, and 28 days, the water was assessed for pH with a pH meter and for Ca++ release by atomic absorption spectrophotometry. Results: G1, G2, G4, and G5 had the highest pH until 14 days (p < 0.05). G1 presented the highest Ca(++) release until 6 h, and G4 and G5, from 12 h through 14 days. Ca(++) release was greater for G1 and G2 at 28 days. G6 released the least Ca(++). Conclusions: MTA, Sealer 26, Epiphany, and Epiphany + CH release OH-and Ca(++) ions. Epiphany + CH may be an alternative as retrofilling material.

In vitro evaluation of apical sealing in root apex treated with demineralization agents and retrofiled with mineral trioxide aggregate through marginal dye leakage

O objetivo deste estudo foi avaliar o selamento de ápices radiculares tratados com diferentes agentes desmineralizantes e retrobturados com agregado de trióxido mineral (MTA), mediante infiltração marginal por corante. Cinqüenta e seis dentes unirradiculares humanos extraídos foram instrumentados, obturados e seccionados apicalmente. Os preparos cavitários apicais foram confeccionados com pontas ultra-sônicas e os agentes desmineralizantes foram aplicados previamente à retrobturação com Pro Root MTA. Os espécimes foram divididos aleatoriamente em 4 grupos (n=14): grupo 1 (sem agente desmineralizante); grupo 2 (ácido fosfórico 35% durante 15 s); grupo 3 (solução de EDTA 17%, pH 7, durante 3 min); grupo 4 (gel de EDTA 24%, pH 7, durante 4 min). A extensão da infiltração de corante (rodamina B 2% a 37°C, por 24 h) foi avaliada em milímetros utilizando-se um estereomicroscópio. Os resultados foram analisados estatisticamente por meio de análise de variância a um critério e do teste Tukey com nível de significância de 5%. Dentre os grupos experimentais, a menor extensão de infiltração do corante foi verificada no grupo 1 (1,89 mm), seguido pelos grupos 2 (2,18 mm), 4 (2,54 mm) e 3 (2,64 mm). Não houve diferenças estatisticamente significante (p>0.05) na infiltração marginal pelo corante entre os grupos 1, 2 e 4 e os grupos 2, 3 e 4. Com base nos resultados obtidos, pode-se concluir que a aplicação de agentes desmineralizantes não pode ser recomendada quando da utilização do MTA em cirurgias parendodônticas.

Testes de biocompatibilidade in vitro de duas formas comerciais do agregado de trióxido mineral

Recently, regular and white mineral trioxide aggregate (MTA) are being used in Dentistry as retrofilling materials. Genotoxicity and cytotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. Thus, the goal of this study was to examine the genotoxicity and cytotoxicity of regular and white MTA in vitro by the single cell gel (comet) assay and trypan blue exclusion test, respectively. Mouse lymphoma cells were exposed to two presentation forms of MTA at final concentrations ranging from 1 to 1,000 μg/mL for 3 h at 37°C. The results showed that both compounds tested did not produce genotoxic effects at all concentrations evaluated. Likewise, no statistically significant differences (p > 0.05) were observed in cytotoxicity. Taken together, our results suggest that regular and white MTA are not genotoxins and are not able to interfere in cellular viability as assessed by single cell gel (comet) assay and trypan blue assay, respectively.

Citotoxicidade e genotoxicidade de cimentos endodônticos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Conceptos actuales en la preparación de la cavidad apical para obturación retrógrada en cirugía perirradicular

The endodontic surgery is indicated in cases of failure and/or impossibility of conventional endodontic treatment. Among the existent modalities in the endodontic surgery, the retrograde filling consists on preparation of apical cavity and filling with a retrofilling material. The technical-scientific progress in Endodontics become possible the use of retrotips activated with ultrasonic for retrocavities preparation with appropriate extension and following the long axis of the root. The aim of the study was to present the current resources in the preparation of the retrograde cavity in endodontic surgery, detaching their advantages in comparison with the use of conventional preparation with burns. A review of the literature will be presented, considering the use of ultrasound and laser for retrograde preparation, seeking the current resources that provide better apical preparation, resulting in better prognostic of the endodontic surgery (AU)

Avaliação do selamento de ápices radiculares retrobturados ou recobertos com diferentes materiais mediante infiltração marginal por corante e análise da interface em microscopia eletrônica de varredura

The purpose of this study was to evaluate the apical sealing ability and the marginal adaptation of five dental materials used in retrofillings or applied to the bevelled root surface. One hundred and forty extracted single rooted human teeth were used, divided into seven groups of twenty each. ln the first, second, third and fourth groups, the teeth were apicoectomized, submitted to cavity preparations and retrofilled with one of the following materiais: zinc free silver amalgam, a dentin bonding system plus composite resin, a glass ionomer cement ora compomer. In the fifth, sixth and seventh groups, the teeth were apicoectomized and capped on the bevelled root surface with one of the following materiais: a dentin bonding system plus composite resin, a glass ionomer cement or a compomer. Two specimens of each experimental group were evaluated for the marginal adaptation using scanning electron microscopy. The remaining 126 specimens were immersed in 2% methylene blue dye, stored for one week at 37ºC and the infiltration was evaluated with a stereomicroscope. The results showed that the glass ionomer cement presented the lowest values of marginal infiltration when used as retrofilling material, with a significant statistical difference when compared with the others tested materials. When used as apical capping, the glass ionomer cement and the compomer were equivalent and significantly better than the dentin bonding system plus composite resin. Using scanning electron microscopy, all the materials showed some slight adjustment problem. ln the retrofilling, the smallest marginal gaps were observed with the compomer and the dentin bonding system plus composite resin, while the largest were observed with the glass ionomer cement and zinc free silver amalgam. ln the apical capping, the smallest marginal gaps were observed with the compomer and the dentin bonding system plus composite resin and ...

Cirurgias do Periápice

Apical surgeries are part of a segment of root canal treatment by which we can correct or eliminate iatrogenic deficiencies arising from conventional endodontic treatment. Currently no consensus among authors regarding to the factors linked to the surgery success as the execution of an apex resection followed by retropreparation and retrofilling. The apex resection performed 3mm from apical vertex allows the elimination of most apical ramifications, and it is a consensus part of the treatment. The preparation of cavities using ultrasonic tips has advantages over those made with drills such as better cleaning of the cavity, the possibility of lower cutting angle of the apical resection and deeper retropreparation. Another detail to consider is the type of tip, since the diamond tips in a more angulated inclination have higher cutting efficiency but causing increased formation of debris on the dentin walls. Finally, filling the cavity with an apical filling material allows proper sealing of the intracanal contents favoring apical healing.