Antibacterial Activity of a New Ready-To-Use Calcium Silicate-Based Sealer

Abstract The aim of this study was to evaluate the antibacterial potential of a calcium silicate-based sealer (Bio-C Sealer, Angelus) against common bacteria in primary and secondary endodontic infections. Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus mutans were exposed to fresh Bio-C Sealer for 24 h by the agar diffusion method (n=5). Additionally, the antibacterial activity was investigated against E. faecalis and S. mutans biofilms (48 h old) grown in discs with 4 mm in diameter and 2 mm in height. (n=3) of set discs of Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) and EndoSequence BC Sealer (Brasseler). The antibacterial activity was evaluated by colony forming unity (CFU) counting using ImageJ software. Data were compared by one-way ANOVA followed by Holm-Sidak test (a=5%). Fresh Bio-C Sealer exhibited antimicrobial activity against all bacteria evaluated by agar diffusion method, except for S. mutans. Set discs of all endodontic sealers tested showed similar CFU values for E. faecalis (p>0.05). S. mutans in biofilms showed higher susceptibility to EndoFill compared with the other sealers (p<0.05). In conclusion, the results indicate that fresh Bio-C Sealer does not inhibit S. mutans growth, but exhibits antibacterial activity against E. faecalis, S. aureus, P. aeruginosa and E. coli. After setting, the Bio-C Sealer exhibits an antimicrobial potential comparable to that of the other sealers evaluated in E. faecalis biofilm, but lower than that of EndoFill for S. mutans biofilm.

Resumo O objetivo deste estudo foi avaliar o potencial antibacteriano do novo cimento biocerâmico (Bio-C Sealer, Angelus) contra bactérias comuns em infecções endodônticas primárias e secundárias. Culturas de Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus e Streptococcus mutans foram expostos a amostras frescas do Bio-C sealer durante 24 h pelo método de difusão em agar (n=5). A atividade antibacteriana de amostras dos cimentos Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) e EndoSequence BC Sealer (Brasseler) após a presa também foi investigada em biofilmes de 48 h das bactérias E. faecalis e S. mutans, crescidos em discos com 4 mm de diâmetro e 2 mm de altura. A atividade antibacteriana foi avaliada por contagem das unidades formadoras de colônias (UFC) utilizando o software ImageJ. Os dados foram comparados por ANOVA a um critério seguido pelo pós-teste Holm-Sidak (a=5%). Amostras frescas do Bio-C Sealer exibiram atividade antimicrobiana contra todas as bactérias avaliadas pelo método de difusão em ágar, exceto para S. mutans. A análise da formação de biofilme mostrou que todos os cimentos endodônticos testados apresentaram valores similares de UFC para E. faecalis (p> 0,05), enquanto biofilmes de S. mutans foram mais suscetíveis ao EndoFill em comparação com os demais cimentos (p<0,05). Conclui-se que o cimento Bio-C Sealer fresco exibe atividade antibacteriana para E. faecalis, S. aureus, P. aeruginosa e E. coli, mas não inibe o crescimento de S. mutans. Após a presa, o cimento Bio-C Sealer exibe potencial antimicrobiano similar ao dos demais cimentos avaliados em biofilme de E. faecalis, mas inferior ao do EndoFill para S. mutans.

Chlorhexidine and proanthocyanidin enhance the long-term bond strength of resin-based endodontic sealer

Abstract The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.

1064-nm Nd: YAG and 980-nm Diode Laser EDTA Agitation on the Retention of an Epoxy-Based Sealer to Root Dentin

Abstract Root canal irrigants are used to minimize the negative effects of smear layer on endodontic sealer retention. The aim of this study was to evaluate the efficacy of agitation of 17% ethylenediaminetetraacetic acid (EDTA) with ultrasonic, 1064-nm Nd:YAG and 980-nm diode laser on the retention of an epoxy-based sealer to the root canal walls. Forty single-rooted bovine teeth were instrumented with ProTaper rotary system and divided into four groups according to the final irrigation protocol (n = 10): (1) 17% EDTA (control); (2) 17% EDTA with 50-s ultrasonic agitation; (3) 17% EDTA with 50-s diode laser (2-W) agitation; and (4) 17% EDTA with 50-s Nd:YAG (1.5-W) laser agitation. After endodontic filling with gutta-percha F5 master cone and Sealer 26, the roots were sectioned at the cervical, middle, and apical root thirds to obtain 1.5-mm slices. Push-out tests were performed using a universal testing machine at a 1 mm/min crosshead speed. Data were analyzed using two-way ANOVA and Tukey's tests (α=0.05). Apical root thirds had significant higher retention values than cervical and middle thirds (p < 0.05). EDTA with 1064-nm Nd:YAG or 980-nm diode laser presented the highest retention values and was significantly different from EDTA with ultrasonic agitation and EDTA only (p < 0.05). Adhesive failures were predominant to EDTA only group. Mixed failures were predominant to all agitation groups. 1064-nm Nd:YAG and 980-nm diode laser EDTA agitation enhanced the retention of the epoxy-based sealer to the root canal walls compared with that due to EDTA only or EDTA with ultrasonic agitation.

Resumo Irrigantes para canais radiculares são usados para minimizar os efeitos negativos da camada de smear na retenção do cimento obturador. O objetivo deste estudo foi avaliar a eficácia da agitação do ácido etilenodiaminotetracético a 17% (EDTA) com ultrassom, Nd:YAG 1064-nm e laser diodo 980-nm na retenção de um cimento obturador à base de resina epóxica nas paredes do canal radicular. Quarenta dentes bovinos unirradiculares foram instrumentados com o sistema rotatório ProTaper e divididos em quatro grupos de acordo com o protocolo de irrigação final (n = 10): (1) EDTA 17% (controle); (2) EDTA 17% com agitação ultrassônica por 50-s; (3) EDTA 17% com agitação com laser diodo (2-W) por 50-s; e (4) EDTA 17% com agitação com laser Nd:YAG (1,5-W) por 50-s. Após obturação endodôntica com cone principal F5 e cimento Sealer 26, as raízes foram seccionadas nos terços radiculares cervical, médio e apical para obtenção de slices de 1,5-mm. Testes de push-out foram realizados utilizando uma máquina universal de ensaios com velocidade de carga de 1 mm/min. Os dados foram analisados utilizando os testes two-way ANOVA e Tukey's (α=0,05). Os terços radiculares apicais tiveram força de adesão significantemente maior que os terços cervical e médio (p<0,05). EDTA com Nd:YAG 1064-nm ou laser diodo 980-nm apresentaram os maiores valores de força de adesão e foram significantemente diferentes do EDTA com agitação ultrassônica e EDTA apenas (p < 0,05). Falhas adesivas foram predominantes apenas no grupo EDTA. Falhas mistas foram predominantes em todos os grupos de agitação. A agitação do EDTA com Nd:YAG 1064-nm e laser diodo 980-nm aumentou a força de adesão do cimento à base de resina epóxica às paredes do canal radicular comparado com a obtida com EDTA apenas ou EDTA com agitação ultrassônica.

Bonding Effectiveness of Universal Adhesive to Intracoronal Bleached Dentin Treated with Sodium Ascorbate

Abstract This study evaluated the effect of restorative protocol with sodium ascorbate on the shear bond strength (SBS) of a universal adhesive to intracoronal bleached dentin. One hundred-and-twenty bovine dentin fragments were randomly divided into 12 groups (n=10), according to the bleaching procedure (unbleached and bleached) and restorative protocol (no treatment, 10% sodium ascorbate -10SA, 35% sodium ascorbate -35SA and two-step etch-and-rinse -ER or one-step self-etch -SE Scotchbond universal adhesive approaches). Four whitening sessions were performed using 35% hydrogen peroxide. The samples from control groups were kept in relative humidity at 37 °C. Immediately after bleaching procedures, the assigned antioxidant solution was applied on dentin and restorative procedures were performed following either the ER or the SE approach. After 24 h, the specimens were subjected to SBS test. Data (MPa) were analyzed by ANOVA and Tukey's test (?=0.05). Lower SBS values were found for bleached specimens (8.54 MPa) compared with those unbleached (12.13 MPa) (p<0.05). The bond strength of the sodium ascorbate-treated groups was higher than those untreated, regardless of the strategy employed (p<0.05). Groups restored without sodium ascorbate showed lower bond strength values for both ER (8.32 MPa) and SE (8.28 MPa) adhesive strategies. The group treated with 10SA submitted to ER approach (10.14 MPa) was similar to untreated groups (p>0.05). It may be concluded that bond strength of composite resin to intracoronal dentin was affected by restorative protocol and reduced by bleaching.

Resumo Este estudo avaliou o efeito do protocolo restaurador empregando ascorbato de sódio na resistência ao cisalhamento do adesivo universal à dentina intracoronária clareada. Cento e vinte fragmentos de dentina bovina foram aleatoriamente divididos em doze grupos (n=10), de acordo com o procedimento clareador (clareados e não clareados) e protocolo restaurador (sem tratamento, ascorbato de sódio 10% (10AS), ascorbato de sódio (35AS) e estratégia de condicionamento total de dois passos (ER) ou estratégia autocondicionante de um passo (SE) com o sistema adesivo Scotchbond universal. Quatro sessões de clareamento foram realizadas empregando peróxido de hidrogênio a 35%. Os espécimes do grupo controle foram mantidos em umidade relativa a 37 °C. Imediatamente após os procedimentos de clareamento, as soluções antioxidantes selecionadas foram empregadas na dentina e os procedimentos restauradores foram realizados seguindo as estratégias ER ou SE. Após 24 h, os espécimes foram submetidos ao teste de resistência ao cisalhamento. Os dados (MPa) foram analisados pela ANOVA e teste de Tukey (?=0,05). Os menores valores de resistência ao cisalhamento foram encontrados para os espécimes clareados (8,54 MPa) comparados com aqueles não clareados (12,13 MPa) (p<0,05). A resistência de união dos grupos tratados com ascorbato de sódio foi maior que aqueles não tratados (p<0,05), independentemente da estratégia empregada. Grupos restaurados sem ascorbato de sódio demonstraram menores valores de resistência de união para ambas as estratégias adesivas ER (8,32 MPa) e SE (8,28 MPa) (p<0,05). O grupo tratado com ascorbato de sódio a 10% submetido à estratégia ER (10,14 MPa) foi similar ao não tratado (p>0,05). Pode ser concluído que a resistência de união da resina composta à dentina intracoronária foi afetada pelo protocolo restaurador e reduzida pelo clareamento.

Effect of thermoplastic filling techniques on the push-out strength of root sealing materials

This study evaluates the effect of two thermoplastic obturation systems (MicroSeal and Obtura II) on bond strength of different sealers to intraradicular dentin. Sixty root canals of human canines were prepared using ProTaper rotary files (crown-down technique) and irrigated with 2.5% sodium hypochlorite and 17% EDTA. The root canals were filled by MicroSeal, Obtura II, or lateral compaction techniques using AH Plus and Epiphany SE. 1.5 mm thick root slices were subjected to the push-out test. ANOVA and Tukey's test showed that the bond strength values (MPa) observed in the groups obturated with MicroSeal (2.96 ± 2.72) and Obtura II (2.68 ± 2.18) did not significantly differ from each other (p > 0.05) but were significantly higher than that observed in the group obturated with lateral condensation (2.01 ± 1.48; p < 0.05). There were no statistically significant differences in strength (p > 0.05) among the root canal thirds (cervical: 2.44 ± 2.03; middle: 2.50 ± 2.27; and apical: 2.70 ± 2.34). Adhesive failures were predominant (60%) in all groups. In conclusion, MicroSeal and Obtura II techniques, using AH plus sealer, increased the resistance to displacement of the filling material, when compared with lateral compaction. Moreover, when used with Epiphany SE, these obturation systems did not affect the bond strength of the material to root dentin.

Effect of root canal filling techniques on the bond strength of epoxy resin-based sealers

Abstract The aim of this study was to evaluate the effects of different root canal filling techniques on the bond strength of epoxy resin-based sealers. Sixty single-rooted canines were prepared using ProTaper (F5) and divided into the following groups based on the root filling technique: Lateral Compaction (LC), Single Cone (SC), and Tagger Hybrid Technique (THT). The following subgroups (n = 10) were also created based on sealer material used: AH Plus and Sealer 26. Two-millimeter-thick slices were cut from all the root thirds and subjected to push-out test. Data (MPa) was analyzed using ANOVA and Tukey's test (α = 0.05). The push-out values were significantly affected by the sealer, filling technique, and root third (p < 0.05). AH Plus (1.37 ± 1.04) exhibited higher values than Sealer 26 (0.92 ± 0.51), while LC (1.80 ± 0.98) showed greater bond strength than THT (1.16 ± 0.50) and SC (0.92 ± 0.25). The cervical (1.45 ± 1.14) third exhibited higher bond strength, followed by the middle (1.20 ± 0.72) and apical (0.78 ± 0.33) thirds. AH Plus/LC (2.26 ± 1.15) exhibited the highest bond strength values, followed by AH Plus/THT (1.32 ± 0.61), Sealer 26/LC (1.34 ± 0.42), and Sealer 26/THT (1.00 ± 0.27). The lowest values were obtained with AH Plus/SC and Sealer 26/SC. Thus, it can be concluded that the filling technique affects the bond strength of sealers. LC was associated with higher bond strength between the material and intra-radicular dentine than THT and SC techniques.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

Abstract: The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05). The results demonstrated no significant difference (p> 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p> 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

Quantitative Assessment of Root Canal Roughness with Calcium-Based Hypochlorite Irrigants by 3D CLSM

Chemical solutions play important roles in endodontic treatment and promote ultrastructural changes in dentin surface. The aim of this study was to quantify root canal roughness at different concentrations of calcium hypochlorite (Ca(OCl)2) and sodium hypochlorite (NaOCl) by confocal laser scanning microscopy (CLSM). Fifty-two human mandibular premolars were sectioned and randomly organized into thirteen groups (n=8): saline (control); 1%, 2.5% and 5% NaOCl; 1%, 2.5% and 5% Ca(OCl)2; the hypochlorite groups were further divided into with or without EDTA. The chlorine concentrations of the different solutions were measured by iodine titration (%). The superficial roughness (Sa) was quantified by CLSM. Ca(OCl)2 presented substantial decrease in chlorine concentration that differed from the package indication, but without compromising the dentin ultrastructure changes. There were no significant differences in dentin roughness between Ca(OCl)2 or NaOCl at all studied concentrations. The combination with EDTA provided similar roughness values among the solutions (p>0.05). The 5% Ca(OCl)2 and NaOCl solutions significantly increased dentin roughness and did not differ from the EDTA association (p>0.05). Ca(OCl)2 promoted similar dentin roughness as the NaOCl at the same concentrations and combined with EDTA. It may be concluded that Ca(OCl)2 modified the root canal dentin roughness similarly to NaOCl, at the same concentrations and EDTA combinations used in this study. Ca(OCl)2 and NaOCl, both at 5%, significantly altered dentin roughness, overcoming EDTA association, thus Ca(OCl)2 concentrations ranging from 1% to 2.5% may be suitable solutions for root canal irrigation protocols.

Soluções químicas são fundamentais para o tratamento endodôntico; entretanto, promovem alterações ultraestruturais na superfície dentinária. O objetivo deste estudo foi quantificar a rugosidade da dentina radicular com diferentes concentrações de hipoclorito de cálcio (Ca(OCl)2) e hipoclorito de sódio (NaOCl) utilizando microscopia confocal à laser (CLSM). Foram utilizados 52 premolares humanos inferiores e aleatoriamente divididos em treze grupos (n=8): Soro fisiológico (controle); NaOCl a 1%, 2,5% and 5%; Ca(OCl)2 a 1%, 2,5% and 5%; os grupos de hipoclorito foram subdivididos pela associação ou não ao ácido etilenodiaminotetracético (EDTA). A concentração de cloro ativo foi avaliada para diferentes soluções utilizando titulação iodométrica (%). A rugosidade superficial (Sa) foi quantificada por CLSM. Ca(OCl)2 apresentou perda substancial de cloro ativo e que foi distinta da condição descrita pelo fabricante, sem entretanto comprometer as alterações no substrato dentinário. Não houve diferenças significantes na rugosidade dentinária produzida pelos Ca(OCl)2 e NaOCl em todas as concentrações estudadas e associação com EDTA. A associação ao EDTA produziu rugosidade semelhante entre as soluções (p>0.05). O Ca(OCl)2 e NaOCl na concentração de 5% aumentaram significativamente a rugosidade dentinária e não apresentaram diferenças dos valores obtidos com a associação de EDTA (p>0.05). O Ca(OCl)2 alterou a rugosidade da dentina radicular de forma semelhante ao NaOCl, nas concentrações e associações utilizadas neste estudo. Como a concentração de 5% de Ca(OCl)2 e NaOCl, apresentou maior rugosidade dentinária, independente da associação ao EDTA, pode-se concluir que Ca(OCl)2 nas concentrações de 1% e 2,5% pode ser considerado uma solução adequada para a irrigação de canais radiculares.