Carisolv as an endodontic irrigant in deciduous teeth: An SEM study.

Aim: Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. "The purpose of this study was to evaluate the efficacy of Carisolv TM , 1% sodium hypochlorite (NaOCl) gel, and 1% NaOCl solution as root canal irrigants in deciduous anterior teeth." Materials and Methods: Thirty-six extracted deciduous anterior teeth were used. Root canals were flooded with NaOCl solution in Group A, NaOCl gel in Group B and Carisolv TM in Group C and incubated for 30 min. Scanning electron microscope photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored. Results: The results showed that regardless of irrigation regime, canals were consistently cleaner in the coronal and middle thirds than in the apical thirds. NaOCl solution, NaOCl gel, and Carisolv TM had comparable activity at coronal third and middle third of root canals. At the apical third, NaOCl solution cleaned canals better than NaOCl gel and Carisolv TM . Carisolv TM cleaned debris better than NaOCl gel at the apical third. Conclusion: Carisolv TM can be used as an adjunct to root canal preparation.

Time-dependent effects of chitosan on dentin structures

Complete debridement with smear layer removal are essential measures for achieving a successful outcome of root canal treatment. The aim of this study was to evaluate the effects of chitosan at different concentrations on the removal of the smear layer and on dentin structure after 3 and 5 min of application. Twelve recently extracted maxillary canine teeth were instrumented using the crown-down technique and irrigated with 1% sodium hypochlorite. The specimens were distributed according to the time and concentration of the final irrigating solution: G1: 0.1% chitosan for 3 min; G2: 0.2% chitosan for 3 min; G3: 0.37% chitosan for 3 min; G4: 0.1% chitosan for 5 min; G5: 0.2% chitosan for 5 min; G6: 0.37% chitosan for 5 min. All samples were prepared for SEM analysis. G1 exhibited removal of the smear layer, but not the smear plugs. G2 showed visible and open tubules with slight erosion of the peritubular dentin. Cleaning in G3 was similar to that in G2, however, the erosive effect was greater. There was expansion of the diameter of the tubules in G4; and in G5 and G6, there was severe erosion with deterioration of dentin surface. In conclusion, 0.2% chitosan for 3 min appeared to be efficient for removing the smear layer, causing little erosion of dentin.

Completo debridamento dos canais radiculares com a remoção da smear layer são medidas essenciais no sucesso do tratamento endodôntico. O objetivo deste estudo foi avaliar os efeitos da quitosana, em diferentes concentrações, na remoção da smear layer e na estrutura da dentina, após 3 e 5 min de aplicação. Doze dentes caninos superiores, recém extraídos, foram instrumentados pela técnica crown-down e irrigados com hipoclorito de sódio 1%. Os espécimes foram distribuídos em seis grupos conforme o tempo e a concentração da solução irrigante final: G1: quitosana 0,1% por 3 min; G2: quitosana 0,2% por 3 min; G3: quitosana 0,37% por 3 min; G4: quitosana 0,1% por 5 min; G5: quitosana 0,2% por 5 min; G6: quitosana 0,37% por 5 min. Todas as amostras foram preparadas para avaliação em MEV. Os resultados mostraram que o G1 apresentou remoção da smear layer, mas não da smear plug. O G2 mostrou túbulos visíveis e abertos com ligeira erosão da dentina peritubular. A limpeza no G3 foi semelhante à do G2, no entanto, o efeito erosivo foi maior. No G4 houve ampliação do diâmetro dos túbulos e no G5 e G6, severa erosão com deterioração da superfície dentinária. Concluiu-se que a quitosana 0,2% por 3 min foi eficiente na remoção da smear layer, ocasionando pequena erosão.

Effect of light-activation with different light-curing units and time intervals on resin cement bond strength to intraradicular dentin

The aim of this study was to assess the bond strength of a resin cement to intraradicular dentin varying the light-curing unit and the moment at which the light was applied. Post spaces of endodontically treated canines were prepared. The roots were distributed into 6 groups (n=10) according to the light-curing unit and the moment of light exposure: I) Quartz tungsten halogen-600 mW/cm² (QTH) + immediate light activation (t0); II) QTH + light activation after 10 min (t10); III) Light-emitting diodes (LED)-800 mW/cm² (LED-800)+ t0; IV) LED-800 + t10; V) LED-1,500 mW/cm² (LED-1500)+ t0; VI) LED-1500 + t10. After post cementation, slices from coronal, middle and apical post/root regions were submitted to the push-out test and failure evaluation. It was verified that LED-800 (4.40 ± 3.00 MPa) and LED-1500 (4.67 ± 3.04 MPa) provided bond strength statistically superior to QTH (3.13 ± 1.76 MPa) (p<0.05), and did not differ from each other (p>0.05). There was no significant difference between t0 and t10 (p>0.05). Coronal post/root region (4.75 ± 3.10 MPa) presented significantly higher bond strength than the apical (3.32 ± 2.30 MPa) (p<0.05) and middle regions (4.14 ± 2.99 MPa) showed intermediate values. Adhesive failures were predominant when using QTH. Adhesive and mixed failures occurred more frequently in the apical region. Higher adhesion of the resin cement to intraradicular dentin was observed in the coronal region with LED light-activation, regardless of the moment of light exposure.

O objetivo deste estudo foi avaliar a resistência de união do cimento resinoso à dentina intrarradicular em função da fonte fotoativadora e do momento de aplicação da luz. Os espaços para cimentação dos pinos foram preparados em caninos tratados endodonticamente. As raízes foram distribuídas em seis grupos (n = 10) de acordo com a fonte fotoativadora e momento de exposição à luz: I) Luz halógena (LH) com densidade de potência 600 mW/cm² + fotoativação imediata (t0); II) LH + fotoativação após 10 min (t10); III) LED com densidade de potência 800 mW/cm² (LED-800)+ t0; IV) LED-800 + t10; V) LED com densidade de potência 1.500 mW/cm² (LED-1500)+ t0; VI) LED-1500 + t10. Após a cimentação dos pinos, slicesdas regiões cervical, média e apical foram submetidos ao teste de push-out e avaliação das falhas. Verificou-se que LED-800 (4,40 ± 3,00 MPa) e LED-1500 (4,67 ± 3,04 MPa) proporcionaram resistência de união estatisticamente superior à LH (3,13 ± 1,76 MPa) (p<0,05), e não diferiram entre si (p>0,05).Não houve diferença estatisticamente significante da resistência de união entre t0 e t10 (p>0,05). A região cervical (4,75 ± 3,10 MPa) apresentou maiores valores de resistência de união que a apical (3,32 ± 2,30 MPa) (p<0,05) e a região média (4,14 ± 2,60 MPa) mostrou valores intermediários. Falhas adesivas foram predominantes no grupo LH, independentemente da região pino/canal. A parte apical apresentou predomínio de falhas adesivas e mistas. Concluiu-se que a resistência de união do cimento resinoso à dentina intrarradicular foi maior no terço cervical,com fotoativação com LED, independente do momentode exposição à luz.

Root canal debris removal using different irrigating needles: An SEM study.

Aim: This study was carried out to compare the efficacy of three irrigating needle designs in removal of debris from different parts of the root canal. Materials and Methods: Thirty human maxillary canines were prepared using HERO Shaper rotary system and irrigated with 1 ml of 5.25% sodium hypochlorite (NaOCl) after each instrument change. Three 25-gauge irrigation needle designs - brush-covered Navi Tip FX (Group I), side-vented needle RC Twents (Group II) and single-beveled (Group III) irrigating needles - were tested for their efficiency in debris removal in three different parts of the root canal (n=10 canals per group). Following instrumentation, the roots were vertically sectioned and divided into coronal, middle and apical thirds for observation under scanning electron microscope (×200 magnification). Debris on the canal wall was evaluated by using a four-scale scoring system described by Paque and his co-workers. Results: The canals irrigated with brush-covered needle Navi Tip FX (Group I) showed lower average debris score, indicating greater removal of debris in coronal third as compared to middle and apical thirds, whereas the canals irrigated with side-vented needle (Group II) and single-beveled needle (Group III) exhibited lower average score in the middle third than coronal and apical thirds. All the three needle designs exhibited higher debris score in apical third of the root canal. Tukey multiple comparisons test was applied at a significance level of P>0.05. A statistically significant difference (P<0.05) was observed in the debris removal in the coronal and middle thirds of root canals irrigated with brush-covered Navi Tip FX (Group I) and side-vented (Group II) needles, respectively, when compared with other needle design groups. Conclusion: Within the limitations of this study, it can be concluded that all the needle designs tested were effective in certain regions of the root canal with apical third uncleaned. Side-vented needle by creating turbulence removed debris effectively in coronal and middle thirds.

Comparison of apical sealing and periapical extrusion of the ThermaFil obturation technique with and without MTA as an apical barrier: An in vitro study.

Aim: The aim of the study was to compare the conventional ThermaFil obturation technique and ThermaFil obturation with mineral trioxide aggregate (MTA) as an apical barrier, with regard to apical sealing and extrusion. Materials and Methods: Twenty extracted human canines were instrumented using a crown-down technique and divided into two groups. The experimental group was obturated using ThermaFil obturation with MTA as an apical barrier and the control group was obturated using the conventional ThermaFil obturation technique. AH Plus sealer was used in both the groups. Apical extrusion was recorded. Teeth of both the groups were coated with nail polish, except for the apical 3 mm. After 24 h, they were suspended in black India ink for 48 h. Canines were decalcified, rendered transparent, and linear dye penetration was measured under ×40 stereomicroscope. Results: There was a significant extrusion noticed in conventional ThermaFil obturation technique. Frequency of extrusion of sealer and/or gutta-percha was supposed to be evaluated using χ² test, but since the values of the samples of ThermaFil plus MTA group were zero, statistical analysis could not be conducted, whereas linear dye leakage was calculated with Mann-Whitney U test because the distribution was abnormal. Conclusion: Although ThermaFil plus MTA group showed microleakage, extrusion of sealer and the core material was prevented in comparison with conventional ThermaFil obturation technique. It is advantageous to use MTA as an apical plug as there is no fear of apical extrusion and the root canal system can then be packed three dimensionally against this barrier using any thermoplasticized gutta-percha obturation technique.

Apical microleakage and SEM analysis of dentin surface after 980 nm diode laser irradiation

This study evaluated the effect of 980-nm diode laser on apical microleakage and intraradicular dentin morphology. Roots of 110 mandibular incisors were used in the study: 92 for microleakage test and 18 for scanning electron microscopy (SEM). Roots were randomly assigned to 3 groups according to the irrigating solution (water, NaOCl and NaOCl/EDTA) and were divided into 3 subgroups according to the laser irradiation protocol (without irradiation, irradiated at 1.5 W and irradiated at 3.0 W). Two specimens of each subgroup were prepared for SEM. The remaining roots were filled with AH Plus and gutta-percha. Apical leakage was assessed by ink penetration and data were analyzed statistically by ANOVA and Tukey-Krammer test (α=0.05). SEM analysis showed intensification of changes with increase of laser power as well as variations according to the irrigating solution. Modified smear layer was observed in specimens treated with water and irradiated with laser. Roots irrigated with NaOCl/EDTA had lower levels of infiltration (0.17 ± 0.18 mm) differing significantly (p<0.05) from those of roots irrigated with water (0.34 ± 0.30 mm), but similar (p>0.05) to those irrigated with NaOCl (0.28 ± 0.29 mm). Non-irradiated roots had lower levels of infiltration (0.10 ± 0.14 mm), differing (p<0.05) from those irradiated at 1.5 W (0.32 ± 0.22 mm) and 3.0 W (0.37 ± 0.32 mm). The 980 nm diode laser modified dentin morphology and increased apical microleakage.

Este estudo avaliou o efeito do laser de diodo 980 nm na microinfiltração apical e na morfologia intrarradicular da dentina. Raízes de 110 incisivos inferiores foram utilizadas no estudo: 92 para o teste de microinfiltração e 18 para microscopia eletrônica de varredura (MEV). As raízes foram divididas em 3 grupos de acordo com a solução irrigante (água, NaOCl e NaOCl/EDTA) e subdivididas em 3 de acordo com a irradiação laser (sem irradiação, irradiados com 1,5 W e irradiados com 3,0 W). Duas amostras de cada subgrupo foram preparadas para MEV. As raízes restantes foram preenchidas com AH Plus e guta percha. A infiltração apical foi avaliada nas raízes por meio da penetração do corante e os dados foram analisados por ANOVA e teste de Tukey-Krammer (α=0,05). Os resultados da MEV mostraram intensificação das mudanças quando se aumentou a potência do laser e variações de acordo com a solução irrigadora. Camada de smear modificada foi observada em espécimes tratados com água e irradiados com laser. Raízes irrigadas com NaOCl/EDTA tiveram níveis menores de infiltração (0,17 ± 0,18 mm) estatisticamente diferente (p<0,05) das raízes irrigadas com água (0,34 ± 0,30 mm), mas semelhante (p>0,05) aos irrigados com NaOCl (0,28 ± 0,29 mm). As raízes não irradiadas tiveram níveis menores de infiltração (0,10 ± 0,14 mm), diferente (p<0,05) de 1,5 W (0,32 ± 0,22 mm) e 3.0 W (0,37 ± 0,32 mm). O laser de diodo 980 nm alterou a morfologia da dentina e aumentou a infiltração marginal apical.

A scanning electron microscopic study of hypercementosis

The purpose of this study was to evaluate morphological characteristics of teeth with hypercementosis that are relevant to endodontic practice. Twenty-eight extracted teeth with hypercementosis had their root apexes analyzed by scanning electron microscopy (SEM). The teeth were divided according to tooth groups and type of hypercementosis. The following aspects were examined under SEM: the contour and regularity of the root surface; presence of resorption; presence and number of apical foramina, and the diameter of the main foramen. The progression of club shape hypercementosis was directly associated with the presence of foramina and apical foramen obstruction. Cases of focal hypercementosis presented foramina on the surface, even when sidelong located in the root. Circular cementum hyperplasia form was present in 2 out of 3 residual roots, which was the highest proportion among the tooth types. The detection of a large number of foramina in the apical third of teeth with hypercementosis or even the possible existence of apical foramen obliteration contributes to understand the difficulties faced during endodontic treatment of these cases.

Comparative sem evaluation by of three solvents used in endodontic retreatment: an ex vivo study

This study compared, by scanning electron microscopy (SEM), the efficacy of three solvents on the removal of filling materials from dentinal tubules during endodontic retreatment. Forty human maxillary canines with straight canals were prepared according to a crown-down technique and enlarged to a#30 apical file size, before obturation with gutta-percha and a zinc-oxide-eugenol based sealer. The samples were stored for 3 months before being randomly assigned to four groups: chloroform (n=10), orange oil (n=10), eucalyptol (n=10) and control (n=10). Solvents were applied to a reservoir created on the coronal root third using Gates Glidden drills. The total time for retreatment using the solvents was 5 minutes per tooth. Following retreatment the roots were split longitudinally for SEM evaluation. SEM images were digitized, analyzed using Image ProPlus 4.5 software, and the number of dentinal tubules free of filling material from the middle and apical thirds was recorded. No significant difference was found among the solvent groups regarding the number of dentinal tubules free of root filling remnants in the middle and apical root thirds (p>0.05). However, the control group had fewer dentinal tubules free of filling material (p<0.05). Under the tested conditions, it may be concluded that there was no significant difference among the solvents used to obtain dentinal tubules free of filling material remnants.