Effects of dentinary contamination by endodontic irrigants on bonding strength of adhesive systems

This study aimed to evaluate if 2.5% sodium hypochlorite compromises the adhesion of bonding materials. The factors in the study were the irrigation solutions in two levels: 2.5% sodium hypochlorite and saline solution; and the adhesive systems used in three levels: three-step adhesive, universal adhesive, and two-step self-etch adhesive systems. The answer variable used was the microshear bond strength obtained through a universal testing machine and fracture mode. Six groups were obtained (n=10) : Etch-and-rinse/Saline (saline solution + 3-step adhesive system - Scotchbond Multipurpose, 3M ESPE); Universal/saline (saline solution + universal adhesive system ­ Prime&Bond,); Self-etch/saline (saline solution + 2-step self-etch adhesive systems - Clearfil SE Bond); Etch-and-rinse/Hypo (sodium hypochlorite 2,5% + 3-step adhesive system - Scotchbond Multiuso); Universal/Hypo (sodium hypochlorite 2,5% + universal adhesive system ­ Prime&Bond); Self-etch/Hypo (sodium hypochlorite 2,5% + 2-step self-etch adhesive system - Clearfil Se Bond). The specimens were obtained from 60 healthy bovine incisors. The crowns were separated from the roots, and the regularization of the buccal surface was performed. The groups received saline solution and 2.5% sodium hypochlorite for 30 minutes, respectively. A matrix of 1mm and 3mm oh height was stabilized by Scotch tape to obtain the resin sticks. Afterward, the bond strength test was performed in a universal testing machine at 1mm/min speed. The data were analyzed with normality Shapiro-Wilk, two-way ANOVA, and Tukey's tests (p<0.001). Etch-and-rinse and Self-etch adhesives presented the highest bond strength values after irrigation with saline solution and 2.5% sodium hypochlorite, respectively (P < 0.01). The irrigation with 2.5% sodium hypochlorite decreased the bond strength values of Etch-and-rinse and Universal (P < 0.01). On the other hand, 2.5% sodium hypochlorite improved the bond strength values of Self-etch (P < 0.01). In conclusion, 2.5% sodium hypochlorite negatively impacted the bond strength of Etch-and-rinse and Universal but improved the adhesion of Self-etch.

Evaluation of the dentinal tubule penetration of an endodontic bioceramic sealer after three final irrigation protocols

Introduction: This study aimed to evaluate the dentinal tubule penetration of an endodontic bioceramic sealer, Sealer Plus BC, after three final irrigation protocols. Methods: Thirty distobuccal roots of maxillary molars were selected. Root canal preparation was performed up to an #40.06 instrument (X1 Blue) under 2.5% sodium hypochlorite irrigation. Specimens were randomly divided into three groups (n=10), according to the final irrigation protocol: G-NaOCl (2.5% sodium hypochlorite + PUI), G-SS (0.9% saline solution + PUI) and G-H20 (Deionized water + PUI). After final irrigation protocols, all specimens were irrigated with phosphate buffer solution. Root canal obturation was performed using the single cone technique and Sealer Plus BC, stained with a specific fluorophore. Specimens were transversely sectioned and each root third was evaluated in a confocal scanning laser microscopy. Images obtained were analyzed for sealer penetration in the dentinal tubules. Results: Dentinal tubule penetration of Sealer Plus BC was not observed in any root third, regardless of the final irrigation protocol investigated. Conclusions: Sealer Plus BC dentinal tubule penetration was not observed after none of the protocols tested. Dentinal tubule penetrability of Sealer Plus BC may be related to other factors rather than the final irrigation protocol.

Resina Filtek Z250 XT precalentada como agente cementante de restauraciones indirectas / Preheated Filtek Z250 XT resin as a luting agent in indirect restorations

Introducción: Las restauraciones indirectas de resina son ampliamente empleadas para realizar tratamientos estéticos en dientes posteriores. Recientemente se ha propuesto el uso de resinas precalentadas como agentes de unión. Objetivo: Evaluar la resistencia a la tracción de restauraciones indirectas cementadas con una resina precalentada comparándola con un cemento de resina autoadhesivo y un cemento resinoso. Métodos: Las preparaciones dentarias se realizaron en 45 premolares con piedras diamantadas calibradas. Las muestras se dividieron aleatoriamente en tres conjuntos (n = 15) según los grupos experimentales: grupo 1 (resina precalentada), grupo 2 (resina autoadhesiva) y grupo 3 (cemento de resinoso adhesivo). Las muestras fueron incluidas en acrílico autopolimerizable. Se realizaron restauraciones indirectas para cada muestra, las superficies internas fueron microarenadas y se aplicó silano antes de la cementación con los agentes de unión. La resistencia a la tracción se realizó utilizando una máquina universal de ensayos con una velocidad de cruceta de 5 mm/min. El análisis estadístico se llevó a cabo con ANOVA de un factor y la prueba post hoc de Tukey. Se adoptó un nivel de significancia de p < 0,05. Resultados: La resina Filtek Z250 XT precalentada a 60 °C durante 15 minutos tuvo una fuerza de resistencia a la tracción de 5,775 MPa, similar a RelyX Ultimate con 5,442 MPa (p > 0,05), ambos grupos poseen una fuerza de resistencia a la tracción significativamente mayor que RelyX U200 (3,430 MPa). Conclusiones: La resina precalentada (Filtek, Z250 XT) y el cemento resinoso (RelyX Ultimate) muestran las mismas propiedades de resistencia a la tracción cuando se usan como agentes adhesivos en restauraciones indirectas de resina(AU)

Introduction: Indirect resin restorations are widely used in the esthetic treatment of posterior teeth. Preheated resins have been recently proposed as luting agents. Objective: Evaluate the tensile bond strength of indirect restorations cemented with a preheated resin versus a self-adhesive resin cement and a resinous cement. Methods: Tooth preparation was conducted of 45 premolars using calibrated diamond-coated stones. The samples were randomly divided into three sets (n = 15) according to the following experimental groups: Group 1 (preheated resin), Group 2 (self-adhesive resin) and Group 3 (adhesive resinous cement), and soaked in self-polimerizable acrylic. Indirect restorations were performed for each sample. The inner surfaces were microsanded, and silane was applied before cementation with the luting agents. Tensile bond strength was verified with a universal testing machine at a crosshead speed of 5 mm/min. Statistical analysis was based on one-factor ANOVA and Tukey's post hoc test. A significance level of p < 0.05 was established. Results: The Filtek Z250 XT resin preheated at 60°C for 15 minutes displayed a tensile bond strength of 5.775 MPa, similar to RelyX Ultimate with 5.442 MPa (p > 0.05). Both groups displayed a significantly greater tensile bond strength than RelyX U200 (3.430 MPa). Conclusions: The preheated resin (Filtek Z250 XT) and the resinous cement (RelyX Ultimate) exhibit the same tensile bond strength properties when used as luting agents in indirect resin restorations(AU)

Recuento de Streptococcus mutans sobre restauraciones realizadas con adhesivo con y sin carga de nanopartículas de óxido de zinc y cobre / Streptococcus mutans count on restorations made with adhesive with and without loading zinc and copper oxide nanoparticles

Objetivo: Determinar las propiedades antimicrobianas de la incorporación de nanopartículas de óxido de zinc y cobre en un adhesivo de grabado y lavado total sobre Streptococcus mutans en pacientes con restauraciones de resina compuesta confeccionadas con adhesivo cargado. Métodos: Estudio experimental, randomizado, la muestra estuvo conformada por 25 pacientes, de ambos sexos, pertenecientes al posgrado de Ortodoncia de la Facultad de Odontología de la Universidad de Chile, en los cuales se confirmó presencia de Streptococcus mutans en saliva. Se confeccionaron restauraciones de resina compuesta oclusales, en premolares superiores con indicación de exodoncia por el tratamiento de ortodoncia, con adhesivo cargado (cuya composición fue 5/0,2 por ciento ZnO y Cu, respectivamente) y control (sin presencia de nanopartículas en su composición), según el listado de aleatorización. Se tomaron muestras microbiológicas en tres tiempos con la técnica de la cubeta (antes, 1 semana y 4 semanas posterior a la confección de las restauraciones). Se obtuvieron, aislaron e identificaron colonias de Streptococcus mutans a partir de las muestras obtenidas. Se usó el test de Mann-Whitney mediante el paquete estadístico SPSS v.21 Resultados: El promedio del recuento de UFC de Streptococcus mutans en el grupo experimental fue mayor posterior a la confección de las restauraciones de resina compuesta. Los resultados de la identificación molecular por PCR demuestran la presencia de Streptococcus mutans en 20 de 25 muestras. Conclusiones: No existen diferencias en el recuento de Streptococcus mutans antes y después de la aplicación del adhesivo sobre las restauraciones de resina compuesta(AU)

Objective: To determine the antimicrobial properties of the incorporation of zinc and copper oxide nanoparticles in an etching and total wash adhesive on Streptococcus mutans in patients with composite resin restorations made with loaded adhesive. Methods: Experimental and randomized trial, the sample were 25 patients, of both sexes, belonging to the FOUCH Orthodontic postgraduate program, in whom the presence of Streptococcus mutans in saliva was confirmed. Occlusal composite resin restorations were made in upper premolars with indication of extraction by orthodontic treatment, with loaded adhesive (whose composition is 5 / 0.2% ZnO and Cu respectively) and control (without the presence of nanoparticles in their composition), according to the scrambling listing. Microbiological samples were taken in three stages with the cuvette technique (before, 1 week and 4 weeks after the restoration was made). Colonies of Streptococcus mutans were obtained, isolated and identified from the samples obtained. The statistical analysis used the SPSS v.21 software, the data was analyzed by Mann Whitney test Results: The average CFU count of Streptococcus mutans in the experimental group (adhesive modified with zinc oxide and copper nanoparticles) was higher after the fabrication of composite resin restorations. The results of molecular identification by PCR demonstrate the presence of Streptococcus mutans in 20 of 25 samples. Conclusions: There are no differences in the count of Streptococcus mutans before and after the application of the adhesive on the composite resin restorations(AU)

Efecto antimicrobiano sobre Streptococcus mutans de sistema adhesivo con nanopartículas de óxido de zinc y cobre / Antimicrobial effect against Streptococcus mutans of an adhesive system with copper and zinc oxide nanoparticles

Objetivo: Determinar las propiedades antimicrobianas de la incorporación de nanopartículas de óxido de zinc y cobre en un adhesivo de grabado y lavado total sobre Streptococcus mutans en pacientes con restauraciones de resina compuesta confeccionadas con adhesivo cargado. Métodos: Este estudio clínico randomizado, participaron 25 pacientes, de ambos sexos, pertenecientes al posgrado de Ortodoncia de la Facultad de Odontología de la Universidad de Chile, en los cuales se confirmó presencia de Streptococcus mutans en saliva. Se confeccionaron restauraciones de resina compuesta oclusales, en premolares superiores con indicación de exodoncia por el tratamiento de ortodoncia, con adhesivo cargado (cuya composición es 5 / 0.2 por ciento ZnO y Cu respectivamente) y control (sin presencia de nanopartículas en su composición), según el listado de aleatorización. Se tomaron muestras microbiológicas en tres tiempos con la Técnica de la cubeta (antes, 1 semana y 4 semanas posterior a la confección de las restauraciones). Se obtuvieron, aislaron e identificaron colonias de Streptococcus mutans a partir de las muestras obtenidas. Los datos fueron analizados por el test de Mann Whittney. Resultados: El promedio del recuento de UFC (unidades formadoras de colonias) de Streptococcus mutans en el grupo experimental fue mayor posterior a la confección de las restauraciones de resina compuesta.Los resultados de la identificación molecular por PCR demuestran la presencia de Streptococcus mutans en 20 de 25 muestras. Conclusiones: No existen diferencias en el recuento de Streptococcus mutans antes y después de la aplicación del adhesivo sobre las restauraciones de resina compuesta(AU)

Objective: Determine the antimicrobial properties of the incorporation of copper and zinc oxide nanoparticles into a total rinse and etch adhesive against Streptococcus mutans in patients with composite resin restorations made with loaded adhesive. Methods: A randomized clinical study was conducted of 25 patients of both sexes from the orthodontics graduate course taught at the Dental School of the University of Chile, in whom the presence of Streptococcus mutans was confirmed in saliva. Occlusal composite resin restorations were performed in upper premolars with exodontia indicated as part of the orthodontic treatment, using loaded adhesive (composition 5 / 0.2 percent ZnO and Cu, respectively) and control (without nanoparticles in its composition), according to the randomization list. Microbiological samples were taken at three moments applying the tray technique (before, 1 week after and 4 weeks after the restorations). Streptococcus mutans were obtained, isolated and identified from the samples taken. Data analysis was based on the Mann-Whitney test. Results: Mean Streptococcus mutans CFU count in the experimental group was higher after the composite resin restorations were made. Results of PCR molecular identification show the presence of Streptococcus mutans in 20 of 25 samples. Conclusions: No differences were found in the Streptococcus mutans count before and after application of the adhesive over the composite resin restorations(AU)

Efecto antibacteriano de los selladores endodónticos en los conductos radiculares / Antibacterial effect of endodontic sealers in root canals

RESUMEN Introducción: Los selladores endodónticos desempeñan un papel crucial en la obturación, dado que dichos materiales, no solo actúan en el momento de su aplicación, sino que continúan haciéndolo con posterioridad, protegiendo al periodonto apical contra los organismos microbianos presentes. Precisamente, una de las propiedades deseadas en los selladores endodónticos es que posean acción antimicrobiana, para eliminar las bacterias remanentes después de la irrigación e instrumentación. Objetivo: Realizar una revisión sistemática del efecto antibacteriano de diferentes selladores endodónticos más utilizados en odontología contra Enterococcus faecalis (E. faecalis). Métodos: Esta revisión sistemática se llevó a cabo siguiendo los lineamientos PRISMA. La búsqueda se realizó en las bases de datos PubMed y Science Direct. Se revisaron los artículos de estudios antimicrobianos in vitro de selladores endodónticos y se excluyeron aquellos de fuente secundaria, como los de revisión de la literatura, así como artículos sobre cementos para otros usos. Desarrollo: Los cementos a base de hidróxido de calcio, resina o biocerámicos son biocompatibles y presentan algún porcentaje de actividad antimicrobiana; sin embargo, se puede apreciar que existe variabilidad en los resultados obtenidos en los estudios incluidos en la revisión, debido al uso de condiciones diferentes para la evaluación antibacteriana, excepto en los selladores endodónticos a base de silicona, los cuales tuvieron, de forma consistente, un efecto antibacterial nulo contra E. faecalis. Conclusión: De acuerdo a la bibliografía revisada, los selladores AH Plus, AH 26, TotalFill, BC Sealer y MTA Fillapex exhibieron efecto antimicrobiano, sin embargo, algunos de ellos mostraron escasa actividad contra E. faecalis(AU)

ABSTRACT Introduction: Endodontic sealers play a crucial role in sealing, for they not only act at the moment of their application, but continue to do so later, protecting the apical periodontium against microbial organisms. One of the properties desired in endodontic sealers is precisely their antimicrobial action against bacteria remaining after irrigation and instrumentation. Objective: Carry out a systematic review about the antibacterial effect of the endodontic sealers most commonly used in dental practice against Enterococcus faecalis (E. faecalis). Methods: The systematic review was based on PRISMA guidelines. The search was conducted in the databases PubMed and Science Direct. Papers were reviewed which dealt with in vitro antimicrobial studies about endodontic sealers, excluding secondary sources such as literature reviews and papers about cements used for other purposes. Discussion: Cements based on calcium hydroxide, resin or bioceramic are biocompatible and display some percentage of antimicrobial activity. However, variability was observed in the results obtained by the studies in the review, due to the use of different conditions for antibacterial evaluation, except for silicone-based endodontic sealers, which consistently displayed no antibacterial activity against E. faecalis. Conclusion: According to the bibliography reviewed, the sealers AH Plus, AH 26, TotalFill, BC Sealer and MTA Fillapex had an antimicrobial effect. However, some of them displayed scant activity against E. faecalis(AU)

Tratamiento Rehabilitador Estético-Oclusal con Resinas Compuestas en una Paciente con Mordida Profunda y Desgaste Severo / Aesthetic-Occlusal Rehabilitation Treatment with Composite Resins in a Patient with Deep Bite and Dental Wear

RESUMEN: La rehabilitación oral tradicional del paciente con mordida profunda y braquifacial puede ser muy compleja e invasiva, sin embargo, podría involucrar muchas especialidades para su resolución ideal. Un análisis integral estético-oclusal es necesario antes de empezar el tratamiento para hacer propuestas con el menor costo biológico, de tiempo y económico. La odontología adhesiva permite una propuesta aditiva y no invasiva como un tratamiento de mediano plazo o transitorio. Este artículo presenta un caso de una paciente de 46años de edad con mordida profunda anterior y desgaste dental severo en las caras palatinas de los dientes antero-superiores, sin disfunción temporomandibular, ni compromisos sistémicos. Se destaca la rehabilitación estética- oclusal con el mínimo compromiso biológico (ultra-conservadora), mediante restauraciones adhesivas semi-indirectas de resina compuesta con acompañamiento de 12meses. Esta propuesta rehabilitadora con resinas compuestas representa una alternativa de tratamiento para el manejo del paciente con mordida profunda anterior. El control a un año de tratamiento demostró que se siguió una secuencia y resolución que aseguró los principios de la rehabilitación oral, al mismo tiempo, se procedió de la manera menos invasiva posible.

ABSTRACT: The traditional oral rehabilitation of the patient with deep bite and brachifacial can be very complex and invasive, however, a number of treatments could be considered to improve rehabilitation. A comprehensive aesthetic-occlusal analysis is necessary prior to starting treatment in order to consider the best procedure, time involved, and economic cost. Adhesive dentistry allows an additive and non-invasive proposal as a medium-term or transitory treatment. A case of a 46-year-old patient is presented, with anterior deep bite and severe dental wear on palatal surfaces of the antero-superior teeth, without temporomandibular dysfunction, or systemic compromises. The objective was to emphasize the aesthetic and occlusal rehabilitation with the least biological commitment (ultraconservative), through semi-indirect adhesive restorations of composite resin with 12 months follow-up. This restorative proposal with composite resins represents an alternative treatment for patient management with anterior deep bite. Control at one year of treatment showed that a sequence and resolution was followed, that ensured adequate oral rehabilitation in the least invasive manner possible.

Comparación in vitro del espesor y homogeneidad de la capa de cementación en carillas indirectas, realizado con resina fluida vs cemento de resina fotodependiente / Comparison of thickness and homogeneity of thecementationlayer in indirectveneers, madewith fluidresin vs. light-cure resincement: in vitro study

Resumen Objetivo: Comparar el grosor y homogeneidad de la capa de cementación entre un cemento de resina fotodependiente y una resina fluida. Materiales y métodos: Para la obtención de la muestra se talló la preparación en un diente de marfilina, el cual fue escaneado y luego replicado 92 veces en un polímero ABS. La muestra se dividió en 2 grupos con 46 muestras cada uno. Se realizó la cementación de las carillas con resina fluida Tetric N-Flow en el grupo G1, y con cemento de resina fotodependiente VariolinkEsthetic en el grupo G2. Cada muestra fue previamente lavada con alcohol de 70°, luego secada y se aplicó una capa de adhesivo TetricN-Bond. Se utilizó presión digital para lograr el asentamiento final de las carillas. Finalmente se realizó un corte medial y uno paramedial para obtener muestras de 2 mm aproximadamente, las cuales se observaron y midieron en un microscopio óptico. Resultados: El promedio de grosor para Tetric N-Flow fue de 119μm en incisal, 113μm en medio y 107μm en cervical. Para VariolinkEsthetic el promedio fue de 117μm, 112μm y 110μm en incisal, medio y cervical respectivamente. La homogeneidad fue de un 93,3% para G1 y 91,3% para G2. Conclusión: No existe diferencia significativa en el grosor y homogeneidad de la capa de cementación realizado con resina fluida y con cemento de resina fotodependiente.

Abstract Objective: Compare the thickness and homogeneity of the cementing layer between a light-cure resin cementand a flowable resin. Materials and methods: To obtain the sample, the preparation was carved in a replica of tooth 1.1 (EWL modelteeth, Kavo), which was scanned and then replicated 92 times in an ABS polymerby 3D printing. The simple was divided into 2 groupswith 46 sample seach. The cementation of the veneres was performed with Tetric N-Flow flowable resin in the G1 group, and with Variolink Esthetic light-cure resin cement in the G2 group. Each simple was previously washed with 70° alcohol, then dried and a layer of Tetric N-Bond was applied. Digital pressure was used to achieve the final settlement of the veneers. Finally, a medial and a paramedial section were made to obtain approximately 2 mm thick samples. The cementation layer was observed with an optical microscope. Results: The average thickness for Tetric N-Flowwas 119μm in incisal, 113μm in medium and 107μm in cervical. For Variolink Esthetic the average was 117μm, 112μm and 110μm in incisal, middle and cervical respectively. The homogeneity was 93.3% for G1 and 91.3% for G2. Conclusion: There is no significant difference in the thickness and homogeneity of the cementing layer made with flowable resin and with light-cure resincement.

Comparación in vitro de la resistencia adhesiva de los sistemas adhesivos grabado y enjuague y autograbado / In vitro Comparison of the adhesive strength of the etch and rinse adhesive systems and self etching

Resumen El propósito del estudio fue comparar in vitro la resistencia adhesiva de los sistemas Etch and rinse (grabado y enjuague), 4ta y 5ta generación; y los sistemas Self Etch (autograbado), 6ta y 7ma generación. Se realizó un estudio descriptivo, comparativo. Se utilizaron 20 terceros molares extraídos por motivos ortodóncico y profilácticos. Los cuales fueron cortados por la mitad y se obtuvo 40 muestras, en forma aleatoria los dientes fueron divididos en cuatro grupos, 10 con 4ta generación, 10 con 5ta, 10 con 6ta y 10 con 7ma. Se realizó una prueba de tracción vertical medida en kilogramos fuerza, para luego ser transformados a megapascales (Mpa). Las resinas de 4ta generación obtuvieron una resistencia adhesiva de 29,9 Mpa, las de 5ta una resistencia de 16,9 Mpa, la de 6ta una resistencia de 27,5 Mpa y las de 7ma generación una resistencia de 11,0 Mpa. Los resultados se sometieron a pruebas de normalidad mediante la prueba de Shapiro Wilk, y que fueron analizados mediante el ANOVA de un factor, y se encontró diferencias estadísticamente significativas entre los cuatro grupos de estudio con un valor p de 0,001. Se concluye que el sistema adhesivo de 4ta generación clasificado como Etch and Rinse presentó mejor resistencia adhesiva, seguido del adhesivo de 6ta generación clasificado como Self Etch.

Abstract The purpose of the study was to compare in vitro the adhesive strength of the Etch and Rinse systems of the 4th and 5th generation; and Self Etch systems of the 6th and 7th generation. A descriptive, comparative study was carried out. Twenty third molars were used for this study, (these molars were extracted for orthodontic and prophylactic purposes). Each teeth were cut into two pieces obtaining 40 pieces in total, then they were chosen randomly of which 10 pieces were cut with the 4th generation adhesive strength, 10 with the 5th generation, 10with the 6th generation and 10th with the 7th generation of the adhesive. A vertical traction test was performed, measured in kilograms force, and then transformed into megapascals (Mpa). The 4th generation resins obtained an adhesive resistance of 29.9 Mpa, the 5th generation resins obtained a resistance of 16.9 Mpa, the 6th generation obtained a resistance of 27.5 Mpa and the 7th generation obtained a resistance of 11.0 Mpa. The results were subjected to normality tests using the Shapiro Wilk test. These results were analyzed using the oneway ANOVA, finding statistically significant differences between the four study groups with a p-value of 0.001. As a conclusion; the 4th generation adhesive system classified as Etch and Rinse showed better adhesive strength, followed by the 6th generation adhesive system classified as Self Etch .

Bonding of universal adhesive system to enamel surrounding real-life carious cavities

Abstract: This study aimed to evaluate the bond strength of a universal adhesive system to enamel surrounding real-life carious cavities. Twenty-eight permanent molars (n = 7) with carious lesions in dentin were subjected to selective carious tissue removal to firm dentin and had their crowns sectioned longitudinally. A universal adhesive system (Single Bond Universal [SBU] used in either etch-and-rinse and self-etch strategies) was compared with an etch-and-rinse Adper Single Bond 2 (ASB) and a self-etch Clearfil SE Bond (CSE) adhesive systems (control systems). Adhesives were applied on the enamel, assumed demineralized, surrounding the cavity margins and on sound enamel (control substrate). Composite cylinders were built (0.72 mm2) and microshear bond strength (µSBS) test was performed after 24 h of water storage. The µSBS values (MPa) were analyzed using two-way ANOVA and Tukey's post hoc tests (α = 0.05). Bond strength values obtained in demineralized enamel surrounding carious cavity margins were significantly lower than that obtained in sound enamel (distant from carious cavity margins) (p = 0.035). The bonding strategy of the SBU did not influenced the bond strength values, which were higher than that obtained with ASB. CSE showed similar µSBS values to ASB and SBU in the self-etch mode. In conclusion, the bond strength to enamel assumed demineralized is lower than to sound enamel. The enamel surrounding carious cavities jeopardize the bonding of universal adhesive system. The bond strength of universal adhesive is similar, regardless to bonding strategy.

A randomized clinical trial of cavity liners after selective caries removal: one-year follow-up

Abstract Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. Objective: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. Methodology: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). Results: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). Conclusion: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.

Retreatment Efficacy of Endodontic Bioceramic Sealers: A Review of the Literature / Eficacia del retratamiento de cementos endodónticos biocerámicos: Revisión de Literatura

Abstract The endodontic retreatment is a feasible solution when post-operative apical periodontitis persists or develops. The complete removal of the filling materials is important in order to ensure the unobstructed contact of the intracanal disinfectants with the microbes. As a new generation of bioceramic endodontic sealers has emerged, their removal efficacy from the root canal system during retreatment is a matter of concern among clinicians. The aim of this article is to provide a comprehensive review of the current literature on the retreatability of these novel obturating materials. A significant amount of bioceramic sealer remnants in the root canal walls was observed in all studies. Even though canal cleanliness could not be obtained at an ideal level, the re-establishment of the working length and patency can be considered manageable and comparable to other endodontic sealers.

Resumen El retratamiento endodóntico es una solución factible cuando la periodontitis apical post-operatoria persiste o se desarrolla. La eliminación completa de los materiales obturadores es importante para garantizar el contacto y acción de los desinfectantes e irrigantes endodónticos con los microorganismos persistentes. A medida que ha surgido una nueva generación de selladores endodónticos biocerámicos, su eficacia de eliminación del sistema de conductos radiculares durante el retratamiento es motivo de preocupación entre los profesionales. El objetivo de este artículo es proporcionar una revisión exhaustiva de la literatura actual sobre la influencia o posibles limitantes del uso de este tipo de cementos bioactivos durante el retratamiento endodóntico. Los estudios determinaron una cantidad significativa de restos de selladores biocerámicos en las paredes del conducto radicular. Aunque la limpieza del canal no se pudo obtener a un nivel "ideal", el restablecimiento de la longitud de trabajo y la permeabilidad se puede considerar manejable y comparable a otros selladores endodónticos.

Evaluation of Microleakage by Gas Permeability and Marginal Adaptation of MTA and BiodentineTM Apical Plugs: In Vitro Study / Evaluación de la microfiltración por permeabilidad de gas y adaptación marginal de tapones apicales de MTA y BiodentineTM: Estudio in vitro

Abstract The endodontic treatment of teeth with incomplete development is always a complex task. Nowadays, biomaterials such as bioceramics offers promising clinical evidence that supports its use. However, the standardization of its use for apexification purpose still needs a deeper understanding of the materials' behavior. The aim of this investigation was to evaluate the marginal adaptability and microleakage by gas permeability of MTA and Biodentine™ apical plugs in an in vitro model. Materials and methods: Twenty- four single rooted human teeth were selected according to previously stablished inclusion criteria. All samples were prepared obtaining standard cylindrical internal canals with a diameter of 1.3 mm. Root canals were gently rinsed using 5.25% sodium hypochlorite and EDTA 17%. The apical 3mm and remaining coronal dental structure were sectioned to obtain 10mm roots. Roots were randomly assigned to 3 different groups as follows: GROUP A: MTA (n=10), GROUP B: Biodentine™ (n=10) and Group C: Control (positive n=1, negative n=3). MTA and Biodentine™ were prepared according to manufacturer's indications, and apical plugs of 4mm were passively placed in the correspondent teeth. All samples were stored in saline solution for 7 days at 37°C before evaluation. Samples were mounted in cylindrical sample-holders using epoxy resin. Microleakage was evaluated with an automatic permeability detector that calculates nitrogen diffusion between the material-root interphase. After microleakage evaluation, the samples were recovered and analyzed by scanning electron microscopy (SEM). Microleakage results were analyzed using Chi-square and adaptation was evaluated with a descriptive analysis. Results: None of the evaluated materials completely avoided the nitrogen microleakage (positive leakage of 10% and 20% of samples for MTA and Biodentine™ respectively); with no statistical significant difference between groups (p=0.527). All apical plugs showed good adaptation under SEM, at 30x, 200x, 1000x and 2500x; with microscopical structures similar to previous reports. Conclusions: Both bioceramics behave similar when used as apical barriers to avoid permeability, with acceptable marginal adaptation. Further in vivo studies are needed to validate these results.

Resumen El tratamiento endodóntico de dientes con desarrollo incompleto es siempre una tarea compleja. Hoy en día, biomateriales como las biocerámicas ofrecen una evidencia clínica prometedora que apoya su uso. Sin embargo, la estandarización de su uso para fines de apexificación todavía necesita una comprensión más profunda del comportamiento de los materiales. El objetivo de esta investigación fue evaluar la adaptabilidad marginal y microfiltración por permeabilidad de gas de los tapones apicales de MTA y Biodentine™ en un modelo in vitro. Materiales y métodos: Veiticuatro dientes humanos uniradiculares fueron seleccionados meticulosamente según criterios de inclusión previamente establecidos. Todas las muestras fueron preparadas con canales cilíndricos internos estandarizados de 1,3 mm de diámetro. Los conductos radiculares fueron gentilmente lavados con hipoclorito de sodio al 5,25% y EDTA al 17%. La estructura dental apical de 3 mm y la coronal restante se seccionó para obtener raíces de 10 mm de longitud. Las raíces se asignaron aleatoriamente a 3 grupos diferentes de la siguiente manera: GRUPO A: MTA (n = 10), GRUPO B: Biodentine™ (n = 10) y Grupo C: Control (n = 1 positivo, n = 3 negativos). El MTA y Biodentine™ se prepararon de acuerdo con las indicaciones de los fabricantes, y se colocaron pasivamente los tapones apicales de 4 mm en los dientes correspondientes. Todas las muestras se almacenaron en solución salina durante 7 días a 37ºC antes de la evaluación. Las muestras se montaron en porta-muestras cilíndricos utilizando resina epóxica. La microfiltración se evaluó con un detector de permeabilidad automática que calcula la difusión de nitrógeno entre la interfase material-raíz. Después de la evaluación de microfiltración, las muestras fueron recuperadas y analizadas por microscopía electrónica de barrido (SEM). Los resultados de microfiltración se analizaron utilizando una prueba estadística de Chi-cuadrado y la adaptación se evaluó con un análisis descriptivo. Resultados: Ninguno de los materiales evaluados evitó completamente la microfiltración de nitrógeno (fuga positiva de 10% y 20% de muestras para MTA y Biodentine™, respectivamente); sin diferencias estadísticamente significativas entre los grupos (p = 0,527). Todos los tapones apicales mostraron una buena adaptación bajo SEM, a 30x, 200x, 1000x y 2500x; con morfologías similares a las previamente reportadas. Conclusiones: ambas biocerámicas se comportan de forma similar cuando se usan como barreras apicales para evitar la permeabilidad de gas, con adaptación marginal aceptable. Se necesitan más estudios in vivo para validar estos resultados.

Adhesivos de cianoacrilato en cirugía oral y maxilofacial / Cyanoacrylate adhesives in oral and maxillofacial surgery

RESUMEN: Los adhesivos de cianoacrilatos (ACA) son materiales sintéticos con propiedades adhesivas. Al ser aplicados en los tejidos polimerizan uniéndose con el tejido subyacente. Desde la década de los 70' se han explorado sus aplicaciones quirúrgicas para el cierre de heridas y fístulas, control de sangrado y fijación de injertos, entre otros, siendo su uso como alternativa para el cierre de heridas en piel y mucosas uno de los más estudiados. Los ACA presentan un limitado grado de absorción, sin evidencia de efectos tóxicos sistémicos. Tienen la ventaja de ser aplicados de forma rápida, indolora, con efecto antibacteriano y hemostático según los reportes de la literatura, pero presentan una reducida fuerza de tensión. El objetivo de esta revisión de la literatura es describir los usos y aplicaciones de los ACA, con enfoque en la cirugía oral y maxilofacial, evaluando de forma crítica sus aplicaciones.

ABSTRACT: The cyanoacrylate adhesives (ACA) are synthetic materials with adhesive properties. When is applied in tissues, it polymerizes and bonds with the underlying tissue. Since the 70s' have been explored their surgical applications for closing wounds, fistulas, bleeding control, and graft fixation, among others. Its use as an alternative for closing wounds in skin and mucous is one of the most studied. The ACA have a limited absorption degree, with no evidence of systemic toxic effects. They have the advantage of being applied quickly, painlessly, with antibacterial effect and hemostatic according to the report of literature, but with reduced tensile strength. The objective of this literature review is to describe the use and applications of ACA, with focus on oral and maxillofacial surgery, with a critically evaluation of their applications.

Aplicación del MTA en un caso de restauración endodóntica avanzada por vía directa. Presentación de caso / Direct placement of MTA in a case of advanced endodontic restoration. Case presentation

IIntroducción Las lesiones endoperiodontales son aquellas de carácter inflamatorio que comprometen simultáneamente la pulpa dental y las estructuras del periodonto de inserción, donde se obtiene un pronóstico favorable solo cuando el diente está en un ambiente cerrado y protegido, y se alcanza la cronicidad del componente periodontal de la afección. Para lo cual el uso de los biomateriales y el esquema operatorio tienen un carácter crucial. Objetivo: Describir un caso de restauración endodóntica avanzada por vía directa, con el uso de MTA. Presentación del caso:Paciente de 45 años, masculino, quien acude a consulta presentando una lesión endoperiodontal combinada con toma del fulcron en (46). El mismo requirió una radiculectomía, reconstrucción de corona y raíz por vía directa, y estabilización a través del uso del Agregado Trióxido Mineral (MTA). Conclusiones:La aplicación del MTA en la restauración endodóntica avanzada combinada con el composite nano híbrido por vía directa es una alternativa factible de realizar en una sola visita, y garantiza una rápida recuperación de las funciones buco-dentales del paciente(AU)

Introduction: Endoperiodontal lesions are those lesions that have an inflammatory character that simultaneously compromise the dental pulp and periodontal structures of insertion, where favorable prognosis is obtained only when the tooth is in a closed and protected environment, and the chronicity of the periodontal component is achieved. Consequently, the use of biomaterials and the operative scheme have a crucial character. Objective: To describe a case of advanced endodontic restoration by direct placement of MTA. Case presentation: 45 years old patient who comes to the consultation presenting a combined endoperiodontal lesion, reaching the fulcron in (46). The patient required a radiculectomy, a direct reconstruction of the crown and the root, and stability through the use of Mineral Trioxide Aggregate(MTA). Conclusions: The direct placement of MTA in an advanced endodontic restoration, combined with the nano-hybrid material is an alternative that is viable to do in a single visit and guarantees a fast recovery of the buccal-dental functions of the patient(AU)

Influência do cimento na radiopacidade de obturações com cone único / Sealer influence on radiopacity of single cone root canal fillings

Objetivo: o objetivo deste estudo foi avaliar a influência dos cimentos AH Plus e Endofill na radiopacidade de obturações em canais simulados, usando-se a técnica do cone único. Métodos: vinte blocos de resina com canais curvos simulados foram preparados até o instrumento rotatório ProTaper Universal F3. Após a irrigação final, os canais foram secos com cones de papel, e um cone de guta-percha F3 foi inserido no canal; em seguida, uma radiografia digital foi realizada para cada espécime. Os espécimes foram distribuídos aleatoriamente em dois grupos experimentais (n = 10), de acordo com cimento empregado. AH Plus e Endofill foram os cimentos associados à guta-percha para obturação dos canais. Após a presa final dos cimentos, novas imagens digitais foram realizadas, da mesma forma que as radiografias pré-operatórias. As imagens das radiografias antes e após a associação da guta-percha com o cimento foram sobrepostas e analisadas, para se registrar o número de pixels das imagens. A análise estatística foi realizada utilizando-se os testes t de Student e Wilcoxon, com nível de significância de 5%. Resultados: ambos os grupos apresentaram radiopacidade semelhante para a guta-percha (p > 0,05). No entanto, a adição do cimento aumentou significativamente (p < 0,05) a radiopacidade das imagens radiográficas. A radiopacidade foi aumentada em 68,10% com o cimento AH Plus e em 46,02% com o cimento Endofill, com diferença estatisticamente significativa entre os cimentos. Conclusões: os cimentos aumentaram significativamente a radiopacidade da obturação com a técnica do cone único. O cimento AH Plus foi mais radiopaco do que o cimento Endofill.

Estudo in vitro do nível de escoamento de cinco cimentos endodônticos: Endofill, AH Plus, MTA Fillapex, Sealer 26 e Pulp Canal Sealer EWT / In vitro study of the flow rate of five root canal sealers: Endofill, AH Plus, MTA Fillapex, Sealer 26 and Pulp Canal Sealer EWT

Objetivo: o objetivo desse trabalho foi estudar, in vitro, o nível de escoamento dos cimentos Endofill, AH Plus, MTA Fillapex, Sealer 26 e Pulp Canal Sealer EWT. Métodos: os cimentos foram manipulados de acordo com as recomendações dos fabricantes. A determinação do escoamento foi conseguida em conformidade com a especificação #57 da ADA (American Dental Association). Na comparação entre os grupos, foi realizada a ANOVA (análise de variância) e posterior teste de Tukey, com nível de confiança de 95%. Resultados: os resultados mostraram que o cimento MTA Fillapex apresentou o maior escoamento entre os cimentos estudados e o cimento AH Plus foi o único que apresentou escoamento estatisticamente significativo após 24 e 48 horas. Conclusão: concluiu-se que todos os cimentos avaliados estão em conformidade com a especificação #57 da ADA. No entanto, o cimento MTA Fillapex foi superior aos outros cimentos analisados, no que se refere ao poder de escoamento. O desempenho clínico do cimento obturador está diretamente relacionado à sua capacidade de penetrar nos túbulos dentinários e canais laterais; daí a importância do estudo do escoamento dos cimentos endodônticos.

Efeito de diferentes sistemas de obturação na resistência à fratura de raízes tratadas endodonticamente / The Influence of different obturation systems on the fracture resistance of endodontically treated roots

Objective: This study aimed to compare the fracture resistance of endodontically treated roots filled by different obturation systems. Material and methods: Ninety-six maxillary central incisors were used and decoronated, retaining 12 mm of the roots. On the basis of obturation systems, the roots were randomly divided into 4 groups (n=24): Group1 (COGR): control group (unprepared, unfilled), Group 2 (AVGR): ActiV GP points/ActiV GP sealer, Group 3 (GPGR): Gutta percha points / AH plus sealer, and Group4 (GAGR): Gutta percha points/ActiV GP sealer. The last three groups were obturated with the single cone technique. The roots were then stored in 100% relative humidity at 37 °C for 2 weeks. A vertical compressive force was exerted in a universal testing machine until fracture occurred. Data were statistically analyzed using one-way ANOVA. Results: Mean (SD) failure loads for groups ranged from 920.51 ± 210.37 to 1113.44 ± 489.42 N. The fracture resistance between the different study groups indicated no statistical difference (p>0.05). Conclusions: ActiV GP system did not exert a significant effect on the fracture resistance of endodontically treated teeth.(AU)

Objective: Comparar a resistência à fratura de raízes tratadas endodonticamente obturadas através de diferentes sistemas. Materiais e Métodos: Noventa e seis incisivos centrais superiores foram utilizados, tiveram as coroas removidas, restando 12 mm de raíz. De acordo com o sistema de obturação, as raízes foram divididas em 4 grupos (n=24): Grupo1 (COGR): grupo controle (sem preparo, sem preenchimento), Grupo2 (AVGR): cones ActiV GP / cimento ActiV GP, Grupo3 (GPGR): cones de guta percha / cimento AH plus, e Grupo4 (GAGR): cones de guta percha / cimento ActiV GP. Os últimos três grupos foram obturados através da técnica de cone único. As raízes foram armazenadas em 100% de umidade relativa a 37 °C durante 2 semanas. Uma força compressiva vertical foi aplicada através de uma máquina de ensaio universal até ocorrer fratura. Os dados foram analisados estatisticamente através de ANOVA ­ 1 fator. Resultados: A carga média (SD) obtida no momento da falha variou entre 920.51 ± 210.37 até 1113.44 ± 489.42 N. A resistência à fratura entre os diferentes grupos estudados não indicaram diferença estatística. Conclusão: O sistema ActiV GP não exerceu um efeito significante na resistência à fratura em dentes tratados endodonticamente.(AU)

Comparison of two methods of visual magnification for removal of adhesive flash during bracket placement using two types of orthodontic bonding agents

ABSTRACT Objective: This study aimed to evaluate the effectiveness of two methods of visual magnification (operating microscope and light head magnifying glass) for removal of composite flash around orthodontic metal brackets. Material and Methods: Brackets were bonded in the center of the clinical crown of sixty well-preserved human premolars. Half of the sample was bonded with conventional Transbond XT (3M Unitek TM, USA), whereas the other half was bonded with Transbond TM Plus Color Change (3M Unitek TM, USA). For each type of composite, the choice of method to remove the flash was determined by randomly distributing the teeth into the following subgroups: A (removal by naked eye, n = 10), B (removal with the aid of light head magnifying glass, under 4x magnification, n = 10), and C (removal with the aid of an operating microscope, under 40x magnification, n = 10). Brackets were debonded and teeth taken to a scanning electron microscope (SS-x-550, Shimadzu, Japan) for visualization of their buccal surface. Quantification of composite flash was performed with Image Pro Plus software, and values were compared by Kruskal-Wallis test and Dunn’s post-hoc test at 5% significance level. Results: Removal of pigmented orthodontic adhesive with the aid of light head magnifying glass proved, in general, to be advantageous in comparison to all other methods. Conclusion: There was no advantage in using Transbond TM Plus Color Change alone. Further studies are necessary to draw a more definitive conclusion in regards to the benefits of using an operating microscope.

RESUMO Objetivo: este estudo teve o objetivo de avaliar a eficácia de dois métodos de magnificação visual (microscópio cirúrgico e lupa de pala) para remoção da resina residual em torno de braquetes ortodônticos metálicos. Material e Métodos: os braquetes foram colados no centro da coroa clínica de 60 pré-molares humanos bem preservados. Metade da amostra foi colada com Transbond XT convencional (3M UnitekTM, EUA), enquanto a outra metade foi colada com TransbondTM Plus Color Change (3M-UnitekTM, EUA). Para cada tipo de resina, a escolha do método para remover o resíduo foi determinada por meio da distribuição aleatória dos dentes nos seguintes subgrupos: A (remoção a olho nu, n = 10), B (remoção com a ajuda de lupa de pala, sob uma ampliação de 4x, n = 10) e C (remoção com auxílio de um microscópio cirúrgico, sob uma ampliação de 40x, n = 10). Os braquetes foram descolados e os dentes, levados a um microscópio eletrônico de varredura (SS-X-550, Shimadzu, Japão) para visualização de sua superfície vestibular. A quantificação da resina residual foi realizada por meio do software Image Pro Plus, onde os valores foram comparados utilizando-se o teste de Kruskal-Wallis e o teste post-hoc de Dunn, ao nível de significância de 5%. Resultados: a remoção da resina ortodôntica pigmentada com o auxílio da lente de aumento de pala provou, em geral, ser mais vantajosa, em comparação aos outros métodos testados. Conclusão: não houve vantagem em se usar a TransbondTM Plus Color Change sozinha. Estudos adicionais são necessários para se chegar a uma conclusão definitiva sobre os benefícios da utilização de microscópio cirúrgico.

In vitro analysis of shear bond strength and adhesive remnant index of different metal brackets

ABSTRACT Introduction: There is a great variety of orthodontic brackets in the Brazilian market, and constantly evaluating them is critical for professionals to know their properties, so as to be able to choose which product best suits their clinical practice. Objectives: To evaluate the bond strength and the adhesive remnant index (ARI) of different brands of metal brackets. Material and Methods: A total of 105 bovine incisors were used, and brackets of different brands were bonded to teeth. Seven different bracket brands were tested (MorelliTM, American OrthodonticsTM, TP OrthodonticsTM, Abzil-3MTM, OrthometricTM, TecnidentTM and UNIDENTM). Twenty-four hours after bonding, shear bond strength test was performed; and after debonding, the ARI was determined by using an optical microscope at a 10-fold increase. Results: Mean shear bond strength values ranged from 3.845 ± 3.997 (MorelliTM) to 9.871 ± 5.106 MPa (TecnidentTM). The majority of the ARI index scores was 0 and 1. Conclusion: Among the evaluated brackets, the one with the lowest mean shear bond strength values was MorelliTM. General evaluation of groups indicated that a greater number of bond failure occurred at the enamel/adhesive interface.

RESUMO Introdução: atualmente, há uma grande diversidade de braquetes ortodônticos no mercado brasileiro, e a avaliação desses é fundamental para que os profissionais conheçam suas propriedades e possam qualificar a sua escolha. Objetivo: avaliar o desempenho de diferentes braquetes metálicos - com diferentes características de base -, por meio da resistência de união e do Índice de Adesivo Remanescente (IAR). Material e Métodos: braquetes de sete marcas distintas foram testados (Morelli®, American Orthodontics®, TP Orthodontics®, Abzil-3M®, Orthometric®, Tecnident® e UNIDEN®). Os braquetes foram colados em incisivos bovinos totalizando 105 corpos de prova. O teste de resistência ao cisalhamento foi realizado 24h após a colagem e, em seguida, foi avaliado o IAR, por meio do uso de um microscópio óptico, em aumento de 10 vezes. Resultados: a média dos valores de resistência de união variou entre 3,845 ± 3,997 MPa (Morelli®) e 9,871 ± 5,106 MPa (Tecnident®). A maioria dos escores do IAR foi de 0 e 1. Conclusão: entre os braquetes avaliados, o que obteve a menor média de resistência de união foi o Morelli®. A avaliação geral dos grupos indicou maior número de falhas de colagem na interface esmalte/adesivo.