Root filling quality and bond strength of endodontic sealers to human and bovine dentin / Qualidade da obturação e resistência de união de cimentos endodônticos à dentina humana e bovina

Objetivo: Este estudo teve como objetivo comparar a qualidade da obturação e a resistência de união de dois cimentos endodônticos, AH Plus e Bio-C Sealer, em dentes humanos e bovinos. Métodos: Os canais radiculares de 60 dentes unirradiculares [30 humanos (H) e 30 bovinos (B)] foram preparados e obturados por condensação lateral da guta-percha e AH Plus (grupos AP-H e AP-B) ou Bio-C Sealer (grupos BC-H e BC-B). Seis fatias de 1,5 mm de espessura foram obtidas de cada raiz. Os espécimes foram observados em estereomicroscópio para avaliar a qualidade da obturação, considerando possíveis espaços vazios no material obturador. Posteriormente, as fatias radiculares foram avaliadas em termos de resistência de união por push-out e modo de falha. Os dados foram analisados pelos testes de Mann-Whitney e coeficientes de correlação de Spearman (α=5%). Resultados: A qualidade de obturação fornecida por AP e BC foi semelhante em ambos os substratos de dentina. No entanto, ao comparar dentes humanos e bovinos, os escores de espaços vazios foram maiores nas amostras bovinas, para ambos os cimentos. AP teve maior resistência de união à dentina humana e bovina do que BC. No entanto, não houve diferença significativa na resistência de união entre os substratos dentinários, para ambos os cimentos testados. Além disso, houve uma correlação positiva e moderada entre os valores de resistência de união de dentes humanos e bovinos. O modo de falha misto foi o mais prevalente. Conclusão: AP e BC fornecem qualidade de obturação semelhante, mas o primeiro apresenta maiores valores de resistência de união à dentina humana e bovina. A utilização de dentes bovinos como substitutos de amostras humanas parece ser adequada em estudos relacionados à resistência de união, mas não naqueles que testam a qualidade da obturação endodôntica.(AU)

Objective: This study aimed to compare the filling quality and bond strength of two endodontic sealers, AH Plus and Bio-C Sealer, in human and bovine teeth. Methods: The root canals of 60 [30 human (H) and 30 bovine (B)] single-rooted teeth were prepared and filled by lateral condensation of gutta-percha and AH Plus (groups AP-H and AP-B) or Bio-C Sealer (groups BC-H and BC-B). Six 1.5-mm-thick slices were obtained from each root. The specimens were observed under a stereomicroscope to assess filling quality, considering possible voids within the filling material. Subsequently, root slices were evaluated in terms of push-out bond strength and failure mode. Data were analyzed by Mann-Whitney tests and Spearman correlation coefficients (α=5%). Results: The filling quality provided by AP and BC was similar in both dentin substrates. However, when comparing human and bovine teeth, void scores were greater in the bovine samples, for both sealers. AP had higher bond strength to human and bovine dentin than BC. However, there was no significant difference in bond strength between dentin substrates, for both sealers tested. Also, there was a positive and moderate correlation between the bond strength values of human and bovine teeth. The mixed failure mode was the most prevalent. Conclusion: AP and BC provide similar filling quality, but the first presents higher bond strength values to human and bovine dentin. The use of bovine teeth as substitutes for human samples seems adequate in studies related to bond strength, but not in those testing root canal filling quality.(AU)

Effect of various intracanal materials on the diagnostic accuracy of cone-beam computed tomography in vertical root fractures / 北京大学学报(医学版)

OBJECTIVE@#To study the effect of various intracanal materials on the accuracy of oral maxillofacial cone-beam computed tomography (CBCT) for the diagnosis of vertical root fracture (VRF).@*METHODS@#A total of twenty-four structurally intact single root canal dried and isolated teeth extracted for orthodontic treatment or periodontal disease were collected. The teeth were decrowned along the cemento-enamel junction (CEJ) and then used as samples for the study after conventional root canal preparation and post preparation. The 24 samples were divided into two groups with 12 samples in each group. Group A was the control group (no VRF group). According to intracanal materials, they were divided into five subgroups: blank group, fiber post group, gutta-percha point group, titanium post group and gold-palladium post group. Group B was the experimental group (VRF group), and subgroups were grouped as above. The VRF model was prepared by a unified method in the VRF group: the root was completely fractured in the buccolingual direction with a custom root canal nail and then cemented and reset. The control group was not subjected to the simulation of VRF. Titanium post and gold-palladium post were made according to the individuality of the root canal preparation, and the tightness of the post to the root canal wall was confirmed by X-ray radiograph. Then all the samples were scanned by CBCT in the isolate swine mandibular alveolar sockets. The diagnostic accuracy was statistically analyzed via blind interpretation by experienced endodontic specialists and oral and maxillofacial medical imaging specialists.@*RESULTS@#The accuracy of the diagnosis of VRF in the blank group, fiber post group, gutta-percha point group, titanium post group, and gold-palladium post group in CBCT was 95.83%, 91.67%, 87.50%, 79.17%, and 45.83%, respectively. Compared with the blank group, the differences were not statistically significant in the fiber post group (P>0.999), the gutta-percha point group (P=0.500) and the titanium post group (P=0.125). The lowest diagnostic accuracy of VRF was found in the gold-palladium post group, and the difference was statistically significant compared with all other groups (P < 0.001).@*CONCLUSION@#Various intracanal materials have different degrees of influence on the diagnostic accuracy of VRF diagnosis in CBCT. The influence of fiber post, gutta-percha point and titanium post was small, while the influence of gold-palladium post was significant.

Selamento de perfuração com técnica de inserção modificada do MTA: relato de caso clínico / Drilling seals rig with a modified MTA insertion technique: clinical case report

O presente artigo tem como objetivo relatar um caso clínico de selamento de perfuração com uma técnica de inserção modificada do MTA. Após a anestesia, foi realizado o isolamento absoluto do dente e remoção do material presente na câmara, com o auxílio do inserto ultrassônico Smart X 1. Realizada a limpeza da perfuração utilizando hipoclorito de sódio e modelagem do canal com o instrumento rotatório, a obturação foi concebida com cone de guta percha e cimento AHPlus. Com broca Gates Glidden #3 foi removida a guta percha até o nível da perfuração. Em seguida, 5 mg de MTA branco foi manipulado, de acordo com recomendações do fabricante usando água destilada na proporção 1:1 e inserido na canaleta de uma régua endodôntica. Com o auxílio do instrumento de RHEM o material foi removido da canaleta e inserido na perfuração, concluindo o vedamento da mesma. Conclui-se neste caso clínico que o selamento de perfuração com MTA obteve sucesso clínico e radiográfico, utilizando a técnica de inserção com MTA modificada(AU)

This article aims to report a clinical case of sealing drilling rig with a modified MTA insertion technique. After anesthesia, the absolute isolation of the tooth and removing the material present in the Chamber, with the aid of ultrasonic Insert Smart X 1. Held drilling cleaning using sodium hypochlorite and modeling the canall with the Rotary instrument, the filling was designed with cone of gutta percha and cement AHPlus. With Gates Glidden bur #3 removed the gutta percha drilling level. Then 5 mg of white MTA was handled, according to manufacturer 's recommendations using distilled water in the ratio 1:1 and inserted in a canal endodontic ruler. With the aid of RHEM instrument the material was removed from the canal and inserted in drilling, completing the enclosure. It is concluded in this case that the sealing of drilling with clinical and radiographic success MTA, using the technique of does not avoid inserting rotating instrument. The obturation was performed with gutta percha cone and AHPlus cement. Removed gutta percha with Gates Glidden drill to drill level. Then, 5 mg of white MTA was handled, according to manufacturer 's recommendations using distilled water in the ratio 1: 1. Soon after, it was inserted in the caneleta of an endodontic ruler and with the aid of the instrument of RHEM the material was inserted in the indicated place. It is concluded in this clinical case that the perforation sealing with MTA obtained clinical and radiographic success, using the insertion technique with modified MTA(AU)

Application of cold flowable gutta-percha in root canal obturation after apexification / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical effect of root canal obturation therapy using cold flowable gutta-percha on young permanent teeth after apexification.@*METHODS@#Ninety cases of young permanent teeth with pulp necrosis or periapical periodontitis treated by apexification were randomly divided into two groups. The cases in each group were divided into single root canal and multiple root canal according to the number of the root canal, and divided into classifications Ⅰ, and Ⅱ/Ⅲ/Ⅳ according to Frank's classification of root development after apexification. Cold flowable gutta-percha and warm gutta-percha obturation techniques were used for root canal obturation of the two groups. The operation time was recorded, and the patients' therapy pain degree was evaluated by visual analog scale (VAS) immediately after operation. Periapical X-ray was performed after operation to evaluate the effect of the root canal filling. The total length of the root was divided into equal three parts on the X-ray film, and three-dimensional tightness of the apical, middle, and coronal region of the root canals were statistically analyzed respectively. Clinical examinations and X-ray examination were performed 6 and 12 months after the operation to evaluate the treatment success rate.@*RESULTS@#The operation time of cold flowable gutta-percha group was significantly lower than that of the control group, which were 51 s and 74 s (P < 0.05); The percentages of pain and discomfort in the two groups were 26.67% and 40.00%, respectively. There were two cases of underfilling and no overfilling in both groups. The percentages of proper filling and tight three-dimensional obturation in the experimental and control groups were 71.11% and 60.00% respectively; and the percentages of tight three-dimensional obturation in the apical third areas were 86.67% and 66.67%, the difference was significant (P < 0.05). There was no significant difference in the three-dimensional tightness between the two groups in the middle and coronal third areas. The percentages of tight three-dimensional obturation in classification Ⅰ groups were 86.67%, 83.33%, 93.33% and 76.67%, 90.00%, 96.67% in experimental and control group, respectively; The percentages of classification Ⅱ/Ⅲ/Ⅳ groups were 86.67%, 86.67%, 100.00% and 46.67%, 86.67%, 100.00%, respectively, and the difference was significant (P < 0.05). There were no apical lesions that occurred in either group during the one-year review period.@*CONCLUSION@#The application of cold flowable gutta-percha on young permanent teeth root canal obturation after apexification can achieve good obturation effect. The root obturation effect in the apical third area is significantly better than that of warm gutta-percha obturation techniques. Cold flowable gutta-percha can shorten the clinical treatment time and ameliorate the patients' therapy comfort.

Application status and prospect of single-cone obturation technique with bioceramic sealers / 中华口腔医学杂志

Compared with cold lateral condensation and continuous wave of condensation which are classically used in clinical, newly emerging single-cone obturation technique is easy-to-operate as well as time-saving. Especially when combined with bioceramic root canal sealers of improved physicochemical and biological properties, single-cone obturation technique showed satisfactory short-term outcomes in clinical observations. However, difficulties still exist in avoiding the root canal overfilling and in operating the retreatment. Besides, the long-term effects of single-cone obturation with bioceramic sealers still remain unclear. This article makes an overview on the history and development of single-cone obturation ,and provides analysis of its pros and corns. Furthermore, we would also like to summarize its clinical application and look into its future improvements.

Effectiveness of disinfecting substances of gutta-percha cones / Efetividade de agentes desinfectantes de cones de guta percha

Aim:To demonstrate the effectiveness of disinfecting substances with 2% and 5% Sodium Hypochlorite and 2% Chlorhexidine Gluconate at each of the pre-established times of 0:15 and 0:30 seconds, and 1, 2, 5, and 10 minutes. Methods: This study selected 96 gutta-percha cones that were contaminated with Enterococcus Faecalis, dried and treated with the aforementioned substances and applied at pre-established times. Subsequently, these were transferred to sterile Brain Heart Infusion broth and placed in a bacteriological incubator at 37°C for 24 hours to evaluate microbial growth, as well as in a nutrient agar medium in Petri dishes. Half of the cone was transferred to individual filter paper packages and exposed to the environment in a dental clinic at Universidade José do Rosário Velano, for 7 days, with subsequent evaluation for microbial growth. The bacterial phenotype test was performed using Gram stain and growth in 6.5% saline solution. The results were submitted to statistical analysis using the Kruskal Wallis H test, with a significance level of 5%. Results:The substances were effective at all times tested and individual storage supported disinfection. In the statistics test, the p-value was greater than 0.05, as there was no variability in the data configurations. Conclusion: The disinfection of gutta-percha cones and individual storage was an effective protocol to be adopted with 2% and 5% Sodium Hypochlorite and 2% Chlorhexidine.

Objetivo: Demonstrar a eficácia de substâncias desinfetantes, Hipoclorito de Sódio a 2% e 5% e Gluconato de Clorexidina 2% em cada um dos tempos pré-estabelecidos de 15 e 30 segundos, e 1,2, 5 e 10 minutos.Métodos: Este estudo selecionou 96 cones de guta-percha,contaminados com Enterococcus Faecalis, secos e tratados com as substâncias citadas e aplicadas em tempos pré-estabelecidos. Posteriormente, estes foram transferidos para tubos contendo caldo Infusão Cérebro Coração estéril e colocados estufa bacteriológica a 37°C por 24 horas para avaliar o crescimento microbiano, também verificado em meio ágar nutriente em Placas de Petri. Metade dos cones foram transferidos para embalagens individuais de papel de filtro, e expostas ao ambiente da clínica odontológica da Universidade José do Rosário Velano por 7 dias, com posterior avaliação do crescimento microbiano. O teste do fenótipo bacteriano foi realizado pela coloração de Gram e crescimento em solução salina a 6,5%. Os resultados foram submetidos à análise estatística por meio do Teste H de Kruskal Wallis, com nível de significância de 5%.Resultados: As substâncias foram eficazes em todos os tempos testados e o armazenamento individual favoreceu a desinfecção. No teste estatístico, o valor de p foi maior que 0,05, pois não houve variabilidade nas configurações dos dados.Conclusão: A desinfecção dos cones com Hipoclorito de Sódio 2% e 5% e Clorexidina 2% a partir de 15 segundos, e o armazenamento individual foram protocolos eficazes para serem adotados.

Avaliação da desinfecção dos cones de guta percha utilizando diferentes produtos químicos: revisão de literatura / Evaluation of the disinfection of guta percha cones using different chemicals: literature review

Introdução: Os cones de guta percha são utilizados para obturação de canais radiculares, entretanto a desinfecção desses cones deve ser realizada previamente à obturação, evitando uma contaminação, uma vez que com o manuseio diário na clínica, pode ocorrer a proliferação de microrganismos. Objetivo: Relatar através de uma revisão de literatura a importância da desinfecção de cones de guta percha previamente á obturação dos canais radiculares, com diferentes soluções desinfetantes utilizadas na odontologia. Metodologia: Foi realizada uma busca em artigos de revisão de literatura nas bases de dados Pubmed, Scielo, Lilacs com diferentes anos de publicação, mas todos com enfoque principal no tema de desinfecção de cones de guta percha com diferentes soluções químicas. Foram utilizados os descritores guta percha, desinfecção, soluções químicas. Conclusão: Medidas de prevenção devem ser empregadas durante o atendimento odontológico, em especial durante a obturação dos canais radiculares, sendo a desinfecção dos cones de guta percha essencial(AU)

Introduction: Gutta percha points are used to fill root canals, however its disinfection must be performed prior to filling, avoiding contamination, since with daily handling in the proliferation of microorganisms can occur. Objective: To report through a literature review the importance of disinfecting gutta percha points prior to root canal filling, with different disinfectant solutions used in dentistry. Methodology: A search for literature review articles was carried out in the Pubmed, Scielo, Lilacs databases with different years of publications, but all with a main focus on the topic of disinfection of gutta-percha points with different chemical solutions. The keywords gutta percha, disinfection, chemical solutions were used. Conclusion: Preventive measures must be used during dental care, especially during root canal filling, with the disinfection of gutta percha points being an essential(AU)

Cones de guta-percha: propriedades para a clínica endodôntica atual / Gutta-percha cones: properties for current endodontic practice

Objetivo: O objetivo do presente estudo é revisar a literatura sobre os tipos de guta-percha para obturação, as suas formas de apresentação e as características físico-químicas e biológicas do material. Métodos: Artigos publicados entre 1973 e 2016 foram selecionados nas bases de dados PubMed e Science Direct. Foram utilizados como descritores na língua inglesa "gutta-percha and obturation"; "cones of gutta-percha" e "obturation cones and endodontic". Revisão: A guta-percha é um material de origem orgânica que pode ser encontrado em duas formas cristalinas. Encontra-se, geralmente, na forma de cones compostos de guta-percha associada a outras substâncias. A guta-percha é considerada inerte e biocompatível, porque causa pouca reação alérgica e possui biodegradação lenta. Pode sofrer alterações físico-químicas quando utilizada em técnicas de termo-obturação, nas quais as altas temperaturas aceleram a sua degradação, comprometendo a sua função. Além disso, a sua degrada- ção precoce é também afetada pela presença ou ausência de lesões periapicais. Conclusão: Os cones de guta-percha ainda são considerados o material mais adequado e acessível para o preenchimento de canais radiculares (AU).

Objective: The objective of this study was to identify the types of gutta-percha for obturation and their forms of presentation, as well as physical-chemical and biological characteristics of the material. Materials and Methods: Articles were selected from the PubMed and Science Direct databases, published between 1973 and 2016. Were used as descriptors: "gutta-percha and obturation"; "cones of gutta-percha" and "obturation cones and endodontic". Review: Gutta-percha is a material of organic origin, which can be found in two crystalline forms. It is usually found in the form of cones composed of gutta-percha associated with other substances. Gutta-percha is considered inert and biocompatible, because it causes little allergic reaction and slow biodegradation. It can suffer physical-chemical changes when used in thermo-obturation techniques, where the high temperatures accelerate its degradation, compromising its function. In addition, its early degradation is also affected by the presence or absence of periapical lesions. Conclusion: Gutta-percha Cones are still considered the most suitable and accessible material for root canal filling

Estudio comparativo de los tiempos registrados por los instrumentos TruNatomy y ProTaper Next para alcanzar la longitud de trabajo en conductos curvos simulados obturados con GuttaCore / Comparative study of the times recorded by the TruNatomy and ProTaper Next instruments to reach the working length in simulated curved canals filled with GuttaCore

Objetivo: Comparar el tiempo empleado por los instrumen- tos TruNatomy Medium y ProTaper Next X3 para penetrar hasta la longitud de trabajo la masa de obturaciones realizadas con Gut- taCore Primary y sellador en conductos curvos simulados. Materiales y métodos: Se prepararon 20 conductos curvos simulados con instrumentos rotatorios WaveOne Gold Primary y se obturaron con GuttaCore Primary y AH Plus. Las muestras fueron divididas en dos grupos de 10 cada uno. Grupo 1: El material de obturación fue penetrado hasta la lon- gitud de trabajo con instrumentos TruNatomy Medium. Gru- po 2: El material de obturación fue penetrado hasta la longitud de trabajo con instrumentos ProTaper Next X3. Se registraron los tiempos de penetración requeridos para cada grupo y los valores obtenidos fueron analizados mediante la prueba t de Student. Resultados: Los instrumentos ProTaper Next X3 pe- netraron la masa del material de obturación más rápidamente que los instrumentos TruNatomy MediumTM. Las diferencias observadas entre ambos instrumentos fueron estadísticamente significativas (P <0.01). Conclusión: Si bien los instrumentos ProTaper Next X3 y TruNatomy MediumTM penetraron la masa de Gutta- Core Primary de manera eficiente, ProTaper Next X3 penetró hasta la longitud de trabajo más rápidamente (AU)

Aim: Compare the time required by the instruments TruNatomy Medium and ProTaper Next X3 to penetrate up to the working length the mass of fillings made with GuttaCore Primary and sealant in simulated curved canals. Materials and methods: The simulated canals of 20 EndoTraining Blocks were prepared with WaveOne Gold Pri- mary and obturated with GuttaCore Primary and AH Plus. The sample was divided into two groups of 10 each. Group 1: The sealing material was penetrated up to working length with TruNatomy Medium. Group 2: The sealing material was penetrated up to working length with ProTaper Next X3. The penetration time was recorded in each group and the obtained values were statistically analyzed with the Student's t test. Results: ProTaper Next X3 instruments penetrated the sealing material mass faster than TruNatomy Medium. Statis- tically significant differences were observed between the two instruments (P <0.01). Conclusion: While the ProTaper Next X3 and TruNat- omy Medium penetrated the GuttaCore mass to the working length efficiently, the ProTaper Next X3 did it in less time (AU)

Capacidad de sellado de los conductos laterales con distintas técnicas de obturación del conducto radicular / Sealing capacity of lateral canals with different root canal obturation techniques

Objetivo: Estimar y comparar la eficacia de diferentes técnicas de obturación para impedir el flujo de colorante a través de los conductos laterales. Materiales y métodos: Se emplearon 50 premolares inferiores extraídos y conservados en formol neutro al 5% hasta el momento de su uso, a los cuales se les realizaron conductos laterales artificiales. Una vez instrumentados los conductos principales, los dientes fueron divididos al azar en 5 grupos (n=10) para ser obturados con cuatro técnicas distintas: A) System B + inyección de gutapercha termoplástica del sistema Elements, Extruder; B) obturadores de Thermafil, ProTaper Universal; C) técnica híbrida y D) obturación con inyección de gutapercha termoplástica del sistema Elements, Extruder. Inmersos en tinta china y diafanizadas las raíces, se evaluó la longitud de penetración de la tinta en los conductos laterales. Se empleó el análisis de la varianza para detectar diferencias significativas (P<0,05) entre los niveles medios de penetración del colorante según las técnicas de obturación y las zonas del diente, y se efectuaron pruebas de rango múltiple (HSD de Tukey) para realizar comparaciones dos a dos, manteniendo fija la tasa de error por familia. Resultados: A la técnica B le correspondió el valor medio más bajo (30,63%) de penetración de tinta china. Los valores medios más elevados (54,52% y 51,74%) correspondieron a las técnicas A y C, respectivamente. Conclusión: Ninguna de las técnicas de obturación del conducto radicular empleadas ha sido capaz de impedir la filtración del colorante en los conductos laterales (AU)

Aim: To estimate and compare the different obturation techniques to avoid the flow of colorant through lateral canals. Materials and methods: 50 extracted lower premolars preserved in 5% neutral formol until the moment of use, had artificial lateral canals made. Once canals were instrumented, the teeth were randomly divided into 5 groups (n=10) to be filled with four different techniques: A) System B + injection of thermoplastic gutta-percha, Elements system, Extruder; B) Thermafil, ProTaper Universal obturators; C) hybrid technique, and D) injection of thermoplastic gutta-percha, Elements system, Extruder. Having immersed the premolars in India ink and diaphanized the roots, the penetration length of the India ink inside the canals was assessed. Analysis of variance was used to detect significant differences (P<0.05) between the mean levels of dye penetration according to the filling techniques and tooth areas, and multiple range tests (Tukey's HSD) were performed for two-to-two comparisons, keeping the error rate per family fixed. Results: Technique B had the lowest mean value (30.63%) of penetration. The highest mean values (54.52% and 51.74%) corresponded to techniques A and C, respectively. Conclusion: No obturation technique of the root canal used was able to avoid filtration of colourant in the lateral canals (AU)

Propriedades físico-químicas dos cimentos AH Plus e Sealer Plus: tempo de endurecimento e escoamento / Physicochemical properties of AH Plus and Sealer Plus cements: hardening and flow time

Introdução: O tratamento endodôntico busca sanificar o sistema de canais radiculares para permitir adequada obturação tridimensional. Para tanto, necessita-se de materiais plásticos, como a guta-percha, associados a cimentos endodônticos com adequadas características físico-químicas. Métodos: Comparação das propriedades físico-químicas tempo de endurecimento e escoamento dos cimentos endodônticos AH Plus e Sealer Plus, de acordo com a especificação 57 da American National Standard Institute/American Dental Association para materiais obturadores. Resultados: O tempo de endurecimento do AH Plus foi de 1178 minutos e do Sealer Plus foi de 422 minutos. O escoamento do APlus foi de 3259 milímetros e do Sealer Plus, 3150 milímetros. Conclusões: O tempo de endurecimento do AH Plus foi maior quando comparado ao do cimento Sealer Plus, e não houve diferença estatística no escoamento entre os cimentos estudados (AU).

Introduction: Endodontic treatment seeks to sanitize the root canal system to allow adequate three-dimensional filling, for which plastic materials such as guttapercha are required, associated with endodontic cements with adequate physico-chemical characteristics. Methods: Comparison of the physico-chemical properties hardening and flow time of the AH Plus and Sealer Plus endodontic sealers according to the American Dental Association / American Dental Association Specification 57 for sealing materials. Results: The hardening time of the AH Plus was 1178 minutes and the Sealer Plus was 422 minutes. The AH Plus flow was 3259 millimeters and the Sealer Plus was 3150 millimeters. Conclusions: The AH Plus hardening time was higher when compared to the Sealer Plus cement and there was no statistical difference in the flow between the cements studied (AU).

Bio-c repair - a new bioceramic material for root perforation management: two case reports

Abstract These case reports aimed to describe the management of lateral perforation in the middle cervical third of the root in two maxillary incisors with pulp canal calcification using Bio-C Repair, with safe and viable clinical treatment strategies. Digital radiographic exams were obtained with different angles and analyzed using different filters. Cone-beam computed tomography (CBCT) images were requested to show the actual position of the canal, location of the perforation, and guide the strategic planning of the case. Subsequently, cavity access was prepared with the aid of dental operating microscopy. After perforation was identified, granulation tissue was removed and the original canal was identified and then dressed with calcium hydroxide. In the second visit, the perforation was filled with Bio-C Repair and the canal system filled with gutta-percha points and a root canal sealer (Bio-C Sealer). The teeth were restored with glass fiber post, 4 mm beyond the perforation level, and provisory crowns. Both teeth treated as described above were functional and asymptomatic with a 1-year clinical and radiographic assessment. The Bio-C Repair is suggested as a new cement option for the management of lateral canal perforations, with effective results as observed after a one-year follow-up.

Resumo O presente relato de caso teve como objetivo descrever o manejo da perfuração lateral no terço médio cervical da raiz em dois incisivos superiores com calcificação pulpar utilizando o Bio-C Repair, com estratégias de tratamento clínico seguras e viáveis. Radiografias digitais foram obtidas em diferentes ângulos e analisadas com diferentes filtros. Imagens de tomografia computadorizada de feixe cônico (TCFC) foram solicitadas para mostrar a real posição do canal e a localização da perfuração, e orientar o planejamento estratégico do caso. Posteriormente, o acesso à cavidade foi preparado com auxílio de microscopia cirúrgica. Após a identificação da perfuração, o tecido de granulação foi removido, o canal original foi identificado e, em seguida, recebeu medicação intracanal à base de hidróxido de cálcio. Na segunda visita, a perfuração foi selada com Bio-C Repair e o sistema de canais obturado com cones de guta-percha e cimento endodôntico (Bio-C Sealer). Os dentes foram restaurados com pino de fibra de vidro, 4 mm além do nível da perfuração, e coroas provisórias. Ambos os dentes tratados conforme descrito acima se mostraram funcionais e assintomáticos na avaliação clínica e radiográfica de 1 ano. O Bio-C Repair é sugerido como uma nova opção de cimento endodôntico para o manejo de perfurações laterais, com resultados efetivos observados após um ano de acompanhamento.

Effect of obturation technique using a new bioceramic sealer on the presence of voids in flattened root canals

Abstract The aim of this study was to evaluate the filling ability of a new ready-to-use calcium silicate-based sealer using thermoplastic or single-cone technique in flattened root canals. Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were prepared and filled (n = 12), according to the following techniques: thermoplastic or single-cone technique using Bio-C Sealer. The teeth were scanned using Skycan 1176 micro-computed tomography (micro-CT) - voxel size 8.74 µm, before and after filling the root canal. The percentage of voids in the filled root canals was evaluated, and the data were statistically analyzed using the unpaired t-test (α = 0.05). The root canals filled using the thermoplastic technique created a smaller percentage of voids in the cervical/middle thirds than those filled using the single-cone technique (p < 0.05). There was no difference in the percentage of voids using either technique in the apical third (p > 0.05). The flattened root canals in the cervical/middle thirds were better filled using the ready-to-use calcium silicate-based sealer associated to the thermoplastic technique, compared with the single-cone technique. In the apical third, the techniques showed similar filling ability.

Finite element analysis of the effects of periodontal tissue temperature by continuous wave technique / 华西口腔医学杂志

OBJECTIVES@#The safety of root canal filling with 200 °C hot gutta-percha was investigated to study the effect of continuous wave technique combined with high-temperature injectable gutta-percha condensation technique on the surface temperature of periodontal tissue.@*METHODS@#CT technique and Mimics, Geomagic, and Solidworks software were utilized to build the entity models of alveolar bone, dentin and root canal, periodontal ligament, and blood flow, respectively, which were then assembled in Solidworks into a finite element model of tooth with blood flow. By utilizing ABAQUS collaborative simulation platform, fluid-structure coupling was analyzed on the whole process of root canal filling. Consequently, the surface temperature of the periodontal tissue was obtained.@*RESULTS@#In the absence of blood flow, the temperature of the periodontal ligament surface reached 50.048 ℃ during root canal filling with 200 ℃ gutta-percha. Considering blood flow, the temperature of periodontal ligament surface was 39.570 ℃.@*CONCLUSIONS@#The temperature of the periodontal ligament surface increased when the continuous wave root canal was filled with 200 ℃ gutta-percha, and the periodontal tissue was not damaged.

Estudio tridimensional de reabsorciones internas obturadas con gutapercha inyectable o cono único de gutapercha más sellador biocerámico / Three-dimensional study of internal resorptions obturated with injected gutta-percha or single guttapercha cone and bioceramic sealer

Objetivo: Evaluar ex vivo, mediante reconstrucción tridimensional con tomografía computarizada de haz cónico, la presencia de vacíos, el volumen y la adaptación de la obturación a las paredes de conductos con reabsorciones dentinarias internas simuladas empleando gutapercha inyectable o cono único de gutapercha más sellador biocerámico. Materiales y métodos: Se utilizaron 10 incisivos centrales superiores humanos extraídos, en cada uno de los cuales se talló una reabsorción artificial para su obturación. La muestra fue sometida, de manera sucesiva, a dos condiciones experimentales diferentes: grupo 1, gutapercha inyectable con sistema EQ-V Master; grupo 2, cono de gutapercha más sellador biocerámico BioRoot RCS. Luego, se realizaron tomografías computarizadas de haz cónico y se hizo el estudio tridimensional. A continuación, se utilizó un programa para identificar los vacíos en la obturación y analizar cuantitativamente el volumen y la superficie cubierta por la obturación en los tercios coronario, medio (ampolla) y apical. Los datos fueron evaluados con la prueba de Wilcoxon (P<0,05). Resultados: El volumen de obturación y la superficie dentinaria en contacto con la obturación fueron similares para las dos técnicas empleadas. Las diferencias entre ambos grupos no fueron estadísticamente significativas (P>0,05). Conclusión: Aunque se observaron vacíos con ambas técnicas (en contacto con la superficie dentinaria cuando se empleó gutapercha inyectable, y en el interior de la obturación cuando se usó cono único de gutapercha más sellador BioRoot RCS), las dos rellenaron adecuadamente las reabsorciones simuladas (AU)

Aim: Ex vivo, tridimensional evaluation with cone beam computed tomography (CBCT), of the presence of voids, the obturation volume and adaption to the root canal walls with simulated internal root resorption, using injected gutta-percha or bioceramic sealer with single gutta-percha cone. Materials and methods: Ten maxillary extracted central human incisors were used and artificial internal root resorption was created in each one. For the root canal obturation, each tooth was subjected to two different experimental conditions successively, conforming two matched groups: Group I: EQ-V Master injected thermo plasticized gutta-percha system. Group II: gutta- percha point plus BioRoot RCS bioceramic sealer. First, the root canals were filled with injected gutta-percha and then, with the bioceramic sealer. Then the teeth were scanned with CBCT and subsequently a digital three-dimensional reconstruction was performed. The presence of voids, obturation volumne and the dentin wall surface covered by the filling material was quantitative analyzed through a software; at the coronal, middle (blister) and apical thirds. The data was analyzed by using Wilcoxon test (P<0.05). Results: The filling material volume and the dentin wall surface covered by it, was similar in both root canal obturation techniques. There was no significant difference between both groups (P>0.05). Conclusion: Although voids were observed in both groups (when the injected thermo plasticized gutta-percha system was used the voids were at the external surface and when BioRoot RCS + gutta-percha cone was used the voids were into the filling material), the obturation of simulated root canal resorption cavities was similar with both obturation techniques (AU)

Avaliação do preenchimento de canais radiculares comparando a técnica manual com Mcspadden com o uso de cone único do sistema Protaper Universal / Evaluation of radicle channel filling comparing manual technique with Mcspadden with the use of the Universal Protaper system single cone

Para o sucesso no tratamento endodôntico é necessário a limpeza e modelagem dos condutos radiculares. Para isso, utilizam-se algumas técnicas de preparo dos canais com o intuito de remover o conteúdo patológico, visando sanar o canal radicular. Após um preparo cuidadoso e preciso, a obturação que acompanha a técnica escolhida deve apresentar um selamento adequado e preencher o sistema radicular com a finalidade de substituir o conteúdo natural ou patológico dos condutos por materiais inertes tolerados pelos tecidos periapicais. Com isso, o objetivo deste estudo in vitro foi avaliar por meio de radiografia digital, a qualidade de preenchimento de canais simulados retos quando os mesmos foram preparados manualmente e obturados utilizando condensação lateral e Mcsppaden e preparados com o sistema rotatório e obturados com a técnica de cone único. Para este estudo foram utilizados 20 blocos de canais radiculares simulados retos com comprimento de 21 mm. Estes blocos foram divididos em terços (cervical, médio e apical) em dois grupos que foram avaliados como ruim, bom e muito bom, onde foram obturados de duas formas diferentes, um grupo utilizando a técnica da condensação lateral mais emprego de Mcspadden e no outro grupo obturação com cone único após o preparo com o sistema mecanizado Protaper Universal. Os dados foram submetidos ao teste Qui-quadrado de Person e Teste Exato de Fisher com nível de significância de 95%. Os resultados obtidos apresentaram diferença significativas entre os terços obturados com as duas técnicas. Pode-se concluir, considerando a metodologia empregada e os resultados obtidos, que há diferença entre as duas técnicas obturadoras em relação a qualidade de preenchimento dos canais radiculares(AU)

Successful endodontic treatment requires cleaning and shaping of the root ducts. For this, some techniques of canal preparation are used in order to remove the pathological content, aiming to remedy the root canal. After careful and accurate preparation, the obturation accompanying the chosen technique must be properly sealed and fill the root system in order to replace the natural or pathological contents of the ducts with inert materials tolerated by the periapical tissues.Thus, the aim of this in vitro study was to evaluate by digital radiography the quality of filling of straight simulated channels when they were manually prepared and filled using lateral condensation and Mcsppaden and prepared with the rotary system and filled with the technique of single cone. For this study 20 blocks of simulated straight root canals with a length of 21 mm were used. These blocks were divided into thirds (cervical, middle and apical) into two groups that were evaluated as bad, good and very good, where they were filled in two different ways, one using the lateral condensation technique plus Mcspadden's and the other single cone obturation group after preparation with the Protaper Universal mechanized system. Data were submitted to Person Chi-square test and Fisher Exact Test with a significance level of 95%. The obtained results showed significant difference between the thirds filled with the two techniques. It can be concluded, considering the methodology employed and the results obtained, that there is a difference between the two obturator techniques in relation to the filling quality of the root canals(AU)

Remoção de obturações endodônticas de Endosequence BC/CPoint em canais radiculares curvos usando instrumentos rotatórios ou reciprocantes / Removal of Endosequence BC/CPoint endodontic fillings in curved root canals using rotary or reciprocating instruments

Objetivo: O presente estudo usou micro-CT para avaliar a quantidade de material obturador remanescente em canais radiculares curvos que tinham sido obturados com cimento Endosequence BC/Cpoint ou com cimento AH/ guta-percha, depois do retratamento utilizando instrumentos rotatórios ou reciprocantes. Métodos: Sessenta canais mesiovestibulares de molares superiores foram instrumentados até MTwo #35.04. As amostras foram randomicamente alocadas em quatro grupos (n=15): os canais do G1 e G2 foram obturados com AH/guta-percha, e os canais do G3 e G4 foram obturados com BC/Cpoint. O material obturador foi removido usando instrumentos rotatórios ou reciprocantes ­ G1 e G3: R25 Reciproc + reinstrumentação com R40; e G2 e G4: Sistema ProTaper Universal Retratamento + reinstrumentação com MTwo 40.06. Micro-CTs foram usadas para medir a quantidade de material obturador remanescente (mm3 ) para o canal inteiro e para cada terço, em dois momentos: 1) após a remoção do material obturador; e 2) após a reinstrumentação. Resultados: Após a remoção do material obturador, BC/CPoint permaneceu mais dentro do canal do que AH/guta-percha quando o canal inteiro (29,92% x 19,25%, p=0,0290) e o terço apical foram analisados. Após a reinstrumentação, BC/CPoint permaneceu mais do que AH/guta-percha somente no terço apical. Protocolos de tratamento com instrumentos rotatórios ou reciprocantes removeram material obturador sem diferença para AH/guta-percha (G1 e G2: p> 0,05) e BC/CPoint (G3 e G4: p> 0,05). Conclusões: BC/Cpoint é mais difícil de ser removido de canais radiculares curvos do que AH/guta-percha. Instrumentos rotatórios e reciprocantes têm habilidade similar na remoção de material obturador (AU).

Objective: This study used micro-CT to evaluate the amount of remaining filling material in curved root canals obturated with Endosequence BC Sealer/Cpoint or AH/gutta-percha after a rotary or reciprocating retreatment. Methods: Sixty mesiobuccal canals of maxillary molars were instrumented up to MTwo #35.04. Samples were randomly assigned to four groups (n=15): canals from G1 and G2 were filled with AH/gutta-percha, and canals from G3 and G4 were filled with BC/Cpoint. Filling material was removed using rotary or reciprocating instruments: G1 and G3: R25 Reciproc + re-shaping with R40; and G2 and G4: ProTaper Universal Retreatment system + re-shaping with MTwo 40.06. Micro-CT was used to measure the remaining amount of filling material (mm3 ), for the whole canal, and for each third, in two moments: 1) after filling removal and 2) after canal re-shaping. Results: After filling removal, BC/CPoint remained more into the canal than AH/Gutta-percha when the whole canal (29.92% x 19.25%, p = 0.0290) and the apical third were analyzed. After re-shaping, BC/CPoint remained more than AH/Gutta-percha only in the apical third. Rotary or reciprocating retreatment protocols removed filling material without difference for AH/gutta-percha (G1 and G2: p > 0.05) and BC/CPoint (G3 and G4: p > 0.05). Conclusion: BC/Cpoint is more difficult to be removed from curved root canals than AH/gutta-percha. Reciprocating and rotary instruments have similar ability to remove filling material (AU).

Filling ability and flow of root canal sealers: a micro-computed tomographic study

Abstract This study evaluated by micro-computed tomography (μCT) the filling ability in curved root canals, besides the flow of AH Plus (AHP) and Neo MTA Plus (NMTAP) sealers using different methodologies. Mandibular molars mesial roots with two root canals and degree of curvature between 20° and 40° were selected. The specimens were prepared with the ProDesign R system up to size 35.05 and were filled with the sealers by a continuous wave of condensation technique, Thermo Pack II (n=12). The teeth were scanned using μCT after root canal preparation and obturation. The volumetric percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 (n=10). Flow and filling were also evaluated in μCT using a glass plate with a central cavity and four grooves from the central cavity (n=6). Flow was linearly calculated into the grooves. The central cavity filling (CCF) and lateral cavity filling (LCF) were calculated in mm³. Data were submitted to non-paired t test with a significance threshold at 5%. The percentage of filling and voids between the root canals filled with AHP or NMTAP was similar (p>0.05). NMTAP presented the lowest flow in conventional test (p<0.05). Using μCT, sealers had similar CCF, LCF and linear flow (p>0.05). In conclusion, NMTAP and AHP had similar filling ability in curved mesial root canals of mandibular molars without presence of isthmus. Although AHP presented better flow than NMTAP using ISO methodology, there was no difference between these materials regarding volumetric filling when evaluated by μCT.

Resumo Este estudo avaliou por microtomografia computadorizada (μCT) a capacidade de preenchimento de canais radiculares curvos, além do escoamento dos cimentos AH Plus (AHP) e Neo MTA Plus (NMTAP) utilizando diferentes metodologias. Foram selecionadas raízes mesiais de molares inferiores com dois canais radiculares e grau de curvatura entre 20° e 40°. As amostras foram preparadas com o sistema ProDesign R até o tamanho 35.05 e foram obturadas com os cimentos por uma técnica de onda contínua de condensação, Thermo Pack II (n=12). Os dentes foram escaneados usando μCT após o preparo e obturação do canal radicular. A porcentagem volumétrica de material de preenchimento e vazios foram calculados. O escoamento foi avaliado com base na norma ISO 6876/2012 (n=10). O escoamento e o preenchimento também foram avaliados em μCT usando uma placa de vidro com uma cavidade central e quatro canaletas a partir da cavidade central (n=6). O escoamento foi calculado linearmente nas canaletas. O preenchimento da cavidade central (PCC) e o preenchimento da cavidade lateral (PCL) foram calculados em mm³. Os dados foram submetidos ao teste t não pareado com nível de significância de 5%. A porcentagem de preenchimento e vazios entre os canais radiculares preenchidos com AHP ou NMTAP foi semelhante (p>0,05). NMTAP apresentou o menor escoamento no teste convencional (p<0,05). Utilizando μCT, os cimentos apresentaram PCC, PCL e escoamento linear semelhantes (p>0,05). Em conclusão, NMTAP e AHP apresentaram capacidade de preenchimento semelhante em canais mesiais curvos de molares inferiores sem presença de istmo. Embora o AHP tenha apresentado melhor escoamento que o NMTAP usando a metodologia ISO, não houve diferença entre esses materiais em relação ao preenchimento volumétrico quando avaliados por μCT.

Comparación de desinfección de diferentes marcas de punta de gutapercha con hipoclorito de sodio / Comparison of disinfection of different brands of gutta-percha tip with sodium hypochlorite

En la terapia endodóncica uno de los principales objetivos es eliminar y prevenir la infección o reinfección del sistema de conductos radiculares y/o los tejidos perirradiculares. Los materiales de obturación utilizados podrían introducir microorganismos a este sistema previamente desinfectado e impedir el éxito del tratamiento. Diversos estudios han demostrado que los conos de gutapercha pueden estar contaminados al ser tomados directamente del empaque, aún sellado y recién abierto. Objetivo: Comparación del grado de desinfección de tres marcas diferentes de puntas de gutapercha. Material y métodos: Es un estudio experimental, comparativo, observacional y de corte transversal. En el cual se analizarán tres marcas diferentes de gutaperchas #35 (Maillefer, Hygienic y Meta-Biomed) para saber qué desinfección hay con el hipoclorito de sodio (NaOCl) al 5.25%. Se llevó a cabo el análisis descriptivo para determinar medidas de tendencia central y medidas de dispersión mediante la prueba estadística de ANOVA p ≤ 0.05. Conclusión: De acuerdo con los resultados de nuestro estudio no se encontró diferencia significativa sobre la marca de gutapercha y el grado de descontaminación después de un minuto de ser sumergidas en hipoclorito de sodio al 5.25% (AU)

In endodontic therapy one of the main objectives is to eliminate and prevent infection or reinfection of the root canal system and/or periradicular tissues. The sealing materials used could introduce microorganisms to this previously disinfected system and impede the success of the treatment. Several studies have shown that gutta-percha cones can be contaminated by being taken directly from the package, still sealed and newly opened. Objective: Comparison of the degree of disinfection of 3 different brands of gutta-percha points. Material and methods: It is an experimental, comparative, observational and cross-sectional study. Where 3 different brands of gutta percha # 35 (Maillefer, Hygienic and Meta-Biomed) will be analyzed to know what disinfection there is with sodium hypochlorite (NaOCl) at 5.25%. The descriptive analysis was carried out to determine measures of central tendency and measures of dispersion through the statistical test of ANOVA p ≤ 0.05. Conclusion: According to the results of our study there is no significant difference on the gutta-percha brand and its decontamination at the moment of being submerged in 5.25% sodium hypochlorite (AU)

Determinación de la contaminación bacteriana en conos de gutapercha en una clínica odontológica docente / Determination of bacterial contamination in gutapercha cones in an university dental clinic

Objetivo: El objetivo de este estudio fue determinar la contaminación bacteriana de los conos de gutapercha de tipo beta (ß) en los tiempos 0, 24, 47 y 72 horas de las diferentes proveedurías de la Clínica Odontológica de la Universidad Científica del Sur (Lima, 2020). Materiales y métodos: Se obtuvo 16 conos de gutapercha tipo beta (ß) de empaques cerrados bajo medidas asépticas, los cuales fueron colocados en viales con 2 ml de caldo BHI y, posteriormente, fueron sembrados en agar BHI, así como en medios selectivos agar manitol salado y agar MacConkey. Pasadas las 24 horas de incubación a 37 °C, se realizó la lectura de las placas y el conteo de UFC. El mismo procedimiento se realizó para los tiempos 24, 48 y 72 horas, lo que dio un total de 64 conos de gutapercha tipo ß. Resultados: Se observó que el nivel de contaminación bacteriana fue el mismo tanto entre las distintas proveedurías como a las 0, 24, 48 y 72 horas. Solo se hallaron diferencias estadísticamente significativas (p = 0,044) entre los distintos tiempos de la proveeduría número 5. Finalmente, todas las muestras sometidas a la prueba de la coagulasa arrojaron resultados negativos. Conclusión: Los conos de gutapercha de tipo beta (ß) se contaminaron por igual producto de su almacenamiento y manipulación, independientemente de la proveeduría en la que permanecieron. (AU)

Objective: The purpose of this study was to determinate the bacterial contamination of Beta (ß) gutta-percha cones at 0, 24, 47 and 72 hours of the different supplies of the Universidad Científica del Sur, Lima 2020. Materials and Methods: 16 ß-type gutta-percha cones were obtained of sealed packages under aseptic measurements, they were placed in vials with 2ml BHI and subsequently planted in BHI agar plates as well as in selective medias as Salted mannitol agar and MacConkey agar after 24 hours of incubation at 37 ° the plates were read and count in CFU, the same procedure was performed for the other times evaluated 24, 48 and 72 hours, giving a total of 64 ß-type gutta-percha cones. Results: It was observed that the level of bacterial contamination was the same among the different supplies in all the establish times of in this study 0, 24, 48 and 72 hours. Therefore, there were no significant differences in the level of bacterial contamination between the supplies. On the other hand, only statistically significant differences (p = 0.044) were found between the different times of the supply number 5. Finally, all the samples submitted to the coagulase test had a negative result. Conclusion: The gutta-percha cones of type ß were contaminated equally regardless of the supply in which they were stored or manipulated. (AU)