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)

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.

Effect of sonic and ultrasonic activation on physicochemical properties of root canal sealers

Abstract Objective: To evaluate the effect of ultrasonic and sonic activation on physicochemical properties of AH Plus, MTA Fillapex, ADSeal, GuttaFlow Bioseal, and GuttaFlow 2 sealers. Methodology: Three experimental groups were formed: no activation (NA), ultrasonic activation (UA), and sonic activation (SA). The sealers were manipulated according to the manufacturers' instructions. A 3-mL syringe was adapted to receive 1 mL of sealer. Activation was performed with a 20/.01 ultrasonic insert (20 s/1W) in the UA group. A size 35.04 sonic tip was used (20 s/10,000 cycles/min-1) in the SA group. The molds for physicochemical analysis were filled and evaluated according to ANSI/ADA specification no. 57: setting time (ST), flow (FL), dimensional change (DC), solubility (SB), and radiopacity (RD). Statistical analysis was performed by Kruskal-Wallis, one-way ANOVA, and Tukey's tests (P<0.05). Results: Regarding ST, only AH Plus and GuttaFlow 2 in the NA group met the ANSI/ADA standards. All FL values were greater than 20 mm in diameter, as determined by ANSI/ADA. The tested sealers and protocols did not comply with the ANSI/ADA standards for DC. As for SB, only MTA Fillapex, regardless of the activation protocol, did not follow the ANSI/ADA standards. All of the investigated sealers, regardless of the activation protocol, presented radiographic density higher than 3 mm Al, as proposed by ANSI/ADA. Conclusions: UA and SA promoted changes in the physicochemical properties of the evaluated root canal sealers, mainly in ST and F. Thus, it is important to evaluate the physicochemical properties of endodontic sealers associated with activation techniques prior to clinical application in order to determine whether the properties follow the parameters set by ANSI/ADA, ensuring safety and quality of root canal filling.

Push-out bond strength of different tricalcium silicate-based filling materials to root dentin

Abstract: The aim of this study was to evaluate the bond strength of different triccalcium silicate cements to retrograde cavity using a push out test. Thirty maxillary central incisors were shaped using #80 hand files and sectioned transversally. Root slices were obtained from the apical 4 mm after eliminating the apical extremity. The specimens were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. The samples were divided into three groups according to the root-end filling material (n = 10): MTA Angelus, ProRoot MTA and Biodentine. A gutta-percha cone (#80) was tugged-back at the limit between the canal and the root-end cavity. The root-end cavity was filled and the gutta-percha cone was removed after complete setting of the materials. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and push out testing was performed at a crosshead speed of 1.0 mm/min. There was no statistically significant difference in resistance to push out by the materials tested (p > 0.01). MTA Angelus and ProRoot MTA showed predominantly mixed failure while Biodentine exhibited mixed and cohesive failures. The tricalcium silicate-based root-end filling materials showed similar bond strength retrograde cavity.

Evaluación ex vivo del sellado obtenido a nivel del conducto lateral con el uso de diferentes materiales y técnicas de obturación / Ex vivo evaluation of the sealing obtainedat the lateral canal level using different fillingmaterials and techniques

Objetivo: Evaluar ex vivo el sellado obtenido a nivel deconductos laterales simulados en piezas dentarias con conductosradiculares amplios, obturadas con ProRoot MTA, DensellMTA y gutapercha más AHPlus con termocompactación.Materiales y métodos: Se seleccionaron 45 incisivoscentrales superiores humanos extraídos con ápices maduros.Se realizaron las aperturas coronarias y se instrumentaron losconductos radiculares hasta la longitud de trabajo con limastipo K (Dentsply/Maillefer) y luego con fresas Largo #1, #2y #3 (Dentsply/Maillefer). Durante la preparación, los conductosradiculares se irrigaron con agua destilada. Luego, en35 de los 45 dientes se talló un conducto lateral simulado enla cara mesial, a aproximadamente 3 mm del ápice anatómico,empleando un instrumento Engine Reamer #15 (Dentsply/Maillefer). Las raíces de los 35 dientes fueron recubiertaspor una lámina de gomaespuma y envueltas con una cintade teflón, a fin de simular el ligamento periodontal. En estascondiciones, se dividieron los 45 dientes en cuatro grupos de10 especímenes cada uno y un grupo control de 5 especímenes.Grupo control: conducto radicular no obturado. Grupo1: conducto radicular obturado con ProRoot MTA (Dentsply/Maillefer). Grupo 2: conducto radicular obturado con MTACemento Reparador (Densell). Grupo 3: conducto radicularobturado con AHPlus (Dentsply De Trey) y conos de gutaperchacon la técnica híbrida empleando un Guttacondensor#45 (Dentsply/Maillefer). Grupo 4: comprende los 10 especímenesen los que no se habían tallado los conductos lateralessimulados. Se obturaron los conductos radiculares conel mismo procedimiento que el grupo 3, y posteriormente setallaron los conductos laterales simulados...

Aim: Ex vivo evaluation of the sealing obtained at thelevel of simulated lateral canals in teeth with wide root canals,filled with ProRoot MTA, Densell MTA and AHPlus withthermo-compacted gutta-percha.Materials and methods: Forty-five extracted maxillaryhuman central incisors with mature apices were selected.The canals were instrumented at the working length with Kfiles (Dentsply/Maillefer) and then using Largo burs #1, #2,and #3 (Dentsply/Maillefer). During the preparation, the rootcanals were irrigated with distilled water. Later, in 35 of the45 teeth, a simulated lateral canal was drilled in the mesialsurface of each sample at approximately 3 mm coronally tothe anatomic apex using an Engine Reamer #15 (Dentsply/Maillefer). The surfaces of these 35 teeth were wrapped upwith a thin layer of foam and covered with teflon tape to simulatethe periodontal ligament. The 45 teeth were divided intofour groups of 10 specimens each, and a control group of 5specimens. Control group: unfilled root canal. Group 1: rootcanal filled with ProRoot MTA (Dentsply/Maillefer). Group2: root canal filled with MTA Cemento Reparador (Densell).Group 3: root canal filled with AHPlus (Dentsply) and thehybrid technique using gutta-percha and Guttacondensor#45 (Dentsply/Maillefer). Group 4: this group includes the10 specimens in which the simulated lateral canals were notdrilled. The root canals were filled with the same procedureas group 3 and then the simulated lateral canals were drilled...

Avaliação da descontaminação de cones de guta-percha usando diferentes métodos de desinfecção / Evaluation of gutta-percha points decontamination through different disinfection methods

A suscetibilidade ao crescimento bacteriano em cones de guta-percha (GP) e a forma de descontaminação desses cones usando quatro diferentes substâncias químicas foram avaliadas. Seis cones de GP foram selecionados de um ambiente clínico e levados com pinça estéril para um meio de cultura de Brain Heart Infusion (BHI), para avaliação de crescimento bacteriano. Outros doze cones foram divididos em quatro grupos experimentais de três cones, sendo: Grupo 1, hipoclorito de sódio a 2,5%; Grupo 2, álcool a 70%; Grupo 3, clorexidina gel a 2%; e Grupo 4, clorexidina líquida a 0,12%, onde cada cone ficou submerso na substância por um minuto, foi seco por meio de esfregaço com gaze estéril e inserido em meio de cultura BHI, para se avaliar a presença ou não de contaminação. Os resultados encontrados mostraram que os cones de guta-percha não apresentavam contaminação, independentemente de serem submetidos ou não a um processo de descontaminação. Dessa forma, conclui-se que não há necessidade de descontaminação dos cones de guta-percha, contanto que seja respeitada a cadeia asséptica do tratamento endodôntico.

Efetividade do ácido peracético na desinfecção rápida de cones de guta-percha e de Resilon expostos ao Enterococcus faecalis / Effectiveness of peracetic acid in rapid disinfection of gutta-percha and Resilon cones exposed to Enterococcus faecalis

Objetivo: o objetivo desse trabalho foi verificar a efetividade do ácido peracético a 2% na descontaminação rápida de cones de guta-percha e de Resilon, comparado ao hipoclorito de sódio e à clorexidina. Métodos: os cones de guta-percha e Resilon foram imersos por cinco minutos para contaminação em suspensão de Enterococcus faecalis, e divididos em grupos (n = 10): ácido peracético a 2% (um e três minutos); NaOCl a 5,25% (um e três minutos); clorexidina a 2% (um e três minutos). Após a realização dos protocolos em teste, os cones foram transferidos para tubos de ensaio contendo meio Enterococcosel® e, então, foram mantidos em estufa a 37º por 48 horas. Após o período de observação, os tubos foram avaliados e os que apresentam turvação do meio foram consideradas positivos. Resultados: os resultados demonstraram que o ácido peracético a 2% parece ser efetivo para a descontaminação de ambos os tipos de cone, de forma alternativa ao NaOCl a 5,25%, enquanto a clorexidina a 2% apresentou menor efetividade (p < 0,05). Conclusão: Ambas as soluções, ácido peracético a 2% e NaOCl a 5,25%, foram efetivas na descontaminação de cones de guta-percha ou de Resilon nos tempos testados.

Evaluation of the physicochemical properties of silicone- and epoxy resin-based root canal sealers

Abstract To assess the physicochemical properties of AH Plus, GuttaFlow 2, GuttaFlow BioSeal, and MM Seal, five samples of each root canal sealer were evaluated to determine their setting time (ST), dimensional change (DC), solubility (SL), flow (FL), and radiopacity (RD) according to American National Standards Institute/American Dental Association (ANSI/ADA) Specification 57. The distilled and deionized water obtained from the SL test were subjected to atomic absorption spectrometry to observe the presence of Ca2+, K+, and Na+ ions. Statistical analysis was performed by using one-way ANOVA and Tukey-Kramer tests (p < 0.05). The following results were obtained: ST (min) (AH Plus 463.6 ± 13.22; GuttaFlow 2 24.35 ± 2.78; GuttaFlow Bioseal 17.4 ± 0.55; MM Seal 47.60 ± 4.39), DC (%) (AH Plus 0.06 ± 0.12; GuttaFlow 2 −26.06 ± 1.24; GuttaFlow Bioseal 2.10 ± 1.47; MM Seal 8.47 ± 2.41), SL (%) (AH Plus 0.41 ± 0.21; GuttaFlow 2 5.13 ± 4.11; GuttaFlow Bioseal 3.03 ± 1.05; MM Seal 0.94 ± 0.17), FL (mm) (AH Plus 36.42 ± 0.40; GuttaFlow 2 36.44 ± 0.05; GuttaFlow Bioseal 35.4 ± 0.03; MM Seal 52.75 ± 0.60), and RD (mmAl) (AH Plus 7.52 ± 1.59; GuttaFlow 2 6.85 ± 0.14; GuttaFlow Bioseal 7.02 ± 0.18; MM Seal 3.32 ± 0.90). ST, DC, SL, FL, and RD showed statistical differences among the root canal sealers (p < 0.05). As AH Plus showed the lowest DC and SL values (p < 0.05), the findings indicate that this sample is the only sealer conforming to ANSI/ADA standards.

Effect of rewetting solutions on micropush-out dentin bond strength of new bioceramic endodontic material

Abstract To evaluate the influence of rewetting solutions on bond strength to root dentin of conventional gutta-percha (GP) or niobium phosphate glass-based gutta-percha (GNb) associated with a bioceramic sealer. The root canals of 80 human mandibular premolars were prepared using nickel-titanium instruments and irrigation with sodium hypochlorite and EDTA. The teeth were randomly divided into four groups according to the gutta-percha used: GNb or GP associated with EndoSequence BC Sealer (BC) and the solution for rewetting dentin before filling (distilled water; phosphate buffer saline solution - PBS; simulated body fluid - SBF; or no solution). The root canals were filled with a single cone using warm vertical condensation. Micropush-out bond strengths associated with the filling materials in slices from middle root thirds was determined 30 days after root filling. The failure mode was analyzed with stereoscopic lens. The data were statistically analyzed by two-way ANOVA and Holm-Sidak test (p < 0.05). There was significant difference in the types of gutta-percha (p < 0.001) and in the different rewetting solutions (p = 0.003). The interaction between gutta-percha and rewetting solutions was not significant (p = 0.53). The SBF solution provided an increase in bond strength for both gutta-percha solutions. The GNb+BC (3.42 MPa) association increased bond strength when compared with GP+BC (2.0 MPa). The use of SBF as a dentin rewetting solution increased bond strength in the groups studied. Association of GNb with bioceramic sealer was beneficial, increasing the bond strength to dentin when compared with the association with GP.

Evaluación comparativa de la adaptación de la obturación endodóntica a las paredes del conducto radicular con dos técnicas de obturación / Comparative evaluation of the adaptation of endodontic obturation to root canal walls with two filling techniques

Objetivo: Evaluar comparativamente y ex vivo la adaptación del material de obturación a las paredes del conducto radicular, empleando dos técnicas de obturación endodóntica. Materiales y métodos. Material y métodos: se seleccionaron 20 raíces mesiales de molares inferiores, cuyos conductos radiculares fueron instrumentados, hasta la longitud de trabajo, con ProTaper Universal y divididos al azar en dos grupos iguales, de 20 espcímenes cada uno, obturados con las siguientes técnicas: grupo A, cono único de gutapercha y sellador; grupo B, GuttaCore y sellador. Las piezas dentarias obturadas fueron conservadas en estufa de cultivo a 37ºC y 100 por ciento de humedad durante 7 días. A continuación se realizaron cortes transversales en los tercios coronario, medio y apical de las raíces y se observaron con un microscopio óptico a X30. A los efectos de cuantificiar los resultados obtenidos, se dividieron los cortes de los conductos radiculares en cuatro cuadrantes y se estableció la siguiente categorización: 0, adaptación de la gutapercha a las paredes del conducto; 1. Adaptación del sellador a las paredes del conducto; 2. Presencia de vacíos en contacto con la pared del conducto. Los resultados fueron evaluados estadísticamente conla prueba no paramétrica de Mann-Whitney. Resultados: el grupo B (GuttaCore) mostró mayor adaptación de la gutapercha a las paredes del conducto radicular y menor cantidad de sellador endodóntico en la interfase material de obturación/pared dentinaria que el grupo A (cono único). Se observaron diferencias estadísticamente significativas entre los dos grupos evaluados (p<0,05). Conclusiones: el GuttaCore presentó muy buena distribución y adaptación de la gutapercha en el sistema del conducto radicular, con escasa cantidad de sellador en la interfase material de obturación/ pared dentinaria.

Análisis morfométrico de conos de gutapercha Mtwo / Morphometric analysis of Mtwo gutta-percha cones

Objetivo: Evaluar cuantitativamente el calibre y la conicidad de los conos de gutapercha Mtwo (VDW, Munich, Alemania). Materiales y métodos: se seleccionaron al azar 50 conos de gutapercha marca Mtwo (VDW, Munich, Alemania) entre 300, provenientes de 5 cajas de conos surtidos #25 .06, #30 .05, #35 .04, #40 .04 y #25 .07. Fueron descartados aquellos que visualmente tenían algún defecto. Los elegidos se separaron en grupos de 10, según el número. Se midió cada cono en el vértice y a 1 mm, 2 mm, 3 mm, 4 mm y 5 mm, con un especímetro centesimal modelo 7301 (Mitutoyo, Japón). Se realizaron 300 determinaciones, que fueron efectuadas por dos operadores. Cuando hubo diferencias, se repitieron las mediciones hasta hallar coincidencia. Los datos fueron registrados en una planilla de Excel (Microsoft Corporation, Estados Unidos) diseñada al efecto. El análisis estadístico se llevó a cabo con prueba de hipótesis de dos colas, contrastando la media con el valor teórico. Resultados: se hallaron diferencias estadísticamente significativas para los conos #25 .06, en la determinación a 2 mm. En cuanto al resto de las mediciones, no hubo diferencias significativas. Conclusión: de acuerdo a los resultados obtenidos sobre la muestra analizada, en general los conos de gutapercha Mtwo respetan las espcificaciones ISO de fabricación.

Ventajas y desventajas de la técnica de cono único / Advantages and disadvantages of the single cone technique

El éxito del tratamiento endodóntico depende de una serie de factores, entre ellos, el de conseguir un buen sellado marginal apical, preparar los conductos radiculares con instrumentos rotatorios de níquel-titanio, obteniéndose preparados con diferentes conicidades de aquellas conseguidas a través de la instrumentación manual. El sellado tridimensional de los conductos radiculares es de fundamental importancia, pues; al ocupar el espacio creado por la instrumentación, la obturación, evita la infiltración del exudado periapical para el interior del conducto radicular. Como consecuencia, inviabiliza la sobrevivencia de microorganismos residuales, ofreciendo condiciones para que ocurra la reparación, contribuyendo de manera decisiva para el éxito de la terapéutica endodóntica. La técnica de cono único es una técnica que utiliza apenas un cono principal o maestro que puede tener diferentes conicidades, y que a lo largo de los años fue retomando su popularidad debido a la capacidad de adaptarse mejor a la conformación de los sistemas rotatorios de níquel-titanio (Ni-Ti) sin la necesidad de usar conos accesorios, reduciendo así el tiempo de trabajo, permitiendo una obturación másfácil y rápida, disminuyendo tanto la fatiga del paciente como la deloperador. En relación con la calidad de la obturación, la microfiltración apical y la penetración de bacterias, esta técnica es semejante a las otras técnicas existentes. La finalidad de este trabajo fue realizar una revisión de literatura abordando las ventajas y desventajas de la técnica de cono único para obturar los conductos radiculares. Llegando a la conclusión que la técnica de cono único presenta las ventajas de la posibilidad deun tratamiento endodóntico más rápido y con mayor comodidad para el paciente y el clínico.

The success of any endodontic treatment depends on a range of factors, including achieving good apical sealing, preparing the rootcanal using rotary nickel-titanium instruments in order to obtain mechanical preparations with tapers unlike those achieved using manual instrumentation. Three-dimensional sealing of the root canal is of theutmost importance, given that proper fi lling of the space created bythe instrumentation prevents the microleakage of periapical exudateinto the root canal. This in turn hampers the survival of residual and resistant microorganisms, thus contributing to the healing process andthe success of the endodontic therapy. The single-cone technique isone that uses a single principal or master cone with diff erent tapers.It has become popular among endodontists over the years due to itsgreater adaptability to the characteristics of nickel-titanium (NiTi)rotary systems without the need for accessory cones, which reducesworking time and allows easier and faster fi lling, causing less fatiguefor both the patient and the operator. However, in terms of qualityof the obturation, apical microleakage, and bacterial penetration,this technique provides similar results to those achieved using othertechniques. This review article is an attempt to highlight the advantages and disadvantages of using the single-cone technique to sealthe root canal, considering the qualities of the endodontic sealerused. The single-cone technique has the advantage of saving timeduring root canal fi lling and being more comfortable for the patientand the physician alike.

Microfiltración apical in vitro causada por las técnicas de obturación con cono único, System B y condensación lateral clásica / In vitro apical microleakage causade by single-cone, System B and cold lateral condensation obturation techniques

La obtención de un sellado hermético en la obturación del conducto radicular es una etapa coadyuvante del éxito endodóntico. Objetivo: Comparar la microfi ltración apical in vitro, calidad de relleno y presencia de espacios vacíos en conductos radiculares obturados con los métodos de obturación cono único, condensación lateral clásica y System B. Material y métodos: Noventa raíces mesiales de molares inferiores fueron instrumentados con ProTaper a un calibre F3 y asignados aleatoriamente para su obturación a tres grupos (n = 30 raíces), grupo 1: condensación lateral clásica con gutapercha #30.02, grupo 2: cono único con gutapercha F3 y grupo 3: System B con gutapercha #30.02; en todas las técnicas se usó una mezcla de óxido de zinc eugenol como sellador.Obturados los conductos las muestras se sumergieron en azul de metileno al 0.5 por ciento, se centrifugaron a 3,200 rpm durante cinco minutos, se diafanizarony se llevaron al microscopio estereoscópico a 12.5x para la mediciónde microfi ltración apical, calidad de relleno y presencia de espacios vacíospor un observador calibrado. Resultados: No se encontraron diferencias significativas en la microfi ltración apical entre el grupo de condensación lateral clásica y System B (p > 0.05) siendo el cono único la técnica que presenta mayor fi ltración. La técnica que ofrece la menor cantidad de espacios vacíos y mejor calidad de relleno es System B. Conclusiones:El método System B y condensación lateral clásica dejan una baja microfiltración apical y adecuada calidad de relleno comparada con la que sepresenta con cono único utilizando como sellador óxido de zinc eugenol...

Estudio comparativo de la penetración de la gutapercha en las irregularidades del conducto radicular: sistema GuttaCore y técnica de cono único / A comparative study of gutta-percha penetration in the root canal irregularities: GuttaCore systema and single cone technique

Objetivo: comparar ex vivo el grado de penetración de la gutapercha en las irregularidades anatómicas del conducto radicular mediante el uso de dos técnicas de obturación endodóntica: la de cono único y el sistema GuttaCore. Materiales y métodos: se utilizaron 40 molares inferiores cuyos conductos mesiales fueron instrumentados hasta la longitud de trabajo con los instrumentos mecanizados del sistema WaveOne Primary (Dentsply/Maillefer, Ballaigues, Suiza). Las raíces mesiales se dividieron al azar en cuatro grupos (A, B, C y D) de 10, de modo que en cada uno hubiera 20 conductos radiculares. Los conductos del grupo A fueron obturados con cono único de gutapercha y los del grupo B, con el sistema GuttaCore. En ninguno de estos dos grupos se utilizó sellador endodóntico. Los conductos de los grupos C y D se obturaron de forma similar a los anteriores, pero en estos dos casos se empleó el sellador endodóntico AHPlus (Dentsply DeTrey GmbH, Konstanz, Alemania). Los especímenes fueron transparentados y fotografiados y las imágenes se analizaron en los tres tercios radiculares de acuerdo a la categorización preestablecida. Los resultados fueron evaluados estadísticamente mediante la prueba de Chi cuadrado. El grupo B mostró una penetración mayor de la gutapercha en las irregularidades del conducto respecto del grupo A, y esta diferencia fue estadísticamente significativa. En el grupo D, la cantidad de gutapercha detectada en las irregularidades fue significativamente mayor que la hallada en el grupo C. Conclusión: el sistema de obturación GuttaCore permitió obtener un relleno con gutapercha más completo de las irregularidades anatómicas del conducto radicular, en comparación con la técnica de cono único de gutapercha.

Efficacy of three thermoplastic obturation techniques in filling oval-shaped root canals / Efetividade de três técnicas de obturação termoplásticas no preenchimento de canais ovais

he purpose of this study was to assess the efficacy of thethermoplastic filling techniques, Touch’n Heat®, TC®System andTagger’s Hybrid Technique, in oval-shaped canals at the apicalthird.Thirty-three human uniradicular lower pre-molar teeth weretreated by the reciprocating movement technique and weresubsequently split into 3 groups, according to the filling techniqueperformed:Touch’n Heat (TH), TC System (TC) and the Tagger’sHybrid Technique (TG).In the sequence, the teeth were sectionedat 2mm and 4mm from the foramen and images were taken tomeasure the percentage of canal area filled with the obturationmaterials as well as void spaces.Data were submitted for Kruskal-Wallis statistical analysis. Irrespective of levels, data showed thatthe TC System delivered the best results.(p<0,001).At 2mm and4mm levels, there was no difference between the TG techniqueand the TH technique (p<0,001).With all the techniques and atall levels, no differences were observed regarding the void areavariable.(p>0,001).The techniques evaluated showed anadequate filling with obturation materials and the TC has reachedthe highest filling with the guta-percha material.

O objetivo desse trabalho foi avaliar a eficiência de preen -chimento das técnicas termoplásticas Touch’nHeat®, SistemaTC®e Híbrida de Tagger em canais de anatomia oval no terçoapical. Trinta e três dentes pré-molares inferiores humanosunirradiculares foram instrumentados pela técnica do movimentoreciprocante e posteriormente separados em 3 grupos segundo atécnica de obturação: Touch’nHeat, Sistema TC e Híbrida deTagger. Em sequência os dentes foram seccionados nos niveis de2 mm e 4 mm a partir do forame e imagens foram capturadaspara mensurar a porcentagem da area do canal preenchida comos materiais obturadores e os espaços vazios. Os dados foramtabulados e submetidos ao teste estatistico de Kruskal-Wallis.Independente dos níveis, os dados mostraram que a TCapresentou os melhores resultados. (p<0,001). Nos níveis de 2 e4mm não houve diferença entre as técnicas TG e TH (p<0,001).Em todas as técnicas e níveis não foram observadas diferençascom relação a variável áreas vazias. (p>0,001). As técnicasavaliadas demonstraram um adequado preenchimento pelosmateriais obturadores, com destaque para o preenchimentosuperior com guta-percha pela técnica TC.

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

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

Volume of sealer in the apical region of teeth filled by different techniques: a micro-CT analysis

Abstract The volume of sealer in the apical 1 mm of teeth filled using different techniques was evaluated by micro-commuted tomography (micro-CT). Sixty-four maxillary central incisors were prepared using NiTi rotary instruments. Teeth were randomly distributed into four groups according to root canal sealers (AH Plus, Endofill, Sealapex, and Sealer 26) and subdivided into two subgroups according to the filling techniques (active and passive lateral condensation; n = 8 each). Subsequently, teeth were examined using the 1174 SkyScan micro-CT device. Images were reconstructed using the NRecon software, and the sealer volume (mm3) in the apical region was analyzed using the two-way ANOVA and post-hoc Student-Newman-Keuls test (α = ٠.٠٥). The lowest volume of sealer was observed in teeth filled with Sealapex (0.100 ± 0.009) and Endofill (0.103 ± 0.010). The highest volume was observed in teeth filled with AH Plus (0.112 ± 0.008) and Sealer 26 (0.109 ± 0.018) (p > 0.05). Regarding the filling technique, a lower sealer volume was observed using the active lateral condensation technique compared with that using the passive lateral condensation technique (0.100 ± 0.010 vs. 0.111 ± 0.012) (p < 0.05). Therefore, the lowest volume of sealer was observed in teeth filled with Sealapex and Endofill using the active lateral condensation technique.

In vitro antibacterial activity of a silicone-based endodontic sealer and two conventional sealers

Abstract The aim of this study was to evaluate whether the modification in the silver component is capable of providing GuttaFlow 2 with antibacterial activity against Enterococcus faecalis compared with epoxy resin-based (AH Plus) and zinc oxide and eugenol-based (Endofill) sealers. The antibacterial activity was evaluated using a reference strain of E. faecalis (ATCC 29212). Freshly mixed sealers were subjected to the agar diffusion test (ADT), while the direct contact test (DCT) was performed after materials setting. ADT results were obtained through measurements, in millimeters, of the inhibition zones promoted by the materials, using a digital caliper. In DCT, values of CFU/mL promoted by the three sealers were compared in three experimental periods (1 min, 1 h, and 24 h). The data were analyzed using Kruskal-Wallis and Dunn post-hoc tests (p < 0.05). In both ADT and DCT, GuttaFlow 2 presented no effect against E. faecalis, while Endofill and AH Plus showed similar inhibition zones. Endofill was the only material capable of reducing bacterial growth in DCT. In conclusion, modifications in the silver particle of GuttaFlow 2 did not result in a sealer with antibacterial effect against E. faecalis.

Reacción del tejido celular subcutáneo de la rata a implantes de conos de Resilon y conos de gutapercha / Reaction of the subcutaneous connective tissue of the rat to Resilon and gutta-percha cones implants

Evaluar la respuesta del tejido celular subcutáneo de la rata a implantes de conos de Resilon (CRE) y conos de gutapercha (CGP). Materiales y métodos: se implantaron en el tejido celular subcutáneo de ratas, conos de CRE y CGP de medidas similares y conicidad .04. La respuesta de los tejidos circundantes se analizó a los 14 y a los 84 días. La reacción a los materiales implantados fue clasificada en cuatro categorías, en función del grado creciente de inflamación y los resultados fueron sometidos a un análisis estadístico. Resultados: a los 14 días, se observó en contacto con CRE y con CGP una cápsula de tejido fibroso joven de poco espesor, vasos de neoformación y áreas ocupadas por escasas células inflamatorias, especialmente linfocitos y plasmocitos. Sólo tres casos de CRE y dos de CGP presentaron un grado de inflamación mayor en los tejidos circundantes. LUego de 84 días, la reacción fue similar para ambos materiales en todos los especímenes. Los conos estaban rodeados por un tejido conectivo fibroso maduro y denso, de mayor espesor, y escasos linfocitos y plasmocitos remanentes en los tejidos circundantes, con la singularidad de que en áreas aisladas y adyacentes a los CGP se observó presencia de partículas aparentemente liberadas por los conos, fagocitadas por macrófagos. Las diferencias entre CRE y CGP, tanto en un mismo período como entre ambos períodos de observación, no fueron significativas (p>0.05). Conclusión: luego de 84 días, los conos de CRE y CGP no se comportaron como materiales totalmente inertes en el tejido celualr subcutáneo de la rata. La persistencia de algunas células inflamatorias en los tejidos circundantes a los CRE y los CGP y la actividad macrofágica estimulada por la presencia de partículas liberadas por los CGP, sugieren evitar en lo posible la sobreobturación con los conos y mantenerlos dentro de los límites del conducto radicular...

Dos conductos en la raíz distovestibular del primer molar maxilar: revisión bibliográfica y reporte de caso clínico / Maxillary first molar with two canals in the distobuccal root: a review of the literature and report of a clinical case

La incidencia de dos conductos en la raíz distovestibular en un primer molar maxilar es una variación anatómica poco frecuente del sistema de conductos. Los investigadores han demostrado múltiples forámenes, conductos adicionales, furcaciones, deltas, conexiones entre conductos, conductos en forma de C y conductos accesorios. Este reporte de caso clínico presenta el tratamiento de un primer molar maxilar con dos conductos en la raíz ovestibular. Se muestra clínicamente la presencia dedos conductos distovestibulares tipo 2-1, los cuales se instrumentaron manualmente con técnica corono- apical con limas K-Flexofi le de 25 mm y se obturaron con la técnica de condensación lateral, con conos de gutapercha, conos accesorios número FF, F y cemento Sealapex. Después del tratamiento se selló el diente con cemento temporal y se refirió para realizar la restauración defi nitiva...

The presence of two canals in the distobuccal root of a maxillary fi rst molar is a rare anatomical variation of the canal systems. Investigators have shown multiple foramina, additional canals, furcations, deltas, intercanal connections, C-shaped canals, and accessory canals. This clinical case reports the clinical treatment of a maxillary fi rst molar with two canals in the distobuccal root. We present a clinical case involving the presence of the two 2-1-type distobuccal canals. Manual instrumentation was performed using the crown-down technique with the aid of 25 mm K-fl exofi le fi les. The canals were fi lled using the lateral condensation technique and gutta-percha cones, FF and F accessory cones, and Sealapex cement. Following the treatment, the tooth was sealed with temporary cement and the patient was referred for fi nal restoration. The aim of this paper is to examine the anatomical variations that can occur in the root canal system and the technologies that can be used to correctly identify the location of additional canals.