Evaluation of apical foramen deformation produced by manual and mechanized patency maneuvers

La permeabilización del foramen apical por maniobras quirúrgicas durante la preparación biomecánica de los conductos radiculares es una meta perseguida por diversas escuelas.El objetivo de este trabajo fue evaluar la deformación del foramen generada por la utilización de limas de acero inoxidable de empleo manual y níquel titanio rotatorio en las maniobras de permeabilización. Se emplearon 40 raíces dentales recientemente extraídascon un solo conducto. Se calibraron todas en 18 mm de longitud y se montaron en tacos acrílicos que permitieron la realización de las maniobras del estudio. Se observó y mapeó cada uno de los forámenes al MEB (Phillips de alto vacío) a x 100 y empleando el programa Golden Ratio (Softonic). Posteriormente se realizó entodas las muestras la preparación quirúrgica endodóntica hasta 1 mm de su foramen con el sistema rotatorio Protaper hasta el instrumento F3, se hicieron maniobras de permeabilidad apical en 20 raíces con limas manuales de acero inoxidable Flexofile (Maillefer-Suiza) calibre .10 y en las restantes 20 con instrumentos Pathfile (Dentsply-Maillefer-Suiza) de NiTi rotatorio calibre .13 a 150 rpm. Quedando conformados dos grupos: A permeabilidad manual) y B (permeabilidad rotatoria). Los forámenes fueron nuevamente observados al MEB realizando las mediciones y mapeo comparativo con las imágenes previas. Se estableció unaescala de valores para la evaluación de las observaciones. Los resultados se analizaron por medio de la prueba de Mann Withney, la que no arrojó diferencias significativas entre los grupos (p=0.110). Como conclusión, en las condiciones de este estudio, larealización de maniobras de permeabilización quirúrgica realizadapor instrumentos manuales de acero o rotatorios de níquel titanio mostró diferente grado de deformación del foramen, sin presentar diferencias significativas entre ambos métodos...

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

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

Cleaning the apical third of curved canals after different irrigation protocols

This study evaluated the protocols of sonic and vacuum irrigation regarding the capacity of debris removal from root canal systems. Canal preparations were carried out on 30 mandibular first molars using the ProTaper Universal System. Teeth were divided into two experimental groups (n=15): Group 1: sonic irrigation and Group 2: vacuum irrigation protocol. Subsequently, the mesial roots were sectioned and observed by stereomicroscopy and scanning electron microscopy. Three independent examiners evaluated images of the apical thirds according to the following scores: 1= small presence of debris, 2= moderate presence of debris, and 3= dense presence of debris. Data were analyzed with ANOVA and Kruskal-Wallis tests (α=0.05). Comparison among the groups revealed that at the apical third, the root halves of Group 1 had significantly less surface debris (p=0.002) than those of Group 2. However, at 2 mm from the working length, Group 2's specimens showed less remaining debris in approximately 75% of the analyzed root canals. At the whole apical third, the sonic irrigation protocol removed significantly more debris than the vacuum protocol. However, in the region at 2 mm from the working length, the second irrigation method demonstrated a better performance.

Este estudo avaliou protocolos de irrigação sônica e a vácuo em relação à capacidade de remoção de debris do sistema de canais radiculares. Trinta primeiros molares mandibulares tiveram seus canais radiculares preparados pela utilização do Sistema ProTaper Universal. Os dentes foram divididos em dois grupos experimentais (n=15): Grupo 1: protocolo de irrigação sônica, e Grupo 2: protocolo de irrigação a vácuo. Posteriormente, as raízes mesiais foram seccionadas e observadas em lupa estereoscópica e microscopia eletrônica de varredura. Três examinadores independentes avaliaram as imagens do terço apical de acordo com as seguintes pontuações: 1. pequena presença de debris; 2: moderada presença de debris; e 3. densa presença de debris. Os dados foram analisados pelos testes estatísticos ANOVA e Kruskal-Wallis (α=0,05). A comparação entre os grupos revelou que, no terço apical, as hemissecções radiculares do Grupo 1 apresentaram debris remanescentes de forma significativamente menor (p=0,002) do que as do Grupo 2. No entanto, a 2 mm do comprimento de trabalho, as amostras do Grupo 2 mostraram menos debris remanescentes em aproximadamente 75% dos canais radiculares analisados. Considerando todo o terço apical, o protocolo de irrigação sônica removeu significativamente mais debris do que o protocolo de irrigação a vácuo. No entanto, na região a 2 mm do comprimento de trabalho, o segundo método de irrigação demonstrou um melhor desempenho.

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

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

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

A SEM evaluation of dentinal adaptation of root canal obturation with GuttaFlow and conventional obturating material.

Objective: The aim of this in-vitro study was to compare dentinal adaptation of conventional obturating material and GuttaFlow in young permanent teeth of child patients. Materials and Methods: Ten young permanent anterior teeth with closed foramen were selected for the study. Root canal preparations were carried out using a step back technique. The canal was alternately irrigated with 5.25% sodium hypochlorite solution and 17% EDTA and normal saline. After root canal preparation specimens were randomly divided into two groups (n=5). GROUP "A": Obturated with zinc-oxide eugenol sealer and gutta-percha cone using cold lateral obturation technique. GROUP "B": Obturated with GuttaFlow as per the manufacturer's instruction. The teeth were split into two halves. Five randomly chosen longitudinal split teeth samples each from Group "A" and Group "B" was observed under scanning electron microscope to access the interface between obturating material and dentin at the level of 2 mm from the apex. Results: On statistical analysis the dentinal adaptation (μm) of Group A was observed with a mean of 0.52 and standard deviation 0.15, while the value of mean and standard deviation were noted 0.12 and 0.02 for Group B. The "t" value on comparison of Group A and Group B is 5.79 with "P " value of <0.001, which is highly significant. Conclusion: From result of the study it can be concluded Group B samples showed significantly superior seal when compared with Group A. Complete seal was not observed in any of Group A samples.

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

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

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

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

Relationship between files that bind at the apical foramen and foramen openings in maxillary central incisors - a SEM study

Considering that instrumentation of the apical foramen has been suggested for root canal infection control, this study analyzed the relationship between the files that bind at the apical foramen and the foraminal openings in 50 maxillary central incisors. After preparation of the pulp chamber, access to the canal was obtained with #1 and 2 LA Axxess and K-files with tip cut were inserted up to the apical foramen until binding was felt. The files were fixed with methyl cyanoacrylate and the tooth-file sets were cross-sectioned 10 mm short of the apex. Scanning electron microscopic analysis was carried out and files and foraminal areas were measured using Image Tool software. Statistically significant difference (p<0.0001) was found between files and the apical foraminal areas. The mean foraminal area was 3.8 times larger than the mean file area. The results of this study suggest that it would require 4 files of greater size beyond the one that bound to the foramen in order to allow a better relationship between files and apical openings of maxillary central incisors.

Uma vez que a instrumentação do forame apical tem sido sugerida para o controle de infecção do canal radicular, este estudo analisou a relação entre as limas que se ajustam no forame apical e a abertura foraminal em cinquenta incisivos centrais superiores. Após o preparo da câmara pulpar, foi feito o acesso radicular com as brocas LA Axxess #1 e 2 e limas K com a ponta cortada foram inseridas até que oferecessem a sensação tátil de ajuste no forame apical. Foram fixadas com cianoacrilato de metila e o conjunto dente-lima foi seccionado a 10 mm aquém do ápice. Foi feita a microscopia eletrônica de varredura e as áreas das limas e dos forames foram medidas por meio do Image Tool software. A análise estatística demonstrou diferença significante entre as áreas das limas e dos forames (p<0,0001). A média da área dos forames apicais foi 3,8 vezes maior que a das limas. Os resultados deste estudo sugerem que seriam necessários 4 instrumentos de calibre maior além do que se ajustou para que haja melhor relação entre as limas e as aberturas foraminais nos incisivos centrais superiores.

Regional bond strengths to root canal dentin of fiber posts luted with three cementation systems

This study evaluated the influence of the cementation system on the regional push-out bond strength and failure pattern of fiber posts to radicular dentin. The roots of 48 extracted human incisors were prepared and divided into 3 groups (n=16), according to the cementation system: AdperScotchbond Multi-Purpose + resin cement RelyX ARC (SBMP+ARC); Adper SingleBond 2 + RelyX ARC (SB+ARC) and; RelyX U100 self-adhesive resin cement (U100). The posts were cemented as per manufacturer’s instructions for each cementation system. After 1 week, the roots were sectioned transversely into 6 discs. Two discs were obtained from the cervical, middle and apical thirds and the push-out test was carried out. The failure pattern was examined on all debonded specimens. The data were analyzed by two-way repeated measures ANOVA and Tukey’s test. When U100 was used, no statistically significant difference (p>0.05) was observed among the different root regions. Statistically higher push-out bond strength values were detected in the cervical third for SBMP+ARC and SB+ARC (p<0.05). The U100 showed significantly more mixed failures than SBMP+ARC in the apical third (p<0.05). In conclusion, the self-adhesive cement RelyX U100 was the only cement not sensitive to the root canal region.

Esse estudo avaliou a influência do sistema de cimentação na resistência de união regional e os padrões de fratura de pinos de fibra à dentina radicular. As raízes de 48 incisivos humanos extraídos foram preparadas e divididas em 3 grupos (n=16) de acordo com o sistema de cimentação: AdperScotchbond Multi-Purpose + cimento resinoso RelyX ARC (SBMP+ARC); AdperSingle Bond 2 + RelyX ARC (SB+ARC) e cimento resinoso autoadesivo RelyX U100 (U100). Os pinos foram cimentados conforme as recomendações dos fabricantes para cada sistema de cimentação. Após uma semana, as raízes foram seccionadas transversalmente em 6 discos. Dois discos foram obtidos para os terços coronário, médio e apical e o teste de push-out foi realizado. O padrão de fratura foi avaliado em todos os espécimes. Os dados obtidos foram analisados através dos testes ANOVA dois fatores e Tukey. Quando o cimento U100 foi testado, não foram observadas diferenças significativas (p>0,05) entre as diferentes regiões radiculares. Valores de resistência de união significativamente superiores foram encontrados no terço coronário para SBMP+ARC e SB+ARC (p<0,05). O U100 apresentou significativamente mais fraturas mistas que o SBMP+ARC no terço apical (p<0,05). Conclui-se que o cimento resinoso autoadesivo RelyX U100 foi o único cimento não afetado pela região do canal radicular.

Nd:YAG laser irradiation effect on apical intracanal dentin - a microleakage and SEM evaluation

The purpose of this in vitro study was to evaluate the effect of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on intracanal dentin surface by SEM analysis and its interference in the apical seal of filled canals. After endodontic treatment procedures, 34 maxillary human incisors were randomly assigned to 2 groups. In the negative control group (n=17), no additional treatment was performed and teeth were filled with vertically condensed gutta-percha; in the laser-treated group (n=17), the root canals were irradiated with Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) before filling as described for the control group. Two specimens of each group were prepared for SEM analysis to evaluate the presence and extent of morphological changes and removal of debris; the other specimens were immersed in 0.5 percent methylene blue dye (pH 7.2) for 24 h for evaluation of the linear dye leakage at the apical third. SEM analysis of the laser-treated group showed dentin fusion and resolidification without smear layer or debris. The Student’s t-test showed that the laser-treated group had significantly less leakage in apical third than the control group. Within the limitations of this study, it may be concluded that the morphological changes on the apical intraradicular dentin surface caused by Nd:YAG laser resulted in less linear dye apical leakage.

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

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

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

Avaliação de cavidades apicais realizadas com pontas ultrassônicas lisas, diamantadas e combinação de ambas / Evaluation of apical cavity preparation with ultrasonic, stainless steel, diamond coated lips and both

OBJETIVO: O objetivo deste trabalho foi avaliar, por meio do microscópio clínico e eletrônico devarredura, as paredes de cavidades apicais, as irregularidades produzidas com as pontas ultrassônicas diamantadas,lisas e com a combinação de ambas. MATERIAL E MÉTODO: Dezoito dentes pré-molaresinferiores de humanos, com apenas um conduto, foram apicetomizados e, no ápice, foram realizadascavidades para obturação retrógrada divididas em três grupos: grupo 1: cavidades preparadas com pontaultrassônica lisa; grupo 2: cavidades preparadas com ponta ultrassônica diamantada e grupo 3: cavidadespreparadas, iniciando com a ponta diamantada e seguida pela lisa. As paredes das cavidades foramobservadas inicialmente sob microscópio clínico e, a seguir, os ápice foram seccionados, metalizados eanalisados no microscópio eletrônico de varredura, atribuindo-se-lhes os seguintes escores: 1 - adequada;2 - regulares e 3 - irregulares. RESULTADOS: A ponta diamantada produziu 3 cavidades adequadas, 2regulares e 1 irregular; a ponta lisa, 5 adequadas, 1 regular e nenhuma irregular. A associação de ambaspropiciou 2 cavidades adequadas, 3 regulares e 1 irregular. CONCLUSÃO: Não houve diferença estatísticana qualidade das cavidades preparadas com pontas lisas, diamantadas ou na associação das duas. Quanto àavaliação realizada com os microscópios clínico e o de varredura, não houve diferença estatística entre eles.

OBJECTIVE: To evaluate the quality of root-end preparations using ultrasonic stainless steel and diamond coated tips used individually or associated. The cavity walls were analyzed using a clinical microscope and by scanning electron microscopy (SEM). MATERIAL AND METHOD: Eighteen single rooted mandibular premolars weresubmitted to apicectomy and root-end cavities were performed using ultrasonic tips. The teeth were divided according to the ultrasonic tip used. Group 1 (n=6) stainless steel tips. Group 2 (n=6) diamond coated tips. Group 3 (n=6) the cavity was done initially with a diamond coated tip and finished using a non-coated tip. Three scores were assigned to evaluate the quality of the cavity walls: 1 adequate; 2 regular; 3 inadequate. RESULTS: Diamond coated tip preparation showed 3 adequate cavities, 2 regulars and 1 inadequate. The stainless steel tip preparation showed 5 adequate cavities and 1 regular. The association of the tips showed 2 adequate cavities, 3 regulars and 1 inadequate. CONCLUSION: There was no statistically difference in the quality preparation for the analyzed groups. There was no statistically difference in the evaluation using a clinical microscope or SEM.

Scanning electron microscopic evaluation of the root apex of mandibular premolars

This aim of this study was to evaluate the root apex of mandibular premolars regarding the presence of main and accessory foramina. The root apexes from fifty extracted mandibular single-rooted premolars were examined by scanning electron microscopy (SEM). The apical openings had their diameter measured and were identified as main or accessory foramina. Double blinded and calibrated examiners analyzed the SEM photographs and classified the premolar roots into three types, based on the presence and size of the apical openings. Type I: roots with a single main apical foramen and no accessory foramina; type II: roots with a main foramen and one or more accessory foramina; type III: roots with accessory foramina only. For the first premolar, 16 roots were classified as type I (48.48%), 4 as type II (12.12%) and 13 as type III (39.40%). For the second premolars, 10 roots were classified as type I (58.83%), 3 as type II (17.65%) and 4 as type III (23.52%). The high incidence of roots with accessory foramina only (type III), mainly in the first premolar, warns of the need for caution during working length determination and apical debridement.

O objetivo deste estudo foi avaliar o apice radicular de premolares inferiores com relacao a presenca de forames ou foraminas. O apice radicular de cinquenta pre-molares unirradiculados humanos extraidos foram examinados pela microscopia eletronica de varredura (MEV). As aberturas apicais tiveram seus diametros medidos e foram identificados como forames ou foraminas. Dois examinadores calibrados e cegos quanto aos grupos analisaram as micrografias em MEV e classificaram as raizes dos pre-molares em tres tipos, baseadas na presenca e tamanho das aberturas apicais. Tipo I: raizes com um unico forame e nenhuma foramina; tipo II: raizes com um forame e uma ou mais foraminas; Tipo III: raizes somente com foramina. Para o primeiro pre-molar, 16 raizes foram classificadas como Tipo I (48.48%), 4 como tipo II (12.12%) e 13 como tipo III (39.40%). Para o segundo pre-molar, 10 raizes foram classificadas como tipo I (58.83%), 3 como tipo II (17.65%) e 4 como tipo III (23.52%). A alta incidencia de raizes do Tipo III, principalmente no primeiro pre-molar, alerta para a necessidade de cuidados na determinacao do comprimento de trabalho e exploracao foraminal.

Effect of sputter-coating on cracking of root-end surfaces after ultrasonic retrograde preparation: A SEM study of resected root apices and their respective impressions

The aim of this study was to evaluate in vitro the effect of sputter- coating for SEM analysis on the formation of cracks on root-end surfaces after retrograde cavity preparation with ultrasonic tips. Root-end cavities were prepared with either Satelec S12/90oD diamond-coated or S12/90o non-coated stainless steel retrotips. Impressions were taken before and after retrograde cavity preparation. The resected root apices and their respective impressions were examined using a scanning electron microscope, and the presence, extension and numbers of cracks were recorded after each procedure. The number of cracks observed directly on the ultrasonically prepared root-end surfaces was larger than that observed in their respective impressions taken after root-end cavity preparation, which suggests that cracking was mostly produced by the sputtercoating process required for SEM analysis. Impressions of the root-end cavities prepared with non-coated ultrasonic stainless steel retrotips showed a greater incidence of cracks (3/10 impressions) than those that replicated cavities prepared with diamond-coated retrotips (1/10 impressions). No statistical difference was found between the diamond and stainless steel retrotips.

El objetivo del presente estudio fue evaluar in vitro el efecto del proceso de metalizacion de la dentina, necesaria para la observacion al microscopio electronico de barrido, sobre la formacion de fracturas dentinarias en retropreparaciones apicales realizadas con ultrasonido. Se realizaron retropreparaciones apicales en 20 piezas dentarias utilizando puntas ultrasonicas diamantadas Satelec S12/90° D (N=10) o puntas no diamantadas Satelec S12/90°. Se tomaron impresiones con silicona antes y despues de que fueran realizadas las retropreparaciones. Los apices radicu - lares y sus respectivas impresiones fueron metalizados y examinadas utilizando un microscopio electronico de barrido. La presencia, extension y numero de fracturas en la dentina fue registrada despues de cada procedimiento. El numero de fracturas observados en la dentina en las retropreparaciones fue mayor que el observado en las impresiones tomadas despues de realizado el procedimiento ultrasonico, lo cual indica que gran cantidad de fracturas en la dentina fueron producidas por el proceso de metalizacion requerido para el analisis al microscopio electronico de barrido y no por el procedimiento ultrasonico. El analisis de las impresiones mostro una mayor incidencia de fracturas cuando se utilizaron las puntas ultrasonicas no diamantadas (3/10) que cuando se utilizaron las puntas ultrasonicas diamantadas (1/10). Sin embargo, la diferencia no fue estadisticamente significativa (p>0.05).

A scanning electron microscopic study of the patterns of external root resorption under different conditions

OBJECTIVE: The aim of this study was to examine if there are qualitative differences in the appearance of external root resorption patterns of primary teeth undergoing physiologic resorption and permanent teeth undergoing pathological root resorption in different conditions. MATERIAL AND METHODS: A total of 40 teeth undergoing external root resorption in different conditions were divided into 4 groups and prepared for examination under scanning electron microscopy at magnifications ranging from 20x to 1000x. Group I: 10 primary molars exfoliated due to physiologic root resorption; Group II: 10 permanent teeth with periapical granulomas showing signs of resorption; Group III:10 permanent teeth therapeutically extracted during the course of orthodontic therapy with evidence of resorption, and Group IV: 10 permanent teeth associated with odontogenic tumors that showed evidence of resorption. RESULTS: In Group I, the primary teeth undergoing resorption showed smooth extensive and predominantly regular areas reflecting the slow ongoing physiologic process. In Group II, the teeth with periapical granulomas showed the resorption was localized to apex with a funnel shaped appearance in most cases. Teeth in Group III, which had been subjected to a short period of light orthodontic force, showed the presence of numerous resorption craters with adjoining areas of cemental repair in some cases. Teeth associated with odontogenic tumors in Group IV showed many variations in the patterns of resorption with extensive loss of root length and a sharp cut appearance of the root in most cases. CONCLUSION: Differences were observed in the patterns of external root resorption among the studied groups of primary and permanent teeth under physiologic and pathological conditions.

A scanning electron microscopic study of hypercementosis

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

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

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

Influence of cervical preflaring on determinationof apical file size in mandibular molars: SEM analysis

This study investigated the influence of cervical preflaring with different rotary instruments on determination of the initial apical file (IAF) in mesiobuccal roots of mandibular molars. Fifty human mandibular molars whose mesial roots presented two clearly separated apical foramens (mesiobuccal and mesiolingual) were used. After standard access opening and removal of pulp tissue, the working length (WL) was determined at 1 mm short of the root apex. Five groups (n=10) were formed at random, according to the type of instrument used for cervical preflaring. In group 1, the size of the IAF was determined without preflaring of the cervical and middle root canal thirds. In groups 2 to 5, preflaring was performed with Gates-Glidden drills, ProTaper instruments, EndoFlare instruments and LA Axxes burs, respectively. Canals were sized manually with K-files, starting with size 08 K-files, inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the file was recorded. The instrument corresponding to the IAF was fixed into the canal at the WL with methylcyanoacrylate. The teeth were then sectioned transversally 1 mm short of the apex, with the IAF in position. Cross-sections of the WL region were examined under scanning electron microscopy and the discrepancies between canal diameter and the diameter of IAF were calculated using the tool "rule" (FEG) of the microscope's proprietary software. The measurements (µm) were analyzed statistically by Kruskal-Wallis and Dunn's tests at 5 percent significance level. There were statistically significant differences among the groups (p<0.05). The non-flared group had the greatest discrepancy (125.30 ± 51.54) and differed significantly from all flared groups (p<0.05). Cervical preflaring with LA Axxess burs produced the least discrepancies (55.10 ± 48.31), followed by EndoFlare instruments (68.20 ± 42.44), Gattes Glidden drills (68.90 ± 42.46)...

Este estudo investigou a influência do alargamento cervical feito com diferentes instrumentos rotatórios na determinação do instrumento apical inicial (IAI) das raizes mésio-vestibulares de molares inferiores. Foram utilizados 50 molares inferiores cujas raízes mesiais apresentavam dois forames apicais nitidamente separados (mésio-vestibular e mésio-lingual). Após o acesso à câmara pulpar de forma convencional e remoção do tecido pulpar, o comprimento de trabalho foi definido a 1 mm do ápice radicular. Os dentes foram divididos aleatoriamente em cinco grupos (n= 10) de acordo com o tipo de instrumento utilizado no alargamento cervical. No grupo 1, o IAI foi definido sem o prévio alargamento dos terços médio e cervical das raízes. Nos grupos 2 a 5, o terço cervical e médio do canal radicular foi alargado com as brocas de Gates-Glidden, instrumentos Pro Taper, Endo Flare e brocas LA Axxes, respectivamente. A determinação do IAI foi realizada manualmente com limas tipo K em ordem crescente de diâmetro a partir da lima 08 até se chegar ao instrumento que permitisse ao operador ter a sensação tátil do mesmo estar firmemente ajustado ao CRT. O instrumento que correspondeu ao IAI foi fixado no interior do canal radicular com cianocrilato de metila. Com o IAI posicionado, os dentes foram seccionados transversalmente até 1 mm do ápice. As seções transversais do CRT foram observadas através da microscopia eletrônica de varredura e os desajustes entre o diâmetro do canal e o diâmetro do IAI foram calculados com a função "régua" (FEG) do software do próprio microscópio. Os resultados foram avaliados estatisticamente pelo testes de Kruskal-Wallis e Dunn ao nível de significância de 5 por cento. Houve diferenças estatisticamente significantes entre os grupos (p<0,05). O grupo sem alargamento apresentou o maior desajuste (125,30 ±51,54) e diferiu significativamente dos demais grupos (p<0,05). O alargamento cervical com as brocas LA Axxess apresentou...

Microbial distribution in the root canal system after periapical lesion induction using different methods

The aim of this study was to evaluate the microbial distribution in the root canal system after periapical lesion induction in dogs' teeth using different methods. Fifty-two root canals were assigned to 4 groups (n=13). Groups I and II: root canals were exposed to the oral cavity for 180 days; groups III and IV: root canals were exposed for 7 days and then the coronal openings were sealed for 53 days. The root apices of groups I and III were perforated, while those of groups II and IV remained intact. After the experimental periods, the animals were euthanized and the anatomic pieces containing the roots were processed and stained with the Brown & Brenn method to assess the presence and distribution of microorganisms. The incidence of microorganisms at different sites of the roots and periapical lesions was analyzed statistically by the chi-square test at 5 percent significance level. All groups presented microorganisms in the entire root canal system. A larger number of microorganisms was observed on the root canal walls, apical delta and dentinal tubules (p<0.05), followed by cementum and cemental resorption areas. In spite of the different periods of exposure to the oral environment, the methods used for induction of periapical periodontitis yielded similar distribution of microorganisms in the root canal system.

O objetivo deste estudo foi avaliar a distribuição microbiana no sistema de canais radiculares após indução de lesões periapicais em dentes de cães por diferentes métodos. Cinqüenta e dois canais radiculares foram divididos em 4 grupos (n=13). Grupos I e II: canais radiculares foram expostos por 180 dias; grupos III e IV: canais radiculares foram expostos por 7 dias e então as aberturas coronárias foram seladas por 53 dias. Os ápices radiculares dos grupos I e III foram arrombados, enquanto os dos grupos II e IV foram mantidos intactos. Após os períodos experimentais, os animais foram mortos e as peças foram processadas e coradas pelo método de Brown e Brenn para avaliação da presença ou ausência e distribuição dos microrganismos. A incidência de microrganismos nas diferentes regiões das raízes e lesões periapicais foi analisada estatisticamente pelo Teste Qui-Quadrado em nível de 5 por cento de significância. Todos os grupos apresentaram microrganismos em todo o sistema de canais radiculares. Um maior número de microrganismos foi observado nas paredes do canal radicular, delta apical e túbulos dentinários, seguido pelo cemento e áreas de reabsorção cementária. Apesar de utilizar diferentes períodos de exposição dos canais radiculares ao meio bucal, os métodos usados para indução das lesões periapicais permitiram semelhante distribuição de microrganismos no sistema de canais radiculares (p>0,05).

Evaluación in vitro del uso del hidróxido de calcio previo al empleo del MTA en dientes con ápices inmaduros / In vitro evaluation of the use of calcium hydroxide before employing MTA in teeth with immature apices

El propósito del presente estudio fue evaluar in vitro en dientes humanos con ápices inmaduros; a) el grado de remoción del hidróxido de calcio cuando es empleado previo a la obturación del conducto radicular con el MTA y b) el nivel de compactación del MTA en esas circunstancias. Se emplearon con este propósito 30 incisivos centrales superiores humanos extraídos. Las coronas se seccionaron para obtener una longitud uniforme de todos los especimenes de 12mm. Los conductos radiculares fueron instrumentados hasta una fresa Elargisseur #2 y posteriormente el foramen apical se instrumentó en forma retrógrada con una fresa de Gates Glidden #6 de modo de simular un diente inmaduro. Las superficies radiculares fueron recubiertas con una delgada aponeurosis bovina e incluidos en hueso de cadera bovino a fin de semejar las condiciones de inserción en los maxilares humanos. Los especimenes fueron divididos al azar en dos grupos de 15 dientes cada uno. Grupo A: obturados con una pasta de hidróxido de calcio-agua destilada con la adición de un colorante para su mejor individualización. Luego de mantener los especimenes obturados con dicha pasta por 7 días a 37ºC 100 por ciento de humedad, se realizó la reinstrumentación con limpas tipo K 3 #80 a los fines de eliminar ese material. A continuación se obturaron los tercios apicales (3 a 5mm) con MTA. Grupo B: obturados con MTA sin previo uso del hidróxido de calcio. Los especimenes se mantuvieron en estas condiciones por 7 días a 37ºC y 100 por ciento de humedad. Luego se seccionaron longitudinalmente con discos de diamante y las hemisecciones fueron evaluadas con microscopio óptico a X50. De los 15 dientes del grupo A, en un caso (6,7 por ciento) se observó la remoción completa del hidróxido de calcio, en tanto en 14 (83,3 por ciento) hubo persistencia del material luego de la reinstrumentación y obturación con MTA. En relación al grado de compactación del MTA, no se observaron diferencias estadísticas entre el grupo A y B .