BlueShaper: un nuevo sistema multialeación para la instrumentación mecanizada en endodoncia: comunicación breve / BlueShaper: a new multialloy system for mechanized instrumentation in endodontics: brief communication

El objetivo de esta comunicación es describir y analizar el sistema BlueShaper para la preparación quirúrgica mecaniza- da de los conductos radiculares. El sistema dispone de un set básico de 4 limas: Z1, Z2, Z3 y Z4, con un D0 de 0,14 mm, 0,17 mm, 0,19 mm y 0,25 mm respectivamente y conicidad variable que oscila entre el 2 y 10 %. La lima Z1 posee una aleación Pink, que le confiere mayor resistencia a la torsión y una gran capacidad de corte. Las limas Z2, Z3 y Z4 presentan una aleación Blue que aumenta la resistencia a la fatiga cíclica e incrementa su flexibilidad. Para conductos radiculares más amplios se incluyen, además, las limas Z5, Z6 y Z7. La empresa comer- cializa conos de gutapercha BlueShaper que se corresponden con las limas Z3, Z4, Z5, Z6 y Z7. El sistema de limas mul- tialeación Blue Shaper podría considerarse como un nuevo aporte clínico para la preparación mecánica de los conductos radiculares (AU)

The aim of this communication was to describe and analyze the BlueShaper system for the mechanized surgical preparation of root canals. The system has a basic set of 4 files: Z1, Z2, Z3 and Z4, with 0.14 mm, 0.17 mm, 0.19 mm and 0.25 mm DO respective- ly, and variable conicity ranging between 2 and 10 %. Z1 file has a Pink alloy, which gives it greater resistance to torsion and great cutting capacity. The Z2, Z3 and Z4 files feature a Blue alloy that increases resistance to cyclic fatigue and increases their flexibility. For larger root canals, the Z5, Z6 and Z7 files are also included. The company supplies specific BlueShaper ́s gutta-percha cones for Z3, Z4, Z5, Z6 and Z7 files. The BlueShaper multialloy file system could be consid- ered as a new clinical contribution for the mechanical prepa- ration of root canals (AU)

Comparação entre Reciproc Blue e quatro instrumentos réplicas: aspectos metalúrgicos, geometria, comportamento em torção e flexão / Comparison between Reciproc Blue and four replicalike instruments: metallurgical aspects, geometry, and behavior in torsion and flexion

A introdução da liga NiTi na endodontia proporcionou a fabricação de instrumentos com excelentes propriedades mecânicas, e uma das principais características é a possibilidade de alteração das temperaturas de transformação da liga, o qual pode possibilitar a presença de martensita em temperatura ambiente e consequentemente um efeito memória de forma. Entretanto, alguns dos sistemas comercializados atualmente possuem pouca ou nenhuma informação científica relatando suas propriedades mecânicas, características de design e métodos de fabricação. O objetivo deste trabalho foi comparar características geométricas, metalúrgicas e propriedades mecânicas (resistência à torção e flexão) de instrumentos Reciproc Blue (VDW, Munique, Alemanha), e quatro sistemas reciprocantes réplicas. Um total de 39 instrumentos de cada um dos sistemas reciprocantes, Reciproc Blue (RB), Prodesign R (PDR), V File (VF), V+ File (V+) e Univy One (UO) foram utilizados na pesquisa. O programa de Image J foi utilizado para mensuração dos diâmetros a cada milímetro da parte ativa e da área da seção transversal a 3 mm da ponta dos instrumentos. Imagens de MEV da parte ativa foram realizados para avaliar o acabamento superficial dos instrumentos. A composição atômica, fases presentes e temperaturas de transformação foram verificadas através de EDS, DRX e DSC, respectivamente. A flexibilidade foi aferida através de ensaios de dobramento até 45º conforme a especificação ISO 3630-1, e os ensaios de resistência à torção foram realizados de acordo com a especificação Nº28 ANSI/ADA. Todos os instrumentos apresentaram uma quantidade aproximadamente equiatômica de níquel e titânio. A análise qualitativa das fases cristalinas realizada através de ensaios de DRX, demonstrou a predominância de Fase R em todos os grupos, com exceção do grupo UO que apresenta uma mistura de fase R e martensita B19'. Na avaliação da área da seção, o instrumento RB obteve valores intermediários, os instrumentos PDR e V+ possuem menores valores e os instrumentos VF e UO possuem maiores valores. Observou-se grande impacto da geometria sobre as propriedades mecânicas, sendo que aqueles sistemas que apresentavam menor área que RB (PDR, V+) mostraram-se mais flexíveis e menos resistentes à torção (p<0.05), e o instrumento VF que teve maior área apresentou, como esperado, menos flexibilidade (p<0.05) e resistência torcional semelhante (p>0.05). A única exceção se deu com o sistema UO, que embora apresentasse uma maior área de seção, mostrou-se mais flexível e menos resistente à torção, provavelmente por influência da maior quantidade de martensita presente à temperatura ambiente. Nenhum dos instrumentos réplicas avaliados apresentaram características e comportamento mecânico iguais ao sistema padrão RB. Sugere-se que mais estudos devem ser realizados para a comparação do comportamento clínico destes instrumentos.

The introduction of NiTi alloy in endodontics has allowed the manufacturing of instruments with excellent mechanical properties, and one of the main characteristics is the ability to change alloy's transformation temperature, which can enable the presence of martensite at room temperature and consequently favor a shape memory effect. However, some of the currently marketed systems have limited or no scientific information regarding their mechanical properties, design characteristics, and manufacturing methods. The aim of this study was to compare the geometric characteristics, metallurgical aspects, and mechanical properties (torsional and flexural strength) of Reciproc Blue instruments (VDW, Munich, Germany) with four replica-like reciprocating systems. A total amount of 39 instruments from each reciprocating system, namely Reciproc Blue (RB), Prodesign R (PDR), V File (VF), V+ File (V+), and Univy One (UO), were used in the study. The Image J program was used to measure the diameters at every millimeter along the instruments active portion and the cross-sectional area at 3 mm from the instrument tip. SEM images of the active portion were obtained to evaluate the surface finishing of the instruments. Atomic composition, phases present, and transformation temperatures were determined through EDS, XRD, and DSC analyses, respectively. Flexibility was assessed by bending tests up to 45° according to ISO 3630-1 specifications, and torsional strength tests were performed according with ANSI/ADA Specification No. 28. All instruments exhibited an approximately equiatomic composition of nickel and titanium. Qualitative analysis of the crystalline phases using XRD tests demonstrated the predominance of the R-phase in all groups, except for the UO group, which exhibited a mixture of Rphase and B19' martensite. In terms of diameter and cross-sectional area evaluation, the RB instrument obtained intermediate values, while the PDR and V+ instruments had smaller values, and the VF and UO instruments had larger values. A significant impact of geometry on mechanical properties was observed, with systems exhibiting a smaller area than RB (PDR, V+) being more flexible and less torsion-resistant (p<0.05), and the VF instrument with a larger area showed, as expected, less flexibility (p<0.05) and similar torsional resistance (p>0.05). The only exception was the UO system, which, despite having a larger geometric configuration, exhibited greater flexibility and less torsional resistance, likely due to the higher amount of martensite present at room temperature. None of the replica-like instruments evaluated showed identical characteristics and mechanical behavior to the standard RB system. Further studies are suggested to compare the clinical performance of these instruments.

Resistencia de diferentes implantes y componentes sometidos a sobre torque. Estudio in-vitro / Resistance of different implants and components subjected to high torque. An in vitro study

Objetivo: Describir las fallas en diferentes sistemas de implantes al ser sometidos a fuerzas de torsión creciente, de- terminar el torque en el cual aparece un daño medible en el implante o alguno de sus componentes y especificar la falla más frecuente. Materiales y métodos: Se realizó un estudio experi- mental in vitro. Se utilizaron 88 implantes agrupados según diseño y marca comercial (Federa, Rosterdent, Biomet 3i, Tree-Oss, B&W, ML) en 11 grupos de 8 implantes cada uno. Éstos fueron inmovilizados en acrílico y fijados en una pren- sa. Se aplicó una fuerza de torsión creciente con torquímetro de precisión digital hasta la aparición de alguna falla en el implante o sus componentes. Se registró el torque en el que se produjo la falla. Se realizó estadística descriptiva para el análisis de datos. Resultados: El 100% de los implantes o alguno de sus componentes mostraron una falla detectable al ser sometidos a fuerzas de torsión creciente (rango de torque: 83,5 Ncm ­im- plante con conexión cono morse 8 grados­ a 384 Ncm ­implan- te de conexión interna sin montar­). El torque promedio más bajo en el que aparecieron los daños fue 103,75 (±8,08) Ncm para implantes de conexión interna tipo cono morse, mientras que el más alto fue 279,87 (±89,73) Ncm para implantes de conexión interna sin montar. La falla más frecuente (28,4%) fue la fractura del tornillo del portaimplante y falseo del hexá- gono externo simultáneamente. Conclusión: Las fallas detectables a fuerzas de torsión creciente ocurrieron entre 83,5 Ncm y 384 Ncm. La falla rei-terada fue la fractura del tornillo del portaimplante y falseo del hexágono simultáneamente (AU)

Aim: To describe the failures in different implant sys- tems when subjected to increasing torsional forces, deter- mine the torque at which measurable damage occurs to the implant or one of its components, and determine the most frequent failure. Materials and methods: This was an experimental in vitro study. A total 88 implants were used, grouped accord- ing to design and trademark (Federa, Rosterdent, Biomet 3i, Tree-Oss, B&W, ML) into 11 groups of 8 implants each. The implants were immobilized in Duralay acrylic and fixed in a vice. Increasing torsional force was applied with a digital pre- cision torque wrench until the occurrence of any failure in the implants or their components. The torque at which the failure occurred was recorded. Descriptive statistics were performed for data analysis. Results: 100% of the implants or any of their compo- nents showed a detectable failure when subjected to increas- ing torsional forces (force range: 83.5 Ncm in an implant with 8-degree Morse taper connection to 384 Ncm in an implant with unmounted internal connection). The lowest average torque at which damage occurred was 103.75 (±8.08) Ncm for conical implants with Morse internal connection, while the highest was 279.87 (±89.73) Ncm for implant with unmounted internal connection. The most frequent failure (28.4%) was fracture of the implant retaining screw and distortion of the external hexagon simultaneously (AU)

Effect of Conventional Versus Passive Self-Ligating Vestibular Appliances on Torque, Tip and Transverse Dental Changes in Patients Affected by Class I Malocclusion: A Retrospective Study

ABSTRACT Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (= 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p<0.05). Results: For both appliances, there is a general increase of both torque and transverse values at T1, especially for PSLAs. Tip shows a general reduction in the lateral sectors for both appliances is registered. The only significant statistical difference referred to appliances' efficacy is located to mandibular intermolar width. Conclusion: Both appliances have an expansive potential for both torque and transverse dental changes. No evident differences are detectable between appliances except for the rate of the mandibular intermolar width increase.

Resistência à fadiga cíclica e torcional dos instrumentos reciprocantes W File e X1 Blue File / Cyclic and torcional fatigue resistance of W File and X1 Blue file reciprocating instruments

Objetivo: O objetivo deste estudo foi avaliar a resistência à fadiga cíclica e torcional dos sistemas reciprocantes WFile 25.07 (WF, TDKaFile, Cidade do México, México) e X1 Blue File 25.06 (X1 BF, MK Life, Porto Alegre, Bra- sil) à temperatura corporal. Material e Métodos: Foram utilizados 40 instrumentos reciprocantes WFile 25.07 (WF 25.07) e X1 BF 25.06 (n=20, cada grupo). O teste de fadiga cíclica foi realizada à temperatura corporal (36±1°C). Os instrumentos foram ativados com movimento reciprocante em um canal artificial de aço inoxidável com ângulo de 60o e 5mm de raio de curvatura (n=10). O teste torcional avaliou o torque e o ângulo de rotação necessários para a fratura dos instrumentos (n=10) nos 3mm iniciais da parte ativa do instrumento, de acordo com a norma ISO 3630-1. Os fragmentos fraturados foram avaliados em microscopia eletrônica de varredura (MEV). Os dados obtidos foram submetidos aos testes estatísticos de Kolmogorov-Smirnov e t de Student, sendo utilizado o nível de significância de 5%. Resultado: O X1BF25.06 apresentou maior tempo e número de ciclos para a fratura do que o WF 25.07 (p<0,05). O teste de torção demonstrou que o WF 25.07 apresentou maior torque do que o X1 BF 25.06 (p<0,05). Em relação ao ângulo de rotação, o X1 BF 25.06 apresentou maiores valores do que o WF 25.07 (p<0,05). Conclusão: O X1 BF apresentou maior resistência à fadiga cíclica e maior ângulo para a fratura do que o WF 25.07. Entretanto, o WF 25.07 apresentou maior torque para a fratura do que o X1 BF 25.06 (AU).

Introduction: The aim of this study was to evaluate the cyclic and torsional fatigue resistance of reciprocating single-file systems W File 25.07 (WF, TDKaFile, Mexico City, Mexico) and X1 Blue File 25.06 (X1 BF, MK Life, Porto Alegre, Brazil) at body temperature. Materials and Methods: Forty reciprocating instruments of the W File 25.07 (WF 25.07) and X1 BF 25.06 (n=20) were used. Cyclic fatigue tests were performed at body temperature (36° ± 1°C). The instruments were reciprocated until fracture occurred in an artificial stainless steel canal with a 600 angle and a 5-mm radius of curvature (n=10). The torsional test evaluated the torque and angle of rotation at failure of new instruments (n=10) in the portion 3 mm from the tip according to ISO 3630-1. The fractured surface of each fragment was observed by using scanning electron microscopy (SEM). Data were analyzed using one-way ANOVA and Tukey tests, and the level of significance was set at 5%. Results: X1 BF 25.06 had significantly higher time and NCF to failure than WF 25.07 (P<0.05). The torsional test showed that WF 25.07 had significantly greater torsional strength (p<0.05). In relation to angular rotation, the X1 BF 25.06 showed higher angular rotation values to failure than WF 25.07 (p<0.05). Conclusion: The X1 BF 25.06 had the highest cyclic fatigue resistance and highest angular rotation values to fracture in comparison with WF 25.07. However, WF 25.07 showed higher torsional resistance to fracture than X1 BF 25.06 (AU).

Torsional Resistance of Two New Heat Treated Nickel Titanium Rotary Instruments: An in Vitro Evaluation

Abstract Objective: To evaluate the difference in torsional resistance, angular deflection and fragment length between two new rotary instruments: AF Blue S4 and S-One. These files share all features except cross-sectional design. Material and Methods: A total of 40 new Nickel-Titanium instruments of 25 mm in length were tested in this study and divided in two groups: 20 AF Blue S4, tip 25 and constant 6% taper and 20 AF-Blue S4 tip 25 and constant 6% taper. The torsional test was performed by the use of a torque recording endodontic motor (KaVo, Biberac, Germany). Torque to Fracture (TtF), Angular Deflection (AD) and Fragment Length (FL) was recorded for each instrument. To ensure an immovable block at 3mm of the instrument tip, an auto-polymerizing resin (DuraLay; Reliance Dental Mfg Co, Worth, IL) was used. Each file was rotated clockwise at a speed of 300 rpm until fracture occurred. Results: Group A (AF Blue S4) showed higher TtF and AD than Group B (S-One), and statistical analysis found significant differences between the two instruments (p<0.05). The mean values for FL showed no significant differences (p>0.05) between the two instruments. Conclusion: The AF Blue S4 seems to have a higher resistance to torsional stress in vitro. Clinically, the use of AF Blue S4 could be safer in narrow canals.

Fadiga cíclica e resistência torcional de instrumentos reciprocantes tratados termicamente tipo Gold / Cyclic fatigue and torsional resistance of Gold-type thermally treated reciprocating instruments

Objetivo: o objetivo do presente estudo foi avaliar a fadiga cíclica e torcional dos instrumentos WA1 e WaveOne Gold. Métodos: vinte instrumentos do sistema WA1 (25/0,07v) e vinte instrumentos do sistema WaveOne Gold (25/0,07v) foram utilizados. A resistência à fadiga cíclica foi testada, medindo o tempo até a fratura em um canal artificial curvo de aço inoxidável com ângulo de 80° e raio de curvatura de 3 mm (n = 10). O torque máximo e ângulo de rotação no momento da falha dos instrumentos (n = 10) foram medidos de acordo com a norma ISO 3630-1. A superfície de fratura de todos os fragmentos foi examinada com um microscópio eletrônico de varredura. Os resultados foram analisados estatisticamente usando o teste t de Student com um nível de significância de 5%. Resultados: não foram observadas diferenças na vida em fadiga cíclica dos instrumentos testados (p > 0,05). A força máxima de torção dos instrumentos WA1 foi menor do que os instrumentos WaveOne Gold (p < 0,05); entretanto, não foram observadas diferenças no ângulo máximo de rotação de ambos os sistemas (p > 0,05). A fotomicrografia eletrônica de varredura da superfície da fratura revelou características similares e típicas de fadiga cíclica e de falha por torção para os dois tipos de instrumentos. Conclusão: dentro dos resultados do presente estudo, pode-se concluir que os instrumentos WaveOne Gold e WA1 tiveram comportamento similar com relação à fadiga cíclica. No entanto, o instrumento WaveOne Gold apresentou maior deflexão angular à fratura por torção, em comparação aos instrumentos WA1 (AU).

Introduction: The aim of the present study was to evaluate the cyclic and torsional fatigue resistance of WA1 and WaveOne Gold instruments. Methods: Twenty instruments of the WA1 system (25/0.07v) and twenty instruments of the WaveOne Gold system (25/0.07v) were used. The cyclic fatigue resistance was tested by measuring the time to fracture in a stainless steel curved artificial canal with an angle of 80° and a radius of curvature of 3 mm (n = 10). The maximum torque and rotation angle at instrument failure (n = 10) were measured according to ISO 3630-1. The fracture surface of all the fragments was examined with a scanning electron microscope. The results were statistically analyzed using the student t-test with a significance level of 5%. Results: There were no differences in cyclic fatigue life of the tested instruments (P> 0.05). The maximum torsional force of the WA1 instruments was lower than the WaveOne Gold instruments (P <0.05); however, no differences were observed in the maximum rotation angle of both systems (P> 0.05). The scanning electron photomicrographs of the fracture surface revealed similar and typical characteristics of cyclic fatigue and torsional failure for the 2 types of instruments. Conclusion: Within the results of the present study, it can be concluded that WaveOne Gold and WA1 instruments had similar behavior regarding cyclic fatigue. However, WaveOne Gold instruments presented greater angular deflection to torsional fracture than WA1 instruments.

Cyclic flexural fatigue resistance of NiTi Controlled Memory and Blue Technology instruments after torsional preloading

Abstract Objective The aim of this study was to evaluate the influence of torsional preloading on the cyclic flexural fatigue resistance of thermally treated NiTi instruments. Material and Methods Ten new instruments New Hyflex CM (HF 30.06; Coltene/Whaladent Inc.), Typhoon CM (TYP 30.06; Clinician's Choice Dental Products) and Vortex Blue (VB 30.06; Dentsply Tulsa Dental) were chosen, based on geometry and specific characteristics of the manufacturing process. The new instruments of each system were tested in a bench device to determine their fatigue resistance through mean value of number of cycles to failure (Nf) (Control Group - CG). Another group of 10 new HF, TYP and VB instruments were submitted to 20 cycles of torsional straining between 0° and 180° (Experimental Group - EG) and then submitted to fatigue until rupture under the same conditions of the CG. Tested instruments were examined by scanning electron microscopy (SEM). Data were analyzed using one-way analysis of variance and post hoc Tukey's test (α=.05). Results Higher fatigue resistance was accomplished by HF instruments, followed by VB and TYP (p<0.05). During the torsional preloading, the lowest mean torque value was observed for TYP instruments (p<0.05). The torsional preload caused a significant reduction in the Nf values (p<0.05) of about 20%, 39% and 45% for instruments HF, VB and TYP, respectively. Longitudinal cracks, generated during the torsional preloading, were present in VB files, but were not observed in the CM instruments (HF and TYP). Conclusions In conclusion, the flexural fatigue resistance of thermally treated instruments is diminished after cyclic torsional loading.

Investigação das propriedades mecânicas de cimentos resinosos duais convencionais e autoadesivos em macro e nanoescala / Investigation of mechanical properties of conventional and self-adhesive resin cements in macro and nanoscale

Objetivo: O objetivo desse estudo foi avaliar e comparar as propriedades mecânicas dos cimentos resinosos duais convencionais e autoadesivos em macro e nanoescala. Métodos: Foram confeccionados 15 espécimes de cada marca de cimentos resinosos, AllCem (FGM), RelyX ARC (3M/ESPE) e RelyX U200 (3M/ESPE), para cada teste realizado (flexão de três pontos, compressão e nanoindentação) de acordo com as instruções dos fabricantes. Os espécimes foram fotoativados com aparelho Optilux Demetron (Kerr) por 40 segundos e armazenados em frascos escuros a 37ºC por 24 horas. Foram obtidos os resultados de resistência flexural, resistência à compressão, dureza e de módulo de Young para os diferentes testes mecânicos. Os dados foram avaliados pelos testes ANOVA, múltiplas comparações de Tukey HSD para análise dos valores de resistência, dureza e módulo de elasticidade entre os diferentes cimentos resinosos e ANOVA dois critérios e múltiplas comparações de Games Howell para análise dos módulos de Young entre os diferentes experimentos. Resultados: Os resultados revelaram que o AllCem obteve os maiores valores de resistência flexural e compressão axial (129±22,01 MPa; 243,71±29,75, respectivamente) e o RelyX U200 os menores valores (82,35±19,83 MPa; 134,57±48,93 MPa, respectivamente). Os valores de dureza não diferiram entre os cimentos estudados. No teste de flexão os valores de módulo de Young não diferiram entre os cimentos resinosos. No teste de compressão axial o AllCem apresentou módulo de Young estatisticamente maiores que dos demais cimentos. Para nanoindentação AllCem e RelyX U200 apresentaram maiores valores de módulo de Young que RelyX ARC. Os valores de módulo de Young diferiram significativamente entre todos os experimentos (p<0.05). Conclusão: Os valores das propriedades dos cimentos resinosos podem ser influenciados pelo tipo de experimento (macro- ou nanoescala) realizado.(AU)

Aim: The aim of this study was to evaluate and compare the mechanical properties of conventional and self-adhesive dual resin cements in macroscale and nanoscale. Methods: Fifteen specimens of each brand of resin cement ­ AllCem (FGM), RelyX ARC (3M/ ESPE), and RelyX U200 (3M/ESPE) ­ were made for each test performed in this study (three point bending, compression, and nanoindentation) according to the manufacturer's instructions. The specimens were photoactivated with Optilux Demetron (Kerr) for 40 seconds and stored in the dark at 37°C for 24 hours. Subsequently, they were submitted to flexural strength and axial compression tests at a speed of 1 mm/min, as well as to the Berkovich nanoindentation test. The results of flexural strength, compressive strength, hardness, and Young's modulus were obtained for the different mechanical tests. Data were evaluated by ANOVA tests; multiple comparisons of Tukey HSD to analyze the values of strength, hardness, and Young's modulus among the different resin cements; and ANOVA two criteria and multiple comparisons of Games Howell to analyze the Young's modulus within the different experiments. Results: The results showed that AllCem obtained the highest values of flexural strength and axial compression (129±22.01, 243.71±29.75 MPa, respectively), while RelyX U200 presented the lowest values (82.35 ± 19.83, 134.57 ± 48.93 MPa, respectively). The hardness values did not differ among the studied cements. In the flexural test, the Young's modulus values did not differ between the resin cements. In the axial compression test, AllCem presented a Young's modulus that was statistically higher than the other cements. In the nanoindentation test, AllCem and RelyX U200 presented higher values for Young's modulus than RelyX ARC. Young's modulus values differed significantly among all experiments (p <0.05). Conclusion: The values of resin cement properties can be influenced by the type of experiment (macroscale and nanoscale) performed.(AU)

Treatment of Scaphoid Nonunion Using 2 Small Diameter (2.2 mm) Headless Compression Screws

PURPOSE: To assess union and complication rates associated with the use of 2 small diameter headless compression screws and volar wedge bone grafting for the treatment of scaphoid fracture waist nonunions with collapse. METHODS: A total of 12 patients (11 male and 1 female) at an average age of 32.5 years were treated with open reduction and internal fixation with 2 small diameter headless compression screws for scaphoid nonunions with a mean follow-up of 11 months. Tricortical wedge shaped autograft were harvested from the iliac crest and placed into the nonunion site to restore length and alignment in all patients. Union was determined by radiographs and computed tomography, and scapholunate and radiolunate angles, and height-to-length ratio were calculated on final radiographs and follow-up computed tomography. RESULTS: All 12 scaphoids united with a mean time for 2.8 months. The mean postoperative scapholunate angle was significantly reduced from 73° preoperatively to 56° postoperatively. The mean radiolunate angle was significantly improved from 21° from neutral preoperatively to 12° postoperatively. The height-to-length ratio was also demonstrated significant improvement from 0.73 preoperatively to 0.60 postoperatively. No hardware problems were identified and no revision procedures have been necessary. CONCLUSION: Our results indicate that the use of 2 small diameter headless compression screws with volar structural bone graft stabilizes the fracture for predictable union, while reducing the deformity reliably from a collapsed scaphoid nonunion. The presented technique is safe and effective, and may provide superior biomechanical stability, especially against the torsional force.

The impact of clinical use on the torsional behavior of Reciproc and WaveOne instruments

ABSTRACT Torsional overload is a fracture representative parameter for instruments in single-file techniques. Objective The aim of this study was to assess the influence of clinical use, in vivo, on the torsional behavior of Reciproc and WaveOne instruments considering the possibility that they degraded with use. Material and Methods Diameter at each millimeter, pitch length, and area at 3 mm from the tip were determined for both types of instruments. Twenty-four instruments, size 25, 0.08 taper, of each system were divided into two groups (n=12 each): Control Group (CG), in which new Reciproc (RC) and WaveOne Primary (WO) instruments were tested in torsion until rupture based on ISO 3630-1; and Experimental Group (EG), in which each new instrument was clinically used to clean and shape the root canals of one molar. After clinical use, the instruments were analyzed using optical and scanning electron microscopy and subsequently tested in torsion until fracture. Data were analyzed using one-way analysis of variance at a=.05. Results WO instruments showed significantly higher mean values of cross-sectional area A3 (P=0.000) and smaller pitch lengths than RC instruments with no statistically significant differences in the diameter at D3 (P=0.521). No significant differences in torsional resistance between the RC and WO new instruments (P=0.134) were found. The clinical use resulted in a tendency of reduction in the maximum torque of the analyzed instruments but no statistically significant difference was observed between them (P=0.327). During the preparation of the root canals, two fractured RC instruments and longitudinal and transversal cracks in RC and WO instruments were observed through SEM analysis. Conclusion After clinical use, no statistically significant reduction in the torsional resistance was observed.

Analysis of fracture healing in osteopenic bone caused by disuse: experimental study

Osteoporosis has become a serious global public health issue. Hence, osteoporotic fracture healing has been investigated in several previous studies because there is still controversy over the effect osteoporosis has on the healing process. The current study aimed to analyze two different periods of bone healing in normal and osteopenic rats. Sixty, 7-week-old female Wistar rats were randomly divided into four groups: unrestricted and immobilized for 2 weeks after osteotomy (OU2), suspended and immobilized for 2 weeks after osteotomy (OS2), unrestricted and immobilized for 6 weeks after osteotomy (OU6), and suspended and immobilized for 6 weeks after osteotomy (OS6). Osteotomy was performed in the middle third of the right tibia 21 days after tail suspension, when the osteopenic condition was already set. The fractured limb was then immobilized by orthosis. Tibias were collected 2 and 6 weeks after osteotomy, and were analyzed by bone densitometry, mechanical testing, and histomorphometry. Bone mineral density values from bony calluses were significantly lower in the 2-week post-osteotomy groups compared with the 6-week post-osteotomy groups (multivariate general linear model analysis, P<0.000). Similarly, the mechanical properties showed that animals had stronger bones 6 weeks after osteotomy compared with 2 weeks after osteotomy (multivariate general linear model analysis, P<0.000). Histomorphometry indicated gradual bone healing. Results showed that osteopenia did not influence the bone healing process, and that time was an independent determinant factor regardless of whether the fracture was osteopenic. This suggests that the body is able to compensate for the negative effects of suspension.

Insertion torque versus mechanical resistance of mini- implants inserted in different cortical thickness

OBJECTIVE: This study aimed to measure insertion torque, tip mechanical resistance to fracture and transmucosal neck of mini-implants (MI) (Conexão Sistemas de PróteseT), as well as to analyze surface morphology. METHODS: Mechanical tests were carried out to measure the insertion torque of MIs in different cortical thicknesses, and tip mechanical resistance to fracture as well as transmucosal neck of MIs. Surface morphology was assessed by scanning electron microscopy (SEM) before and after the mechanical tests. RESULTS: Values of mechanical resistance to fracture (22.14 N.cm and 54.95 N.cm) were higher and statistically different (P < 0.05) from values of insertion torque for 1-mm (7.60 N.cm) and 2-mm (13.27 N.cm) cortical thicknesses. Insertion torque was statistically similar (P > 0.05) to torsional fracture in the tip of MI (22.14 N.cm) when 3 mm cortical thickness (16.11 N.cm) and dense bone (23.95 N.cm) were used. Torsional fracture of the transmucosal neck (54.95 N.cm) was higher and statistically different (P < 0.05) from insertion torsional strength in all tested situations. SEM analysis showed that the MIs had the same smooth surface when received from the manufacturer and after the mechanical tests were performed. Additionally, no significant marks resulting from the manufacturing process were observed. CONCLUSION: All mini-implants tested presented adequate surface morphology. The resistance of mini-implants to fracture safely allows placement in 1 and 2-mm cortical thickness. However, in 3-mm cortical thickness and dense bones, pre-drilling with a bur is recommended before insertion. .

OBJETIVOS: os objetivos foram determinar os torques de inserção, a resistência mecânica à fratura da ponta e do perfil transmucoso de mini-implantes (MI) de uma marca comercial (Conexão Sistemas de Prótese), e analisar sua morfologia de superfície. MÉTODOS: foram realizados testes mecânicos para medir o torque de inserção dos MI em corticais de diferentes espessuras, também foi avaliada a resistência à fratura da ponta e do perfil transmucoso. Antes e após os ensaios mecânicos, foi avaliada a superfície dos MI no microscópio eletrônico de varredura (MEV). RESULTADOS: os valores de resistência à fratura dos MI (22,14N.cm2 e 54,95N.cm2) foram maiores e estatisticamente diferentes (p < 0,05) dos torques de inserção nas corticais de 1mm (7,60N.cm2) e de 2mm (13,27N.cm2). Entretanto, o valor do torque de inserção na cortical de 3mm (16,11N.cm2) e no osso denso (23,95N.cm2) foi estatisticamente semelhante (p > 0,05) ao torque de fratura da ponta do MI (22,14N.cm2). O torque de fratura do perfil transmucoso (54,95N.cm2) foi maior e estatisticamente diferente (p < 0,05) dos torques de inserção em qualquer uma das situações testadas. A análise em MEV mostrou que os MI, como recebidos e após os testes mecânicos, possuem superfícies lisas e sem marcas significativas oriundas do processo de fabricação. CONCLUSÃO: os MI avaliados apresentaram adequada morfologia da superfície. A resistência do MI foi compatível com a instalação em corticais de 1 e 2mm, porém, em cortical de 3mm e em ossos densos recomenda-se prévia perfuração com broca. .

Resistencia a la torsión de los instrumentos endodónticos PathFile sometidos a fatiga cíclica / Torsional strength of PathFile endodontic instruments undergoing cyclic fatigue

La fatiga cíclica y la torsión son los dos factores más importantes a los que se ve sometido un instrumento rotatorio endodóntico durante su empleo. Objetivo: evaluar la influencia de la fatiga cíclica en la resistencia a la fractura por torsión de instrumentos rotatorios de níquel-titanio utilizados en endodoncia para la preparación quirúrgica. Materiales y métodos: se conformó una muestra de 30 instrumentos PasthFile (Dentsply-Maillefer, Ballaigues, Suiza) nuevos, calibre .16 con 2 por ciento de conicidad, divididos aleatoriamente en 5 grupos (n=6). Un total de 24 instrumentos fueron sometidos a fatiga cíclica por rotación continua en un conducto simulado por un tubo cilíndrico de acero inoxidable, con un calibre interno de 0,5 mm y 25 mm de longitud, una curva de 45 grados y 8 mm de radio a 5 mm de su extremo apical, a 300 rpm y 1 Ncm de torque, en diferentes tiempos: los del grupo A (GA), 15 s; los del grupo B (GB), 75 s; los del grupo C (GC), 150 s, y los del grupo D (GD), 300 s. El grupo N (GN) se conservó como control absoluto, sin uso. Luego, los instrumentos de todos los grupos fueron montados en un dispositivo diseñado para producir la rotación a 2 rpm y 1 Ncm de torque; los 3 mm apicales de sus puntas fueron fijados en un bloque de resina hasta producir la fractura por torsión. Se registraron los tiempos de fractura correspondientes a cada instrumento, que fueron traducidos a grados de rotación de acuerdo con la velocidad empleada en la prueba, y se volcaron los datos en tablas para su análisis. Resultados: los resultados fueron evaluados por medio del análisis de varianza de una vía, seguido de la prueba de Tukey de comparaciones múltiples y se encontraron diferencias significativas (P<0.001) entre los grupos. La comparación de los grados hasta la fractura registró cuatro diferencias significativas entre los grupos GN y GC; GN y GD; GA y GD y GB y GD. Ninguna otra comparación resultó significativa. Conclusión: al aumentar la fatiga cíclica.

Influência do movimento recíproco na resistência à torção dos instrumentos de NiTi: reciproc, waveone e protaper universal / Influence of the reciprocal movement on the torsion resistance of NiTi instruments: reciproc, waveone and universal protaper

As propriedades mecânicas dos instrumentos endodônticos são afetadas por fatores como diâmetro, design, composição química, e tratamentos termomecânicos aplicados durante o processo de fabricação. O objetivo deste trabalho foi avaliar a flexibilidade e a resistência torcional de instrumentos de NiTi Reciproc (RC), Wave One (WO) e ProTaper Universal (PTU), novos e após o uso clínico. A composição química dos instrumentos foi analisada por espectroscopia de energia de raios X (EDS), as fases presentes identificadas por difração de raios X (DRX) e as temperaturas de transformação determinadas por calorimetria exploratória diferencial (DSC). Imagens das seções longitudinal e transversal foram empregadas para determinar o diâmetro e a área a 3 mm da ponta (D3 e A3), posição onde as solicitações mecânicas se concentram durante o uso clínico e os instrumentos são apreendidos nos testes. O comportamento mecânico foi avaliado através de ensaios de flexão e torção até a ruptura, de acordo com a especificação ISO 3630-1. Os instrumentos RC, WO e PTU apresentaram composição química semelhante e fase ß como principal constituinte à temperatura ambiente. No entanto, os instrumentos Reciproc e WaveOne apresentaram um aumento relevante nas temperaturas de transformação, sugerindo a presença da fase B19', coexistindo com a fase austenítica. Apesar de apresentarem D3 semelhantes, a análise estatística dos valores de A3 entre os pares de instrumentos analisados mostrou diferença significativamente menor para os instrumentos RC. Os instrumentos RC foram significativamente mais flexíveis, possivelmente devido ao tratamento termomecânico a que foram submetidos os fios utilizados na fabricação dos mesmos (MWire), além da morfologia de sua sessão tranversal, seguidos por WO, que também são fabricados a partir do fio M-Wire, e PTU, nesta ordem. Dentre os instrumentos novos, os PTU apresentaram valores de torque máximo, quando ensaiados em torção, significativamente menores. Os instrumentos PTU apresentaram os maiores valores de deflexão angular, seguidos pelos instrumentos RC e WO, nesta ordem. Todos os sistemas após serem utilizados na prática clínica apresentaram redução da resistência torcional. Entretanto, a comparação estatística entre os valores de torque máximo para os instrumentos novos e após uso clínico, não apresentou diferença estatisticamente significativa para nenhum dos sistemas avaliados. Com relação à deflexão angular, a comparação entre instrumentos novos e após uso clínico, mostra uma redução dos valores desse parâmetro após o uso clínico, com exceção dos instrumentos RC. Entretanto, as análises estatísticas mostraram não haver diferenças significativas entre os pares de instrumentos analisados.(AU)

The mechanical properties of the endodontic instruments are affected by factors such as diameter, design, chemical composition and thermo-mechanical treatments applied during the manufacturing process. The main goal of this study was to assess the flexibility and torsional resistance of the NiTi Reciproc (RC), Wave One (WO) and ProTaper Universal (PTU) instruments, new and after clinical use. The instruments chemical composition was analyzed with X-Ray energy spectroscopy (EDS), the present phases were determined by X-Ray Diffractions (DRX) and the transformation temperatures were obtained with differential scanning calorimeter (DSC). Images from the longitudinal and transversal sections were used for determining the diameter and the area at 3mm from the tip (D3 and A3), the position where the mechanical requests are focused in clinical use and where the instruments are apprehended during the tests. The mechanical behavior has been evaluated through simulation of bending and torsion until rupture according to ISO 3630-1. The RC, WO and PTU instruments have presented a similar chemical composition with the predominance of ß phase at room temperature. However, Reciproc and Waveone instruments showed a significant increase in transformation temperatures, suggesting the presence of B19 phase, coexisting with the austenitic phase Despite showing similar D3, statistical analysis of the values of A3 between pairs of instruments analyzed showed significantly lower difference for RC instruments. The RC instruments were significantly more flexible, possibly due to the thermomechanical treatment applied to the wire (M-Wire) used in their manufacture process in addition to their cross section design, followed by WO instruments, which are also made of M-Wire, and PTU instruments, in that order. Among the new instruments, PTU showed significantly lower maximum torque values in torsion tests. PTU instruments presented the highest angular deflection values, followed by RC and WO instruments, in that order. All systems reduced their torsional strength after clinical use. However, statistical comparison between the maximum torque values for new and after clinical use instruments, showed no statistically significant difference for any of the evaluated systems. Regarding the angular deflection, the comparison between new and after clinical use instruments demonstrated a reduction of the values of this parameter after clinical use, with the exception of RC instruments. However, statistical analysis showed no significant differences between the pairs of instruments analyzed.(AU)

Study on preparation of andrographolide composite particles based on mechanical crushing method and its dissolution / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare andrographolide composite particles, and evaluate their particle structure and dissolution.</p><p><b>METHOD</b>The mechanical crushing method was adopted to prepare andrographolide and polyethylene glycol (PEG) 6000 composite particles. The structures were characterized by the scanning electron microscope (SEM) and the differential scanning calorimeter (DSC). The contact angles were determined by the contact angle analyzer. The in vitro dissolution curve was detected.</p><p><b>RESULT</b>Andrographolide and PEG 6000 gave rise to coated composite particle structures, with the decrease in the crystallinity of andrographolide. The in vitro dissolution rate of composite particles was significantly obvious than that of its raw materials, ultrafine powder and their physical mixtures.</p><p><b>CONCLUSION</b>Andrographolide composite particles based on the mechanical crushing method could notably enhance the in vitro dissolution of andrographolide.</p>

Comparação da flexibilidade e da resistência torsional de instrumentos automatizados de níquel-titânio

Introdução: esse estudo comparou a flexibilidade e a resistência a torção de dois instrumentos fabricados com ligas de niquel-titânio (NiTi) especiais, com um instrumento fabricado com liga convencional. Métodos: instrumentos Twisted File (TF) de liga de NiTi, contendo a fase R (SybronEndo, Orange, EUA) e instrumentos ProFile Vortex (Dentsply Tulsa Dental, Tulsa, OK, EUA) fabricados com a liga NiTi M-Wire foram comparados aos instrumentos RaCe (FKG Dentaire, La Chaux-de-Fonds, Suíça), produzidos por fio de NiTi convencional. Foram realizados ensaios de flexibilidade e torção. Um total de 20 instrumentos de cada fabricante foi testado, todos de 25/0,06. A análise estatística foi realizada utilizando ANOVA. Resultados: houve diferença significativa na resistência mecânica entre os instrumentos testados.Os instrumentos TF foram os mais flexíveis, seguidos pelos RaCe e ProFile Vortex (p < 0,01). No ensaio de torção, os instrumentos ProFile Vortex suportaram maiores valores de força máxima e torque máximo antes da fratura, seguidos pelos RaCe e TF (p < 0,01). Os instrumentos RaCe e TF não apresentaram diferença estatística significativa na resistência a torção (p = 0,061). Conclusão: pode-se observar que existe uma relação entre a flexibilidade com a resistência à torção (torque máximo e ângulo máximo). O instrumento mais flexível (TF) foi o menos resistente à torção. O instrumento mais resistente à torção (ProFile Vortex) foi o menos flexível. O instrumento RaCe apresentou um resultado intermediário tanto para a flexibilidade quanto para a resistência à torção.

Influence of the Ultimate Torsion on the Geometry of Dental Implants

This study evaluated the profile of implants subjected to torsion test. Four types of implants (Conexão®) were analyzed: Master Porous (MP - external hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm), Master Screw (MS - external hexagon, cylindrical, machined implants; 11.5 X 3.75 mm), Conect Conic (CC - external hexagon, cylindrical, machined implants; 11.5 X 3.5 mm) and Master Conect AR (CA - internal hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm). The Nikon® model C profile projector was used for the analysis before and after torsion test with a Mackena® model MK-20XX digital torque meter. The measures analyzed in the profile of implants were: diameter and height of the platform, diameter of the screw/platform connection, angle of the screw/platform connection, external diameter, internal diameter, thread pitch, height and length of the thread. Statistical analysis was performed using ANOVA and Tukey test at 5% significance level. The torsion test caused a visible deformity on the external implant profile. There was a statistical difference among the implants before and after torsion (p<0.05) for the variables: platform diameter, platform height, diameter of the screw/platform connection and length. Changes were observed in platform height of CC and CA, fracture of CA implants, fracture of the MP and MS assembler/connectors, and internal thread stripping of CC. Thus, it was concluded that excessive or some unadvised torque by the manufacturer can lead to changes in different geometric measurements of implants.

Este estudo avaliou o perfil de implantes submetidos à torção. Foram analisados quatro tipos de implantes (Conexão®): Master Porous (MP – implantes cilíndricos com encaixe hexagonal externo e superfície duplamente porosa; 11,5 X 3,75 mm), Master Screw (MS - implantes cilíndricos com encaixe hexagonal externo e superfície usinada; 11,5 X 3,75 mm), Conect Conic (CC - implantes cilíndricos com encaixe hexagonal externo e superfície usinada; 11,5 X 3,5 mm) e Master Conect AR (CA - implantes cilíndricos com encaixe hexagonal externo e superfície duplamente porosa). Utilizou-se para a análise o projetor de perfil Nikon® modelo C, antes e após o ensaio de torção, com torquímetro digital Mackena® modelo MK-20XX. As medidas analisadas do perfil dos implantes foram: diâmetro da plataforma, altura da plataforma, diâmetro da conexão plataforma-rosca, ângulo da conexão plataforma-rosca, diâmetro externo, diâmetro interno, passo de rosca, altura da rosca e comprimento. Para obtenção dos resultados foi realizada análise estatística ANOVA e Teste de Tukey com 5% de nível de significância. O ensaio de torção causou deformação visível no perfil externo dos implantes. Houve diferença estatística entre os implantes (p<0,05), antes e após a torção, nas variáveis: diâmetro da plataforma, altura da plataforma, diâmetro da conexão plataforma-rosca e comprimento. Foram observadas alterações na altura da plataforma dos implantes CC e CA, fratura dos implantes CA, fratura do montador de MP e MS, e espanamento das roscas internas de CC. Portanto, os implantes são homogêneos antes da torção, porém esta influenciou no perfil desses quando excessiva, causando deformação do parafuso.

Biomecânica de quatro técnicas de fixação da fratura em quatro partes da cabeça umeral / Biomechanics of four techniques for fixation of the four-part humeral head fracture

Objetivo: Realizar um estudo biomecânico de quatro técnicas de fixação das fraturas em quatro partes da cabeça umeral. Métodos: A fratura foi reproduzida em 40 úmeros plásticos, divididos em grupos de dez conforme a técnica de fixação, cada uma delas empregando diferentes recursos de fixação, em configurações distintas. Os modelos umerais foram montados em uma escápula de alumínio, com tiras de couro mimetizando os tendões do capuz rotador, e submetidos a ensaios de encurvamento e de torção em uma máquina universal de ensaios, usando a rigidez relativa como parâmetro de avaliação. Montagens com o úmero intacto foram analisadas para comparação. Resultados: O comportamento biomecânico das técnicas de fixação variou dentro de uma ampla faixa, as montagens incluindo a placa DCP e os parafusos de 4,5mm de diâmetro sendo significantemente mais rígidos do que as montagens com os fios de Kirschner e os parafusos 3,5 mm de diâmetro. Conclusão: As quatro técnicas foram capazes de suportar cargas compatíveis com a demanda fisiológica, mas aquelas com a maior rigidez relativa devem ser as preferidas para finalidades clínicas. Trabalho experimental.

Objective: To carry out a biomechanical study of four techniques for fixation of four-part humeral head fractures. Methods: The fracture was reproduced in 40 plastic humeri, divided into groups of ten according to the fixation technique, each one employing different fixation resources, in different configurations. The humeral models were mounted on an aluminum scapula, with leather straps simulating the rotator cuff tendons, and submitted to bending and torsion tests in a universal testing machine, using relative stiffness as an evaluation parameter. Assemblies with intact humeri were analyzed for comparison. Results: The biomechanical behavior of the fixation techniques varied within a wide range, where the assemblies including the DCP plate and the 4.5mm diameter screws were significantly more rigid than the assemblies with the Kirschner wires and the 3.5mm diameter screws. Conclusion: The four fixation techniques were able to bear loads compatible with the physiological demand, but those with higher relative stiffness should be preferred for clinical application. Laboratory investigation.