Spectrophotometric analysis of crown discoloration induced by MTA- and ZnOE-based sealers

Crown discoloration can be induced by root canal sealer remnants following root canal treatment. Objective: The aim of this study was to evaluate chromatic alterations in human tooth crowns induced by a Mineral Trioxide Aggregate-based sealer (MTA Fillapex®) and a commonly used ZnOE-based sealer (Roth-811). The tested null hypothesis was that the application of the materials did not induce clinically perceptible crown discoloration (Ho: CIE color difference ΔE<3.7). Material and Methods: Forty five fully developed, intact, mandibular third molars were sectioned 1 mm below the cemento-enamel junction. The pulp chambers were chemomechanically debrided via the cervical access. The specimens were randomly assigned into three groups Group 1: MTA Fillapex, Group 2: Roth 811, Group 3: Negative control (unfilled) and immersed in individually marked vials containing distilled water up to the cervix (37±1°C). The spectral reflectance lines were recorded by utilizing a UV-VIS spectrophotometer equipped with integration sphere in the visual spectrum at baseline, 1 week, 1 and 3 months after material placement. Data were transformed into values of the CIE L*a*b* color system and the corresponding ΔE values were calculated. Statistical analysis was performed using two-way mixed ANOVA models, at p=0.05 level of significance. Results: A statistically significant increase in a* and b* chromatic parameters of the MTA Fillapex Group was measured. However, ΔE values did not exceed the human eye perceptibility threshold (set at ΔE<3.7) during the experimental period (ΔEt3=2.88). In Roth-811 Group, a statistically significant decrease in L* and a statistically significant increase in a* and b* chromatic parameters was measured, during all observation periods. Resultant ΔE values exceeded the human eye perceptibility threshold after 1 week (ΔEt1=5.65). Conclusions: Application of MTA Fillapex in tooth crowns resulted in minimal color alterations, while Roth 811 induced severe discoloration, in vitro. It could be suggested that, in terms of aesthetics, the use of MTA Fillapex appears to be favorable.

Comparing coronal discoloration between AH26 and ZOE sealers

Intrinsic tooth discolorations after endodontic treatment are principally attributed to the composition of necrotic pulp tissue, hemorrhage within the pulp cavity, endodontic medicaments and/or filling materials. Residual sealer left in pulp chamber after obturation can cause discoloration. The objective of this in vitro study was to evaluate coronal discoloration created by AH26 and ZOE sealers after four months. Fifty intact human extracted maxillary central incisors were employed. Access cavities were prepared in all samples and root canals were instrumented; coronal orifices were then sealed using self-cure glass ionomer. The teeth were divided into two experimental groups [n=20] according to utilized sealer in pulp chambers including AH26 and Dorifill [ZOE]. The remaining 10 teeth served as negative and positive controls [n=5]. The access cavities were sealed with self-cure glass ionomer. Teeth were kept in incubator for four month. Preliminary digital images of the teeth were taken and then compared with those related to 4-month follow-up. The images were assessed using Photoshop software. Data was analyzed using paired t-test and independent samples t-test. The teeth which were filled with AH26 sealer showed significantly greater discoloration than those filled with ZOE sealer [Dorifill] [P<0.05]. AH26 sealer causes greater discoloration of the crown compared to ZOE sealer. Despite the other disadvantage of AH26 sealer, it seems that Dorifill is more esthetically considerate

Influence of eugenol-containing temporary restorations on the microleakage of total-etch and self-etching adhesive systems / Influência de restaurações temporárias contendo eugenol na microinfiltração de sistemas adesivos convencional e autocondicionante

Purpose: This in vitro study evaluated the influence of zinc oxide-eugenol temporary cement (ZOE-TC) on the sealing ability of composite restorations using two adhesive systems. Methods: Standard Class V cavities were prepared in 20 bovine incisors and restored with either ZOE-TC (IRM®) or eugenol-free cement (Cavit®) (n=10/temporary cement type). After 7 days, five teeth per material group were restored using Single Bond® (SB) and five using Adper Prompt® (AP). The cavities were filled with composite (Filtek Z-250), thermal cycled (500 cycles), immersed in basic fuchsine solution, and longitudinally sectioned. Dye penetration was evaluated using optical-microscopy and scored. Data were analyzed by Kruskal-Wallis test (P = 0.05). Results: Overall, leakage in dentin was similar to that in enamel. In enamel margins, only the group with Cavit® cement associated with AP presented significant higher leakage. In dentin margins, AP exhibited higher leakage than the groups restored with SB; there was no significant difference between eugenol-free cement and ZOE-TC. Conclusion: In general, SB showed better marginal sealing than AP, and ZOE-TC did not increase dye leakage. Eugenol in the temporary cement did not affect the marginal sealing of adhesive restorations.

Objetivo: Este estudo in vitro avaliou a influência de um cimento restaurador temporário à base de óxido de zinco-eugenol (CT-OZE) no selamento marginal de restaurações diretas, utilizando dois sistemas adesivos. Metodologia: Cavidades classe V foram preparadas em 20 incisivos bovinos e restauradas com dois cimentos temporários, CT-OZE (IRM®) ou cimento livre de eugenol (Cavit®) (n=10/cimento temporário). Após sete dias, cinco dentes de cada grupo de cimento temporário foram restaurados utilizando o sistema Single Bond® (SB) e os demais cinco com o sistema Adper Prompt® (AP). As cavidades foram restauradas com resina composta (Filtek Z-250), termocicladas (500 ciclos), imersas em fucsina básica e longitudinalmente seccionadas. A penetração do corante foi avaliada em microscópio ótico. Os dados foram analisados por teste de Kruskal-Wallis (P = 0,05). Resultados: A infiltração em dentina foi similar à do esmalte. Em esmalte, o grupo com Cavit® e AP apresentou infiltração significativamente maior. Em dentina, AP exibiu maior infiltração que SB, e não houve diferença entre CT-OZE e Cavit®. Conclusão: Em geral, SB produziu melhor selamento marginal que AP, e CT-OZE não aumentou a penetração de corante. A presença de eugenol no material restaurador temporário não afetou o selamento marginal de restaurações adesivas.

Angioedema neurótico: reporte de un caso clínico / Neurotic angioedema: report of a case

Las reacciones alérgicas abarcan manifestaciones clínicas variadas, que pueden ir de leve (como la que describiremos en este artículo), reacciones retardadas que pueden ocurrir hasta 48 horas después de la exposición al alergeno; hasta las reacciones inmediatas de hipersensibilidad - anafilaxis, las cuales se desarrollan en segundos y ponen en peligro la vida del paciente. Aunque el angioedema es una ocurrencia poco común en el consultorio dental, puede convertirse en una situación embarazosa para el odontólogo. El artículo tiene por finalidad presentar un caso clínico de angioedema neurótico de labio superior, su manejo y los aspectos que deben ser considerados para evitar dichas reacciones. Igualmente, el artículo pretende motivar a los odontólogos a reforzar los conocimientos en el manejo de urgencias médicas

Estudo histológico da ação do formocresol de Buckley's em dentes decíduos humanos pulpotomizados e selados com pasta de Oxido de Zinco e Eugenol / Histological study of deciduous teeth submitted to pulpotomy and treated with Buckley's formocresol and sealed with zinc oxide eugenol paste

Foram estudadas as alterações histológicas que ocorrem em dentes decíduos quando da pulpotomia com formocresol e técnica dos cinco minutos com formocresol ou não na pasta seladora. Em ambos tratamentos verificou-se alterações pulpares caracterizados por necrose de coagulação, inflamação e áreas de reabsorção interna. No tratamento onde se empregou formocresol na pasta seladora, notou-se mais necrose, presença de tecido eosinófilo e subjacente conjuntivo fibroso