ABSTRACT
O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)
Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)
Subject(s)
Humans , Male , Middle Aged , Dental Cavity Preparation , Dental Restoration, Permanent , Dental CementsABSTRACT
Aim: This study aimed to compare the influence of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2 ] on the apical sealing capacity of AH Plus (Dentsply Maillefer) and Bio-C Sealer (Angelus) endodontic sealers. Methods: Sixty permanent human lower incisors were randomly allocated (http://www.randomized.org), according to the irrigant used, into three groups (n=20): 0.9% sodium chloride (NaCl/Control); 2.5% NaOCl; and 2.5% Ca(OCl)2 . The root canal was prepared with rotary files under 10 mL of the solution corresponding to the experimental group. Each group was subdivided into two (n=10) according to the sealer used for filling: AH Plus (Dentsply Maillefer) or Bio-C Sealer (Angelus). Then, all samples were immersed in black India ink for one week. After the storage period, the roots were then grooved longitudinally and split, and the ink penetration was measured from the apical part to the coronal part of the root canal into which the ink penetrated using a stereomicroscope. Data were analyzed by one-way ANOVA and Tukey's post-hoc tests. Results: There was no statistical difference in ink penetration between the different endodontic sealers tested for the same irrigating solution (p > 0.05). However, when the Bio-C Sealer (Angelus) was used, the group treated with 2.5% Ca(OCl)2 was associated with lower values of apical leakage, compared to 2.5% NaOCl (p < 0.05). For the AH Plus sealer (Dentsply Maillefer), there was no difference between the irrigants (p > 0.05). Conclusions: Associating Ca(OCl)2 irrigant with Bio-C Sealer (Angelus) seems to be a good option to reduce apical leakage
Subject(s)
Root Canal Obturation , Sodium Hypochlorite , Calcium Compounds , Dental Cements , Dental Leakage , Calcium HypochloriteABSTRACT
Postoperative pain is a frequent complication after root canal treatment. Its management is an important aspect of endodontic practice. Some treatment-related parameters were associated with the development of postoperative pain, including the sealer composition and extrusion. Objective: This systematic review aimed to answer the clinical question: Do root canal sealers composition influence postoperative pain after endodontic treatment of permanent teeth? Material and Methods: Electronic searches were conducted in PubMed, Scopus, Web of Science, Cochrane, LILACS, and grey literature databases until September 2021. The studies were qualitatively assessed using the RoB2 tool (Cochrane) and the certainty of evidence (GRADE). Sensitivity and pooled estimates were calculated using a random-effects model. Twelve articles were included. Results: The risk of bias was high in one study, low in nine, and two had some concerns. Qualitative analyses showed no influence of sealer extrusion on postoperative pain. Meta-analyses showed no significant difference in postoperative pain with moderate to very low levels of certainty between AH Plus and calcium silicate-based sealers, in a 95% confidence interval. Analysis between AH Plus, Zinc Oxide and Eugenol (ZOE), and calcium hydroxide (Ca(OH)2)-based sealers were not performed due to heterogeneity and lack of data. Conclusion: Literature showed contrasting results in postoperative pain between AH Plus and ZOE-based sealers, with low to moderate certainty of evidence. Regarding Ca(OH)2-based sealers, a single study with a low level of certainty concluded that AH Plus presented less postoperative pain than Apexit Plus. Therefore, further studies are needed to assess the influence of these sealers on postoperative pain. Evidence showed no difference in postoperative pain between AH Plus and calcium silicate-based sealers. Sealer extrusion is a variable that requires further studies (AU)
A dor pós-operatória é uma complicação frequente após o tratamento endodôntico. O seu manejo é um importante aspecto na prática endodôntica. Algumas variáveis relacionados ao tratamento foram associados com o desenvolvimento da dor pós-operatória, incluindo a composição e extrusão dos cimentos endodônticos. Objetivo: Esta revisão sistemática objetivou responder a seguinte pergunta clínica: A composição dos cimentos endodônticos podem influenciar a dor pós-operatória de dentes permanentes tratados endodonticamente?Material e Métodos: Buscas eletrônicas foram realizadas nas bases de dados no PubMed, Scopus, Web of Science, Cochrane, LILACS, e literatura cinzenta até setembro de 2021. Os estudos foram avaliados qualitativamente usando a ferramenta RoB2 (Cochrane) e a certeza de evidência (GRADE). A sensibilidade e as estimativas agrupadas foram calculadas usando um modelo de efeitos aleatórios. Doze artigos foram incluídos. Resultados: O risco de viés foi alto em um estudo, baixo em nove e dois tiveram algumas preocupações. A análise qualitativa mostrou que não há influência da extrusão do cimento na dor pós-operatória. A meta-análise mostrou que não houve diferença estatisticamente significante na dor pós-operatória entre o AH Plus e os cimentos a base de silicato de cálcio com moderada a muito baixa certeza de evdência. Análises entre os cimentos AH Plus, óxido de zinco e eugenol (OZE) e hidróxido de cálcio não foram realizados devido a heterogeneidade e falta de dados. Conclusão:A literatura sugere resultados contrastantes com relação a dor pós-operatória e entre os cimentos AH Plus e OZE, com baixa a moderada certeza de evidência. Já os cimentos a base de hidróxido de cálcio, um único estudo com baixa certeza de evidência concluiu que o AH Plus apresentou menos dor pós tratamento endodôntico do que o Apexit Plus. Portanto,mais estudos são necessários para avaliar a influência desses tipos de cimentos na dor pós-operatória. Com relação ao cimento AH Plus e os cimentos a base de silicato de cálcio não houve diferença estatística entre eles e a dor. A extrusão dos cimentos é uma variável que requer mais estudos (AU)
Subject(s)
Pain, Postoperative , Dental CementsABSTRACT
ABSTRACT Objective: To evaluate the clinical and radiographic response of pulp-dentin complex after selective caries removal with or without pulp lining in primary teeth. Material and Methods: Twenty-four primary molars with deep occlusal caries lesions and without pulpal alterations were selected from children, both genders, aged between 5 and 9 years old. After selective caries removal, the teeth were divided into three groups: without cavity liner (Group I), calcium hydroxide cement - CH (Group II), and Mineral trioxide aggregate - MTA (Group III). The final restoration was performed with resin-modified glass ionomer cement. Clinical and radiographic assessments were conducted at 6-month follow-up. The Kappa test determined intraexaminer reliability. Fisher's exact test evaluated intergroup comparisons (p<0.05). Results: All teeth showed clinical and radiographic success at the 6-month follow-up without statistically significant differences (p>0.05). Conclusion: Selective caries removal without cavity lining was acceptable for deep caries lesions in primary teeth.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Tooth, Deciduous , Radiography, Dental/instrumentation , Dental Caries/prevention & control , Dental Pulp Capping , Calcium Hydroxide , Data Interpretation, Statistical , Dental Cements/chemistry , Dental PulpABSTRACT
ABSTRACT Objective: To assess the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (ACP) containing bonding agents on dentin shear bond strength and remineralization potential. Material and Methods: This in vitro study evaluated 45 extracted human premolars. The teeth were decoronated, and the tooth crown was split into buccal and lingual halves. The specimens were then flat-grounded by a 180-grit abrasive. The specimens were then randomized into three groups (n=15). Adper Scotchbond Multi-Purpose (SBMP) primer and adhesive were used for bonding in the control group. ACP in 10wt% and 20wt% concentrations was added to SBMP adhesive and used in groups 2 and 3, respectively. After the application of primer and adhesive and light-curing them for 10 s, a transparent silicon cylinder was placed on a dentin surface and cured for 10 s; then, the cylinder was filled with composite resin and was cured for the 40s from each side. The specimens underwent 3000 thermal cycles, and a universal testing machine measured the SBS. To assess the remineralization quality, a total of 6 dentin samples (2 specimens for group) were prepared and underwent X-ray diffraction, attenuated total reflection Fourier-transform infrared spectroscopy, and scanning electron microscopy-energy dispersive X-ray analysis. One-way analysis of variance was used to analyze the data. The level of p<0.05 was considered significant. Results: No significant difference in dentin shear bond strength was noted between the groups (p>0.05) - the addition of ACP to SBMP adhesive enhanced dentin remineralization. Increasing the ACP concentration from 10% to 20% increased the formation of hydroxyapatite. Conclusion: Adding amorphous calcium phosphate confers remineralizing property to SBMP adhesive without compromising its shear bond strength to dentin.
Subject(s)
Humans , Phosphopeptides/chemistry , Tooth Remineralization , Caffeine/pharmacology , Composite Resins/chemistry , Dental Cements/chemistry , Chi-Square Distribution , Analysis of Variance , Statistics, Nonparametric , Shear StrengthABSTRACT
Objective: This study aimed to investigate of bioactive materials with specific properties, particularly highly plastic bioceramic cements. These materials are being studied extensively due to their potential to maintain pulp vitality and promote tissue regeneration. Material and Methods: Tooth discoloration induced by an experimental tricalcium silicate-based cement (EC) was evaluated and compared with that of Biodentine (BD) and white MTA-Angelus (MTA). Cavities were prepared on the lingual surfaces of thirty-two blocks of healthy bovine incisors. The blocks were chemically cleaned and then subjected to an initial color evaluation (CIELab values) using a spectrophotometer and randomly divided into three experimental groups (n=10); two additional blocks served as controls. After manipulation, the cements were placed in the cavities, which were subsequently restored with composite restorations. After another color measurement (baseline), they were immersed in bottles of distilled water; they were stored at 37 °C and 100% humidity for the entire test period. The color change (ΔE) was measured after 14, 30, 120 and 150 days. ANOVA and Tukey tests showed significant differences after 14 days (EC vs. MTA), 30 days (EC vs. BD) and 120/150 days (EC vs. BD/MTA) (p < 0.05). Results: All tested materials induced ΔE changes, with the EC group showing the least change at the end of the experiment (ΔE=4.08). Conclusion: EC induced less color change over a 5-month period and thus showed color stability over the entire period, whereas BD and MTA showed progressive discoloration. (AU)
Objetivo: O objetivo deste estudo foi investigar materiais bioativos com propriedades específicas, particularmente cimentos biocerâmicos altamente plásticos. Esses materiais estão sendo amplamente estudados devido ao seu potencial para manter a vitalidade da polpa e promover a regeneração dos tecidos. Material e Métodos: A descoloração dentária induzida por um cimento experimental à base de silicato tricálcico (CE) foi avaliada e comparada com a do Biodentine (BD) e do MTA-Angelus branco (MTA). Foram preparadas cavidades nas superfícies linguais de trinta e dois blocos de incisivos bovinos saudáveis. Os blocos foram quimicamente limpos e, em seguida, submetidos a uma avaliação inicial de cor (valores CIELab) usando um espectrofotômetro e divididos aleatoriamente em três grupos experimentais (n=10); dois blocos adicionais serviram como controles. Após a manipulação, os cimentos foram colocados nas cavidades, que foram posteriormente restauradas com compósito. Após outra medição de cor (valor de referência), eles foram imersos em frascos de água destilada; oram armazenados a 37 °C e 100% de umidade durante todo o período de teste. A alteração de cor (ΔE) foi medida após 14, 30, 120 e 150 dias. Os testes ANOVA e Tukey mostraram diferenças significativas após 14 dias (CE vs. MTA), 30 dias (CE vs. BD) e 120/150 dias (CE vs. BD/MTA) (p < 0,05). Resultados: Todos os materiais testados induziram alterações de ΔE, sendo que o grupo EC apresentou a menor alteração no final do experimento (ΔE=4,08). Conclusão: O EC induziu menos alterações de cor em um período de 5 meses e, portanto, apresentou estabilidade de cor durante todo o período, enquanto o BD e o MTA apresentaram descoloração progressiva.(AU)
Subject(s)
Silicate Cement , Tooth Discoloration , Biomedical and Dental Materials , Dental Cements , EndodonticsABSTRACT
As perfurações endodônticas podem ocorrer patologicamente por lesão cariosa profunda, bem como durante o acesso ou na instrumentação dos canais radiculares, que em sua grande maioria estão relacionadas com a negligência ou desconhecimento das variações anatômicas internas do dente. O presente trabalho descreve um caso clínico de perfuração de furca, onde o tratamento inicial foi baseado na descontaminação e selamento da comunicação com uma técnica de inserção modificada do MTA. Após a anestesia, foi realizado o isolamento absoluto e remoção de tecido infectado presente na câmara pulpar. Feita a limpeza da perfuração utilizando soro fisiológico e modelagem do canal com o instrumento reciprocante, a obturação foi concebida com cone de guta percha e cimento biocerâmico. Em seguida, o MTA foi manipulado, de acordo com recomendações do fabricante usando água destilada na proporção 1:1 e inserido na canaleta de uma régua endodôntica com a espátula de inserção nº1. O material foi removido da canaleta e inserido na perfuração, finalizando o vedamento da mesma. Portanto, concluiu-se que o selamento da perfuração apresentou um resultado satisfatório, tanto clínico como radiográfico, destacado pela proservação de 5 meses, evidenciando discreta formação de trabeculado ósseo na região de furca(AU)
Endodontic perforations can occur pathologically due to a deep carious lesion, as well as during access or instrumentation of root canals, which are mostly related to negligence or ignorance of the internal anatomical variations of the tooth. The present work describes a clinical case of furcation perforation, where the initial treatment was based on decontamination and sealing of the communication with a modified MTA insertion technique. After anesthesia, absolute isolation and removal of infected tissue present in the pulp chamber was performed. After cleaning the perforation using saline solution and modeling the canal with the reciprocating instrument, the filling was designed with a gutta-percha cone and bioceramic cement. Then, the MTA was manipulated, according to the manufacturer's recommendations, using distilled water in a 1:1 ratio and inserted into the groove of an endodontic ruler with the #1 insertion spatula. The material was removed from the channel and inserted into the perforation, finishing its sealing. Therefore, it was concluded that the sealing of the perforation presented a satisfactory result, both clinical and radiographic, highlighted by the 5-month followup, evidencing a slight formation of bone trabeculate in the furcation region(AU)
Subject(s)
Humans , Male , Adult , Root Canal Obturation , Biocompatible Materials , Furcation Defects , Dental Cements , Root Canal Therapy , Dental Pulp , Gutta-PerchaABSTRACT
Aim: To evaluate the bond strength of a universal adhesive system to dentin submitted to radiotherapy. Materials and Methods: Sixty extracted human teeth were divided into two groups (n = 30): without radiotherapy (control); with radiotherapy, according to the adhesive protocol (n=15): ER-etch-and-rinse (acid + Single Bond Uni-versal); SE-self-etch (Single Bond Universal). The analyzes were shear bond strength (SBS) (n=10), failure pattern (n=10) and scanning electron microscopy (n=5). Data was analyzed by a two-way ANOVA (α =0.05). Results: The radiotherapy decreased SBS of the restorative material to dentin (p<0.0001). The ER protocol provided lower bond strength values (p<0.001). The predominant type of fracture without radiotherapy was mixed (SE), cohesive to the material (ER). Both protocols presented adhesive failures with radiotherapy. Teeth had a hybrid layer and long resin tags (without radiotherapy) and few tags (with radiotherapy). Conclusions: The SE adhesive mode favors the shear bond strength of resin to dentin in teeth submitted to radiotherapy.
Objetivo: Evaluar la fuerza de adhesión de un sistema adhesivo universal a la dentina sometida a radioterapia. Materiales y Métodos: Sesenta dientes humanos extraídos se dividieron en dos grupos (n = 30): sin radioterapia (control); con radioterapia, según protocolo adhesivo (n=15): ER-grabado y enjuague (ácido + Single Bond Universal); autograbado SE (Single Bond Universal). Los análisis ejecutados fueron resistencia al cizallamiento (SBS) (n=10), patrón de falla (n=10) y microscopía electrónica de barrido (n=5). Los datos se sometieron al test de ANOVA de dos vías (α =0,05). Resultados: La radioterapia disminuyó la SBS del material restaurador a la dentina (p<0,0001). El protocolo ER proporcionó valores de fuerza de unión más bajos (p<0,001). El tipo de fractura predominante sin radioterapia fue mixta (SE), cohesiva al material (ER). Ambos protocolos presentaron fallas adhesivas con radioterapia. Los dientes tenían una capa híbrida y colas de resina largas (sin radioterapia) o pocas colas de resina (con radioterapia). Conclusión: El modo adhesivo SE favorece la resistencia al corte de la resina a la dentina en dientes sometidos a radioterapia.
Subject(s)
Humans , Dental Bonding/methods , Dentin-Bonding Agents/chemistry , Dental Cements/chemistry , Dental Stress Analysis/methods , Composite Resins , DentinABSTRACT
OBJECTIVES@#The current study aimed to investigate the bonding properties of a novel low-shrinkage resin adhesive containing expanding monomer and epoxy resin monomer after thermal cycling aging treatment.@*METHODS@#Expanding monomer of 3,9-diethyl-3,9-dimethylol-1,5,7,11-tetraoxaspiro-[5,5] undecane (DDTU) as an anti-shrinkage additive and unsaturated epoxy monomer of diallyl bisphenol A diglycidyl ether (DBDE) as a coupling agent were synthesized. A blend of DDTU and DBDE at a mass ratio of 1∶1, referred to as "UE", was added into the resin matrix at the mass fraction of 20% to prepare a novel low-shrinkage resin adhesive.Then, the methacrylate resin adhesive without UE was used as the blank control group, and a commercial resin adhesive system was selected as the commercial control group. Moreover, the resin-dentin bonding and micro-leakage testing specimens were prepared for the thermal cycling aging treatment. The bonding strength was tested, the fracture modes were calculated, the bonding fracture surface was observed by scanning electron microscope (SEM), and the dye penetration was used to evaluate the tooth-restoration marginal interface micro-leakage. All the data were analyzed statistically.@*RESULTS@#After aging, the dentin bonding strength of the experimental group was (19.20±1.03) MPa without a significant decrease (P>0.05), that of the blank control group was (11.22±1.48) MPa with a significant decrease (P<0.05) and that of the commercial control group was (19.16±1.68) MPa without a significant decrease (P>0.05). The interface fracture was observed as the main fracture mode in each group after thermal cycling by SEM. The fractured bonding surfaces of the experimental group often occurred on the top of the hybrid layer, whereas those of the blank and commercial control groups mostly occurred on the bottom of the hybrid layer. Micro-leakage rating counts of specimens before and after thermal cycling were as follows: the experimental group was primarily 0 grade, thereby indicating that a relatively ideal marginal sealing effect could be achieved (P>0.05); meanwhile, the blank control group was primarily 1 grade, and the penetration depth of dye significantly increased after thermal cycling (P<0.05); the commercial control group was primarily 0 grade without statistical difference before and after thermal cycling (P>0.05), while a significant difference was observed between the commercial control group and experimental group after thermal cycling (P<0.05).@*CONCLUSIONS@#The novel low-shrinkage resin adhesive containing 20%UE exhibited excellent bonding properties even after thermal cycling aging treatment, thereby showing a promising prospect for dental application.
Subject(s)
Composite Resins , Dental Bonding , Dental Cements , Surface Properties , Resin Cements , Dentin-Bonding Agents , Dentin , Materials Testing , Microscopy, Electron, ScanningABSTRACT
OBJECTIVE@#To analyze the cement flow in the abutment margin-crown platform switching structure by using the three-dimensional finite element analysis, in order to prove that whether the abutment margin-crown platform switching structure can reduce the inflow depth of cement in the implantation adhesive retention.@*METHODS@#By using ANSYS 19.0 software, two models were created, including the one with regular margin and crown (Model one, the traditional group), and the other one with abutment margin-crown platform switching structure (Model two, the platform switching group). Both abutments of the two models were wrapped by gingiva, and the depth of the abutment margins was 1.5 mm submucosal. Two-way fluid structure coupling calculations were produced in two models by using ANSYS 19.0 software. In the two models, the same amount of cement were put between the inner side of the crowns and the abutments. The process of cementing the crown to the abutment was simulated when the crown was 0.6 mm above the abutment. The crown was falling at a constant speed in the whole process spending 0.1 s. Then we observed the cement flow outside the crowns at the time of 0.025 s, 0.05 s, 0.075 s, 0.1 s, and measured the depth of cement over the margins at the time of 0.1 s.@*RESULTS@#At the time of 0 s, 0.025 s, 0.05 s, the cements in the two models were all above the abutment margins. At the time of 0.075 s, in Model one, the gingiva was squeezed by the cement and became deformed, and then a gap was formed between the gingiva and the abutment into which the cement started to flow. In Model two, because of the narrow neck of the crown, the cement flowed out from the gingival as it was pressed by the upward counterforce from the gingival and the abutment margin. At the time of 0.1 s, in Model one, the cement continued to flow deep inside with the gravity force and pressure, and the depth of the cement over the margin was 1 mm. In Model two, the cement continued to flow out from the gingival at the time of 0.075 s, and the depth of the cement over the margin was 0 mm.@*CONCLUSION@#When the abutment was wrapped by the gingiva, the inflow depth of cement in the implantation adhesive retention can be reduced in the abutment margin-crown platform switching structure.