Root filling quality and bond strength of endodontic sealers to human and bovine dentin / Qualidade da obturação e resistência de união de cimentos endodônticos à dentina humana e bovina

Objetivo: Este estudo teve como objetivo comparar a qualidade da obturação e a resistência de união de dois cimentos endodônticos, AH Plus e Bio-C Sealer, em dentes humanos e bovinos. Métodos: Os canais radiculares de 60 dentes unirradiculares [30 humanos (H) e 30 bovinos (B)] foram preparados e obturados por condensação lateral da guta-percha e AH Plus (grupos AP-H e AP-B) ou Bio-C Sealer (grupos BC-H e BC-B). Seis fatias de 1,5 mm de espessura foram obtidas de cada raiz. Os espécimes foram observados em estereomicroscópio para avaliar a qualidade da obturação, considerando possíveis espaços vazios no material obturador. Posteriormente, as fatias radiculares foram avaliadas em termos de resistência de união por push-out e modo de falha. Os dados foram analisados pelos testes de Mann-Whitney e coeficientes de correlação de Spearman (α=5%). Resultados: A qualidade de obturação fornecida por AP e BC foi semelhante em ambos os substratos de dentina. No entanto, ao comparar dentes humanos e bovinos, os escores de espaços vazios foram maiores nas amostras bovinas, para ambos os cimentos. AP teve maior resistência de união à dentina humana e bovina do que BC. No entanto, não houve diferença significativa na resistência de união entre os substratos dentinários, para ambos os cimentos testados. Além disso, houve uma correlação positiva e moderada entre os valores de resistência de união de dentes humanos e bovinos. O modo de falha misto foi o mais prevalente. Conclusão: AP e BC fornecem qualidade de obturação semelhante, mas o primeiro apresenta maiores valores de resistência de união à dentina humana e bovina. A utilização de dentes bovinos como substitutos de amostras humanas parece ser adequada em estudos relacionados à resistência de união, mas não naqueles que testam a qualidade da obturação endodôntica.(AU)

Objective: This study aimed to compare the filling quality and bond strength of two endodontic sealers, AH Plus and Bio-C Sealer, in human and bovine teeth. Methods: The root canals of 60 [30 human (H) and 30 bovine (B)] single-rooted teeth were prepared and filled by lateral condensation of gutta-percha and AH Plus (groups AP-H and AP-B) or Bio-C Sealer (groups BC-H and BC-B). Six 1.5-mm-thick slices were obtained from each root. The specimens were observed under a stereomicroscope to assess filling quality, considering possible voids within the filling material. Subsequently, root slices were evaluated in terms of push-out bond strength and failure mode. Data were analyzed by Mann-Whitney tests and Spearman correlation coefficients (α=5%). Results: The filling quality provided by AP and BC was similar in both dentin substrates. However, when comparing human and bovine teeth, void scores were greater in the bovine samples, for both sealers. AP had higher bond strength to human and bovine dentin than BC. However, there was no significant difference in bond strength between dentin substrates, for both sealers tested. Also, there was a positive and moderate correlation between the bond strength values of human and bovine teeth. The mixed failure mode was the most prevalent. Conclusion: AP and BC provide similar filling quality, but the first presents higher bond strength values to human and bovine dentin. The use of bovine teeth as substitutes for human samples seems adequate in studies related to bond strength, but not in those testing root canal filling quality.(AU)

Application status and prospect of single-cone obturation technique with bioceramic sealers / 中华口腔医学杂志

Compared with cold lateral condensation and continuous wave of condensation which are classically used in clinical, newly emerging single-cone obturation technique is easy-to-operate as well as time-saving. Especially when combined with bioceramic root canal sealers of improved physicochemical and biological properties, single-cone obturation technique showed satisfactory short-term outcomes in clinical observations. However, difficulties still exist in avoiding the root canal overfilling and in operating the retreatment. Besides, the long-term effects of single-cone obturation with bioceramic sealers still remain unclear. This article makes an overview on the history and development of single-cone obturation ,and provides analysis of its pros and corns. Furthermore, we would also like to summarize its clinical application and look into its future improvements.

Micro-push-out bond strength of mineral­based root canal sealer in canals with different tapers / Fuerza de unión por micro-expulsión del sellador de conductos radiculares a base de minerales en conductos con diferentes ahusamientos

Objective: The aim of this study was to assess the micro-push-out bond strength of a mineral-based root canal sealer, BioRoot RCS in canals prepared by K3XF rotary systems of two different tapers. Material and Methods: Eighty caries free maxillary central incisors were used in this study. The samples were allocated into 4 groups (n=20) according to the root canal sealer and taper of the rotary instruments. The samples were obturated using single cone obturation technique. From each root 1mm thick slices at coronal, middle and apical thirds were collected using hard tissue microtome under continuous water coolant. Push-out tests were done for these sections using a Universal testing machine (INSTRON 8801) at a crosshead speed of 1mm/min. One-way analysis of variance (ANOVA) was used to compare the bond strengths within groups and Tukey's multiple post hoc analysis was used for pair-wise comparison of bond strengths. Results: AH Plus exhibited higher micro-push-out bond strength than BioRootRCS though they did not differ significantly (p>0.05). Preparation of root canals with 6% taper rotary instruments showed higher bond strength than 4% though they did not differ significantly (p>0.05). Conclusion: There was no significant difference between micro-push-out bond strength values of BioRoot RCS and AH Plus. The bond strength values were high in 6% taper canals than 4% canals though the difference was not significant statistically.

Objetivo: El objetivo de este estudio fue evaluar la fuerza de unión por micro-expulsión de un sellador de conductos radiculares de base mineral, BioRoot RCS, en conductos preparados por sistemas rotativos K3XF con dos conos diferentes. Material y Métodos: En este estudio se utilizaron 80 incisivos centrales superiores libres de caries. Las muestras se distribuyeron en cuatro grupos (n = 20) de acuerdo al sellador del conducto radicular y al cono de los instrumentos rotativos. Las muestras se obturaron mediante la técnica de obturación de un solo cono. De cada raíz se recogieron rodajas de 1 mm de grosor en los tercios coronal, medio y apical utilizando un micrótomo de tejido duro con refrigeración continua por agua. Posteriormente, se realizó una prueba de expulsión para estas secciones utilizando una máquina de prueba universal (INSTRON 8801) a una velocidad del cabezal transversal de 1mm/min. Se utilizó el análisis de varianza unidireccional (ANOVA) para comparar las resistencias de la unión dentro de los grupos y el análisis post hoc multiple de Tukey se utilizó para la comparación por pares de las resistencias de la unión. Resultados: AH Plus exhibió una fuerza de unión de micro-expulsión más alta que BioRootRCS, aunque no difirieron significativamente (p>0,05). La preparación de los conductos radiculares con instrumentos rotativos ahusados al 6% mostró una fuerza de unión superior al 4%, aunque no difirieron significativamente (p>0,05). Conclusión: No hubo diferencias significativas entre los valores de fuerza de unión de micro-expulsión de BioRoot RCS y AH Plus. Los valores de la fuerza de unión fueron más altos en canales cónicos al 6% que en canales al 4%, aunque la diferencia no fue significativa estadísticamente.

Comparative effects of final canal irrigation with chitosan and EDTA

Abstract Chitosan is a natural, biocompatible chelating substance with potential for dental use. This study compared the effects of final canal irrigation with chitosan and EDTA on dentin microhardness, sealer dentin tubules penetration capacity, and push-out strength. Methodology: Fifty canine roots were distributed according to the final irrigation protocol (n=10): G1- 15% EDTA with conventional irrigation; G2- 15% EDTA with Endovac; G3- 0.2% chitosan with conventional irrigation; G4- 0.2% chitosan with Endovac; and G5- without irrigation. Specimens were obturated (AH Plus) and sectioned in 3 slices per root third. The first slice was used for microhardness and sealer penetration assessments under a laser confocal microscope. The second was utilized in a push-out strength test. The third slice was discarded. Data were analyzed using 2-way ANOVA and Tukey's post hoc test (α<0.05). Failure mode was determined at x40 magnification. Results: Microhardness reduction was more significant in groups G2 and G4 (p<0.05). Sealer penetration through dentin was significantly greater in group G2 (p<0.05). There was no significant difference between groups G1, G3, and G4 (p>0.05). In general, all experimental groups presented similar bond resistance (p>0.05) that significantly differed from the control (p<0.001). Mixed type failures were predominant. Conclusions: In general, 0.2% chitosan and 15% EDTA solutions act in a similar manner with regard to the variables studied. The use of Endovac potentiates the effect of these solutions.

Penetration of bioceramic and epoxy-resin endodontic cements into lateral canals

Abstract: The aim of the present study was to assess the penetration capacity of two endodontic cements, Endosequence BC Sealer and AH Plus, in artificial lateral canals. Twenty-six two-rooted, maxillary first premolars were instrumented to size 40.06 using K3 files. In each root, six lateral canals of two diameters (0.06 and 0.10 mm) were created with a working length of 2, 4, and 6 mm. The specimens were randomly divided into two groups according to the endodontic cement to be used (Endosequence BC Sealer and AH Plus) and obturated by the single-cone technique. The specimens were imaged by digital periapical radiography and scores from 0 to 4 were attributed according to the degree of penetration by sealers into the lateral canals. Data were analyzed statistically by Kruskal-Wallis and Student-Newman-Keuls tests, and a significance level of p < 0.05 was adopted. No significant difference was observed between the two endodontic cements used to fill the simulated lateral canals (p > 0.05). The diameter of lateral canals only influenced the capacity of the Endosequence BC Sealer in filling the canals, and presented greater penetration in the lateral canals of diameter 0.10 mm (p < 0.05). We concluded that the bioceramic endodontic cement Endosequence BC Sealer presented similar ability as AH Plus to fill simulated lateral canals.

Cytotoxicity and biocompatibility of a new bioceramic endodontic sealer containing calcium hydroxide

Abstract: This study evaluated the cytotoxicity and biocompatibility of a new bioceramic endodontic sealer (i.e., Sealer Plus BC) in comparison with those of MTA Fillapex and AH Plus. L929 fibroblasts were cultured and Alamar Blue was used to evaluate cell viability of diluted extracts (1:50, 1:100, and 1:200) from each sealer at 24 h. Polyethylene tubes that were filled with material or empty (as a control) were implanted in the subcutaneous tissue of rats. The rats were killed after 7 and 30 d (n = 8), and the tubes were removed for histological analysis. Parametric data was analyzed using a one-way ANOVA test, and nonparametric data was analyzed via the Kruskal-Wallis test followed by the Dunn test (p < 0.05). A reduction in cell viability was observed in the extracts that were more diluted for Sealer Plus BC when compared to that of Control and AH Plus (p < 0.05). However, the 1:50 dilution of the Sealer Plus BC was similar to that of the Control (p > 0.05). Conversely, more diluted extracts of MTA Fillapex (1:200) and AH Plus (1:100 and 1:200) were similar to the Control (p > 0.05). Histological analysis performed at 7 d did not indicate any significant difference between tissue response for all materials, and the fibrous capsule was thick (p > 0.05). At 30 d, Sealer Plus BC was similar to the Control (p > 0.05) and MTA Fillapex and AH Plus exhibited greater inflammation than the Control (p < 0.05). The fibrous capsule was thin for the Control and for most specimens of Sealer Plus BC and AH Plus. Thus, Sealer Plus BC is biocompatible when compared to MTA Fillapex and AH Plus, and it is less cytotoxic when less-diluted extracts are used.

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

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

Effect of peracetic acid used as single irrigant on the smear layer, adhesion, and penetrability of AH Plus

Abstract The aim of this study was to evaluate the effect of peracetic acid (PAA) as a single irrigant on the smear layer, on the intraradicular dentinal bond strength, and on the penetrability of an epoxy-based resin sealer into the dentinal tubules. A total of 120 roots were distributed into 4 groups according to the irrigant used in root canal preparation: 1% PAA (PAA); 2.5% NaOCl followed by final irrigation with 17% EDTA and 2.5% NaOCl (NaOCl-EDTA-NaOCl); 2.5% NaOCl (NaOCl); and saline solution (SS). The smear layer was evaluated using scanning electron microscopy. The bond strength of an epoxy-based resin sealer (AH Plus) to root dentin was evaluated by the push-out test and penetrability of the sealer into dentinal tubules was observed by confocal laser microscopy. The results were analyzed by the Kruskal-Wallis and the Dunn post-test (α = 0.05). The use of 1% PAA as single root canal irrigant provided smear layer removal and improved the penetrability and bond strength of AH Plus to root dentin in a manner similar to that of the NaOCl-EDTA-NaOCl group (p > 0.05). The NaOCl and SS groups had higher values of smear layer and lower values of sealer penetrability and dentin bond strength than the PAA and NaOCl-EDTA-NaOCl groups (p < 0.05). Thus, 1% PAA has the potential to be used as a single irrigant in root canals.

Evaluation of physicochemical properties of new calcium silicate-based sealer

Abstract This study aimed to evaluate the physicochemical properties of a calcium silicate-based sealer (Sealer Plus BC; MK Life, Porto Alegre, Brazil) compared with an epoxy-resin sealer (AH Plus; Dentsply DeTrey GmbH, Konstanz, Germany). Initial and final setting time was assessed based on ISO 6876:2012 and ASTM C266:03. Calcium ion release and pH were evaluated by filling polyethylene tubes with sealers and then immersing them in 10 mL of deionized water. Following experimental periods of 1, 24, 72 and 168 hours, the samples were measured regarding pH and calcium ion release with a pH meter and a colorimetric spectrophotometer, respectively. The flow was examined based on ISO 6876:2012. Rings of 10 mm in diameter with 1 mm thickness were prepared to analyze the radiopacity (ISO 6876:2012 and ADA n.57) and solubility (ISO 6876:2012). The data were analyzed by variance analysis, Student-T and Tukey tests (p<0.05). The calcium ion release and pH values were significantly higher for the Sealer Plus BC compared with the AH Plus (p<0.05). Lower setting time, flow and radiopacity were observed for the bioceramic sealer than for AH Plus (p<0.05). Sealer Plus BC exhibited higher solubility compared with AH Plus (p<0.05). Sealer Plus BC showed physicochemical properties as setting time, pH, calcium release, flow, and radiopacity following the required standards, but higher solubility than the minimum values required by ISO 6876:2012.

Resumo Este estudo teve por objetivo avaliar as propriedades físico-químicas de um cimento à base de silicato de cálcio (Sealer Plus BC MK Life, Porto Alegre, Brasil) e compará-las a um cimento à base de resina epóxica (AH Plus, Dentsply DeTrey GmbH, Konstanz, Alemanha). Tempo de presa inicial e final foram avaliados com base na ISO 6876:2012 e ASTM C266:03. Liberação de íons cálcio e pH foram avaliados após o preenchimento de tubos de polietileno com os cimentos e imersão em 10 mL de água deionizada. Após os tempos experimentais de 1,24,72 e 168 horas, os valores de pH e liberação de íons cálcio foram mensurados utilizando um medidor de pH e um espectofotômetro colorimétrico, respectivamente. Escoamento foi avaliado com base na ISO 6876:2012. Moldes de 10 mm de diâmetro e 1 mm de espessura foram preparados para análise de radiopacidade (ISO 6876:2012 e ADA n.57), solubilidade (ISO 6876:2012). Os dados foram analisados por análise de variância, teste T de Student e teste de Tukey (p<0,05). A liberação de íons cálcio e os valores de pH foram significativamente maiores para o Sealer Plus BC em comparação com o AH Plus (p<0,05). Menores valores de tempo de presa, escoamento e radiopacidade foram observados para o cimento biocerâmico quando comparados com o AH Plus (p<0,05). Sealer Plus BC apresentou propriedades físico-químicas de tempo de presa, pH, liberação de íons cálcio, escoamento, radiopacidade de acordo com as normas exigidas, porém maior solubilidade que aquelas previstas pela ISO 6876:2012.

Efeito do hipoclorito de cálcio na resistência de adesão do cimento obturador AH Plus à dentina / Effect of calcium hypochlorite on the bond strength of the AH Plus sealer to dentin

Objetivo: avaliar o efeito do uso de hipoclorito de cálcio (Ca(OCl)2) como irrigante na resistência de adesão do cimento AH Plus (De Trey-Dentsply, Konstanz, Alemanha) à dentina pelo teste de micro push-out. Materiais e método: trinta e três dentes humanos monorradiculares foram seccionados transversalmente na junção amelocementária e divididos em três grupos: hipoclorito de sódio (NaOCl) 2,5%, hipoclorito de cálcio 2,5% e soro fisiológico. Os canais foram preparados, irrigados ao final com EDTA 17% e obturados com cones de guta percha e cimento AH Plus. Após armazenagem por 7 dias, em 100% de umidade e a 37°C, os dentes foram seccionados transversalmente ao longo do eixo da raiz. Foram obtidas três fatias de cada dente (n=33), que foram submetidas ao ensaio de push-out. O tipo de falha foi analisado por fractografia e classificado em falha adesiva, coesiva ou mista. Os valores de resistência de união foram analisados pelo teste de Kruskal-Wallis, com nível de significância de 95%. Resultados: o grupo Ca(OCl)2 2,5% apresentou a menor média de resistência de adesão, diferindo estatisticamente do NaOCl e do soro fisiológico (p<0,05). Não houve diferença estatística entre os grupos irrigados com soro e NaOCl (p>0,05). Conclusões: a falha predominante em todos os grupos foi a do tipo adesiva. O Ca(OCl)2 2,5% teve um efeito negativo sobre a força de adesão do AH Plus à dentina radicular quando comparado ao NaOCl 2,5%. (AU)

Objective: to evaluate the effect of calcium hypochlorite (Ca(OCl)2) as an irrigant on the bond strength of the AH Plus sealer (De Trey-Dentsply, Konstanz, Germany) to dentin, using the micro push-out test. Materials and method: thirty-three single-rooted human teeth were cross-sectioned on the cementoenamel junction and divided into three groups: 2.5% sodium hypochlorite (Na- OCl), 2.5% calcium hypochlorite, and saline solution. The canals were prepared, irrigated with 17% EDTA at the end, and filled with gutta-percha cones and AH Plus sealer. After being stored for seven days at 100% humidity and 37ºC, the teeth were cross-sectioned along the root axis. Three slices of each tooth (n=33) were obtained and subjected to the push-out test. Failure mode was analyzed by fractography and classified as adhesive, cohesive, or mixed. Bond strength values were analyzed by the Kruskall-Wallis test at 95% significance level. Results: the 2.5% Ca(OCl)2 group showed the lowest bond strength mean, differing statistically from 2.5% NaOCl and saline solution (p<0.05). There was no statistical difference between the groups irrigated with saline solution and NaOCl (p>0.05). Conclusion: the adhesive failure was predominant in all groups. The 2.5% Ca(OCl)2 had a negative effect on the bond strength of AH Plus to the root dentin when compared to 2.5% NaOCl. (AU)

Epoxy sheet plastination on a rabbit head - new faster protocol with Biodur® E12/E1 / Plastinación de cortes con resina epoxi en una cabeza de conejo - nuevo protocolo rápido con Biodur® E12/E1

SUMMARY: Plastination is an anatomical technique of cadaveric preservation that allows the preservation of anatomical pieces indefinitely, in dry and odorless form. It was created in 1978 by Gunther von Hagens, in Heidelberg, Germany. In particular, the sheet plastination technique, with epoxy resin, allows the generation of thin sections of various anatomical regions, allowing an accurate visualization of anatomical structures of difficult access through dissection or cadaveric exploration. The aim of this work was to present a new sheet plastination protocol with Biodur® E12/E1, which is faster in its implementation, applied, for the first time, in a rabbit head.

RESUMEN: La plastinación es una técnica anatómica de preservación cadavérica que permite la conservación de piezas anatómicas indefinidamente, en forma seca e inodora. Fue creada en 1978 por Gunther von Hagens, en Heidelberg, Alemania. En particular, la técnica de plastinación de cortes, con resina epoxi, permite la generación de secciones delgadas de diversas regiones anatómicas, asegurando una visualización precisa de estructuras anatómicas de difícil acceso mediante disección o exploración de cadáveres. El objetivo de este trabajo fue presentar un nuevo protocolo de plastinación de cortes con resina Biodur® E12/E1, más rápido en su implementación, aplicada por primera vez, en una cabeza de conejo.

How to improve root canal filling in teeth subjected to radiation therapy for cancer

Abstract The aim of this study was to evaluate the influence of radiation therapy on root canal sealer push-out bond strength (BS) to dentin and the sealer/dentin interface after different final irrigation solutions (NaOCl, EDTA, and chitosan). Sixty-four maxillary canines were distributed into two groups (n=30): non-irradiated and irradiated with 60 Gy. Canals were prepared with Reciproc-R50 and subdivided (n=10) for final irrigation (NaOCl, EDTA, chitosan) and filled. Three dentin slices were obtained from each root third. The first slice of each third was selected for BS evaluation, and the failure mode was determined by stereomicroscopy. SEM analysis of the sealer-dentin interface was performed in the remaining slices. Two-way ANOVA and Tukey's tests (α=0.05) were used. Lower BS (P<0.0001) was obtained after irradiation (2.07±0.79 MPa), regardless of the final irrigation solution used. The NaOCl group (P<0.001) had the lowest BS in the irradiated (1.68±0.72) and non-irradiated (2.39±0.89) groups, whereas the EDTA (irradiated: 2.14±0.77 and non-irradiated: 3.92±1.54) and chitosan (irradiated: 2.37±0.73 and non-irradiated: 3.51±1.47) groups demonstrated a higher BS (P<0.05). The highest values were observed in the coronal third (3.17±1.38) when compared to the middle (2.74±1.36) and apical ones (2.09±0.97)(P<0.0001). There were more cohesive failures and more gaps in irradiated specimens, regardless of the final solution. The present study showed that radiation was associated with a decrease in BS, regardless of the final solution used, whereas chitosan increased BS in teeth subjected to radiation therapy.

Evaluation of the sealing ability of different root canal sealers: a combined SEM and micro-CT study

Abstract Objective: The purpose of this study was to analyze the ability of multiple compounds to seal the dental tubules using scanning electron microscopy (SEM) and micro-computed tomogra-phy (micro-CT). Material and Methods: Twenty-four single-root human mandibular premolars were selected and instrumented with nickel-titanium rotary file and the final file size was #40/06. They were then randomly allocated into 2 groups, and all samples were filled with single cone gutta-percha (#40/06) and one of the tested sealers (AH Plus and EndoSequence BC sealers). All specimens were scanned using micro-CT and then three from each group were randomly selected for SEM analysis. Results: According to SEM, both root canal sealers showed sufficient adaptation to dentin along the whole length of the root canal, though the coronal sections presented superior sealing than the apical sections. Micro porosity analyses revealed that the volume of closed pores and the surface of closed pores had the largest values in the coronal sections, followed by the middle and the apical sections for both sealants (p<0.05). However, no significant difference was observed for those two parameters between AH Plus and EndoSequence BC sealers in any of the three sections (p>0.05), whereas they were larger in the apical section when the AH Plus sealer was used. Conclusions: By using the single cone technique, neither EndoSequence or AH Plus pro-vides a porosity-free root canal filling. The EndoSequence BC sealer may have similar sealing abilities regarding the whole root canal as the AH Plus sealer. A better sealing effect could be obtained in the coronal and middle sections of a root canal than the apical part by using the tested sealers.

Influence of ethanol on dentin roughness, surface free energy, and interaction between AH Plus and root dentin

Abstract This study aimed to evaluate the influence of different ethanol concentrations on dentin roughness, surface free energy, and contact angle between AH Plus and the root canal dentin. One hundred human maxillary anterior teeth were split longitudinally and 200 dentin specimens were polished to make the surface flatter and smoother. An acrylic bar was positioned between two dentin specimens and impression material was added to create a block, simulating an instrumented root canal space. Specimens were removed from the mold and cleaned in an ultrasonic bath for 10 min. Thereafter, dentin specimens were divided into four groups (n = 50) according to the drying methods used: a) wet: vacuum only, b) paper points: vacuum + absorbent paper points, c) 70% alcohol: 70% alcohol (1 min) + vacuum + absorbent paper points, and d) 100% alcohol: 100% alcohol (1 min) + vacuum + absorbent paper points. A rugosimeter and a goniometer were used to verify the roughness (Ra) and to measure the surface free energy and the contact angle between the AH Plus sealer and the root canal dentin. ANOVA and Tukey tests (α = 0.05) were used for statistical analysis. The 70% and 100% ethanol groups showed significantly decreased roughness as well as increased surface free energy in the root canal dentin when compared to the wet and paper point groups. In addition, ethanol significantly reduced the contact angle between the AH Plus sealer and the root canal dentin. Ethanol solutions (70% and 100%) provide better wettability of AH Plus sealer on dentin surfaces.

Can low-fusing glass application affect the marginal misfit and bond strength of Y-TZP crowns?

Abstract To evaluate the effect of different surface treatments on the marginal misfit and retentive strength between Y-TZP crowns and an epoxy resin. Forty (40) epoxy resin (G10) abutments (height: 5mm, conicity: 60, finish line: large chamfer) with equal dimensions were milled and included in polyurethane to simulate the periodontal ligament. Next, 40 Y-TZP crowns (thickness: 1mm) were milled (Cerec in Lab) and randomly divided into four groups (n=10) according to the surface treatment: GS(glaze spray), GP(glaze powder/liquid), P(zirconia primer) and RS(tribochemical silica coating). The conditioned surfaces were cemented with dual self-adhesive cement, light cured and submitted to thermomechanical cycling (2x106, 100N, 4Hz, 5°/55°C). Marginal misfit was analyzed by a stereomicroscope and SEM. Retentive strength test was performed (1mm/min) until crown debonding. Glaze layer thickness was also performed to GS and GP groups. Marginal misfit data were analyzed by Kruskal Wallis and Dunn tests; one-way ANOVA and Tukey (5%) analyzed the tensile strength data. The marginal misfit of the GS (48.6±19.9μm) and GP (65.4±42.5μm) were statistically lower than the RS (96±62.9μm) and P (156±113.3μm) (p=0.001). The retentive strength of the GP (470.5±104.1N) and GS (416.8±170.2N) were similar to the P (342.1±109.7N), but statistically higher than those of the RS (208.9±110N). The GS and GP glaze layer was 11.64μm and 9.73μm respectively. Thus, glaze application promoted lower marginal discrepancy and higher retentive strength values than conventional techniques.

Effect of photodynamic therapy and non-thermal plasma on root canal filling: analysis of adhesion and sealer penetration

Abstract Objective The aim of this study was to evaluate the effect of photodynamic therapy (PDT) and non-thermal plasma (NTP) on adhesion and sealer penetration in root canals. Material and Methods Sixty single-rooted premolars were used. The teeth were prepared using a crown-down technique. NaOCl and EDTA were used for irrigation and smear layer removal, respectively. The root canals were divided into three groups: control, PDT, and NTP. After treatments, the roots were filled using gutta-percha and either AH Plus (AHP) or MTA Fillapex (MTAF) sealers. Samples were sectioned at 4, 8, and 12 mm from the apex (1-mm slices)and analyzed by the push-out bond strength test (adhesion) and confocal laser scanning microscopy (sealer penetration). Data were statistically evaluated using Kruskal-Wallis, Dunn's, and Spearman's tests. Results Regarding AHP, bond strength was similar in the NTP group and in the control group, but significantly lower in the PDT group. As to MTAF, both therapies showed lower values than the control group. In the confocal analysis of AHP, maximum and mean penetration, and penetrated area were statistically higher in the control group than in the PDT and NTP groups. Penetrated perimeter was similar among groups. Regarding MTAF, all parameters yielded better results in the NTP than in the control group. The PDT and control groups showed similar results except for penetrated area. Conclusion PDT and plasma therapy affected the adhesion and sealer penetration of root canals filled with AH Plus and MTA Fillapex and there is no positive correlation between adhesion and sealer penetration.

Effectiveness of different final irrigation techniques and placement of endodontic sealer into dentinal tubules

Abstract: The aim of this study was to compare two irrigation techniques and four devices for endodontic sealer placement into the dentinal tubules. Ninety-nine single-rooted human teeth were instrumented and allocated to either the control (CO) (n=11) or experimental groups according to the irrigation method: syringe and NaveTip needle (NT) (n=44), and EndoActivator (EA) (n=44). These groups were subdivided according to sealer placement into K-File (KF), lentulo spiral (LS), Easy Clean (EC), and EndoActivator (EA) subgroups. Moreover, the distances of 5 mm and 2 mm from the apex were analyzed. The teeth were obturated with AH Plus and GuttaCore X3. Analyses were performed by scanning electron microscopy associated to cathodoluminescence. The percentage and maximum depth of sealer penetration were measured. Data were evaluated by three-way analysis of variance (ANOVA) and Games-Howell test (p<0.05). EA was superior to NT in percentage of sealer penetration. EC was significantly superior to EA (subgroup) for sealer penetration, and both improved the percentage of sealer penetration when compared to LS. Better sealer penetration was observed at the distance of 5 mm from the apex. Sealer penetration into the dentinal tubules was significantly improved by sonic irrigant activation.

Influence of solvents on the bond strength of resin sealer to intraradicular dentin after retreatment

Abstract This study evaluated the removal of filling material with ProTaper Universal Rotary Retreatment system (PTR) combined with solvents and the influence of solvents on the bond strength (PBS) of sealer to intraradicular dentin after canal reobturation. Roots were endodontically treated and distributed to five groups (n = 12). The control group was not retreated. In the four experimental groups, canals were retreated with PTR alone or in combination with xylol, orange oil, and eucalyptol. After filling material removal, two specimens of each group were analysed by SEM and µCT to verify the presence of filling remnants on root canal walls. The other roots were reobturated and sectioned in 1-mm-thick dentin slices that were subjected to the push-out test. Data were analysed by two-way ANOVA and Tukey’s test (α = 0.05). SEM and µCT analysis revealed that all retreatment techniques left filling remnants on canal walls. The control group (3.47 ± 1.21) presented significantly higher (p < 0.05) PBS than the experimental groups. The groups retreated with PTR alone (2.59 ± 0.99) or combined with xylol (2.54 ± 0.77) and orange oil (2.32 ± 0.93) presented similar bond strength (p > 0.05), and differed significantly from the group with eucalyptol (1.89 ± 0.63). The solvents reduced the PBS of the sealer to dentin and no retreatment technique promoted complete removal of filling material.

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

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

Effects of different irrigation regimes in physico-chemical properties of dentin and consequences of changes in the adhesion of microorganisms and AH Plus sealer / Efeitos de diferentes regimes de irrigação nas propriedades físicoquímicas da dentina e consequências das alterações na adesão de microrganismos e do cimento endodôntico AH Plus

Besides of the desired effects, the chemical solutions used to assist the endodontic instruments in the cleanliness and disinfection of the root canal system can also cause changes in the physicochemical properties of dentin, and consequently affect the adhesion of endodontic sealers and microorganisms to the root canal walls. However, the effects of new irrigators and irrigation protocols remain unknown. The objectives of this thesis were to verify the alterations in the properties of some irrigants when used combined in mixtures, to define the time necessary for the smear layer removal by a new irrigant, to determine the organic matter dissolution capacity and the effects in the physicochemical properties of dentin of some irrigation solutions and protocols, and to evaluate the adhesion of microorganisms and AH Plus sealer to dentin after its submission to different irrigation sequences. In all experiments with dentin, the samples used were obtained from bovine teeth. In the analysis performed in this thesis, the following solutions were tested isolated and combined in different irrigation protocols: saline solution (control), sodium hypochlorite (NaOCl), trisodium (EDTAHNa3), alkaline ethylenediaminetetraacetic acid tetrasodium (EDTANa4), chlorhexidine (CHX), peracetic acid (PAA), and etidronic acid (HEDP). The EDTAHNa3 and EDTANa4 were tested in relation to their effects on the free chlorine content of NaOCl. The solutions were mixed in a 1:1 ratio and the iodometric titration of the mixtures performed in different time intervals. The time necessary for smear layer removal from dentin samples by solutions of EDTAHNa3 and different concentrations of EDTANa4 isolated and mixed with NaOCl was determined with the aid of the scanning electron microscope (SEM). The capacity of NaOCl to dissolve organic matter was determined by weighting fragments of bovine muscle before and after immersion in solutions of 1%, 2.5%, and 5% of NaOCl in different periods of time. Also, the effects of EDTAHNa3, EDTANa4 and HEDP on the organic matter dissolution by NaOCl were evaluated. The alterations produced by all solutions isolated and some irrigation protocols in the organic and inorganic components of the dentin surface were analysed by the attenuated total reflectance of Fourier transform infrared spectroscopy (ATR-FTIR) technique. Absorbance spectra were collected from the dentin surface before and after immersion of samples in the irrigants and the ratios of the amide III/phosphate and carbonate/phosphate bands were calculated. To quantify the adhesion of CHX to mineralized dentin and to dentin demineralized by different irrigation protocols, the areas of the band associated with CHX with the peak in 1492 cm−1 were determined in spectra obtained by ATR-FTIR. The effects of different irrigation protocols in the roughness and wettability of dentin surface were measured with a benchtop roughness tester and the sessile drop technique, respectively. For the assays of microorganisms' adhesion, samples were prepared and treated the same way and with the same irrigation protocols used in the roughness and wettability tests. Following, Candida albicans and Enterococcus faecalis were maintained in contact with the dentin for 2 hours and the samples were analyzed on the confocal laser scanning microscope (CLSM). Tests of push-out were performed to determine the impact of different irrigation protocols on the dentin bonding strength of AH Plus sealer over time. Canals of bovine incisors teeth were instrumented, irrigated and following obturated using only the sealer AH Plus. Half of the samples were submitted to pushout assessment 7 days after the obturation and the other half 20 months later. The results of the experiments showed that the EDTAHNa3 caused an almost complete and immediate loss of free available chlorine from NaOCl, whilst EDTANa4 promoted a slow and concentration-dependent decline. The smear layer was removed only by decalcifying solutions and in about 1 min by the 17% EDTAHNa3 and 5 min by the EDTANa4, both isolated or mixed with NaOCl. The increase in NaOCl concentration and contact time with the samples intensified the dissolution of organic matter. The mixtures of NaOCl with EDTANa4 and HEDP were able to dissolve the fragments of bovine muscle over-time, however, the EDTAHNa3 strongly affected the NaOCl dissolution capacity when they were mixed. The results of ATR-FTIR experiments showed that the increase in the NaOCl concentration intensified the deproteination of the dentin collagen with a reduction in the amide III/phosphate ratio. For the same decalcifying agent, the higher the concentration and immersion time the greater the removal of phosphate, exposure of the collagen matrix and consequently the increases in amide III/phosphate ratio. The PAA caused greater increases in amide III/phosphate ratio, followed by EDTAHNa3, EDTANa4 and HEDP and this order was maintained in the protocols in which NaOCl was used before the decalcifying agents. NaOCl required approximately 0.5 min to deproteinate the collagen matrix exposed after phosphate removal by EDTAHNa3 and PAA. The carbonate/phosphate ratio decreased after 30 s of samples immersion in solutions of NaOCl at 1%, 2.5% and 5% with no more alterations over time. The carbonate of the dentine was removed faster than phosphate by all decalcifying agents employed alone and in the irrigation protocols in which the use of the NaOCl was followed by the use of the EDTAHNa3, PAA and HEDP. For irrigation protocols that associate NaOCl with chelating solutions, the last irrigant used defined the final dentine amide III/phosphate and carbonate/phosphate ratios. For the ATR-FTIR analysis of CHX adhesion, the results showed that the adsorption of this irrigant to the dentin was potentiated when chelating agents were used prior to the CHX. In relation to the experiments of surface roughness, the saline solution, NaOCl, HEDP and CHX did not alter the roughness of the dentin, but EDTAHNa3 and PAA increased it. The wettability of the surface increased after the use of all irrigants, being the HEDP to cause the greater increases. In the assays of microorganisms' adhesion, the smear layer and collagen exposed by the chelating agents favored the adhesion of E. faecalis. The C. albicans adhesion was major in surfaces with smear layer and more mineral. The use of CHX as the final irrigant reduced the adhesion of both microorganisms. The wettability did not influence the microorganisms' adhesion, while increases in roughness seems to potentiate the adherence of E. faecalis. The experiments of bond strength of AH Plus to the dentin showed that the irrigation with NaOCl and mixture of NaOCl + EDTANa4 produced the lowest push-out bond strength values in 7 days compared to NaOCl + EDTAHNa3, NaOCl + EDTAHNa3 + NaOCl, NaOCl + EDTAHNa3 + CHX and the mixture of NaOCl + HEDP. After 20 months the lowest values were obtained in the groups irrigated with NaOCl and NaOCl + EDTAHNa3. The groups of NaOCl + EDTAHNa3 + NaOCl, mixture NaOCl + HEDP, and mixture NaOCl + EDTANa4 presented values of push-out bond strength in 20 months similar to the values in 7 days. It was possible to conclude that the irrigation solutions tested in this study have different effects in the organic and inorganic matter and some of them can affect the action of each other when mixed. Independent of being used isolated or combined in irrigation protocols, these irrigants cause modifications in the dentin physicochemical properties that influence the adhesion of AH Plus sealer in short and long term and the microorganisms' adherence to the surface in cases of recontaminations.(AU)

Além dos efeitos desejados, as soluções químicas utilizadas para auxiliar os instrumentos endodônticos na limpeza e desinfecção do sistema radiculares podem causar alterações nas propriedades físico-químicas da dentina e consequentemente afetar a adesão de cimentos endodônticos e microrganismos às paredes do canal radicular. Contudo, os efeitos de novos irrigantes e protocolos de irrigação ainda são desconhecidos. Os objetivos desta tese foram verificar as alterações nas propriedades de alguns irrigantes quando utilizados combinados em misturas, definir o tempo necessário para a remoção da camada de smear layer por um novo irrigante, determinar a capacidade de dissolução de matéria orgânica e os efeitos de algumas soluções e protocolos de irrigação nas propriedades físico-químicas de dentina e avaliar a adesão de microrganismos e cimento AH Plus à dentina após a submissão desta a diferentes sequências de irrigação. Em todos os experimentos com dentina as amostras utilizadas foram obtidas a partir de dentes bovinos. Nas análise realizadas nesta tese as seguintes soluções foram testadas isoladas e combinadas em diferentes protocolos de irrigação: solução salina (controle), hipoclorito de sódio (NaOCl), ácido etilenodiaminotetraacético trisódico (EDTAHNa3), ácido etilenodiaminotetracético tetrassódico alcalino (EDTANa4), clorexidina (CHX), ácido peracético (PAA) e ácido etidrônico (HEDP). O EDTAHNa3 e o EDTANa4 foram testados em relação aos seus efeitos sobre o teor de cloro livre do NaOCl. As soluções foram misturadas em uma proporção de 1:1 e a titulação iodométrica das misturas realizada em diferentes intervalos de tempo. O tempo necessário para a remoção da smear layer de amostras de dentina pela solução de EDTAHNa3 a 17% e diferentes concentrações de EDTANa4 isoladas e misturadas com NaOCl foi determinado com o auxílio do microscópio eletrônico de varredura (SEM). A capacidade de dissolução de matéria orgânica pelo NaOCl foi determinada pesando fragmentos de músculo bovino antes e depois da imersão em soluções de 1%, 2,5% e 5% de NaOCl em diferentes períodos de tempo. Além disso, os efeitos do EDTAHNa3, EDTANa4 e HEDP na dissolução de matéria orgânica pelo NaOCl foram avaliados. As alterações produzidas por todas as soluções isoladas e alguns protocolos de irrigação nos componentes orgânicos e inorgânicos da superfície da dentina foram analisadas pela técnica de reflexão total atenuada em espectroscopia no infravermelho por transformação de Fourier (ATRFTIR). Espectros de absorbância foram coletados da superfície da dentina antes e após a imersão das amostras nos irrigantes, e foram calculadas as razões das bandas de amida III/fosfato e carbonato/fosfato. Para quantificar a adesão da CHX à dentina mineralizada e à dentina desmineralizada por diferentes protocolos de irrigação, foram determinadas as áreas da banda associada a CHX com pico em 1492 cm−1 em espectros obtidos por ATR-FTIR. Os efeitos de diferentes protocolos de irrigação na rugosidade e molhabilidade da superfície da dentina foram medidos com um rugosímetro de bancada e a técnica de gota séssil, respectivamente. Para os ensaios de adesão de microrganismos, amostras foram preparadas e tratadas da mesma maneira e com os mesmos protocolos de irrigação utilizados nos testes de rugosidade e molhabilidade. Em seguida, Candida albicans e Enterococcus faecalis foram mantidos em contato com a dentina por 2 horas e as amostras foram analisadas no microscópio confocal de varredura laser (CLSM). Testes de push-out foram realizados para determinar o impacto de diferentes protocolos de irrigação na resistência de união à dentina do cimento AH Plus ao longo do tempo. Canais de dentes incisivos de bovinos foram instrumentados, irrigados e em seguida obturados utilizando apenas o cimento AH Plus. Metade das amostras foi submetida a avaliação de push-out 7 dias após a obturação e a outra metade após 20 meses. Os resultados dos experimentos mostraram que o EDTAHNa3 causou uma perda quase completa e imediata do cloro livre do NaOCl, enquanto o EDTANa4 promoveu um declínio lento e concentração dependente. A smear layer foi removida apenas por soluções descalcificantes e em cerca de 1 min pelo EDTAHNa3 a 17% e em 5 min pelo EDTANa4, tanto isolados ou misturados com o NaOCl. O aumento da concentração de NaOCl e do tempo de contato com os fragmentos de músculo bovino intensificou a dissolução da matéria orgânica. As misturas de NaOCl com EDTANa4 e HEDP foram capazes de dissolver as amostras de músculo ao longo do tempo, no entanto, o EDTAHNa3 afetou fortemente a capacidade de dissolução do NaOCl quando eles foram misturados. Os resultados dos experimentos com ATR-FTIR mostraram que o aumento da concentração do NaOCl intensificou a desproteinização do colágeno da dentina com redução da relação amida III/fosfato. Para o mesmo agente de descalcificação, quanto maior a concentração e o tempo de imersão, maior a remoção de fosfato, exposição da matriz de colágeno e consequentemente o aumento da proporção amida III/fosfato. O PAA causou os maiores aumentos na relação amida III/fosfato, seguido de EDTAHNa3, EDTANa4 e HEDP e esta ordem foi mantida nos protocolos em que o NaOCl foi usado antes dos agentes descalcificantes. O NaOCl necessitou aproximadamente 0,5 min para desproteinizar a matriz de colágeno exposta após a remoção de fosfato pelo EDTAHNa3 e o PAA. A relação carbonato/fosfato diminuiu após 30 s de imersão das amostras em soluções de NaOCl a 1%, 2,5% e 5%, sem mais alterações ao longo do tempo. O carbonato da dentina foi removido mais rápido do que o fosfato por todos os agentes descalcificantes empregados sozinhos e nos protocolos de irrigação em que o uso do NaOCl foi seguido pelo uso do EDTAHNa3, PAA e HEDP. Para os protocolos de irrigação que associam o NaOCl com soluções quelantes, o último irrigante utilizado definiu as proporções finais de amida II/fosfato e carbonato/fosfato da dentina. Para as análises da adesão da CHX em ATR-FTIR, os resultados mostraram que a adsorção deste irrigante à dentina foi potencializada quando agentes quelantes foram utilizados antes da CHX. Em relação aos experimentos de rugosidade da superfície, a solução salina, o NaOCl, o HEDP e a CHX não alteraram a rugosidade da dentina, mas o EDTAHNa3 e o PAA a aumentaram. A molhabilidade da superfície aumentou após o uso de todos os irrigantes, sendo que o HEDP causou os maiores aumentos. Nos ensaios de adesão dos microrganismos, a smear layer e o colágeno exposto pelos agentes quelantes favoreceram a adesão de E. faecalis. A adesão da C. albicans foi maior em superfícies com smear layer ou mais mineral. O uso de CHX como irrigante final reduziu a adesão de ambos os microrganismos. A molhabilidade não influenciou a adesão dos microrganismos, enquanto o aumento da rugosidade parece potencializar a adesão do E. faecalis. Os experimentos de resistência de união do AH Plus à dentina mostraram que a irrigação com NaOCl e a mistura de NaOCl + EDTANa4 produziram valores de resistência de união em 7 dias mais baixos em comparação com NaOCl + EDTAHNa3, NaOCl + EDTAHNa3 + NaOCl, NaOCl + EDTAHNa3 + CHX e a mistura de NaOCl + HEDP. Após 20 meses, os valores mais baixos foram obtidos nos grupos irrigados com NaOCl e NaOCl + EDTAHNa3. Os grupos de NaOCl + EDTAHNa3 + NaOCl, mistura de NaOCl + HEDP e mistura de NaOCl + EDTANa4 apresentaram valores de força de união por push-out em 20 meses semelhante aos valores em 7 dias. Foi possível concluir que as soluções de irrigação testadas neste estudo têm diferentes efeitos na matéria orgânica e inorgânica e elas podem afetar as ações umas das outras quando misturadas. Independentemente de serem utilizadas isoladas ou combinadas em protocolos de irrigação, os irrigantes causam modificações nas propriedades físico-químicas dentinárias que influenciam na adesão do cimento AH Plus a curto e longo prazo e na adesão de microrganismos à superfície em casos de recontaminação.(AU)