Clinical implementation of comprehending dentin on a microscopic level

SUMMARY: The aim of the present in vitro study is to visualize dentin to get an in-depth knowledge of the nature of dentin that could provide useful information regarding conditioning dentinal substrate when treating dentinal lesions. Forty-nine extracted human third molars were obtained and prepared to produce artificial dentinal lesions through demineralizing with acetic acid for 7 and 14 days, or lactic acid for 7 days. The teeth were divided into groups and treated with either NaOCl, pepsin, trypsin, or phosphoric acid. To obtain information on the morphology of the treated dentinal surfaces, all samples were visualized under high resolution field emission scanning electron microscope. With high magnification reaching x50000 dentin was clearly visualized together with its constitutes. The effect of various demineralization approaches and various treatment protocols were demonstrated clearly. The relationship between the conditioning procedure steps and the subsequent bond strength was discussed. To our best knowledge, there is no previous clear highly magnified scanning electron microscope images for dentin, and dentinal components and constitutes with and without various treatments. The current in vitro study suggests the complexity nature of dentin as a substrate that should be treated carefully especially with technique sensitive procedures such as adhesive restorations.

El objetivo del presente estudio in vitro fue visualizar la dentina para obtener un conocimiento completo de la naturaleza de ella lo que podría proporcionar información útil sobre el acondicionamiento del sustrato dentinario en el tratamiento de lesiones dentinarias. Se obtuvieron 49 terceros molares humanos extraídos y se prepararon para producir lesiones dentinales artificiales mediante desmineralización con ácido acético por 7 y 14 días, o ácido láctico por 7 días. Los dientes se dividieron en grupos y se trataron con NaOCl, pepsina, tripsina o ácido fosfórico. Para obtener información sobre la morfología de las superficies dentinarias tratadas, todas las muestras se visualizaron bajo un microscopio electrónico de barrido de emisión de campo de alta resolución. Con un gran aumento que alcanzó x50000, la dentina se visualizó claramente junto con sus componentes. Se demostró el efecto de varios enfoques de desmineralización y varios protocolos de tratamiento. Se discutió la relación entre los pasos del procedimiento de acondicionamiento y la subsiguiente fuerza de unión. Hasta donde sabemos, no hay imágenes claras previas de microscopio electrónico de barrido altamente ampliadas para la dentina y los componentes y constituyentes de la dentina con y sin diferentes tratamientos. El estudio in vitro actual sugiere la naturaleza compleja de la dentina como sustrato que debe tratarse con cuidado, especialmente en los procedimientos sensibles a la técnica, tal como las restauraciones adhesivas.

Adhesión a dentina parte I: características del sustrato y sistemas adhesivos / Dentin bonding part I: substrate characteristics and bonding systems

La Odontología Restauradora contemporánea no puede concebirse sin la adhesión de los materiales restauradores a las estructuras dentarias. En mu-chos procedimientos restauradores, no sólo el esmal-te sino también la dentina se encuentra involucrada, por lo tanto, la adhesión a esta última juega un rol cla-ve en el éxito clínico. No obstante, todavía supone un gran desafío lograr una adhesión estable y predeci-ble en el tiempo. El propósito del presente artículo es analizar las características principales de la dentina como sustrato adhesivo y describir los sistemas ad-hesivos actuales y sus mecanismos de acción (AU)

Contemporary Restorative Dentistry cannot be conceived without the adhesion of restorative materials to dental structures. In many restorative procedures not only the enamel, but also the dentin is involved, therefore dentin bonding plays a key role in their success. However, it is still a great challenge to achieve stable and predictable dentin bonding over time. The aim of this article is to analyze the main characteristics of dentin as an adhesive substrate and to describe current adhesive systems and their bonding mechanisms (AU)

Caracterización microscópica de la dentina de dientes temporales / Microscopic characterization of the dentin of temporary teeth

La dentina se compone de un mineral de fosfato de calcio identificado como dahllita, que se dispone en pequeños cristales de hidroxiapatita carbonatada con dimensiones de 36 × 25 × 4 nm, y por una fase orgánica cuyo principal componente es el colágeno tipo 1 en 90%, que se orienta en forma de malla. Esta conformación corresponde a los dientes permanentes. Dentro de las estructuras, encontramos túbulos dentinarios que miden, aproximadamente, entre 0.5-1 µm de diámetro en la periferia y hasta 3-5 µm cerca de la pulpa. En el presente estudio, realizado en dentina de dientes temporales, el lumen de dichos túbulos es más grande cuando se encuentra cerca de la pulpa dental. Asimismo, se encontraron cambios elementales importantes de acuerdo con las diferentes profundidades en las que se observó, encontrando un aumento en el peso porcentual de carbono cuando se encuentra a mayor profundidad, lo que indica una composición orgánica mayor en la dentina pulpar. En estudios de dientes permanentes esta composición es disminuida y con mayor concentración en la dentina cercana a la unión amelodentinaria. En dentina de dientes temporales se encontraron diferencias en el recuento de túbulos dentinarios por mm2, comparado a la dentina de dientes permanentes, donde el número de túbulos no varía mucho (AU)

Dentin is composed of a calcium phosphate mineral identified as dahllite, which is arranged in small crystals of carbonated hydroxyapatite with dimensions of 36 × 25 × 4 nm, and by an organic phase whose main component is type l collagen in 90%, which is oriented in the form of a mesh. This conformation corresponds to permanent teeth. Within the structures, we find dentin tubules that measure approximately 0.5-1 µm in diameter at the periphery and up to 3-5 µm near the pulp. In the present study, carried out in dentin of primary teeth, the lumen of these tubules is larger when it is close to the dental pulp. Likewise, important elemental changes were found according to the different depths in which it was observed, finding an increase in the percentage weight of carbon when it is at a greater depth, indicating a greater organic composition in the pulp dentin. In studies of permanent teeth, this composition is decreased and with a higher concentration in the dentin near the amelodentinal junction. In dentin of primary teeth, differences were found in the count of dentin tubules per mm2, compared to dentin of permanent teeth, where the number of tubules did not vary much (AU)

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.

Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness

Abstract The aim of this study was to evaluate the influence of an extended use of desensitizing toothpastes (DTs) on dentin bonding, microhardness and roughness. One hundred and twenty bovine incisor teeth were randomly divided into four groups: G1, distilled water (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-Relief (CSPR); and G4, Sensodyne Repair ?αμπ; Protect (SRP). Dentin surfaces were etched with 17% EDTA and 2 years of simulated tooth brushing (20,000 cycles) was performed on their surfaces. Knoop microhardness, surface roughness and scanning electron microscopy (SEM) were performed before and after the simulated tooth brushing. For microshear bonding test, a 2-step self-etching adhesive system (Clearfil SE Bond) was used and 0.8 mm diameter composite resin (Filtek Z350 XT) cylinders were built. Microshear test was performed with an orthodontic wire and with a crosshead speed of 0.5 mm/min. The data were analyzed for: 1) bond strength (one-way ANOVA), 2) microhardness intra-group (Student's test) and inter-group (one-way ANOVA/Tukey's test) comparisons, 3) roughness intra-group (Student's test/Wilcoxon's test) and inter-group (Kruskal-Wallis/Student-Newman-Keuls test) comparisons. The extended use of both dentifrices (conventional and for sensitive teeth) did not affect the bond strength and produced a significant increase in microhardness and roughness of the dentin, except for the microhardness of the SRP group. The simulated tooth brushing technique with water produced an increase in roughness, without reducing significantly the dentin microhardness.

Resumo O objetivo deste estudo foi avaliar a influência do uso prolongado de dentifrícios dessensibilizantes (DTs) na adesão, microdureza e rugosidade da dentina. Cento e vinte dentes incisivos bovinos foram divididos aleatoriamente em quatro grupos: G1, água destilada (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-alívio (CSPR); e G4, Sensodyne Repair ?αμπ; Protect (SRP). As superfícies dentinárias foram condicionadas com EDTA a 17% e foram realizados 2 anos de escovação dental simulada (20.000 ciclos) em suas superfícies. A microdureza Knoop, rugosidade de superfície e microscopia eletrônica de varredura (MEV) foram realizadas antes e após escovação dental simulada. Para o teste de adesão por microcisalhamento, foi aplicado um sistema adesivo auto condicionante de 2 passos (Clearfil SE Bond) e foram construídos cilindros de resina composta (Filtek Z350 XT) de 0,8 mm de diâmetro. O teste de microcisalhamento foi realizado com um fio ortodôntico e com velocidade de 0,5mm/min. Os dados foram analisados para: 1) resistência de união (ANOVA 1 fator), 2) comparações de microdureza intra grupo (teste t de Student) e inter grupo (ANOVA 1 fator / teste de Tukey), 3) comparações de rugosidade intra grupo (teste t de Student / teste de Wilcoxon) e inter grupo (Kruskal Wallis / teste de Student-Newman-Keuls). O uso prolongado de ambos dentifrícios (convencional e para dentes sensíveis) não interferiu na resistência de união e produziu um aumento significativo na microdureza e rugosidade da dentina, exceto para a microdureza do grupo SRP. A técnica de escovação dental simulada com água promoveu aumento na rugosidade, sem reduzir significativamente a microdureza da dentina.

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.

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

Abstract This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10) according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA), 1% peracetic acid (PA), 2.5% NaOCl (solution control), and distilled water (negative control). The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05), while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05). CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion.

In vivo model for microbial invasion of tooth root dentinal tubules

ABSTRACT Objective Bacterial penetration of dentinal tubules via exposed dentine can lead to root caries and promote infections of the pulp and root canal system. The aim of this work was to develop a new experimental model for studying bacterial invasion of dentinal tubules within the human oral cavity. Material and Methods Sections of human root dentine were mounted into lower oral appliances that were worn by four human subjects for 15 d. Roots were then fixed, sectioned, stained and examined microscopically for evidence of bacterial invasion. Levels of invasion were expressed as Tubule Invasion Factor (TIF). DNA was extracted from root samples, subjected to polymerase chain reaction amplification of 16S rRNA genes, and invading bacteria were identified by comparison of sequences with GenBank database. Results All root dentine samples with patent tubules showed evidence of bacterial cell invasion (TIF value range from 5.7 to 9.0) to depths of 200 mm or more. A spectrum of Gram-positive and Gram-negative cell morphotypes were visualized, and molecular typing identified species of Granulicatella, Streptococcus, Klebsiella, Enterobacter, Acinetobacter, and Pseudomonas as dentinal tubule residents. Conclusion A novel in vivo model is described, which provides for human root dentine to be efficiently infected by oral microorganisms. A range of bacteria were able to initially invade dentinal tubules within exposed dentine. The model will be useful for testing the effectiveness of antiseptics, irrigants, and potential tubule occluding agents in preventing bacterial invasion of dentine.

Effect of EDTA on TGF-ß1 released from the dentin matrix and its influence on dental pulp stem cell migration

Abstract: Bioactive molecules stored in dentin, such as transforming growth factor beta1 (TGF-b1), may be involved in the signaling events related to dental tissue repair. The authors conducted an in vitro evaluation of the amount of TGF-b1 released from dentin slices after treatment with 10% ethylenediaminetetraacetic acid (EDTA), 2.5% sodium hypochlorite (NaOCl) or phosphate-buffered saline (PBS), and the effect of this growth factor on stem cell migration from human exfoliated deciduous teeth (SHED). Sixty 1-mm-thick tooth slices were prepared with or without the predentin layer, and treated with either 10% EDTA for 1 minute, 2.5% NaOCl for 5 days or kept in PBS. Tooth slice conditioned media were prepared and used for TGF-b1 ELISA and migration assays. Culture medium with different concentrations of recombinant human TGF-b1 (0.5, 1.0, 5.0 or 10.0 ng/mL) was also tested by migration assay. The data were evaluated by ANOVA and Tukey's test. Optical density values corresponding to media conditioned by tooth slices either containing or not containing the predentin layer and treated with 10% EDTA were statistically greater than the other groups and close to 1 ng/mL. Increased rates of migration toward media conditioned by tooth slices containing the predentin layer and treated with PBS, 10% EDTA or 2.5% NaOCl were observed. Recombinant human TGF-b1 also stimulated migration of SHED, irrespective of the concentration used. EDTA may be considered an effective extractant of TGF-b1 from the dentin matrix. However, it does not impact SHED migration, suggesting that other components may account for the cell migration.

A new improved protocol for in vitro intratubular dentinal bacterial contamination for antimicrobial endodontic tests: standardization and validation by confocal laser scanning microscopy

Objectives To compare three methods of intratubular contamination that simulate endodontic infections using confocal laser scanning microscopy (CLSM). Material and Methods Two pre-existing models of dentinal contamination were used to induce intratubular infection (groups A and B). These methods were modified in an attempt to improve the model (group C). Among the modifications it may be included: specimen contamination for five days, ultrasonic bath with BHI broth after specimen sterilization, use of E. faecalisduring the exponential growth phase, greater concentration of inoculum, and two cycles of centrifugation on alternate days with changes of culture media. All specimens were longitudinally sectioned and stained with of LIVE/DEAD® for 20 min. Specimens were assessed using CLSM, which provided images of the depth of viable bacterial proliferation inside the dentinal tubules. Additionally, three examiners used scores to classify the CLSM images according to the following parameters: homogeneity, density, and depth of the bacterial contamination inside the dentinal tubules. Kruskal-Wallis and Dunn’s tests were used to evaluate the live and dead cells rates, and the scores obtained. Results The contamination scores revealed higher contamination levels in group C when compared with groups A and B (p<0.05). No differences were observed between group A and B (p>0.05). The volume of live cells in group C was higher than in groups A and B (p<0.05). Conclusion The new protocol for intratubular infection resulted in high and uniform patterns of bacterial contamination and higher cell viability in all specimens when compared with the current methods.

The influence of display modalities on proximal caries detection and treatment decision / Influência dos meios de apresentação radiográfica no diagnóstico e tratamento da cárie

The aim of this study was to investigate the influence of digital radiographic display on caries detection and choice of treatment among undergraduate students. Forty images of extracted human teeth were acquired using a PSP digital system. The proximal surfaces were evaluated for the presence of proximal caries and choice of treatment by 36 undergraduate students,divided into three groups according to the semester they were taking. The images were evaluated in two forms of image display: laptop, and printed on acetate viewed on a lightbox.The accuracy of the different forms of image display on caries detection was evaluated by means of ROC curve analysis andits effect by mixed linear regression. Residue analysis was used to verify the adequacy of the treatment of choice for the chosen diagnosis. There was no significant effect either for the display modalities (p=0.058) or for the different undergraduate student groups (p=0.991). The Az was 0.539 for printed images and0.516 for laptop. The decisions based on treatment of choice were consistent with the scores achieved for caries detection. Accuracy of caries detection using a laptop was comparable to accuracy using printed images. Treatment decision was not affected by image display modality. The semester of the dentistry course that undergraduate students were taking did not significantly increase the accuracy of their proximal caries detection.

Objetivo deste estudo foi investigar a influência do meio de apresentação da imagem radiográfica digital no diagnóstico dacarie e na decisão de tratamento realizado por alunos de graduação. Foram obtidas 40 imagens digitais de dentes humanos extraídos através do sistema digital PSP. As superfícies proximais dos dentes foram avaliadas quanto à presença de cárie proximal por 36 estudantes de odontologia, distribuídos em três grupos de acordo com o nível de formação. As avaliações foram efetuadas em um laptop e em imagens impressas com o auxílio do negatoscópio. A acurácia dos meios de apresentação quanto à detecção de cárie incipiente foi avaliada pela média das áreas sob as curvas ROC e seu efeito por uma análise de regressão linear mista. Para a tomada de decisão terapêutica foi realizada uma análise de resíduos para verificar sua adequação ao diagnóstico. Não houve efeito significativo nem para a modalidade de visualização (p=0.058) e nem para os grupos de alunos (p=0.991). A média das áreas sob as curvas Roc para o filme foi de 0.539 e de 0.516 para negatoscópio. A decisão de tratamento foi condizente com o diagnóstico efetuado. A acurácia do diagnóstico da cárie proximal realizado em tela de laptop é comparável ao realizado em negatoscópio. A tomada de decisão terapêutica não foi afetada pelo meio de apresentação da imagem radiográfica digital. A progressão do aluno no curso não melhora a precisão diagnóstica da cárie proximal.

The smear layer created by scaling and root planing is physiologically eliminated in a biphasic process

Mechanical instrumentation of the root surface causes the formation of a smear layer, which is a physical barrier that can affect periodontal regeneration. Although different procedures have been proposed to remove the smear layer, there is no information concerning how long the smear layer persists on root surfaces after instrumentation in vivo. This study assessed the presence of the smear layer on root surfaces over a 28-day period after subgingival instrumentation with hand instruments. Fifty human teeth that were referred for extraction because of advanced periodontal disease were scaled and root planed (SRP) by a single experienced operator. Ten teeth were randomly assigned to be extracted 7, 14, 21, and 28 days after SRP. Another 10 teeth were extracted immediately after instrumentation (Day 0, control group). The subgingival area of the instrumented roots was evaluated with scanning electron microscopy. Representative photomicrographs were assessed by a blinded and calibrated examiner according to a scoring system. A rapid and significant (p < 0.05, Z test) initial reduction in the amount of smear layer was observed at 7 days, and a further significant (p < 0.05) decrease was observed 28 days after SRP. Interestingly, even 28 days after SRP, the smear layer was still present on root surfaces. This study showed that the physiological elimination of the smear layer occurred in a biphasic manner: a rapid initial reduction was observed 7 days after instrumentation, which was followed by a slow process leading to a significant decrease 28 days after instrumentation.

Evaluation of bond strenght between leucite-based and lithium disilicate-based ceramics to dentin after cementation with conventional and self-adhesive resin agents

The aim of this study was to compare the microtensile bondstrength of two heat-pressed ceramics (leucite-based - IPSEmpress Esthetic/ Ivoclar Vivadent, and lithium disilicate-based- IPS e.max Press/ Ivoclar Vivadent) to dentin with the use ofconventional and self-adhesive resin cements. The occlusal surfaceof 60 intact human molars was removed and the dentin wasexposed. Ceramic blocks were cemented randomly with regardto the cementation systems (n=10): conventional dual resincement (Variolink II/ Ivoclar Vivadent), conventional self-polymerizingresin cement (Multilink/ Ivoclar Vivadent), and dualself-adhesive resin cement (RelyX U100/ 3M ESPE). The dualcementation systems were photoactivated with a LED lightdevice (Radii Cal, SDI) for 40 seconds. The specimens were sectionedto obtain sticks of approximately 1 mm2 for microtensiletests on a universal testing machine (EMIC). The type of fracturewas analyzed under a scanning electron microscope. TheAnalysis of Variance (ANOVA) and the Tukey test (α=0.05)showed that there was no difference between types of ceramic.Average microtensile bond strength was higher for the conventionaldual resin cement (Variolink II) and the self-adhesive dualresin cement (RelyX U100), despite greater prevalence of prematureloss of the sticks with the latter. Average bond strengthwas lower when the conventional self-polymerizing resin cement(Multilink) was used. Leucite-based and lithium disilicate-basedcements present similar bond strength to the dentin withconventional dual resin cement (Variolink II) and a dual selfadhesivecement (RelyX U100)...

O objetivo deste estudo foi avaliar a resistência de união pormicrotração à dentina humana entre cerâmicas prensadas (abase de leucita - IPS Empress Esthetic/ Ivoclar Vivadent, e abase de dissilicato de lítio - IPS e.max Press/ Ivoclar Vivadent)após cimentação com agentes resinosos e convencionais eautoadesivos. As superfícies oclusais de 60 molares humanoshígidos foram removidas e a dentina foi exposta. A cimentaçãodos blocos cerâmicos foi realizada de forma aleatória de acordocom os sistemas de cimentação (n=10): cimento resinosodual convencional (Variolink II/ Ivoclar Vivadent), cimentoresinoso autopolimerizável convencional (Multilink/ IvoclarVivadent) e cimento resinoso dual autoadesivo (RelyX U100/3M ESPE). Os sistemas de cimentação duais foram fotoativadoscom aparelho de luz LED (Radii Cal, SDI) por 40segundos. Os espécimes foram seccionados para a obtençãode palitos com aproximadamente 1 mm2 para a realização doteste de microtração em máquina universal de ensaios (EMIC).O padrão de fratura foi analisado em microscópio eletrônicode varredura. A Análise de Variância (ANOVA) e o teste deTukey (α=0,05) mostraram que não houve diferenças entre ostipos de cerâmicas. Houve maiores médias de resistência deunião por microtração para o cimento resinoso dual convencional(Variolink II) e para cimento resinoso dual autoadesivo(RelyX U100), apesar de maior prevalência de perdas prematurasdos palitos com este cimento. Houve menores médias deresistência de união ao se utilizar o cimento resinoso autopolimerizávelconvencional (Multilink). As cerâmicas a base deleucita (IPS Empress Esthetic) e a base de dissilicato de lítio(IPS e.max Press) apresentaram resistência de união semelhanteà dentina ao se utilizar o cimento resinoso dualconvencional (Variolink II) e o dual autoadesivo (RelyX U100)...

Dentina / Dentin

Si bien la dentina y la pulpa tienen marcadas diferencias en su composición y estructura, ambas están tan íntimamente ligadas por su origen embriológico, que cualquier cosa que afecte a la dentina lo hará sobre la pulpa y viceversa. El ejemplo más claro en ese sentido está dado por el líquido intersticial. Este líquido, semejante al plasma pero con menos proteínas, constituye una continuidad entre ambos tejidos y sus efectos hidrodinámicos son muy importantes, tanto en los estados fisiológicos como en los patológicos

Comparison of Silorane and Methacrylate-Based Composites on the Polymerization Heat Generated with Different Light-Curing Units and Dentin Thicknesses

This study evaluated the temperature variation in the pulp chamber during photoactivation of two restorative composite resins (Filtek P90 silorane-based composite and Heliomolar methacrylate-based composite) with either a quartz-tungsten-halogen (QTH) or light-emitting diodes (LED) light-curing unit (LCU) and using dentin thicknesses (0.5 and 1.0 mm). Standardized cavities (2x2x2 mm) were prepared in 80 bovine incisors, which were randomly assigned to 8 groups according to the photoactivation method and dentin thickness. Filtek P90 and Heliomolar (both in shade A3) were used with their respective adhesive systems (P90 self-etch primer / P90 adhesive bond and Excite adhesive). All experiments were carried out in a controlled environment (37°C). The temperature variations (°C) were recorded using a digital thermometer attached to a K-type thermocouple. The results were analyzed statistically by ANOVA and Tukey's test (α=0.05). For composite/dentin thickness interaction, temperature increase was significantly higher in 0.5 mm dentin thickness (40.07°C) compared with 1.0 mm dentin thickness (39.61°C) for Filtek P90. For composite/LCU interaction, the temperature increase was significantly higher for Filtek P90 (39.21°C - QTH and 40.47°C - LED) compared with Heliomolar (38.40°C - QTH and 39.30°C - LED). The silorane-based composite promoted higher temperature increase in the pulp chamber than the methacrylate-based composite.

Este estudo avaliou a variação de temperatura na câmara pulpar durante a fotoativação de duas resinas compostas (Filtek P90 – compósito à base de silorano e Heliomolar – compósito à base de metacrilato) com as unidades foto-ativadoras (UFs) luz de quartzo-tungstênio-halogênio (QTH) ou diodo emissor de luz (LED) e utilizando espessuras de dentina (0,5 e 1,0 mm). Cavidades padronizadas (2×2×2 mm) foram preparadas em 80 incisivos bovinos, as quais foram aleatoriamente divididas em 8 grupos de acordo com os métodos de fotoativação e espessura da dentina. Filtek P90 e Heliomolar (ambos na cor A3) foram utilizadas com seus respectivos sistemas adesivos (Primer P90 auto-condicionante / adesivo P90 e adesivo Excite). Todos os experimentos foram realizados em um ambiente controlado (37°C). As variações de temperatura (°C) foram mensuradas usando um termômetro digital conectado a um termopar tipo-K. Os resultados foram analisados estatisticamente por ANOVA e teste de Tukey (α=0,05). Para interação compósito/espessura de dentina, o aumento da temperatura foi estatisticamente superior para a espessura de dentina de 0,5 mm (40,07°C) quando comparado com a espessura de dentina de 1,0 mm (39,61°C) para a Filtek P90. Para a interação compósito/UFs, o aumento de temperatura foi estatisticamente superior para o Filtek P90 (39,21°C – QTH e 40,47°C – LED) quando comparado ao Heliomolar (38,40°C – QTH e 39,30°C – LED). Compósitos à base de silorano promovem maior aumento da temperatura na câmara pulpar em relação aos compósitos à base de metacrilato.

Influence of Endodontic Sealer Composition and Time of Fiber Post Cementation on Sealer Adhesiveness to Bovine Root Dentin

This study aimed to assess the influence of the type of endodontic sealer (salicylate resin-based sealer vs. two endodontic sealers) and the time of fiber post cementation after root filling on the post adhesion to bovine root dentin. Sixty bovine roots were assigned to six groups (n=10), considering an experimental design with two factors (factorial 3x2): endodontic sealer factor in three levels [epoxy resin-based sealer (AH Plus), eugenol-based sealer (Endofill), and salicylate resin-based sealer plus mineral trioxide aggregate - MTA (MTA Fillapex)] and time for post cementation factor in two levels (immediate post cementation or 15 days after root canal filling). After post cementation, 2-mm-thick slices were produced and submitted to push-out test. The failure modes were analyzed under a 40× stereomicroscope and scored as: adhesive at cement/dentin interface; adhesive at cement/post interface; cement cohesive; post cohesive; dentin cohesive; or mixed. Data were analyzed using two-way ANOVA and Tukey's post-hoc tests (α=0.05). When the fiber posts were cemented immediately after the root canal filling, the bond strengths were similar, independent of the endodontic sealer type. However, after 15 days, the epoxy resin-based sealer presented higher bond strength than the other sealers (p<0.05). Comparison between each sealer in different experimental times did not reveal any differences. The main failure type was adhesive at dentin/cement interface (89.4%). The time elapsed between the root canal filling and post cementation has no influence on post/root dentin adhesion. On the contrary, the type of endodontic sealer can influence the adhesion between fiber posts and root dentin.

Este estudo objetivou avaliar a influência do tipo de cimento endodôntico (um cimento à base de resina de salicilato e dois cimentos endodônticos) e do tempo decorrido entre a obturação do conduto e a cimentação do pino de fibra na adesão de pinos de fibra à dentina radicular bovina. Sessenta dentes bovinos foram divididos em seis grupos (n=10), considerando um desenho experimental de dois fatores (3x2): cimento endodôntico em três níveis [à base de resina epóxica (AH Plus), eugenol (Endofill) e resina de salicilato e MTA (MTA Fillapex)] e o tempo para cimentação em dois níveis (cimentação imediata e 15 dias pós a obturação). Após cimentação do pino de fibra, fatias com 2 mm de espessura foram obtidas e submetidas ao teste de push-out. Os padrões de falha foram analisados em estereomicroscópio (40×) e classificados em: adesiva na interface cimento/dentina, adesiva cimento/pino, coesiva do cimento, coesiva do pino, coesiva da dentina e mista. Os dados foram analisados através dos testes de ANOVA a dois fatores e post hoc de Tukey (α=0,05). Quando os pinos de fibra foram cimentados imediatamente após a obturação dos condutos, a resistência adesiva foi similar, independentemente do tipo de cimento endodôntico. Entretanto, após 15 dias, os dentes obturados com cimento resinoso à base de resina epóxica apresentaram os maiores valores de resistência adesiva (p<0,05). Os valores de resistência adesiva do mesmo cimento nos diferentes tempos experimentais não foram alterados. O principal tipo de falha foi adesiva na interface cimento/dentina (89,4%). O tempo decorrido entre a obturação dos condutos e a cimentação do pino não influenciou a adesão do pino de fibra à dentina radicular. Por outro lado, o tipo de cimento endodôntico influencia a adesão entre dentina radicular e pinos de fibra.

Dentina / Dentin

Si bien la dentina y la pulpa tienen marcadas diferencias en su composición y estructura, ambas están tan íntimamente ligadas por su origen embriológico, que cualquier cosa que afecte a la dentina lo hará sobre la pulpa y viceversa. El ejemplo más claro en ese sentido está dado por el líquido intersticial. Este líquido, semejante al plasma, pero con menos proteínas, constituye una continuidad entre ambos tejidos y sus efectos hidrodinámicos son muy importantes tanto en los estados fisiológicos como en los patológicos.

Dentina / Dentin

Si bien la dentina y la pulpa tienen marcadas diferencias en su composición y estructura, ambas están tan íntimamente ligadas por su origen embriológico, que cualquier cosa que afecte a la dentina lo hará sobre la pulpa y viceversa. El ejemplo más claro en ese sentido está dado por el líquido intersticial. Este líquido, semejante al plasma, pero con menos proteínas, constituye una continuidad entre ambos tejidos y sus efectos hidrodinámicos son muy importantes tanto en los estados fisiológicos como en los patológicos.

Sealing Ability of MTA Used as a Root End Filling Material: Effect of the Sonic and Ultrasonic Condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .