Effects of Diode Laser, Gaseous Ozone, and Medical Dressings on Enterococcus faecalis Biofilms in the Root Canal Ex Vivo.

The objective was to compare the antibacterial effects of adjunctive disinfection using diode laser and gaseous ozone compared to the medical dressings calcium hydroxide (Ca(OH)2) and chlorhexidine gel (CHX-Gel) on Enterococcus faecalis biofilms in human root canals ex vivo. Root canals of 180 human extracted teeth were infected by E. faecalis and divided into 3 main groups (G): G1, control; G2, instrumentation and irrigation using 0.9% NaCl; G3, instrumentation and irrigation using 1% NaOCl. In each main group, the following treatments were applied: gaseous ozone, diode laser, and medical dressings of Ca(OH)2 or CHX-Gel for 7 days (n = 15). Reduction of colony forming units (CFUs) inside the root canal of planktons and frequencies of adherent bacteria after treatment were calculated. Bacterial reduction was significantly affected by the irrigation protocol (p < 0.0005) and the disinfection method (p < 0.0005), and a significant interaction between both factors could be observed (p < 0.0005; ANOVA). In G3 (instrumentation using 1% NaOCl), no significant effect of disinfection methods could be demonstrated on planktonic bacteria (p = 0.062; ANOVA) and frequencies of adherent bacteria (p > 0.05; chi-square test). Instrumentation and irrigation using NaOCl combined with ozone or laser application resulted in comparable bacterial reduction on E. faecalis to the application of medical dressings.

Randomized clinical trial comparing the effects of post placement on failure rate of postendodontic restorations: preliminary results of a mean period of 32 months.

INTRODUCTION: The aim of this randomized clinical trial was to assess whether the placement of a fiber post (DT Light Post) (DT) and the amount of residual coronal dentin affect the time to failure of single-unit postendodontic restorations. METHODS: Ninety patients providing 120 teeth were selected. Three groups (n = 40) were defined on the basis of the amount of residual coronal dentin: 2-walls group, 2 or more coronal walls; 1-wall group, 1 coronal wall; no-wall group, no wall exceeding 2 mm above the gingival level. Within each group teeth were randomized and allocated to 2 intervention groups (n = 20), including subgroups no post (no root canal retention) and subgroups post (placement of DT). RESULTS: After a mean observation period of 32.4 (13.7) months in subgroups no post, the failure rates were 10%, whereas in subgroups post, failure rates of 7% were observed (P = .318). In no-wall group post placement significantly affected the time to failure of total restorations (P = .029, log-rank test). Teeth without post retention revealed a significantly higher failure rate (31%) compared with teeth restored with post retention (7%). CONCLUSIONS: Within the observation time of the present study, fiber post placement was efficacious to reduce failures of postendodontic restorations only with teeth that exhibited no coronal walls. Post insertion for teeth showing a minor substance loss should be critically reconsidered.

Efficacy of calcium hydroxide, Er:YAG laser or gaseous ozone against Enterococcus faecalis in root canals.

PURPOSE: To evaluate the efficacy of Ca(OH)2, Er:YAG laser or gaseous ozone (either alone or combined with instrumentation and various irrigants) against Enterococcus faecalis in root canals. METHODS: 180 extracted, human, single-rooted teeth were divided into four groups of 45 teeth each. In Group 1 root canal enlargement up to ISO-size 60 (MAF) was performed, whereas only initial shaping (MAF ISO-size 40) was carried out in Groups 2 to 4. After sterilization all teeth were inoculated with E. faecalis and incubated for 3 days, followed by evaluation of CFU. Subsequently, root canal enlargement up to ISO-size 60 was performed in Groups 2 to 4 using NaCl solution (0.9%) in Group 2, NaOCl (1%) in Group 3 and CHX (0.2%) in Group 4. Finally, each group of 45 teeth was subdivided into three groups (n= 15 each) either applying Ca(OH)2 for 7 days, using Er:YAG laser radiation for 30 seconds or gaseous ozone for 120 seconds, followed by final evaluation of CFU. RESULTS: Both in Groups 1 and 2 the median reduction of bacteria after application of Ca(OH)2 (factor 10(4) each) and ozone (in Group 1: factor 5 x 10(3); in Group 2: factor 5 x 10(4)), respectively, was significantly higher than after Er:YAG laser treatment (factor 102 each, Mann-Whitney test). The antibacterial efficacy was significantly increased by the additional use of NaOCl or CHX as irrigants in all subgroups (Groups 3 and 4) compared to corresponding subgroups of Group 1 (Mann-Whitney test).

Bond strength of fiber posts after the application of erbium:yttrium-aluminum-garnet laser treatment and gaseous ozone to the root canal.

The aim of the present study was to investigate the effects of antibacterial agents (erbium:yttrium-aluminum-garnet [Er:YAG] laser or gaseous ozone) intended to disinfect root canals on bond strengths of fiber posts compared with canals that were finally irrigated using chlorhexidine (CHX). One hundred forty-four human anterior teeth were divided into three groups (n = 48); root canal instrumentation was performed, and antimicrobial pretreatment was conducted as follows: control group: CHX, group 2: Er:YAG laser, and group 3: gaseous ozone. In all groups, fiber posts were inserted using Panavia F 2.0 (Kuraray, Osaka, Japan), Variolink II (Ivoclar Vivadent, Schaan, Liechtenstein), RelyX Unicem (3M Espe; Seefeld, Germany), or Ketac Cem (3M Espe) (n = 12 each). Push-out bond strengths to root canal dentin were affected by the type of luting agent but not by the antimicrobial pretreatment regimen. However, significant interactions between the luting agent and pretreatment could be observed, and adhesion of the self-adhesive resin cement RelyX Unicem was significantly reduced after using gaseous ozone.

Influence of chlorhexidine on fluoride uptake by bovine dentin in vitro.

PURPOSE: To evaluate five different mouthrinses with respect to fluoride uptake by sound and demineralized dentin. METHODS: The pharmacy-made mouthrinses contained either (1) 0.06% chlorhexidine, (2) 0.025% sodium fluoride, (3) 0.06% chlorhexidine and 0.025% fluoride (NaF) or (4) water (control). Additionally, the commercially available solution (5) Chlorhexamed Lösung 0.06% + F (GlaxoSmithKline) was used. 240 cylindrical dentin blocks were obtained from 120 bovine incisors. Half of the specimens were divided into five groups of 24 samples each and immersed in one of the mouthrinses (2.5 ml/specimen, 30 seconds). Accordingly, the remaining specimens were again divided into five groups of 24 specimens each; prior to treatment with one of the mouthrinses, these specimens were subjected to a demineralization procedure (lesion depth: 90-100 microm) using Buskes' solution for 6 days. All specimens were assessed for KOH-soluble fluoride and structurally bound fluoride immediately after treatment. Structurally bound fluoride was determined in three successive layers of 30 microm each. RESULTS: Compared with all other mouthrinses, only the application of NaF resulted in higher amounts of KOH-soluble fluoride, and, in the outer layer, of structurally bound fluoride in both sound and demineralized dentin. Similarly, in the deeper layers, only the NaF groups showed elevated fluoride levels.

Effect of silanization on bond strengths of fiber posts to various resin cements.

OBJECTIVES: To investigate the effects of pretreatment (silanization) on bond strengths between 3 different types of fiber posts and 4 resin cements, respectively. METHOD AND MATERIALS: Prefabricated quartz-fiber (Unicore Post, Ultradent) and prefabricated glass-fiber (FRC Postec, Ivoclar Vivadent) posts with a cross-linked polymer matrix and individually formed glass-fiber posts with an interpenetrating polymer network (IPN Post, Stick Tech) (n = 160 each) were inserted into resin composite disks (2 mm thick) using the following resin cements and silane solutions: Panavia F/Porcelain Bond Activator (Kuraray), PermaFlo DC/Silane (Ultradent), Variolink II/Monobond S (Ivoclar Vivadent) and RelyX Unicem/Espe Sil (3M Espe). Nonsilanated posts served as controls. The push-out bond strengths were determined before (n = 10) and after (n = 10) thermocycling (2,000 cycles, 5 degrees C to 55 degrees C, dwelling time 30 seconds). RESULTS: Bond strengths (mean [SD]) were significantly affected by the resin cement (P < .001), the pretreatment (P < .001), and the type of post (P < .001), but not by thermocycling (P = .955, 4-way ANOVA). The IPN post demonstrated significantly higher bond strengths compared to the other posts (P < .05; Tukey B). Silanization significantly increased bond strengths (15.2 [5.2] MPa) compared to those of the control groups (13.9 [4.9] MPa). CONCLUSION: The type of fiber post revealed a significant influence on bond strengths, whereas the effects of silanization appeared to be clinically negligible.

Tissue responses to an experimental calcium phosphate cement and mineral trioxide aggregate as materials for furcation perforation repair: a histological study in dogs.

The aim was to evaluate histologically the inflammatory reactions and tissue responses to an experimental tricalcium phosphate cement (TCP) and mineral trioxide aggregate (MTA) when used as repair materials in furcation perforations in dogs. Perforations were performed in 24 mandibular premolars of six anaesthetised dogs and filled either with ProRoot MTA (grey) or TCP. The root canals were subsequently shaped and filled, and the access cavities were closed with a bonded composite resin. The animals were killed at 12 weeks. After radiological examination, the teeth and surrounding structures were processed for light microscopy. Concerning the grades of inflammation, MTA exhibited significantly better results than TCP (chi-square test according to Pearson). No furcation was free of inflammatory cells. Mild inflammation was observed in nine of twelve cases with MTA and only twice in those with TCP. No significant differences were revealed between MTA and TCP in terms of bone reorganization or deposition of fibrous connective tissue (Mantel-Haenszel chi-square test). The grade of radiological examination corresponded with the grade of inflammation or differed by only one grade plus or minus. Perforations located in the furcation of teeth remain an endodontic and a periodontal problem with an uncertain prognosis, in spite of the promising modern materials applied.

[Calcium phosphate cements in medicine and dentistry--a review of literature]. / Kalziumphosphatzemente in der Medizin und Zahnmedizin--eine Literaturübersicht.

Calcium phosphates represent the largest group of biominerals in vertebrate animals. They also have many uses in industry, agriculture, medicine and everyday life. The calcium phosphates containing the ionic species HPO4(2-) and PO4(3-) are biologically relevant. In medicine, calcium phosphates have been used for bone regeneration for several decades. The requirement of a mouldable, self-setting material has been fulfilled since the mid-1980s because of the development of calcium phosphate cements. Basically, they consist of a powder (e. g. di-, tri- or tetra-calcium phosphates) that is mixed with a liquid. Their properties depend on kind, amount, and location of each atom within the crystal structure. In dentistry calcium phosphate cements play a secondary role at the moment, although they often have an excellent biocompatibility. This review gives a general idea on development and chemistry of calcium phosphate cements and presents different cement types tested in vitro and in vivo.