Influence of clinical usage of GT and GTX files on cyclic fatigue resistance.

AIM: To compare static cyclic fatigue resistance of unused, unused and sterilized and clinically used conventional NiTi GT and M-Wire GTX files. METHODOLOGY: One hundred and sixty new files (80 GT and 80 GT series X) were divided into four control groups and four experimental groups (n = 20 each). Control groups were new unused files and new sterilized files. In the experimental groups, instruments were used in three (GT1 and GTX1 groups) or four molars (GT2 and GTX2 groups). Cyclic fatigue resistance was tested in stainless steel curved canals (60°, r = 3 mm). Each file was rotated until fracture (300 rpm, 2 N cm torque). Time-to-fracture (s) was registered. Mean life, eta and beta parameters of their Weibull distributions were calculated. RESULTS: Unused and sterilized GTX files will last significantly longer than GT files with a probability of 75% and 65%, respectively; whilst mean life was significantly longer for GT than for GTX in used files with a probability of 68%. Sterilized GT files will last longer than unused files with a probability of 66%. In both brands, unused and sterilized files will last significantly longer than files used clinically with a probability higher than 98%. The probability that GT will last longer after being used in three rather than four molars was 62% (statistically significant) and 52% (not statistically significant) for GTX. CONCLUSIONS: GTX files had an extended cyclic fatigue life when compared with GT when they were unused or unused and sterilized, but GT were significantly more resistant to cyclic fatigue after clinical usage than GT series X files 3 mm from the tip. Sterilization of files enhanced the cyclic fatigue resistance of GT instruments. Clinical use of files diminished cyclic fatigue resistance.

Predictive models of pain following root canal treatment: a prospective clinical study.

AIM: To determine the probability of the incidence, intensity, duration and triggering of post-endodontic pain, considering factors related to the patient (age, gender, medical evaluation) and to the affected tooth (group, location, number of canals, pulp vitality, preoperative pain, periapical radiolucencies, previous emergency access, presence of occlusal contacts with antagonist). METHODOLOGY: A total of 500 one-visit root canal treatments (RCTs) were performed on patients referred to an endodontist. Shaping of root canals was performed manually with Gates-Glidden drills and K-Flexofiles, and apical patency was maintained with a size 10 file. A 5% NaOCl solution was used for irrigation, and canals were filled with lateral compaction and AH-Plus sealer. Independent factors were recorded during the treatment, and characteristics of post-endodontic pain (incidence, intensity, type and duration) were later surveyed through questionnaires. Of the 500 questionnaires, 374 were properly returned and split in two groups for two different statistical purposes: 316 cases were used to adjust the logistic regression models to predict each characteristic of post-endodontic pain using predictive factors, and the remaining 58 cases were used to test the validity of each model. RESULTS: The predictive models showed that the incidence of post-endodontic pain was significantly lower when the treated tooth was not a molar (P = 0.003), demonstrated periapical radiolucencies (P = 0.003), had no history of previous pain (P = 0.006) or emergency endodontic treatment (P = 0.045) and had no occlusal contact (P < 0.0001). The probability of experiencing moderate or severe pain was higher with increasing age (P = 0.09) and in mandibular teeth (P = 0.045). The probability of pain lasting more than 2 days was increased with age (P = 0.1) and decreased in males (P = 0.007) and when a radiolucent lesion was present on radiographs (P = 0.1). CONCLUSIONS: Predictive formulae for the incidence, the intensity and the duration of post-endodontic pain were generated and validated taking account of the interrelation of multiple concomitant clinical factors. A predictive model for triggering post-endodontic pain could not be established.

Polymerization shrinkage influences microtensile bond strength.

Shrinkage results from a complex spatial strain network, producing movements within materials. The purpose of this study was to test whether microtensile bond strength (microTBS) of a light-curing resin composite to enamel depends on distance to the center of the curing mass. Labial surfaces of bovine incisors were ground flat, divided into 2 groups (n = 8), acid-etched, and coated with an unfilled resin bond. A resin-based composite was placed in one increment (group A) or separately at gingival, central, and incisal sites (group B), and light-cured. Teeth were sectioned, yielding stick-shaped specimens assigned to one of 9 groups according to distance to incisal edge of restoration (NDistanc). Microtensile bond strength was transformed to percentages of its maximum values within each tooth (PMPa). Comparisons within groups showed (group A) that mean PMPa decreased from central to gingival and from central to incisal (p < 0.01). Comparisons between groups showed that mean PMPa was significantly lower in group A compared with group B, only at gingival and incisal sites. Microtensile bond strength significantly decreased as the distance increased to the center of the curing mass.

Accuracy of the Justy II Apex locator in determining working length in simulated horizontal and vertical fractures.

AIM: To study the effectiveness of an electronic apex locator (EAL; Justy II; Yoshida Dentcraft, Tokyo, Japan) in locating simulated horizontal and vertical fractures in single roots. METHODOLOGY: An EAL was used to measure the distance within the canal of horizontal (n = 31) and vertical (n = 31) fractures, created with a disk in single-rooted teeth. Accuracy of the EAL was evaluated by comparing the measurements with those made using a size 10 file. Data were analysed with the non-parametric Passing and Bablok method. RESULTS: For simulated horizontal fractures, the EAL measured exactly the same length as a size 10 file, without constant or proportional errors. In vertical simulated fractures, the EAL measured (on average) with a constant error of 7.5 mm shorter than the size 10 file; the difference had a wide confidence interval (-72.3 to 2.6 mm). CONCLUSIONS: In this laboratory study, the Justy II EAL was able to determine accurately the position of simulated horizontal fractures, but was unreliable when measuring simulated vertical fractures.

A predictive formula of the contraction stress in restorative and luting materials attending to free and adhered surfaces, volume and deformation.

OBJECTIVES: To find a predictive formula of stress, considering the surfaces (free, adhered) involved, the volume and characteristics of material and the deformation of the measuring system. MATERIALS AND METHODS: 231 samples of five chemically cured restoratives (Silar (SIL, 23), Clearfil F2 (CLE, 39), P10 (P10, 33), Concise (CON, 30), Isopast (ISO, 28)) and four luting (3M Experimental 241 (EXM, 20), Variolink II (VAR, 13), Vitremer LC (VTM, 20) and Dyract Cem (DYR, 25)) materials were allowed to polymerize until they reached a maximum tension (T(max), 25 min) between six pairs (null 5.81, 8.5, 11.26, 12.42, 17.02, 23.14 mm) of polished metallic discs (range of distances: 0.02-5.9 mm) mounted in a tension machine. The deformation of the measuring system was measured for the recorded forces. RESULTS: A descriptive non-linear formula T(max)=KVol(-3.267)FS(3.283)AS(0.642)Def(0.561) was found that individualizes the material's characteristics (K) that considers volume (Vol), free (FS) and adhered (AS) surfaces and deformation (Def) of the system for each force. This formula renders good correlation (material K (r(2) coefficient)): SIL 0.9998 (0.995), CLE 1.0062 (0.989), P10 1.0224 (0.990), CON 0.9908 (0.992), ISO 0.9648 (0.974), EXM 1.0083 (0.991), VAR 0.9777 (0.996), VTM 0.9925 (0.993), DYR 0.9971 (0.997) between actual T(max) and calculated Tension. There are statistically significant differences (p=0.002) between K values of both (restorative and luting) groups. SIGNIFICANCE: Predictive parameters have influence in a different way to what is actually considered, if the system is allowed to have deformation, as occurs naturally and volume and material's characteristics are considered.

Sealing and dentin bond strength of adhesive systems in selected areas of perfused teeth.

OBJECTIVES: (1) Test the sealing capacity and tensile strength of various adhesive systems: Scotch Bond 1 (Single Bond in USA)(SB1)+Z100, Syntac Sprint (SYN)+Tetric Ceram, Prime and Bond 2.1 (PB21)+TPH Spectrum, F2000 (Adhesive+Compomer) (F2000) and Optibond Solo (OPT)+Prodigy, to perfused teeth (30 cm distilled H2O), in select areas. (2) Determine the relationship between sealing ability and size of adhesive area (BA) with tensile strength (TS). METHODS: Segments of human third molars (n=67) sealed with amalgam on their coronal side were connected to a perfusion system (30 cm distilled H2O), to measure the basal permeability. Access cavities were drilled through the amalgam to expose dentin (area range: 8.7-20.8 mm2) and measure the permeability of that area. Cavities were sealed with one of the test materials and permeability measured prior to tensile testing. The percentage of decrease in permeability (PPD) that occurred with the different combinations of materials was also measured. RESULTS. TENSILE STRENGTH: there were no statistically significant differences among groups. PERMEABILITY: ANOVA showed that there were statistically significant differences in the mean % decrease in permeability (PPD) among groups (p=0.018). Student-Newman-Keuls test (p<0.05) detected that the mean PPD of F2000 ranked statistically higher than that of SB1. Relationship among variables: a linear correlation was found defined by the formula TS=7.47+0.008 x PPD-0.23 x BA, with a significance of the model p=0.0097. SIGNIFICANCE: None of the materials studied reduced permeability up to 100%. They all produced low tensile bond strengths (maximum mean value of groups: 5.51 MPa (OPT)).

Porosity of resin cements and resin-modified glass-ionomers.

PURPOSE: To quantify the internal free surface in various resin cements and glass-ionomer-based materials. MATERIALS AND METHODS: Materials tested were Nexus fluid (NXF) and viscous (NXV), Vitremer (VTM), Fuji II LC (FII), Vitremer Luting Cement (VLC), Dyract (DYR) and Compoglass (COM). Samples (n=5) were made of each material between two microscopic glass slides under same weight. With a transmitted light microscopy, four zones of each sample were evaluated, finding the number of porosities per mm2 (NP), the average radius of porosities (RP), the ratio of total area of surface porosities (micron2) to area (mm2) of specimen surface (TA) and the ratio of total volume of porosities (micron2) to area (mm2) of material surface (VP). RESULTS: Median test was used. NP: NXV, NXF and DYR had smaller NP than VTM and FII and (likely) than VLC (P> 0.0000001). RP was smaller for DYR than for VLC and (likely) than for NXV (P= 0.00019). TA: NXV, NXF and DYR had smaller TA than VTM, FII and VLC (P< 0.0000001). VP: NXV and DYR had smaller VP than FII and (likely) than VTM and VLC (P< 0.0000001).

Analysis of sealing vs tensile bond strength of eight adhesive restorative material systems.

PURPOSE: Using a simulated perfusion system, the intent was to determine: 1) the sealing ability of eight restorative materials (five composite resins and three compomers) used together with their corresponding dentin bonding systems, 2) their tensile bond strength, and 3) the correlation (if any) between both parameters. MATERIALS AND METHODS: Permeability in crown segments from sound human third molars (n = 140) subjected to simulated perfusion (32 cm of distilled water) was measured before and after restoring with each material, and the percentage of decrease in permeability (PPD) was recorded. Specimens were later subjected to tensile tests to determine the tensile bond strength (TBS) of the interface. Finally, parameters were analyzed for correlation. RESULTS: For the eight adhesive systems, the percentage of reduction in permeability was relatively high [mean in %, (SD)]: F2000 93.6 (5.7), SB1 88.6 (11.3), SSC 86.0 (5.7), PB20 81.1 (15.9), COM 77.5 (10.8), OPTS 75.3 (20.6), DYR 73.7 (12.7), SSPR 65.5 (19.8). TBS values were relatively low [mean (SD)], in MPa: F2000 1.8 (0.7), SB1 4.9 (1.4), SSC 2.6 (1.4), PB20 4.3 (1.2), COM 2.4 (1.1), OPTS 4.5 (1.7), DYR 1.6 (0.6), SSPR 4.2 (1.5). We could not demonstrate any statistically significant correlation between both parameters for these results (maximum significance [F2000]: r = 0.39, p = 0.206). CONCLUSION: No material completely ceased to filtrate through the interface. The low TBS values were probably due to the large size of adhesive areas. No significant correlation was found between PPD and TBS for the materials tested. There was a statistically significant relationship (r2 = 0.063, p = 0.018) between TBS and TBA (total bonded area), described by the equation TBS = 5.9 - 0.03.TBA.

Sealing and dentin bond strengths of adhesive systems.

The objectives of this research were (1) to analyze the variations of the permeability of dentin after restoration with two polyacid-modified resin composites (Compoglass, Dyract) and four single-bottle adhesives (Prime & Bond 2.0, Syntac Single Component, OptiBond Solo, and Single Bond--Scotch Bond 1 in Europe--immediately (approximately 1 hour) after insertion. A perfusion system with distilled water was used at a pressure of 32.5 cm of water; (2) to study the bond strength of their interfaces; and (3) to find the correlation, if any, between both parameters. None of the materials used produced a complete cessation in fluid filtration. Tensile bond strengths were very low (maximum: P&B = 3.96 MPa) probably because of the very large bonding surfaces used (mean bonded surface area = 88.8 mm2). No significant correlation was found between tensile bond strength and the sealing ability for any material.

Quantification of the configuration factor in Class I and II cavities and simulated cervical erosions.

The configuration factor of adhesive cavities is defined as the ratio of the restoration's bonded to unbonded (free) surfaces. Such a configuration factor was described, on ideal cavities, as having a potential value in predicting the behaviour of the restorations, because it is related to the restoration's capacity for relieving stress by flow. The aim of this study was to measure the configuration factor value for real Class I and II cavities and simulated cervical erosions prepared in molars. Ten Class I, five Class II cavities and seven cervical erosions were analysed using a computerised digitising system. The configuration factor values found were 4.03 +/- 0.33 for Class I cavities, 1.85 +/- 0.59 for Class II cavities and 1.10 +/- 0.09 for simulated cervical erosions (P < 0.01).

Rokitansky's syndrome in association with reno-ureteral abnormalities. Teratogenic period.

A case of Rokitansky's syndrome in association with complete duplication of the right upper urinary tract is presented. From a chronological point of view, the morphogenetic processes of the urinary and genital tract are analyzed. It is supposed that the congenital abnormality is produced between the 30th and 37th day of gestation, because reno-ureteral duplication appears at 30-32 days and involution of the Müllerian structures appears at 37 days.