Histological Evaluation of Periapical Tissues after Root Canal Treatment with or without Coronal Seal in Dogs for Six Months.

Introduction: Preventing recontamination of the obturated root canal is important for successful root canal treatment (RCT). The main purpose of this study was assessing the histological health of periradicular tissue in obturated root canals with or without coronal seal between two and six months. Methods and Materials: Sixty roots from five dogs with vital pulps were randomly assigned to one of the following five groups (n=12): Group 1, RCT and six months oral exposure; Group 2, RCT and immediate amalgam restoration; Group 3, RCT and amalgam restoration after two months exposure to the oral cavity; Group 4, RCT and amalgam restoration after four months exposure to the oral cavity; Group 5, RCT with two months exposure to oral cavity. The teeth were prepared and filled with gutta-percha and sealer using lateral condensation technique. Two intact root canals of each animal were regarded as the negative control group (n=10), and the two root canals exposed to the oral cavity constituted the positive one (n=10). After six months the animals were euthanized. The upper and lower jaws were removed and submitted for histological processing. Longitudinal sections were obtained from each root. After staining the sections, periradicular regions were examined histologically under light microscope. The Kruskal-Wallis and Mann-Whitney tests was used to analyze the data (P<0.05). Results: The results showed a significant difference between all groups (P<0.05). The negative control group was free of any inflammation. Two-by-two comparison revealed that the positive control group, Group 1 and Group 4 displayed the most intense inflammation. Groups 2, 3 and 5 showed similar results without developing any significant inflammation. Conclusion: Based upon the findings of this animal study, it can be recommended that the obturated root canals which are exposed to oral cavity for around four months or more should be retreated before crown restoration.

Immediate endodontic access cavity sealing: fundamentals of a new restorative technique.

Endodontic access cavity sealing is conventionally performed after endodontic irrigation, referred to as delayed endodontic sealing (DES). Evidence shows that endodontic irrigation with NaOCl decreases dentinal bond quality and could cause coronal leakage. Access cavity sealing before endodontic irrigation is a new restorative approach, referred to as immediate endodontic sealing (IES). The primary aim of this in vitro study was to investigate whether IES improved internal adaptation. The secondary aim was to investigate the influence of the viscosity of the composite used to seal the dentine, on the internal adaptation in both IES and DES groups. Third molars (n= 40) with fully developed apices were used. The teeth were prepared into standard Class II MO cavities, and divided in 4 groups according to the approach, and composite viscosity was used for sealing. Group 1: IES + low viscosity composite; group 2: IES + high viscosity composite; group 3: DES + low viscosity composite; and group 4: DES + high viscosity composite. Samples were then sectioned axially for observation using scanning electron microscopy. Outcome was evaluated by determining the internal adaptation of the samples, which was judged based on the percentage of a continuous margin at the tooth-composite interface. The results were analyzed using a two-way analysis of variance and Mann-Whitney test. IES groups exhibited significantly greater internal adaptation (p = 0.000) as compared with DES groups. Composite viscosity did not significantly affect internal adaptation in either IES or DES groups (p > 0.005).

Periapical inflammation subsequent to coronal inoculation of dog teeth root filled with resilon/epiphany in 1 or 2 treatment sessions with chlorhexidine medication.

INTRODUCTION: Therapeutic methods that inhibit microbial ingress into filled root canals are desirable. This in vivo study assessed the inhibition of periapical inflammation subsequent to coronal inoculation in canals medicated with 2% chlorhexidine gel and filled with Resilon/Epiphany (Pentron Clinical Technologies, Wallingford, CT). METHODS: Six Beagle dogs each had 10 two-rooted premolars treated. In group 1 (n = 36 roots), 1 root/tooth had the canal conditioned with Primer Epiphany, filled with Epiphany sealer and Resilon core in 1 session, and coronally sealed with PhotacFil. In group 2 (n = 36 roots), the second root/tooth had the canal medicated with 2% chlorhexidine gel for 1 week and then filled and coronally sealed as in group 1. After 3 weeks, canals were exposed to the oral environment for 7 days, inoculated with isologous plaque, and coronally sealed. Negative controls treated as groups 1 and 2 remained sealed. Positive controls had canals unfilled and exposed. Seven months after inoculation, dogs were euthanized; jaw blocks processed for histologic examination; and periapical inflammation (PI) recorded as none, mild, or severe. RESULTS: In groups 1 and 2, severe PI occurred in 5 of 65 roots (8%) and mild PI in 18 of 65 roots (28%) with a significantly higher (P = .031) PI incidence in group 2 than in group 1. Negative controls had only mild PI in 9 of 29 roots (31%). Roots medicated with 2% chlorhexidine gel had mild PI significantly more (P = .009) than roots filled in 1 session (more than 2-fold). CONCLUSIONS: Intracanal medication with 2% chlorhexidine gel and root filling with Resilon/Epiphany did not effectively inhibit apical periodontitis subsequent to coronal inoculation.

Avaliação da microinfltração coronária de três materiais utilizados na restauração provisória da cavidade endodôntica: estudo in vitro. / Coronal leakage of three materials used for temporary restoration of endodontic access cavities: an in vitro study

O objetivo deste trabalho foi avaliar a capacidade seladora de um material restaurador provisório, Villevie, e de uma resina composta, Tetric Ceram, associada a dois tipos de sistema adesivos, XENO III e Single Bond. Quarenta incisivos inferiores unirradiculares foram distribuídos em três grupos de dez dentes cada e cinco dentes para cada grupo controle, positivo e negativo. Os espécimes, após a cirurgia de acesso, foram preparados por meio de sistema de instrumentação rotatória e irrigados com água destilada e deionizada. A porção externa dos dentes foi impermeabilizada até 2 mm aquém da margem externa da cirurgia de acesso. Colocou-se no interior do canal radicular um cone de papel seguido de uma pensa de algodão impregnados com solução alcoólica de dimetilglioxima 1%. A cavidade endodôntica foi selada de acordo com os seguintes grupos: GA- sistema adesivo autocondicionante XENO III + resina composta; GB- sistema adesivo Single Bond + resina composta; e GC- selador provisório. Os espécimes foram imersos em recipientes contendo solução de sulfato de níquel 5% e submetidos à ciclagem térmica por 72h. Os testes de Kruskal-Wallis e Dunn foram utilizados para análise dos resultados com nível de 5% de signifcância. O menor nível de microinfltração foi observado no grupo do restaurador provisório (GC), com diferença estatística signifcante em relação aos demais grupos (P<0,001). Os grupos A e B mostraram-se semelhantes ao controle positivo (P>0,05), com os maiores índices de microinfltração. Concluiu-se que nenhum dos materiais avaliados foi capaz de impedir a microinfltração coronária.

The purpose of this study was to evaluate the sealing capacity of a temporary restorative material (Villevie) and a composite resin, Tetric Ceram, associated with two adhesive systems (XENO III and Single Bond). Forty single-rooted mandibular incisors were distributed into three experimental groups of 10 teeth each, and two control groups (positive and negative) of 5 teeth each. After preparation of the access cavities, the canals were instrumented with a rotary system and irrigated with distilled deionized water. The external surfaces of the teeth were rendered water-proof up to 2 mm from the external margins of the access cavities. A paper point and a coton mesh impregnated with an alcoholic 1% dimethylglyoxime were placed inside the root canals, and the endodontic access cavities were sealed according to the following groups: GA- XENO III self-etch adhesive system + composite resin; GB- Single Bond etch-and-rinse adhesive system + composite resin; and GC- temporary restorative material. The specimens were immersed in receptacles containing a 5% nickel sulfate solution and subjected to a thermal cycling regimen during 72 h. The Kruskal-Wallis and Dunn's tests were used for statistical analysis of the results at 5% signifcance level. The group restored with the temporary restorative material (GC) presented statistically signifcant less coronal leakage than the other groups (p<0.001). GA and GB were statistically similar to the positive control (p>0.05), showing the highest levels of coronal leakage. None of the tested materials was able to prevent the occurrence of coronal leakage.

An Evaluation of the Sealing Ability of MTA and Resilon: A Bacterial Leakage Study.

INTRODUCTION: The purpose of this study was to evaluate the sealing ability of gray-colored mineral trioxide aggregate (GMTA), white-colored MTA (WMTA), and Resilon as root filling materials. MATERIALS AND METHODS: Sixty-six human maxillary central incisors were used in the present study. In the group A, 20 teeth were filled with GMTA. In the group B, 20 teeth were filled with WMTA and in the group C, 20 teeth were filled with Resilon/Epiphany. Three teeth were used as positive (obturated using the single gutta-percha cone technique without sealer) and three were used as negative (obturated with gutta-percha and AH-26 sealer, coated with two layers of nail varnish) controls. A bacterial leakage model utilizing Enterococcus faecalis was used for evaluation. Leakage was noted when turbidity was observed. RESULTS: Controls behaved as expected. In the group A (GMTA) three samples, in the group B (WMTA) four samples, and in the group C (Resilon/Epiphany), two samples were leaked. There was no statistically significant difference between GMTA and WMTA or GMTA and Resilon. CONCLUSION: In conclusion, sealing ability of GMTA and WMTA was similar to Resilon as orthograde root filling materials.

Periapical tissue healing after post space preparation with or without use of a protection plug and root canal exposure to the oral environment: study in dogs

The purpose of this study was to evaluate the influence of coronal leakage on the healing of dogs' periapical tissues after root canal filling, post space preparation and protection or not with a temporary sealer plug. Forty root canals of dogs' teeth were instrumented and filled by the lateral condensation technique with gutta-percha points and Endomethasone or CRCS sealers. After post space preparation, the remaining filling material was protected or not with a plug of temporary Coltosol sealer and exposed to the oral environment for 90 days. Thereafter, the animals were sacrificed and the specimens were removed and prepared for histomorphological and histobacteriological analysis. The findings revealed 35 percent of microbial leakage in the groups without plugs and 15 percent of leakage in the groups with plugs. Statistical analysis showed that the use of a Coltosol plug improved significantly the histomorphological results regardless of the type of root canal sealer (p=0.05) and that CRCS and Endomethasone sealers showed similar results (p>0.05).

O propósito deste trabalho foi avaliar a influência da infiltração coronária no reparo dos tecidos periapicais após obturação dos canais radiculares, preparo para pino e proteção ou não de um "plug" de cimento temporário. Quarenta canais de dentes de cães foram instrumentados e obturados pela técnica da condensação lateral ativa com cones de guta-percha e os cimentos Endomethasone e CRCS. Após preparo para pino os remanescentes do material obturador foram protegidos ou não com um "plug" do cimento temporário Coltosol e expostos ao meio oral por 90 dias. Decorrido este período, os animais foram mortos e os espécimes foram removidos e preparados para análises histomorfológica e histobacteriológica. Foi observado 35 por cento de casos de infiltração bacteriana nos grupos sem "plug" e 15 por cento nos grupos com "plug". Concluiu-se estatisticamente que o "plug" de Coltosol foi eficiente no controle da infiltração coronária de microorganismos (p=0,05), e que os cimentos CRCS e Endomethasone apresentaram resultados semelhantes (p>0,05).

Bacteriologic in vitro coronal leakage study of before and after post space preparation / 대한치과보존학회지

The purpose of present study was to compare the speed of coronal leakage before and after post space preparation using Streptococcus mutans. Forty straight extracted human teeth were selected. The crowns were removed to a uniform remaining root length 14 mm. Canals were enlarged by 06 taper Profiles(R) to a size #40 as a master apical file. And these were filled with gutta percha point and Tubuliseal(R) sealer, using continuous wave technique. Groupings are as follows. Group 1 - These teeth were obturated without sealer. Group 2 - These teeth were obturated and covered the surface of the root completely with sticky wax. Group 3 - These teeth were obturated. Group 4 - These teeth were obturated and prepared for post space remaining 5 mm of gutta percha. The teeth were suspended in plastic tubes. The upper chamber received the bacterial suspension everyday to simulate clinical situation. The lower chamber consisted of BHI added Andrade's indicator. All roots in the positive control group (Group 1) turned yellow within 24 h and those of negative control group (Group 2) remained red throughout the experimental period (70 days). The samples of group 3 were contaminated within an average of 27.2 days. The samples of group 4 were contaminated within an average of 15.7 days, ranging from 9 to 22 days. There was significant difference between group 3 and group 4 statistically (p < 0.05).

The effect of the endodontic access cavity on the marginal leakage of crowns / 대한치과보존학회지

The marginal integrity of the crown can be broken during endodontic access cavity preparation due to the vibration of burs. Therefore, the purpose of this study was to evaluate the effect of endodontic access cavity preparation on the marginal leakage of full veneer gold crowns. 24 intact molars were mounted in acrylic resin blocks and prepared for crowns by a restorative dentist and crowns were cast with gold alloy. 20 Crowns were cemented with glass ionomer cement and 2 crowns were not cemented for positive control. 200 thermo-cycles from 5degrees C to 50degrees C with a travel time of 20s were completed. Then samples were randomly divided into 2 experimental groups of 9 each. Endodontic access preparation and zinc-oxide eugenol temporary fillings were done in Group 1. Teeth in Group 2 were not treated. Samples were coated with 2 layers of nail varnish and were immersed in 1% methylene blue dye for 20 hrs. Endodontic access was prepared in 2 samples, which were coated with nail varnish on all surfaces for negative control. After washing in running water, gold crowns were cut with a #330 bur. Four buccolingual sections, 2 mm apart, were cut from the central section of each tooth and were examined and scored under the microscope for dye leakage. Score 1: leakage to the cervical 1/3 of the axial wall, Score 2: leakage to the middle 1/3 of the axial wall, Score 3: leakage to the coronal 1/3 of the axial wall, Score 4: leakage to the occlusal surface. The median value for Group 1 is 4 and for Group 2 is 2. The result of this study showed that samples in Group 1 leaked more than those in Group 2. This finding was significant(P<0.001).