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

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.

Longevity of bond strength of resin cements to root dentine after radiation therapy.

AIM: To evaluate the bond strength and adhesive interface between several resin cements and root dentine immediately and 6 months after radiotherapy. METHODOLOGY: Sixty maxillary canines were selected and randomly assigned to two groups (n = 30): one group was not irradiated and the other one was subjected to a cumulative radiation dose of 60 Gy. The teeth were sectioned to obtain roots 16 mm long and the canals were prepared with the Reciproc system (R50) and filled using a lateral condensation technique with an epoxy resin sealer. Each group was divided into three subgroups (n = 10) according to the resin cement used for fibreglass fibre post cementation: RelyX-U200, Panavia-F2.0 and RelyX ARC. The posts were cemented in accordance with the manufacturer's recommendations. Three 1-mm-thick dentine slices were then obtained from each root third. The first two slices in the crown-apex direction of each third were selected for the push-out test. The failure mode after debonding was determined with a stereo microscope. The third slice from each root third was selected for scanning electron microscopy (SEM) analyses to examine the resin cement-dentine interface with 100, 1000, 2000 and 4000× magnification. Bond strength data were analysed by anova and Tukey's test (α = 0.05). RESULTS: Significantly lower bond strength (P < 0.0001) was obtained after irradiation compared to nonirradiated teeth. RelyX-U200 cemented fibre posts had the higher bond strength (15.17 ± 5.89) compared with RelyX ARC (P < 0.001) and Panavia-F2.0 (P < 0.001). The evaluation after 6 months revealed lower bond strength values compared to the immediate values (P < 0.001) for irradiated and nonirradiated teeth. Cohesive failures occurred in the irradiated dentine. SEM revealed fractures, microfractures and fewer collagen fibres in irradiated root dentine. RelyX-U200 and Panavia-F2.0 were associated with a juxtaposed interface of the cement with the radicular dentine in irradiated and nonirradiated teeth, and for RelyX ARC, hybrid layer formation and tags were observed in both irradiated and nonirradiated teeth. CONCLUSION: Radiation was associated with a decrease in the push-out bond strength and with lower resin cement/root dentine interface adaptation. Self-adhesive resin cement was a better alternative for fibre post cementation in teeth subjected to radiation therapy. The bond strength decreased after 6 months.

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.

Material Properties of a Tricalcium Silicate-containing, a Mineral Trioxide Aggregate-containing, and an Epoxy Resin-based Root Canal Sealer.

INTRODUCTION: The aim was to compare the solubility, radiopacity, and setting times of a tricalcium silicate-containing (BioRoot RCS; Septodont, St Maur-des-Fossés, France) and a mineral trioxide aggregate-containing sealer (MTA Fillapex; Angelus, Londrina, Brazil) with an epoxy resin-based sealer (AH Plus; Dentsply DeTrey, Konstanz, Germany). METHODS: Solubility in distilled water, radiopacity, and setting time were evaluated in accordance with ISO 6876:2012. The solubility was also measured after soaking the materials in phosphate-buffered saline buffer (PBS). All data were analyzed using 1-way analysis of variance and the Student-Newman-Keuls test. RESULTS: After immersion for 1 minute in distilled water, BioRoot RCS was significantly less soluble than AH Plus and MTA Fillapex (P < .05). At all other exposure times, AH Plus was significantly less soluble than BioRoot RCS, whereas BioRoot RCS was significantly more soluble than the other 2 sealers (P < .05). All sealers had the same solubility in PBS and distilled water, except for BioRoot RCS after 28 days. At this exposure time, BioRoot RCS was significantly less soluble in PBS than in distilled water and less soluble than MTA Fillapex (P < .05). All BioRoot RCS specimens immersed in PBS had a surface precipitate after 14 and 28 days. The radiopacity of all sealers was greater than 3 mm aluminum with no statistical significant difference between the sealers (P > .05). The final setting time was 324 (±1) minutes for BioRoot RCS and 612 (±4) minutes for AH Plus. The difference was statistically significant (P < .05). MTA Fillapex did not set completely even after 1 week. CONCLUSIONS: The solubility and radiopacity of the sealers were in accordance with ISO 6876:2012. PBS decreased the solubility of BioRoot RCS.

Influence of therapeutic cancer radiation on the bond strength of an epoxy- or an MTA-based sealer to root dentine.

AIM: To evaluate the influence of radiation on root canal sealer push-out bond strength to dentine and sealer/dentine interface in teeth filled with AH Plus (Dentsply Ind. Com. Ltda, Petrópolis, RJ, Brazil) and MTA Fillapex (Angelus Ind. Prod. Odontológicos S/A, Londrina, PR, Brazil). METHODOLOGY: Thirty-two maxillary canines were selected and randomly assigned to 2 groups (n = 16): one group was not irradiated, and the other was subjected to a cumulative radiation dose of 60 Gy. Root canals were prepared with the Reciproc system (VDW GmbH, Munich, Germany), and each group was divided into 2 subgroups (n = 8) according to the sealer - AH Plus or MTA Fillapex - using the single-cone filling technique. Then, 1-mm-thick dentine slices were obtained from each root third for the push-out test to evaluate sealer bond strength to dentine and for scanning electron microscopy (SEM) to examine the sealer/dentine interface. Failure mode after debonding was determined with a stereomicroscope at ×25 magnification. Bond strength data were analysed by two-way anova with a split-plot design and post hoc Tukey's test (α = 0.05). RESULTS: Significantly lower bond strength (P < 0.0001) was obtained after irradiation (0.71 ± 0.20 versus 0.97 ± 0.29 MPa) and in specimens filled with MTA Fillapex (0.70 ± 0.18 MPa) compared with AH Plus (1.00 ± 0.27 MPa). Percentage of adhesive failures increased after radiation in all root thirds in the teeth filled with AH Plus. SEM revealed more gap-containing regions and fewer tags at the sealer/dentine interface in irradiated specimens, with more tag formation and fewer gaps with AH Plus sealer. CONCLUSIONS: Radiation was associated with a decrease in the push-out bond strength of sealers to intraradicular dentine and formation of more gaps and fewer tags at the sealer/dentine interface regardless of the sealer.

Influence of ultrasonic activation of 4 root canal sealers on the filling quality.

INTRODUCTION: The purpose of this study was to evaluate the effects of ultrasonic activation on the filling quality (intratubular sealer penetration, interfacial adaptation, and presence of voids) of 4 epoxy resin-based sealers. METHODS: Eighty-four extracted human canines were divided into 4 groups (n = 20) according to the sealer used to obturate the root canals instrumented with F5 ProTaper instruments (50/05) (Dentsply Maillefer, Ballaigues, Switzerland). The canals were filled by the lateral compaction technique. Previously, the sealers were labeled with rhodamine B dye to allow analysis under a confocal microscope. At the time of obturation, the specimens were divided again into 2 groups (n = 10) according to the ultrasonic activation of the sealers: ultrasonically activated and nonultrasonically activated groups. All samples were sectioned at 2, 4, and 6 mm from the apex. The percentages of voids, gaps, and dentinal sealer penetration segments of the canal were analyzed. RESULTS: Regarding the sealer penetration segments, there was a significant increase for the AH Plus (Dentsply Maillefer), Acroseal (Specialités Septodont, Saint Maur-des-Fossés, France), and Sealer 26 (Dentsply Maillefer) at the 4-mm level and the AH Plus and Sealer 26 at the 6-mm level with ultrasonic activation (P < .05). Concerning the gaps, the ultrasonic activation promoted a smaller presence for all sealers at the 4- and 6-mm levels (P < .05). No statistical significant differences were found for the percentages of voids (P < .05). CONCLUSIONS: The use of ultrasonic activation of an epoxy resin-based sealer promoted greater dentinal sealer penetration and less presence of gaps.

Study on detecting spatial distribution of neutrons and gamma rays using a multi-imaging plate system.

In order to measure the spatial distributions of neutrons and gamma rays separately using the imaging plate, the requirement for the converter to enhance specific component was investigated with the PHITS code. Consequently, enhancing fast neutrons using recoil protons from epoxy resin was not effective due to high sensitivity of the imaging plate to gamma rays. However, the converter of epoxy resin doped with (10)B was found to have potential for thermal and epithermal neutrons, and graphite for gamma rays.

Fabrication process and electromagnetic wave absorption characterization of a CNT/Ni/epoxy nanocomposite.

Since carbon nanotube (CNT) was first discovered in 1991, it has been considered as a viable type of conductive filler for electromagnetic wave absorption materials in the GHz range. In this paper, pearl-necklace-structure CNT/Ni nano-powders were fabricated by a polyol process as conductive fillers. Compared to synthesized CNT, pearl-necklace Ni-decorated CNT increased the electrical conductivity by an order of 1 due to the enhancement of the Ni-conductive network. Moreover, the decorated Ni particles prevented the agglomeration of CNTs by counterbalancing the Van der Walls interaction between the CNTs. A CNT/Ni nanocomposite showed a homogeneous dispersion in an epoxy-based matrix. This enhanced physical morphology and electrical properties lead to an increase in the loss tangent and reflection loss in the CNT/Ni/Epoxy nanocomposite compared to these characteristics of a CNT/Epoxy nanocomposite in range of 8-12 GHz. The electromagnetic wave absorption properties of CNT/Ni/epoxy nanocomposites will provide enormous opportunities for electronic applications where lightweight EMI shielding or electro-magnetic wave absorption properties are necessary.

Effect of chemical and Er:YAG laser treatment on bond strength of root canal resin-based sealers.

Different treatments of dentin walls, as laser irradiation, prior to obturation can influence the adhesion ability of endodontic sealers. Therefore, the objective of this study was to compare in vitro the shear bond strength of four resin-based sealers to dentin treated with citric acid solution or erbium: yttrium, aluminum, garnet (Er:YAG) irradiation. A total of 240 slices with 1.6 mm of thickness were cut using middle third of 84 teeth. Each slice was widened using a #45 taper.06 rotary K3 instrument. The sample was divided into groups according to dentin pretreatment (15 % citric acid or Er:YAG laser) and sealer used (AH Plus, Acroseal, EndoREZ, or RealSeal). Shear bond strength was measured using a universal materials testing machine. As results, significant differences were found when comparing sealers between all groups (p < 0.05) by Kruskal-Wallis test, regardless of the pretreatment used. Comparing pretreatments, 15 % citric acid solution had better outcomes than Er:YAG laser, with significant differences in all groups, except for Acroseal groups (p < 0.05). It was concluded that RealSeal and 15 % citric acid solution achieved the best results regarding the sealer and pretreatment used, respectively.

Influence of prior 810-nm-diode intracanal laser irradiation on hydrophilic resin-based sealer obturation

Dentin wall structural changes caused by 810-nm-diode laser irradiation can influence the sealing ability of endodontic sealers. The objective of this study was to evaluate the apical leakage of AH Plus and RealSeal resin-based sealers with and without prior diode laser irradiation. Fifty-two single-rooted mandibular premolars were prepared and divided into 4 groups, according to the endodontic sealer used and the use or non-use of laser irradiation. The protocol for laser irradiation was 2.5W, continuous wave in scanning mode, with 4 exposures per tooth. After sample preparation, apical leakage of 50% ammoniacal silver nitrate impregnation was analyzed. When the teeth were not exposed to irradiation, the RealSeal sealer achieved the highest scores, showing the least leakage, with significant differences at the 5% level (Kruskal-Wallis test, p = 0.0004), compared with AH Plus. When the teeth were exposed to the 810-nm-diode laser irradiation, the sealing ability of AH Plus sealer was improved (p = 0282). In the RealSeal groups, the intracanal laser irradiation did not interfere with the leakage index, showing similar results in the GRS and GRSd groups (p = 0.1009).

Influence of prior 810-nm-diode intracanal laser irradiation on hydrophilic resin-based sealer obturation.

Dentin wall structural changes caused by 810-nm-diode laser irradiation can influence the sealing ability of endodontic sealers. The objective of this study was to evaluate the apical leakage of AH Plus and RealSeal resin-based sealers with and without prior diode laser irradiation. Fifty-two single-rooted mandibular premolars were prepared and divided into 4 groups, according to the endodontic sealer used and the use or non-use of laser irradiation. The protocol for laser irradiation was 2.5W, continuous wave in scanning mode, with 4 exposures per tooth. After sample preparation, apical leakage of 50% ammoniacal silver nitrate impregnation was analyzed. When the teeth were not exposed to irradiation, the RealSeal sealer achieved the highest scores, showing the least leakage, with significant differences at the 5% level (Kruskal-Wallis test, p = 0.0004), compared with AH Plus. When the teeth were exposed to the 810-nm-diode laser irradiation, the sealing ability of AH Plus sealer was improved (p = 0282). In the RealSeal groups, the intracanal laser irradiation did not interfere with the leakage index, showing similar results in the GRS and GRSd groups (p = 0.1009).

Light-transmitting ability of marketed fiber posts.

If proper polymerization of resin-based cements is to be achieved for fiber post luting, light activation is needed for photo-curing agents, recommended for self-curing materials. The study was aimed at verifying whether the light-transmitting ability of marketed fiber posts reflected the manufacturers' claims for translucency. Ten posts per type were light-irradiated with a curing unit. Spectrophotometric measurements of the amount of photons reaching different post levels were taken. Data were statistically analyzed (linear regression, two-way ANOVA; alpha = 0.05). No light transmission was recorded through FibreKleer and Tech21 X-OP. For the other posts, light intensity decreased from coronal to apical and rose again at the apical tip, where it peaked for GC Fiber Post, Macrolock Illusion Post, and Radix Fiber Post. Light transmission was significantly higher at the coronal level. A statistically significant difference in translucency was found for Dentin Post X and FRC Postec Plus in comparison with Reforpost, FibreKleer, Tech21 X-OP, and Composipost.

Effects of light exposure time on composite resin hardness after root reinforcement using translucent fibre post.

OBJECTIVES: The purpose of this in vitro study was to evaluate the Vickers hardness (VHN) of a Light Core (Bisco) composite resin after root reinforcement, according to the light exposure time, region of intracanal reinforcement and lateral distance from the light-transmitting fibre post. METHODS: Forty-five 17-mm long roots were used. Twenty-four hours after obturation, the root canals were emptied to a depth of 12 mm and the root dentine was artificially flared to produce a 1mm space between the fibre post and the canal walls. The roots were bulk restored with the composite resin, which was photoactivated through the post for 40s (G1, control), 80 s (G2) or 120 s (G3). Twenty-four hours after post-cementation, the specimens were sectioned transversely into three slices at depths of 2, 6 and 10mm, corresponding to the coronal, middle and apical regions of the reinforced root. Composite VHN was measured as the average of three indentations (100g/15 s) in each region at lateral distances of 50, 200 and 350 microm from the cement/post-interface. RESULTS: Three-way analysis of variance (alpha=0.05) indicated that the factors time, region and distance influenced the hardness and that the interaction timexregion was statistically significant (p=0.0193). Tukey's test showed that the mean VHN values for G1 (76.37+/-8.58) and G2 (74.89+/-6.28) differed significantly from that for G3 (79.55+/-5.18). CONCLUSIONS: Composite resin hardness was significantly lower in deeper regions of root reinforcement and in lateral areas distant from the post. Overall, a light exposure time of 120 s provided higher composite hardness than the shorter times (40 and 80s).

Low shrinkage light curable nanocomposite for dental restorative material.

OBJECTIVES: The aim of this study was to develop a low shrinkage visible light curable nanocomposite dental restorative material without sacrificing the other properties of conventional materials. This nanocomposite was developed by using an epoxy resin 3,4-epoxycyclohexylmethyl-(3,4-epoxy)cyclohexane carboxylate (ERL4221) matrix with 55% wt of 70-100 nm nanosilica fillers through ring-opening polymerization. GPS (gamma-glycidoxypropyl trimethoxysilane) was used to modify the surfaces of silica nanoparticles. RESULTS: The nanocomposite was shown to exhibit low polymerization shrinkage strain, which is only a quarter of currently used methacrylate-based composites. It also exhibited a low thermal expansion coefficient of 49.8 microm/m degrees C which is comparable to that of the methacrylate based composites (51.2 microm/m degrees C). The strong interfacial interactions between the resin and fillers at nanoscales were demonstrated by an observed high strength and high thermal stability of the nanocomposite. A microhardness of 62 KHN and a tensile strength of 47 MPa were reached. A high degree of conversion ( approximately 70%) can be obtained after less than 60 s of irradiation upon the nanocomposite. A transmission electron microscope (TEM) study of the nanocomposite showed no aggregation of fillers. Comparable results to the methacrylate based composites were obtained from the one day MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) cytotoxicity test. SIGNIFICANCE: The developed epoxy resin based nanocomposite demonstrated low shrinkage and high strength and is suitable for dental restorative material applications.

Photopolymerization of developmental monomers for dental cationically initiated matrix resins.

OBJECTIVES: The objectives were to investigate the structure and selected physical properties of products resulting from the photopolymerization of a binary mixture containing an aliphatic dioxirane, 3,4-epoxycyclohexylmethyl-3,4-epoxycyclohexane carboxylate (ECHM-ECHC) and a potential expanding monomer, 3,9-bis(oxiranylcyclohexylmethyl)-1,5,7,11-tetraoxaspiro[5.5]undecane (BOCHM-TOSU). METHODS: Reaction mixtures were irradiated with a dental curing lamp at room temperature. Some reactions were quenched prior to gel point. Oligomeric products were separated from unreacted monomers by column chromatography, and analyzed by NMR. Physical properties of polymeric solids were measured using accepted standard methods. Protonation energies for monomers were calculated using semi-empirical quantum mechanical methods. RESULTS: Types of oligomers found included poly(ether)s and poly(carbonate)s. Quantum mechanical calculations indicated preferential attack at the more nucleophilic oxaspirocyclic ring sites. For cured solid polymer samples, the elastic modulus was 2.39 +/- 0.24 GPa and the fracture toughness was 0.73 +/- 0.10 MPa m(1/2). These values were similar to those measured for a cured conventional BISGMA/TEGDMA matrix resin. SIGNIFICANCE: The room-temperature photopolymerization of an aliphatic dioxirane and a potential expanding monomer demonstrates the possibility of making cross-linked copolymer resins with improved polymerization shrinkage characteristics for use in dental composites.