Effect of endodontic retreatment on the bond strength of resin cements to root canal dentin.

PURPOSE: To evaluate the effect of endodontic retreatment on the bond strength of different cementation techniques (self-adhesive and conventional resin cement) through the push-out mechanical testing and the penetrability of resin cements to root dentin. METHODS: 60 human teeth with single oval-shaped canals were used (n=15) : G1 - Endodontic treatment and cementation with RelyX ARC (ETA); G2 - Endodontic treatment and cementation with U200 (ETU); G3 - Endodontic retreatment and cementation with RelyX ARC (ERA); G4 - Endodontic retreatment and cementation with U200 (ERU). The groups with conventional endodontic treatment were filled with AH plus (ETA and ETU), while the groups that were submitted to endodontic retreatment were initially filled with Endofill and afterwards with AH Plus. Each radicular third (cervical, middle, and apical, of each tooth) was submitted to push-out bond strength testing, followed by evaluation with confocal laser microscopy to determine the penetration of the resin cements, and scanning electron microscopy was used to evaluate the failure mode. The parametric data were evaluated by two-way ANOVA and Tukey tests, and non-parametric data by Kruskal-Wallis and Dunn tests (α< 0.05). RESULTS: The ETA group had higher bond strength values to intra-radicular dentin than the other groups in all root thirds (P< 0.05). Endodontic retreatment had a negative impact on the penetration and push-out bond strength of RelyX ARC and U200 cement, regardless of the analyzed radicular third. CLINICAL SIGNIFICANCE: The bond strength between fiber post and root dentin can be affected by several factors, such as technical failure, cementation technique, pretreatment of the dentin, type of post and adaptation. The endodontic retreatment interferes negatively on the bond strength and penetrability of RelyX ARC and U200 cements to dentin, regardless of the analyzed radicular third. Therefore, the endodontic retreatment might have an adverse effect due to over preparation and aggression to the root canal.

Effect of fiber post space irrigation with different peracetic acid formulations on the bond strength and penetration into the dentinal tubules of self-etching resin cement.

STATEMENT OF PROBLEM: The post space must be irrigated with solutions that do not interfere with the bond strength and enhance penetration into the dentinal tubules of self-etching resin cement. Which solution is best is unclear. Peracetic acid with different formulations appears to be a good option. PURPOSE: The purpose of this in vitro study was to evaluate the effect of irrigating the fiber post space by using 1% peracetic acid (PA) at low (LH) or high (HH) hydrogen peroxide concentration on the bond strength and penetration into the dentinal tubules of RelyX U200 self-etching resin cement. MATERIAL AND METHODS: After intraroot preparation for fiber posts in 60 endodontically treated teeth, the specimens were divided into 4 groups (n=15) according to the irrigation protocol: CG (control), distilled water; NA (NaOCl), 2.5% sodium hypochlorite; LHPA, PA with a low concentration of hydrogen peroxide; and HHPA, PA with a high concentration of hydrogen peroxide. The fiber posts were then cemented with self-etching resin cement labeled with rhodamine. Cross sections of the thirds were obtained by confocal scanning microscopy and submitted to the push-out and cement penetration tests. The data obtained in the push-out tests were evaluated by using ANOVA and the Tukey post hoc test, and those data obtained in the confocal screening were evaluated by using the Kruskal-Wallis and Dunn (Bonferroni correction) tests (α=.05). RESULTS: Bond strength values in the cervical third of the CG were higher than those in NA (P=.035) but similar to those of the other groups (P=.05). In the other thirds, CG and LHPA values were similar to one another (P=.05) but higher than those of NA and HHPA (P<.001). The penetration rate assessed by confocal scanning microscopy revealed similar results in the cervical third for all groups (P=.075), except for NA which provided the lowest penetration. In the remaining thirds, CG and LHPA provided the highest penetration rate (P=.015). CONCLUSIONS: The LHPA group had no negative effects on the bond strength and penetration into the dentinal tubules of the self-etching resin cement.

Irrigação ultrassônica passiva proporciona menor incidência de debris após preparo do espaço para o pino / Passive ultrasonic irrigation provides less debris after post space preparation

Objetivo: esse estudo avaliou a incidência de resíduos (debris) na dentina, no espaço preparado para pino de fibra, submetida a um dos seguintes protocolos de irrigação: água destilada (AD); hipoclorito de sódio a 2,5% (HS); hipoclorito de sódio a 2,5% mais EDTA a 17% (HSE); hipoclorito de sódio a 2,5% agitado com irrigação ultrassônica passiva (HSUS). Métodos: os canais radiculares de quarenta incisivos bovinos, com comprimento radicular de 17,0 mm, foram obturados pela técnica do cone único. Após sete dias, um espaço para o pino de fibra foi preparado com brocas de Largo #1 e #2 e broca DC2 (White Post; FGM). Os espécimes foram aleatoriamente distribuídos em quatro grupos (n = 10), de acordo com o protocolo de irrigação usado: AD; HS, HSE ou HSUS. As raízes foram clivadas longitudinalmente e obtidas imagens, em microscopia eletrônica de varredura (500X), da superfície dentinária dos segmentos radiculares cervical e apical do espaço preparado para pino de fibra. Escores foram atribuídos de acordo com a presença de debris. Resultados: no segmento cervical, HSE e HSUS apresentaram menor incidência de debris do que AD e HS (p < 0,05). No segmento apical, HSUS proporcionou a menor incidência de debris na dentina radicular (p < 0,05). Não houve diferença entre os demais protocolos de irrigação, tanto no segmento cervical quanto no apical (p > 0,05). Conclusões: o protocolo HSUS proporcionou menor incidência de debris sobre a superfície dentinária do espaço preparado para pino de fibra (AU).

Objective: The present study evaluated the residues (debris) incidence in dentin fiber post space submitted to irrigation protocols using distilled water (DW), 2.5% sodium hypochlorite (HS), 2.5 % sodium hypochlorite and 17% EDTA (HSE), or 2.5% sodium hypochlorite energized bypassive ultrasonic irrigation (HSUS). Methods: Forty bovine incisors root canals with standardized root length (17.0mm) were obturated using single cone technique and epoxyresin sealer. After 7 days, the fiber post space was prepared using # 1 and # 2 Largo burs, and DC2 (White Post; FGM).The specimens were randomly divided into four groups (n= 10), according to the irrigation protocol: AD; HS, HSE or HSUS. After 48 hours, the roots were sectioned. Cervical and apical segment images were obtained using scanning electron microscopy (500X). Scores were assessed according to debris presence. Results: In cervical segment, HSE and HSUS presented debris incidence lower than DW and HS (P <0.05). DW and HS or HSE and HSUS were similar to each other (P > 0.05). Conclusions: HSUS provided the lower debris incidence in dentin surface of the fiber post space (P < 0.05) (AU).

Enamel evaluation by scanning electron microscopy after debonding brackets and removal of adhesive remnants.

BACKGROUND: The bonding of accessories in the dental crown during the orthodontic treatment creates microporosities, thus promoting micromechanical retention of the adhesive to the enamel structure. After debonding brackets, at the end of the active orthodontic treatment, a certain amount of adhesive remnants must be mechanically removed from the enamel. The objective of this study was to compare, by means of scanning electron microscopy, three different methods to remove the adhesive remnants after orthodontic bracket removal. MATERIAL AND METHODS: An experimental analytical study was conducted on human premolar specimens, extracted within a year or less. The preparation of the enamel was carried out with the application of 35% phosphoric acid and Transbond XT Light Cure Adhesive Primer® adhesive. Edgwise Standart prescription brackets, slot .022 "(Morelli Orthodontia) were glued to the enamel using Transbond XT® bonding resin. The brackets were placed on the center of the vestibular face of the clinical crown, and a 300-gram pressure was exerted against the surface of the enamel, measured with an orthodontic dynamometer. The brackets were debonded with adhesive removing pliers, and the samples were divided into groups, according to the protocol used for adhesive remnant removal: high-speed multi-laminated drill bit, low-speed multi-laminated drill bit, and low-speed glass fiber. After removal of the adhesive remnants, the samples went through scanning electron microscopy, obtaining electro micrographs with a magnification range of 150 X, 500 X, and 2,000 X. RESULTS: The tested method showed that the best effectiveness for the removal of the adhesive remnants after bracket debonding was the use of a tungsten carbide multi-laminated high speed, followed by the use of a tungsten carbide multi-laminated, low-rotation drill. The use of fiberglass drill alone has proved to be inefficient for clinical use, given the large amounts of adhesive remnants it leaves on the enamel. CONCLUSIONS: All methods evaluated in this study proved to be inefficient for total removal of adhesive remnants from the enamel. Key words:Dental enamel, microscopy, orthodontics.

Effects of different peracetic acid formulations on post space radicular dentin.

STATEMENT OF PROBLEM: The optimal irrigating solution with antimicrobial and dentin cleansing properties for post space preparation for fiber posts is unclear. Peracetic acid is one option but is available in various chemical formulations that require evaluation. PURPOSE: The purpose of this in vitro study was to evaluate dentin surface cleanliness based on the presence of a smear layer and the number of open dentin tubules. It also investigates the chemical composition of residues after canal irrigation with a 1% peracetic acid solution (PA) at low or high concentration of hydrogen peroxide during the preparation of intracanal fiber posts. MATERIAL AND METHODS: After filling the root canals of 40 mandibular incisors, a rotary instrument was used for intracanal preparation to place fiber posts. The teeth were divided into 4 groups (n=10) according to the post space irrigation protocol as follows: CG (control): distilled water; NA (NaOCl): 2.5% sodium hypochlorite; LH: PA with low concentration of hydrogen peroxide; and HH: PA with high concentrations of hydrogen peroxide. After irrigation, the teeth were sectioned, and the intracanal dentin surface was subjected to analysis using energy dispersive spectroscopy to evaluate chemical composition and to scanning electron microscopy (×500) to evaluate the presence of the smear layer. The number of open dentin tubules was measured by scanning electron microscopy analysis (×2000) using photo-editing software. ANOVA and the Tukey test (α=.05) were used to evaluate the data, except for the presence of a smear layer, for which the Kruskal-Wallis and Dunn tests were used (α=.05). RESULTS: The highest concentrations of oxygen in the dentin residues were detected in LH and HH (P<.05); CG and NA showed similar oxygen concentrations (P>.05). NA had a higher concentration of chlorine (P<.05), whereas LH had a lower amount of smear layer and a larger number of open dentin tubules than the other groups (P<.05). These were equivalent to each other (P>.05), except for HH, which also had a larger number of open dentin tubules than CG and NA (P<.05). CONCLUSIONS: PA 1% with a low concentration of hydrogen peroxide yielded a lower amount of smear layer and a larger number of open dentin tubules in the dentin of the post space when compared with PA 1% with a high concentration of hydrogen peroxide, despite maintaining a similar oxygen concentration in these dentin residues.

Endodontic Management of Open Apex Teeth Using Lyophilized Collagen Sponge and MTA Cement: Report of Two Cases.

Teeth with open apices, such as in immature teeth or those with apical root resorption are clinical cases with difficult immediate resolution. With the use of mineral trioxide aggregate (MTA) in dentistry, it was possible to optimize the treatment time of these cases by immediate placement of apical plug and the root canal filling. However, some negative effects can occur if MTA is extruded beyond the apex. To avoid this accident, it has been recommended to use of an apical matrix prior to placement of MTA. This study reports two clinical cases of apical plug placement in teeth with pulp necrosis and open apices. One case had an immature apex due to dental trauma and the other case had apical resorption due to the presence of endodontic infection in the root canal. MTA apical plug with approximately 4 mm thickness, was placed in the apical zone of the root and immediately the canal was obturated with gutta-percha and endodontic sealer. Follow-up evaluations showed clinical and radiographic evidence of success.