Is α-Tocopherol or Sodium Ascorbate Effective as Antioxidant on Fracture Resistance of Bleached Teeth?

AIM: To evaluate the effect of two antioxidant formulations (sodium ascorbate and α-tocopherol) on fracture resistance of endodontically treated teeth. MATERIALS AND METHODS: Sixty human premolars were endodontically treated and divided into six groups (n = 10): G1 (negative control)-unbleached and restored with composite resin; G2 (positive control)-bleached in three sessions, using hydrogen peroxide (15 H2O2) plus titanium dioxide (TiO2) nanoparticles, photoactivated by LED laser system and restored with composite resin; G3-bleaching similar to G2, after the use of 10% sodium ascorbate gel for 24 hours and restored with composite resin; G4-similar to G3, but with the use of 10% sodium ascorbate solution and restored with composite resin; G5 and G6-similar to G3, but with the use of 10% α-tocopherol in alcohol or carbopol, respectively, and was also restored. A mechanical fracture resistance test was performed and the Kruskal-Wallis test was used to evaluate the results (α = 0.05). RESULTS: No statistical difference was observed in fracture resistance between groups (p > 0.05). Regarding the antioxidant and pharmaceutical formulation applied, no statistical difference was detected in any comparison (p > 0.05). The frequency of fractures considered favorable was higher in G1 and G3 compared to the other groups. CONCLUSION: The endodontically treated teeth bleached with 15 H2O2 plus TiO2 nanoparticles and photoactivated with the LED laser did not decrease the fracture resistance and the use of sodium ascorbate or α-tocopherol did not increase the crown fracture resistance. CLINICAL SIGNIFICANCE: The literature reports a significant reduction in the bond strength of restorations on the bleached dentin. Therefore, the use of antioxidant agents may have a promising effect on fracture resistance of endodontically treated teeth.

Peracetic acid as a single endodontic irrigant: effects on microhardness, roughness and erosion of root canal dentin.

The aim was to assess the effects of 1% peracetic acid (PAA) as a single endodontic irrigant on microhardness, roughness, and erosion of root canal dentin, compared with 2.5% sodium hypochlorite (NaOCl) and with 2.5% NaOCl combined with 17% EDTA. Forty human, single-rooted tooth hemisections were submitted to Knoop microhardness test, before and after the following irrigation protocols: PAA = 1% PAA; NaOCl = 2.5% NaOCl; NaOCl-EDTA-NaOCl = 2.5% NaOCl +17% EDTA +2.5% NaOCl; and SS = saline. Another 40 roots were instrumented, irrigated with the same protocols, and sectioned longitudinally. The roughness analysis was performed on the mesial section using a confocal laser scanning microscope, whereas erosion was analyzed on each third of the distal section, using a scanning electron microscope. The data were analyzed using ANOVA and Tukey post-tests, and Kruskal-Wallis and Dunn post-tests (α = .05). The PAA and NaOCl-EDTA-NaOCl groups showed no significant differences (p > .05); both promoted reduction in microhardness and increase in roughness, compared with the NaOCl and SS groups (p < .05). NaOCl-EDTA-NaOCl promoted higher erosion in the cervical and middle thirds than the other groups (p < .05); there was no difference among PAA, NaOCl, and SS (p > .05). There was also no difference among the groups regarding the apical third (p > .05). PAA used as a single endodontic irrigant caused reduction in root canal dentin microhardness and increase in roughness in a similar way to NaOCl-EDTA-NaOCl; however, PAA caused less erosion than NaOCl-EDTA-NaOCl.

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.

The effectiveness of glass ionomer cement as a fiber post cementation system in endodontically treated teeth.

This study compared the performance of a glass ionomer (GC Gold Label 1, GIC) as a fiber post cementation system for glass fiber posts with a self-adhesive resin cement (Relyx U200, RUC) and a conventional resin cement system (Scotchbond Muli-Purpose and Relyx ARC, RAC). Thirty endodontically treated canines were randomly divided in three groups (n = 10), according to the fiber post cementation system: (RAC)-Scotchbond Multi-Purpose and Relyx X ARC; (RUC)-Relyx U200 and (GIC)-GC Gold Label 1 Luting & Lining. Rhodamine was incorporated into the cementation system prior to the fiber post cementation. After glass fiber post cementation, roots were incubated in artificial saliva for 6 months. After that, specimens from the cervical, middle, and apical thirds of the post space were prepared and analyzed using a push-out bond strength test and confocal laser microscopy. ANOVA one way and Tukey tests showed that GIC and RUC demonstrated similar push-out bond strength values, independently of the post space third (p > .05); however, values were greater than those shown by RAC (p < .05). For dentin penetrability, GIC and RUC also had similar results (p > 0.05) and lower than RAC (p < 0.05). Inside the root canal, the cementation system using glass ionomer cement (GC Gold Label 1 Luting & Lining) has similar push-out bond strength to the self-adhesive resin cement (Relyx U200) and these were higher than the conventional resin (Relyx ARC), despite its higher dentin penetrability.

Effects of the Ratio between Pigment and Bleaching Gel on the Fracture Resistance and Dentin Microhardness of endodontically treated Teeth.

INTRODUCTION: The aim of this study was to evaluate the effects of bleaching gel using 35% hydrogen peroxide (HP), associated with red carmine pigment (RC), in the 3:1 or 1:1 ratio, on fracture resistance and dentin microhardness of endodontically treated teeth. MATERIALS AND METHODS: A total of 40 lower incisors were endodontically treated and divided into four groups (n = 10), according to the bleaching protocol: G1 (HP3), 35% HP + RC (3:1); G2 (HP1), 35% HP + RC (1:1); G3 (positive), 38% HP; and G4 (negative), unbleached. Four dental bleaching sessions were performed. The dental crowns were restored after the last session and submitted to the fracture resistance test. Totally, 60 specimens from the endodontically treated lower incisor crowns were prepared to evaluate the effects on dentin microhardness. The analysis was measured (in Knoop) prior to and after the last dental bleaching session using similar bleaching protocols. RESULTS: G2 presented the lowest fracture resistance (p < 0.05). The other groups were similar to each other (p > 0.05). No difference was observed in the reduction of dentin microhardness among the groups (p > 0.05). CONCLUSION: A 1:1 ratio (bleaching gel:pigment) caused a significant fracture resistance reduction in relation to the other protocols. No effect on the dentin microhardness reduction was observed. CLINICAL SIGNIFICANCE: The pigment addition to the bleaching agent accelerates the bleaching chemical reaction. However, no studies have evaluated the ideal proportion to optimize tooth bleaching.

Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration.

INTRODUCTION: This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. MATERIALS AND METHODS: Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. RESULTS: The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. CONCLUSION: It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. CLINICAL SIGNIFICANCE: The quality of the root filling and coronal restoration is closely related to periapical health.

Effects of the Residues from the Endodontic Sealers on the Longevity of Esthetic Restorations.

The substances used in the root canal treatment, especially sodium hypochlorite solution and oxidant agents, can negatively interfere on the bond strength of the adhesive systems to dentin and on the dental crowns fracture resistance.(1,2).

Effect of sodium hypochlorite under several formulations on root canal dentin microhardness.

AIM: The aim of the present study was to evaluate the effect of three different formulations of sodium hypochlorite on the microhardness of root canal dentin in cervical and apical segments. METHODS: Twenty-four extracted human teeth had their roots sectioned along their long axes in a buccolingual direction. One half of each root was selected, and transversely sectioned resulting in two segments, cervical and apical, with similar lengths. The specimens were divided into three groups (n = 16), according to the sodium hypochlorite formulation used: (a) group 1, 2.5% sodium hypochlorite; (b) group 2, Chlor-XTRA; and (c) group 3, 5.5% sodium hypochlorite gel. These groups were subdivided in two subgroups (n = 8): cervical and apical root segments. Before testing the substances, dentin microhardness was measured on each section, 100 µm from the root canal with a Knoop tester. After 15 min of application, a new measurement was performed on each segment. Data were collected and registered for statistical treatment. RESULTS: In both segments, the substances reduced dentin microhardness. No differences were observed between the groups, independent of the analyzed segment (P > 0.05). CONCLUSIONS: All substances reduced dentin microhardness. Chlor-XTRA and 5.5% sodium hypochlorite gel promoted a reduction similar to the 2.5% sodium hypochlorite solution.

Clorexidina como irrigante endodôntico: avaliação, in vitro, do selamento apical / Chlorhexidine as an endodontic irrigant: in vitro apical seal evaluation

O objetivo do presente trabalho foi avaliar, in vitro, infiltração marginal apical apresentada por obturações endodônticas de canais biomecanizados com diferentes regimes de irrigação. Foram utilizados 40 caninos extraídos de humanos, divididos em quatro grupos experimentais de acordo com os seguintes regimes de irrrigação: Grupo I, solução de clorexidina a 2 por cento(CHX); grupo II, solução de hipoclorito de sódio a 1 por cento (NaOCI); grupo III, CHX+EDTA; grupo IV, NaOCI+EDTA. Após obturação, os dentes foram imersos em solução de azul de metileno a 2 por cento; após clivagem dos espécimes, as infiltrações marginais de corante foram medidas. Foram usados testes não paramétricos de Kruskal-Wallis e de Dunn para análise estatística. Os resultados mostraram menor infiltração no grupo IV, seguidos pelos III, I e II. Concluiu-se que o regime de irrigação endodôntica associando a solução de CHX+EDTA permite uma infiltração marginal, em obturações endodônticas, maior porém semellhante ao da associação NaOCI a 1 por cento + EDTA. Os regimes de irrigação utilizando CHX ou NaOCI somente permitem as maiores infiltrações marginais apresentadas, sem diferença entre elas.