Effect of different disinfection protocols in bacterial viability of an intraradicular biofilm formed in situ.

The present study aimed to evaluate bacterial viability after the use of different disinfection protocols in root canals infected with a multispecies biofilm (MB) formed in situ. Palatal roots with a single canal were obtained from extracted maxillary molars and sterilized before being inserted into the mouth. The roots were contaminated with a MB in an intraoral appliance worn by ten volunteers. All volunteers wore six roots simultaneously in two intraoral devices for 21 days. One root from each volunteer was assigned to each group (n=10): PUI - passive ultrasonic irrigation; EC - Easy Clean; XPF - XP-endo Finisher; aPDT - antimicrobial photodynamic therapy; CI - conventional irrigation; and NC - negative control. The samples were evaluated under confocal laser scanning microscopy. The percentage of viable cells (VC) was calculated over the total percentage of MB biovolume. Data were statistically analyzed (α=5%). The cell viability in the entire root canal or for each third was compared between groups (Kruskal-Wallis test, Dunn post-hoc test) and for the same group (Friedman test, Dunn post-hoc test). Disinfection protocols were not significantly different from each other (P>.05). Samples in EC, PUI, and aPDT had lower cell viability than in NC (P<.05). In the coronal third of samples in the EC, XPF, PUI and aPDT, the percentage of VC biovolume was lower than in the NC (P<.05). The percentage of VC in EC samples was lower in the coronal and middle thirds than in the apical third (P<.05). EC, PUI and aPDT had significant effects on cell viability in intraradicular multispecies biofilm formed in situ when compared with untreated samples.

Effect of different disinfection protocols in bacterial viability of an intraradicular biofilm formed in situ

Abstract The present study aimed to evaluate bacterial viability after the use of different disinfection protocols in root canals infected with a multispecies biofilm (MB) formed in situ. Palatal roots with a single canal were obtained from extracted maxillary molars and sterilized before being inserted into the mouth. The roots were contaminated with a MB in an intraoral appliance worn by ten volunteers. All volunteers wore six roots simultaneously in two intraoral devices for 21 days. One root from each volunteer was assigned to each group (n=10): PUI - passive ultrasonic irrigation; EC - Easy Clean; XPF - XP-endo Finisher; aPDT - antimicrobial photodynamic therapy; CI - conventional irrigation; and NC - negative control. The samples were evaluated under confocal laser scanning microscopy. The percentage of viable cells (VC) was calculated over the total percentage of MB biovolume. Data were statistically analyzed (α=5%). The cell viability in the entire root canal or for each third was compared between groups (Kruskal-Wallis test, Dunn post-hoc test) and for the same group (Friedman test, Dunn post-hoc test). Disinfection protocols were not significantly different from each other (P>.05). Samples in EC, PUI, and aPDT had lower cell viability than in NC (P<.05). In the coronal third of samples in the EC, XPF, PUI and aPDT, the percentage of VC biovolume was lower than in the NC (P<.05). The percentage of VC in EC samples was lower in the coronal and middle thirds than in the apical third (P<.05). EC, PUI and aPDT had significant effects on cell viability in intraradicular multispecies biofilm formed in situ when compared with untreated samples.

Resumo O presente estudo teve como objetivo avaliar a viabilidade bacteriana após o uso de diferentes protocolos de desinfecção em canais radiculares infectados com um biofilme multiespécies (MB) formado in situ. Raízes palatinas com canal único foram obtidas de molares superiores extraídos e esterilizadas antes de serem inseridas na boca. As raízes foram contaminadas com MB em um aparelho intraoral usado por dez voluntários. Todos os voluntários usaram seis raízes simultaneamente em dois dispositivos intrabucais por 21 dias. Uma raiz de cada voluntário foi atribuída a cada grupo (n=10): PUI - irrigação ultrassônica passiva; EC - Easy clean; XPF - XP-endo Finisher; aPDT - terapia fotodinâmica antimicrobiana; IC - irrigação convencional; e, NC - controle negativo. As amostras foram avaliadas em microscopia confocal de varredura a laser. A porcentagem de células viáveis (VC) foi calculada sobre a porcentagem total do biovolume de MB. Os dados foram analisados estatisticamente (α=5%). A viabilidade celular em todo o canal radicular ou em cada terço foi comparada entre os grupos (teste de Kruskal-Wallis, teste post-hoc de Dunn) e no mesmo grupo (teste de Friedman, teste post-hoc de Dunn). Os protocolos de desinfecção não foram significativamente diferentes entre si (P>0,05). Amostras dos grupos EC, PUI e aPDT apresentaram menor viabilidade celular do as do NC (P<0,05). No terço cervical das amostras do EC, XPF, PUI e aPDT, a porcentagem de biovolume de VC foi menor do que no NC (P<0,05). A porcentagem de VC nas amostras do EC foi menor nos terços cervical e médio do que no terço apical (P<0,05). EC, PUI e aPDT tiveram efeitos significativos na viabilidade celular do biofilme multiespécies intrarradicular formado in situ quando comparado com amostras não tratadas. Estudos clínicos devem investigar o papel da redução de cargas bacterianas viáveis no sistema de canais radiculares para o sucesso do tratamento endodôntico.

XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals.

This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals

Abstract: This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

Marginal gaps and internal voids after root-end filling using three calcium silicate-based materials: A Micro-CT analysis.

This study evaluated the 3D quality of root-end filling, assessing the presence (volume and percentage) of marginal gaps and internal voids formed after retro-filling with three calcium silicate-based materials: MTA Angelus (Angelus Soluçoes Odontologicas, Londrina, PR, Brazil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, France) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Florida, US). Thirty human, extracted, single rooted teeth were used. Orthograde root canal treatment, root resection (3mm shorter than the apex) and retrograde cavity preparation with ultrasonic tips were performed. Teeth were divided into 3 groups (n =10 each) following a stratified randomization according to the initial volume of the root-end cavity. After retrofilling, samples were stored for 7 days. Then, two rounds of micro-CT scans were performed: soon after root-end preparation (with the cavity still empty) and 7 days after root-end filling. Marginal gaps, internal voids volume (mm3 and %), as well as, the overall defects (sum of gaps and voids) were evaluated. Statistics compared the three groups in relation to those defects. There was not statistical difference between groups regarding the marginal gaps (P≥ 0.05), the internal voids (P≥ 0.05), and the overall defects (P≥ 0.05). Median (mm3) and % of overall air-entrapment defects (gaps and/or voids) was: 0.004mm3 and 1.749% for MTA Angelus, 0.018mm3 and 6.660% for Biodentine, and 0.012mm3 and 4.079% for Neo MTA Plus. All materials had gaps and/or voids. No differences were found between MTA Angelus, Biodentine and Neo MTA Plus.

Marginal gaps and internal voids after root-end filling using three calcium silicate-based materials: A Micro-CT analysis

Abstract This study evaluated the 3D quality of root-end filling, assessing the presence (volume and percentage) of marginal gaps and internal voids formed after retro-filling with three calcium silicate-based materials: MTA Angelus (Angelus Soluçoes Odontologicas, Londrina, PR, Brazil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, France) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Florida, US). Thirty human, extracted, single rooted teeth were used. Orthograde root canal treatment, root resection (3mm shorter than the apex) and retrograde cavity preparation with ultrasonic tips were performed. Teeth were divided into 3 groups (n =10 each) following a stratified randomization according to the initial volume of the root-end cavity. After retrofilling, samples were stored for 7 days. Then, two rounds of micro-CT scans were performed: soon after root-end preparation (with the cavity still empty) and 7 days after root-end filling. Marginal gaps, internal voids volume (mm3 and %), as well as, the overall defects (sum of gaps and voids) were evaluated. Statistics compared the three groups in relation to those defects. There was not statistical difference between groups regarding the marginal gaps (P≥ 0.05), the internal voids (P≥ 0.05), and the overall defects (P≥ 0.05). Median (mm3) and % of overall air-entrapment defects (gaps and/or voids) was: 0.004mm3 and 1.749% for MTA Angelus, 0.018mm3 and 6.660% for Biodentine, and 0.012mm3 and 4.079% for Neo MTA Plus. All materials had gaps and/or voids. No differences were found between MTA Angelus, Biodentine and Neo MTA Plus.

Resumo Este estudo avaliou a qualidade 3D de retro-obturações, avaliando a presença (volume e percentagem) de "gaps" marginais e "voids" internos formados a partir da retro-obturação com três materiais à base de silicato de cálcio: MTA Angelus (Angelus Soluções Odontológicas, Londrina, PR, Brasil), Biodentine (Septodont Ltd., Saint Maur-des-Faussés, França) and Neo MTA Plus (Avalon Biomed Inc., Bradenton, Flórida, US). Trinta dentes humanos unirradiculares extraídos foram usados. Após tratamento de canal ortrógrado, resecção radicular (3 mm apicais), o prepare da cavidade retrógrada com pontas ultrassônicas foi realizado. Os dentes foram divididos em três grupos (n= 10 cada) seguindo uma randomização estratificada, de acordo com o volume inicial da cavidade retrógrada. Depois da retro-obturação as amostras foram armazenadas por 7 dias. Duas rodadas de escaneamento de micro-CT foram realizadas: logo após o preparo retrógrado (com a cavidade ainda vazia) e 7 dias após a retro-obturação. O volume de "gaps" marginais e de "voids" internos (mm3 e %), bem como, os defeitos totais (soma de "gaps" e "voids") foram avaliados. Não houve diferença estatística entre os grupos em relação aos "gaps" marginais (P≥ 0,05), "voids" internos (P≥ 0,05), e aos defeitos totais (P≥ 0,05). A mediana (mm3) e porcentagem dos defeitos totais de aprisionamento de ar foi 0,004mm3 e 1,749% para o MTA Angelus, 0,018mm3 e 6,660% para o Biodentine, e 0,012mm3 e 4,079% para o Neo MTA Plus. Todos os materiais tiveram defeitos ("gaps"e/ou "voids"). Não houve diferença entre MTA Angelus, Biodentine e Neo MTA Plus.

Influence of photobiomodulation therapy on root development of rat molars with open apex and pulp necrosis.

This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.

Antimicrobial effect of bioceramic cements on multispecies microcosm biofilm: a confocal laser microscopy study.

OBJECTIVES: To assess the viability of multispecies microcosm biofilm after contact with NeoMTA Plus, Biodentine, and MTA Angelus. MATERIALS AND METHODS: Fifty-four human dentin blocks (4 × 5 × 4 mm) were allocated to Hawley retainers, worn by six volunteers for 72 h. The blocks were then individually incubated in BHI broth for 21 days at 37 °C. At the end of experimental time for biofilm growth, the samples were randomly divided into four groups (n = 12): NeoMTA Plus, Biodentine, MTA Angelus, and negative control. The materials were placed in contact with the blocks. All samples were placed in cell-culture plate wells and incubated in BHI broth for 7 days at 37 °C. One sample from each volunteer (n = 6) was analyzed by SEM to describe the biofilm morphology. CLSM was performed to determine the percentage of viable biofilm biovolume. The data were statistically analyzed by one-way ANOVA and Tukey's multiple comparison test (α = 5%). RESULTS: SEM showed biofilm formed by spherical and rod-shaped bacteria surrounded by an extracellular matrix. No material was able to kill all biofilm cells, and all groups had more than 50% of viable bacteria. NeoMTA Plus was significantly different from the negative control group (P < .05). CONCLUSIONS: All tested materials were not effective against multispecies microcosm biofilm. CLINICAL RELEVANCE: NeoMTA Plus, Biodentine, and MTA Angelus were not effective against multispecies microcosm biofilm. It is essential to understand that these bioceramic cements are indicated for infected clinical situations. Thus, complementary disinfection procedures should be conducted prior to filling with these materials.

Bone tissue reaction, setting time, solubility, and pH of root repair materials.

OBJECTIVES: This study aims to compare the bone tissue reaction, setting time, solubility, and pH of NeoMTA Plus, Biodentine (BD), and MTA Angelus (MTA-A). MATERIALS AND METHODS: Initial and final setting times (n = 7) and solubility up to 7 days (n = 11) were evaluated in accordance with ASTM C266-15 and ANSI/ADA Specification No. 57, respectively. pH (n = 10) was measured up to 28 days. Bone tissue reactions in 48 rats' femur were histologically analyzed after 7, 30, and 90 days. ANOVA and Tukey's tests compared setting time, solubility, and pH data; bone reactions data were compared by Kruskal-Wallis and Dunn's tests. RESULTS: NeoMTA Plus had longer initial and final setting times than MTA-A and BD (P < 0.05). At 7 days, BD showed the highest solubility, similar to NeoMTA Plus (P > 0.05) and different from MTA-A (P < 0.05). NeoMTA Plus had a progressive mass loss over time; at 7 days, it was significantly different from the initial mass (P < 0.05). BD showed higher pH in the periods assessed when compared to the other materials (P < 0.05). Bone tissue repair had no differences between groups in each experimental period (P > 0.05). All groups presented no difference from 30 to 90 days (P > 0.05) and had better bone repair at 90 days than at 7 days (P < 0.05). CONCLUSIONS: NeoMTA Plus, BD, and MTA-A showed satisfactory setting time, high mass loss, alkaline pH, and allowed bone repair. CLINICAL RELEVANCE: Calcium silicate-based cements are indicated for multiple clinical situations. NeoMTA Plus and BD showed satisfactory physical-chemical and biological properties, being considered as alternatives to MTA-A, as root repair materials for clinical use.

Efficacy of a thermally treated single file compared with rotary systems in endodontic retreatment of curved canals: a micro-CT study.

OBJECTIVES: This study aimed to compare WaveOne Gold with ProTaper and RaCe systems regarding remaining filling material, apical transportation (AT), and working time (WT) after (i) filling removal and (ii) shaping of curved canals. METHODS: Thirty mesiobuccal canals of maxillary molars were prepared and filled. After 30 days, they were randomly assigned into three groups (n = 10), according to the instruments used for filling removal and shaping, respectively: WOG-WaveOne Gold Primary and Medium; PTG-ProTaper Retreatment and ProTaper Next; RCG-D-RaCe and RaCe. Micro-CT analysis assessed the residual filling material and AT. WT was recorded. Data were statistically analyzed (α = .05). RESULTS: There was no significant difference between groups in the amount of filling material at any evaluated moment (P > .05). All groups presented low AT values. The WT was similar in all groups in filling removal (P > .05), and in shaping step WOG was faster than PTG and RCG (P < .05). CONCLUSIONS: Neither system could completely remove the filling material. The instruments evaluated were safe and the reciprocating system was faster than the rotary systems in shaping the canals. CLINICAL RELEVANCE: This study provided consistent information on filling material removal capacity of WaveOne Gold. Considering that all tested systems were safe, WaveOne Gold may be an alternative with cost-effectiveness and shorter learning curve for endodontic retreatment.

Influence of photobiomodulation therapy on root development of rat molars with open apex and pulp necrosis

Abstract This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.

Effect of human, dentin, albumin and lipopolysaccharide on the antibacteerial activity of endodontic activity of endodontic irrigants.

CONTEXT: Human dentin powder (HD), bovine serum albumin (BSA) and endotoxin (LPS) may affect the antimicrobial activity of irrigating solutions. AIM: To evaluate the inhibitory effect of HD powder, BSA, and LPS on the antibacterial activity of 0.5%, 1%, 2.5%, and 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gel, BioPure mixture of tetracycline, citric acid, and detergent (MTAD), and QMix. METHODS: The direct contact test against Enterococcus faecalis (ATCC 29212) for 2-min, 30-min and 6-h was used. Sterile pyrogen-free water was the negative control. After experimental periods, a neutralizing agent was used. Colony-forming units were determined by 10-fold serial dilutions and culture on agar plates. Data were analyzed by Kruskal-Wallis and Dunn's test (α = 5%). RESULTS: In the absence of inhibitors, all irrigants eliminated E. faecalis. In contact with HD, all solutions eliminated E. faecalis within 2-min, with the exception of MTAD. In the presence of BSA, only 5% NaOCl killed E. faecalis within 2-min. LPS did not affect the antibacterial effect of any irrigant. At 30-min and at 6-h, all substances eliminated E. faecalis. CONCLUSIONS: In the presence of albumin, irrigants needed >2-min to eliminate E. faecalis, except for 5% NaOCl. The same was observed in the presence of dentin when E. faecalis was exposed to MTAD.

Shaping ability of rotatory or reciprocating instruments in curved canals: a micro-computed tomographic study.

This study aimed to compare apical transportation, centering ratio, and working time during root canal preparation with Wizard Navigator (WN), WaveOne (WO), or ProTaper Universal (PT) and to describe deformation and fracture of these instruments. Thirty-six mesiobuccal roots from maxillary molars were micro-computed tomography (micro-CT) scanned and then sorted into three groups (n = 12): Wizard Navigator (WN), WaveOne (WO), and ProTaper Universal (PT). The root canals were prepared using WN, WO, or PT; the time of each canal preparation was timed; and the specimens were micro-CT re-scanned. The instruments were submitted to scanning electron microscopy (SEM) before and after their use. The data on canal transportation at 1, 2, 3, 4 and 5 mm and preparation time were analyzed by the Kruskal-Wallis test, followed by the Mann-Whitney U test. The centering ratio was analyzed by ANOVA, followed by Tukey's test. Both instrument deformation and fracture were described. Apical transportation was similar among groups at 1, 2, 3 and 4 mm. The WO group showed higher canal transportation at 5mm than the other groups (p = 0.03). There was no significant difference in centering ratio among the groups. Preparation time in the WO group was significantly lower than in the other groups (p = 0.004). Small differences were observed in the surface area of all instruments. The WN, WO, and PT groups had a similar centering ratio without procedural errors or significant structural changes. At 5 mm from the apex, the WO group showed the largest canal transportation toward the furcation and root canal preparation was faster than in the WN and PT groups.

The effect of final irrigation on the penetrability of an epoxy resin-based sealer into dentinal tubules: a confocal microscopy study.

INTRODUCTION: The aim of this study was to compare the effect of QMix, BioPure MTAD, 17 % EDTA, and saline on the penetrability of a resin-based sealer into dentinal tubules using a confocal laser scanning microscope (CLSM) and to describe the cleaning of root canal walls by SEM. METHODS: Eighty distobuccal roots from upper molars were selected and randomly divided into four groups (n = 20) before root canal preparation according to the solution used in the final rinse protocol (FRP): QG (QMix), MG (BioPure MTAD), EG (17 % EDTA), and CG (control group: saline). Ten roots of each group were prepared for SEM, and images (×2000) from the canal walls were acquired. The remaining canals were filled with a single gutta-percha cone and AH Plus with 0.1 % Rhodamine B. The specimens were horizontally sectioned at 4 mm from the apex, and the slices were analyzed in CLSM (×10). Sealer penetration was analyzed with Adobe Photoshop software. RESULTS: QG and EG presented similar amounts of sealer penetration (P > .05). MG and CG presented the lowest penetrability values (P < .05). The best results for smear layer removal of the apical third of the root canal were achieved by the QG and EG groups when compared with MG and CG (P < .05). CONCLUSIONS: Seventeen percent EDTA and QMix promoted sealer penetration superior to that achieved by BioPure MTAD and saline. CLINICAL RELEVANCE: Despite studies have not confirmed the relationship between sealing ability of endodontic sealers and their penetration in dentinal tubules, sealer penetration assumes importance, since endodontic sealers, unlike gutta-percha, are able to penetrate in dentinal tubules, isthmus, and accessory canals, filling the root canal system.

Shaping ability of rotatory or reciprocating instruments in curved canals: a micro-computed tomographic study

Abstract This study aimed to compare apical transportation, centering ratio, and working time during root canal preparation with Wizard Navigator (WN), WaveOne (WO), or ProTaper Universal (PT) and to describe deformation and fracture of these instruments. Thirty-six mesiobuccal roots from maxillary molars were micro-computed tomography (micro-CT) scanned and then sorted into three groups (n = 12): Wizard Navigator (WN), WaveOne (WO), and ProTaper Universal (PT). The root canals were prepared using WN, WO, or PT; the time of each canal preparation was timed; and the specimens were micro-CT re-scanned. The instruments were submitted to scanning electron microscopy (SEM) before and after their use. The data on canal transportation at 1, 2, 3, 4 and 5 mm and preparation time were analyzed by the Kruskal-Wallis test, followed by the Mann-Whitney U test. The centering ratio was analyzed by ANOVA, followed by Tukey's test. Both instrument deformation and fracture were described. Apical transportation was similar among groups at 1, 2, 3 and 4 mm. The WO group showed higher canal transportation at 5mm than the other groups (p = 0.03). There was no significant difference in centering ratio among the groups. Preparation time in the WO group was significantly lower than in the other groups (p = 0.004). Small differences were observed in the surface area of all instruments. The WN, WO, and PT groups had a similar centering ratio without procedural errors or significant structural changes. At 5 mm from the apex, the WO group showed the largest canal transportation toward the furcation and root canal preparation was faster than in the WN and PT groups.