Physicomechanical Properties of Tertiary Monoblock in Endodontics: A Systematic Review and Meta-analysis.

Introduction: A systematic review and meta-analysis were conducted to evaluate the physicomechanical properties of tertiary monoblock obturation with different obturation techniques. Methods and Materials: PubMed (MEDLINE), Web of Science, Scopus, the Cochrane Library, LILACS, IBECS, and BBO were searched time. PICO question was: "In extracted human teeth (Population), does tertiary monoblock obturation (Intervention) have superior physicomechanical properties (Outcome) compared to conventional obturation systems (Comparison)?". Statistical analyses for push-out bond strength were performed with RevMan software by comparing the mean differences of each study, with a 95% confidence interval. Inverse variance was used as statistical method, random-effects models as analysis model, and heterogeneity between studies was assessed by Cochran's Q test and I2 statistic (P <0.05). Results: Of 2162 studies retrieved, 31 were included in this review for "Study Characteristics". Ten studies were included in the meta-analysis. Analysis demonstrated that conventional obturation had significantly higher push-out bond strength than tertiary monoblock obturation (P <0 .01), with a mean difference of -1.00 (95% CI, -1.41 to -0.58; I2=100%). Subgroups using single-cone and cold lateral condensation techniques showed significantly lower push-out bond strength for tertiary monoblock obturation (P <0.01), respectively with a mean difference of -0.09 (95% CI, -1.13 to -0.67; I2=97%) and of -1.97 (95% CI, -3.19 to -0.75; I2=100%). The warm vertical compaction subgroup showed no statistically significant difference between tertiary monoblock and conventional systems (P =0.13), with a mean difference of 0.49 (95% CI, -0.14 to 1.12; I2=10%). Conclusion: Tertiary monoblock systems have a push-out bond strength similar to conventional systems when used with warm vertical compaction.

Cytotoxicity of Chelating Agents Used In Endodontics and Their Influence on MMPs of Cell Membranes.

This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Cytotoxicity of chelating agents used in endodontics and their influence on mmps of cell membranes

Abstract This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Resumo Este estudo avaliou o efeito citotóxico e a capacidade de inibição das metaloproteinases da matriz extracelular (MMP-2 e MMP-9) pela quitosana 0,2%(CH) e o ácido acético 1% (AA) em comparação com o ácido etilenodiaminotetracético 17% (EDTA). O ensaio de viabilidade celular foi realizado de acordo com a ISO 10993-5 com fibroblastos de camundongo (L929). A cultura foi exposta a CH 0,2%, AA 1% e EDTA 17%. Os agentes quelantes foram avaliados imediatamente após o contato com as células e após 6 h, 12 h e 24 h de incubação. A viabilidade celular foi analisada utilizando o ensaio de brometo de 3- (4,5-dimetitiazol-2-il) -2,5-difeniltetrazólio (MTT). A inibição da atividade gelatinolítica de MMP-2 e MMP-9 foi avaliada por zimografia de gelatina. Diferentes concentrações de CH foram avaliadas: 50 mM, 5 mM, 0,5 mM e 0,05 mM. EDTA (0,5 mM) foi usado como controlo positivo. Os resultados demonstraram que CH e AA apresentaram um efeito citotóxico inicial, que diminuiu após 6 h, 12 h e 24 h, sendo estatisticamente similar ao EDTA (P> 0,05). Adicionalmente, CH a concentrações de 50 mM, 5 mM e 0,5 mM tiveram um efeito inibidor sobre MMP-2 e MMP-9, semelhante ao controlo com EDTA. Os agentes quelantes apresentaram efeitos não citotóxicos após 24 h. MMP-2 e MMP-9 foram inibidas pelas soluções experimentais.

Experimental Resin-Based Monoblock Endodontic Obturation System.

OBJECTIVE: The aim of the present study was to characterize a novel resin-based monoblock endodontic obturation system consisting of a polymeric cone and a resin-based endodontic sealer. METHODS: The preliminary tests performed for the experimental cone were as follows: cohesive strength, dimensional stability, standardization of the diameter and taper, calcium ion release, and radiopacity, for the characterization of the experimental sealer, film thickness and flow tests were performed. Tests were performed according to the American National Standards Institute/American Dental Association (ANSI/ADA) Standards Nos. 57 and 78. The experimental cone was compared to gutta-percha, whereas the experimental sealer was compared to AH Plus. Data were analyzed by Student's t-test (α = 0.05). RESULTS: The experimental cone had superior values for cohesive strength and dimensional stability compared to gutta-percha. Regarding calcium ion release, the experimental system continued to release calcium ions after 30 days. Film thickness was similar for both endodontic sealers; conversely, the experimental resin-based sealer achieved higher values for flow compared to AH Plus. CONCLUSION: The experimental resin-based monoblock obturation system fully met the requirements of the ANSI/ADA Standard No. 78 and the ANSI/ADA Standard No. 57, except for radiopacity. Considering this, further studies are still needed to evaluate other radiopacifiers and the effect of their incorporation on the physicochemical properties of this novel resin-based monoblock endodontic obturation system.

Effectiveness of different endodontic irrigants against Enterococcus faecalis: an ex vivo study

Aim: To evaluate the effectiveness of different endodontic irrigants against Enterococcus faecalis (ATCC 29212). Methods: Seventy bovine mandibular incisors were prepared, inoculated with a bacterial strain for 60 days and divided into the following groups: positive control; negative control; 2.5% NaOCl; 17% EDTA; 0.2% chitosan; 2.5% NaOCl + 0.2% chitosan; and 2.5% NaOCl + 17% EDTA. The irrigation protocol was performed using an experimental peristaltic pump device, with the irrigating solutions circulating within the apparatus at a constant flow for 10 min. Paper-point samples were then collected from the root canals and immersed in 7 mL of brain heart infusion broth, followed by incubation at 37°C for 48 h. Bacterial growth was assessed by turbidity of the culture medium. Results: E. faecalis was present in all samples after the use of different irrigants. Conclusion: The different irrigants tested were not effective in completely eliminating dentin bacterial contamination with E. faecalis.