RESUMO
In clinical dentistry, the strength of bonding zirconia posts to root canal dentinal walls currently needs enhancement, and laser application can be an important contribution owing to its features that accommodate adjustable modifications on dental materials. Herein, the effect of different laser treatments applied to dentin surfaces on the strength of bonding zirconia posts to root canal dentinal walls is evaluated by using the pull-out bond strength test in a laboratory setting. A total of 40 single-rooted permanent mandibular premolar teeth that were freshly extracted were used here. The root canal preparation steps were performed using the crown-down technique. Custom-made zirconia posts were produced using CAD/CAM technology. Prior to the application of resin cement, the internal surfaces of the root canals were irradiated using Nd:YAG, Er:YAG, and KTP lasers. Pull-out tests were performed on each specimen by using a universal testing machine. One-way analysis of variance and Tukey post hoc tests were used to compare the pull-out bond strength data. The bond strengths of the laser-treated specimens were greater than those of the untreated controls (p < 0.05). While the value of the pull-out bond strength after Nd:YAG laser treatment was significantly higher than the values obtained after the applications of the Er:YAG and KTP lasers (p < 0.05), the pull-out bond strength after Er:YAG laser treatment was considerably greater than that after KTP laser treatment (p < 0.05). The bond strength between the root canal dentin and the CAD/CAM custom-made zirconia post was improved upon using all the laser modalities in current laboratory settings, among which, application of the Nd:YAG laser was the most successful.
Assuntos
Desenho Assistido por Computador , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/efeitos da radiação , Dentina/efeitos dos fármacos , Dentina/efeitos da radiação , Lasers de Estado Sólido/uso terapêutico , Zircônio/farmacologia , Cavidade Pulpar/ultraestrutura , Humanos , Cimentos de Resina/químicaRESUMO
Objective: The objective of this study is to evaluate the wall adaptation and apical microleakage values following the application of various irrigation protocols in primary teeth.Material and methods: For the two parts of the study, extracted upper incisor primary teeth were randomly included to the 1% sodium hypochlorite (NaOCl), 10% ethylenediaminetetraacetic acid (EDTA)+1% NaOCl, 6% citric acid (CA)+1% NaOCl and 0.9% physiological saline (PS) groups. Canal wall adaptation and apical microleakage were assessed by scanning electron microscopy (SEM) and stereomicroscope, respectively.Results: 6% CA + 1% NaOCl group was found to be the most successful irrigation protocol in providing strong canal wall adaptation and less apical microleakage, followed by 10% EDTA +1% NaOCl. 6% CA +1% NaOCl was significantly superior regarding apical microleakage (p < .05).Conclusions: Due to the ability to provide appropriate changes in the root canal walls to make a well-adapted and leak-proof canal filling, 6% CA + 1% NaOCl can be recommended as an irrigation protocol in primary teeth.
Assuntos
Infiltração Dentária , Ácido Edético/administração & dosagem , Microscopia Eletrônica de Varredura/métodos , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular , Camada de Esfregaço , Hipoclorito de Sódio/administração & dosagem , Dente Decíduo/diagnóstico por imagem , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/ultraestrutura , Humanos , Irrigantes do Canal Radicular/administração & dosagem , Fatores de TempoRESUMO
Objective: To validate the capability of the dual wavelength laser (Er,Cr:YSGG and diode 940 nm) and the XP-Endoshaper and finisher in removing the smear layer from curved canals. Methods: Forty curved root canals were prepared using the R25 file of the Reciproc® system. The teeth were randomly divided into five groups: G1: negative control irrigated with distilled water, G2: positive control irrigated with EDTA 17% and a final rinse of NaOCl 3%, G3: XP-Endoshaper and finisher with EDTA 17%, G4: dual wavelength Er,Cr:YSGG (1.25 W, 50 Hz, 50 µs) and diode 940 nm (2 W, 50% DC), and G5: dual wavelength Er,Cr:YSGG (2 W, 20 Hz, 50 µs) and diode 940 nm (2 W, 50% DC). Laser scanning microscope images (1000 × ) were scored with the Hülsmann scoring system. Results: Superior smear layer removal was observed in G5 in comparison with G4, especially in the apical third of the canal. Furthermore, the XP-Endoshaper and finisher exhibited positive results in all parts of the canal. Conclusions: The higher power output of the Er,Cr:YSGG in the dual wavelength laser may be a suitable approach to remove the smear layer from the apical third of curved canals. Moreover, the XP-Endoshaper and finisher with EDTA could expose the dentinal tubules, however, the negative side effects of applying EDTA 17% for longer periods must be taken into consideration. This work is clinically significant as it addresses the main aim of endodontic treatment and provides a suitable method to remove the debris, smear layer, and bacterial remnants from the clinically challenging curved root canals.
Assuntos
Cavidade Pulpar/efeitos da radiação , Lasers Semicondutores , Lasers de Estado Sólido , Preparo de Canal Radicular/instrumentação , Camada de Esfregaço , Cavidade Pulpar/ultraestrutura , Dentina/efeitos da radiação , Dentina/ultraestrutura , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Distribuição Aleatória , Irrigantes do Canal Radicular/farmacologia , Propriedades de SuperfícieRESUMO
The aim of this study was to examine the smear layer removal capacity of various etidronate treatments. Seventy-eight roots were instrumented up to apical size X4 and randomly divided into five treatment groups and a positive control group (n = 13). Groups were as follows: irrigation with 5 ml of sterile saline (control) for 3 min, 5 ml of 17% ethylenediaminetetraacetic acid (EDTA) for 3 min, 5 ml of 9% A1-hydroxyethylidene-1,1-bisphosphonate (HEBP) for 3 min, 5 ml of 18% HEBP for 3 min, irrigation with 5 ml of 1% sodium hypochlorite (NaOCl) + 9% HEBP for 3 min, and 5 ml of 2% NaOCl + 18% HEBP for 3 min. The roots were examined using a scanning electron microscope. The smear layer scores in the 2% NaOCl + 18% HEBP group were lower than those in the other treatment groups and the control group (p < .05). There were no significant differences among the treatment groups in the smear layer scores of the coronal and middle thirds. However, the smear layer scores in the 2% NaOCl + 18% HEBP treatment group were lower those in the 9% HEBP and 18% HEBP treatment groups in the apical third (p < .05). In the clinical setting, the recommended concentration of HEBP is 18%, and it should be used with an oxidizing agent to ensure optimum smear layer removal.
Assuntos
Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/ultraestrutura , Ácido Etidrônico/administração & dosagem , Irrigantes do Canal Radicular/administração & dosagem , Camada de Esfregaço/ultraestrutura , Dente Pré-Molar/efeitos dos fármacos , Dente Pré-Molar/ultraestrutura , Humanos , Microscopia Eletrônica de Varredura , Resultado do Tratamento , TurquiaRESUMO
INTRODUCTION: Successful endodontic treatment vastly depends to a high degree on an accurate knowledge of root canal system morphology. It is a prerequisite to be aware of all possible reservoirs where bacteria and/or toxins can persist, compromising the surrounding tissues; such knowledge results in endodontic success. METHODS: The presence of interradicular canals and diverticula between the pulp chamber floor and the bifurcation area surface of 117 mandibular first molars was investigated. Access cavities were prepared, the teeth were embedded in plastic, and the pulp chambers were flooded with methylene blue and then centrifuged. An average of 4.2 (0.145 ± 0.03 mm thickness) slices per tooth were obtained by means of a diamond band saw. The presence of interradicular canals and diverticula was investigated using a light microscope (125×). RESULTS: Interradicular canals were observed in 9 teeth. Seven teeth had 1 interradicular canal, and 2 teeth had 2 interradicular canals. Diverticula (blind interradicular canals) were observed in 11 teeth originating either on the pulp chamber floor or the bifurcation side. The number of diverticula per tooth varied between 1 and 5 and originated in 3 teeth in the pulp chamber floor and 8 teeth in the bifurcation area. Two teeth had both 1 interradicular canal and 3 diverticula. Of the 117 mandibular molars investigated, 18 had either 1 or 2 interradicular canals, 1 to 5 diverticula, or an interradicular canal and 3 diverticula. CONCLUSIONS: Based on the results obtained with this ex vivo study and because of the difficulties involved in the clinical performance of mechanical cleaning of possibly existing interradicular canals, it is highly recommended to perform thorough chemical cleaning and disinfection of the pulp chamber floor area in order to enhance the sealing possibility of such structures and minimize treatment failure.
Assuntos
Cavidade Pulpar/anatomia & histologia , Mandíbula , Dente Molar/anatomia & histologia , Cavidade Pulpar/patologia , Cavidade Pulpar/ultraestrutura , Humanos , Microscopia , Tratamento do Canal Radicular/métodosRESUMO
This study evaluated the influence of canal irrigation protocols with 5.25% calcium hypochlorite [Ca(OCl)2 ], 5.25% sodium hypochlorite (NaOCl) and 17% EDTA solution on the inorganic component of root canal dentin. Sixty roots were randomly divided into six groups (n = 10): Saline solution (SS) (control); Saline solution (SSE) +17% EDTA; CH - 5.25% Ca(OCl)2 ; CHE - 5.25% Ca(OCl)2 + 17% EDTA; SH - 5.25% NaOCl; SHE - 5.25% NaOCl +17% EDTA. After canal irrigation, the specimens were longitudinally split and analyzed by scanning electron microscopy (SEM). Dentinal tubules were observed in transverse (middle and apical thirds) direction. The images were classified in scores, according to smear layer removal and peritubular dentin alteration, and data were analyzed by Kruskal-Wallis's test, followed by Dunn's test (α = 0.05). In the middle third, all groups with EDTA presented better removal of the smear layer with higher peritubular dentin alteration (p < .05). In the apical third, this happened only in SHE (p < .05). Ca(OCl)2 and NaOCl exhibit similar performance to remove smear layer and alteration of the inorganic component in the middle third. In the apical third, NaOCl associated with EDTA showed better performance in smear layer removal.
Assuntos
Compostos de Cálcio/metabolismo , Cavidade Pulpar/efeitos dos fármacos , Dentina/efeitos dos fármacos , Ácido Edético/metabolismo , Irrigantes do Canal Radicular/metabolismo , Camada de Esfregaço/ultraestrutura , Hipoclorito de Sódio/metabolismo , Dente Pré-Molar/efeitos dos fármacos , Dente Pré-Molar/ultraestrutura , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Humanos , Microscopia Eletrônica de VarreduraRESUMO
The aim of this study was to evaluate the ability of spectral-domain optical coherence tomography (SD-OCT) to display the roof of the pulp chamber and to estimate the residual dentin thickness (RDT) of the pulp complex. The roots of 20 extracted human molars were embedded in epoxy resin, and crowns were longitudinally sectioned in the mesial-distal direction, exposing the pulp chamber. The coronal part of the crown was removed up to an RDT to the pulp chamber roof of 2 mm. Samples were imaged by SD-OCT from coronal view and by light microscopy (LM) in the sagittal plane. Using a microtome, dentin was subsequently removed in four levels from the occlusal aspect in steps of 250 µm. At each level, RDT was documented and measured by both methods. The data were compared (Spearman's rho correlation coefficient, Wilcoxon signed-rank test). Using OCT, the roof of the pulp chamber was first displayed at a maximum RDT of 1.94 mm. The minimal RDT that could be imaged by OCT was 0.06 mm. Values from both methods were strongly correlated (r, 0.83-0.95; pi ≤ 0.05) and differed significantly for large RDTs (dentin levels 1, 2; pi < 0.05) but not for small RDTs (levels 3, 4; pi ≥ 0.226). The roof of the dental pulp chamber could be already visualized by SD-OCT with a RDT of 1.94 mm. Therefore, the method could be a useful diagnostic tool during the preparation of deep dentin cavities and might help to preserve the integrity of the pulp chamber.
Assuntos
Cavidade Pulpar/anatomia & histologia , Dentina/anatomia & histologia , Tomografia de Coerência Óptica/métodos , Estudos Transversais , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Humanos , Dente Molar/anatomia & histologia , Estatísticas não ParamétricasRESUMO
The success of endodontic treatment depends on the thorough removal of microorganisms from the root canal system. The search for new ways to eliminate the microorganisms is therefore justified. Nd:YAP is a laser that uses yttrium aluminum perovskite, doped with neodymium crystal, as active laser medium. We used the Nd:YAP laser in an in vitro experiment to evaluate the bactericidal effect of three parameters of Nd:YAP laser-activated irrigation on biofilms of Enterococcus faecalis in root canals. The canals of 45 extracted human single-root teeth were prepared on a #35 Mtwo instrument and contaminated with E. faecalis for 14 days. Forty infected single-root teeth were then randomly divided into four groups according to the irrigation agitation protocols as follows: 5.25% sodium hypochlorite (NaOCl), Nd:YAP laser (180 mJ) + NaOCl, Nd:YAP laser (280 mJ) + NaOCl, and Nd:YAP laser (360 mJ) + NaOCl. The remaining bacteria were counted immediately using the cell count method. Teeth were firstly spilt and one half examined by scanning electron microscopy (SEM). The other half involved examination of bacterial colonization in dentinal tubules using confocal laser scanning microscopy (CLSM). Nd:YAP laser (280 mJ) + NaOCl and Nd:YAP laser (360 mJ) + NaOCl completely removed the E. faecalis biofilms from the root canal walls and made it the cleanest among the treatment groups. Bacterial reductions in the treatment groups for dentinal tubules are presented in a descending order as follows: Nd:YAP laser (360 mJ) (53.7%), Nd:YAP laser (280 mJ) (51.5%) > Nd:YAP laser (180 mJ) (45.3%) > 5.25% NaOCl (31.9%) > control (19.3%) (p < 0.05). Nd:YAP laser of 280 mJ and 360 mJ showed effective bactericidal effect in removing E. faecalis biofilm from the root canal walls and dentinal tubules.
Assuntos
Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/efeitos da radiação , Lasers de Estado Sólido/uso terapêutico , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Cavidade Pulpar/efeitos da radiação , Cavidade Pulpar/ultraestrutura , Dentina/microbiologia , Enterococcus faecalis/fisiologia , Enterococcus faecalis/ultraestrutura , Humanos , Viabilidade Microbiana/efeitos dos fármacos , Viabilidade Microbiana/efeitos da radiaçãoRESUMO
AIM: To investigate whether a minimally invasive basic root canal preparation technique has an influence on root canal cleanliness in extracted mandibular molar teeth. METHODOLOGY: A total of 80 root canals (40 mesio-buccal and 40 mesio-lingual) from 40 mandibular molars were included. The teeth were divided equally into four different experimental groups depending on the subsequently root canal preparation technique: Group 1: a basic preparation was performed up to size 20, .04 taper; Group 2: a basic preparation was performed up to size 2, .06 taper; Group 3: a basic preparation was performed up to size 25, .04 taper; and Group 4: a basic preparation was performed up to size 25, .06 taper. After the use of each instrument, each root canal was irrigated with 2.5 mL of 6% sodium hypochlorite for 30 s. Then, 1 mL NaOCl was activated for 20 s using an EDDY sonic tip. Final irrigation was performed using a total of 5 mL of 17% EDTA solution. The roots were then split longitudinally and all root canal thirds were observed through scanning electron microscopy (SEM) to evaluate the presence of superficial debris and smear layer using a scoring system. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests with a level of significance set at P < 0.05. RESULTS: In all groups, there was significantly more residual debris and smear layer in the apical third (P < 0.05), with no differences between the middle and coronal thirds (P > 0.05). For both the parameters analysed, there was no difference amongst the groups in the middle and coronal thirds (P > 0.05), whilst in the apical third significantly less debris and smear layer was found in specimens from groups 3 and 4 than for groups 1 and 2 (P < 0.05). CONCLUSION: All basic root canal preparation techniques were associated with less debris and smear layer on the canal walls in the middle and coronal thirds, without differences among them. Even though debris and smear layer were always present in the apical third, an apical size of 25 resulted in significantly cleaner canals walls compared to a size 20.
Assuntos
Cavidade Pulpar/ultraestrutura , Microscopia Eletrônica de Varredura , Dente Molar/cirurgia , Preparo de Canal Radicular/instrumentação , Humanos , Técnicas In Vitro , Mandíbula , Irrigantes do Canal Radicular/administração & dosagem , Camada de Esfregaço , Hipoclorito de Sódio/administração & dosagemRESUMO
AIMS: The aim of the present study was to evaluate the efficacy of reverse rotary instrumentation in disinfection of the root canal at the apical third and qualitative confirmatory analysis using the scanning electron microscope (SEM). SUBJECTS AND METHODS: Sixty single-rooted mandibular premolars were instrumented up to Protaper rotary file size F2 and contaminated with a known species of Enterococcus faecalis (ATCC 29212). The samples were then divided into three groups; Group 1: Experimental group-irrigation by agitation of 1% NaOCl with reverse rotary instrumentation; Group 2: Negative control-no irrigation; and Group 3 positive control-irrigation with 1% NaOCl using a 30-gauge needle. The colony forming units of all the groups were checked. SEM analysis of the samples was focused on the apical third to confirm the absence of E. faecalis biofilms. The data obtained were statistically analyzed by the Fisher's exact test and Pearson's Chi-square test. RESULTS: Group I and III showed significant reduction in the growth of E. faecalis (P ≤ 0.001). SEM confirmed dense bacterial colonies in the Group II consistent with biofilm formation and reduction in bacterial colonies in Group I and II. CONCLUSION: Agitation with reverse rotary instrumentation in the apical third of the root canal along with 1% sodium hypochlorite proved effective in disinfection of the apical third of the root canal, which was further confirmed by scanning electron microscopic analysis. Hence, it can be used as an adjunct during rotary instrumentation in efficient cleansing of the root canal system in the apical third of the root canal system.
Assuntos
Cavidade Pulpar/microbiologia , Cavidade Pulpar/ultraestrutura , Desinfecção/instrumentação , Preparo de Canal Radicular/instrumentação , Dente Pré-Molar/microbiologia , Biofilmes/crescimento & desenvolvimento , Contagem de Colônia Microbiana , Enterococcus faecalis/crescimento & desenvolvimento , Enterococcus faecalis/ultraestrutura , Humanos , Mandíbula , Microscopia Eletrônica de Varredura , Hipoclorito de Sódio/administração & dosagemRESUMO
AIM: The purpose of this study was to evaluate the influence of widening the apical root canal preparation (RCP) on the efficiency of different ethylenediaminetetraacetic acid (EDTA) agitation protocols on smear layer removal: EDTA; EDTA + Easy Clean in rotary movement (ECROT); EDTA + Easy Clean in reciprocating movement (ECREC); and EDTA + Passive ultrasonic irrigation (PUI). MATERIALS AND METHODS: A total of 80 mandibular premolars had their crowns sectioned and then were divided into two groups according to widening: size 25 or 40, 0.08 taper. Sequentially they were once again allocated to subgroups according to the agitation protocol performing eight experimental groups (n = 10). Ten additional teeth were prepared for controls (C+/C-). The specimens were then submitted to the cleaning protocols and thereafter cleaved and microphotographed by variable pressure scanning electron microscopy (SEM) at previously determined points along their root thirds (750*). Scores were attributed to the images, and data were analyzed by the Kruskal-Wallis, Student-Newman-Keuls and Friedman tests. RESULTS: A higher widening was observed to have a positive influence on cleaning efficiency offering significant differences in global and apical third evaluations (p < 0.05). Relative to the agitation, significant differences were observed mainly in the apical third, with PUI and ECROT providing the best results (p < 0.05); no difference for C+ was observed when higher widening was employed. CONCLUSION: A greater widening of the apical third provided a significant improvement in the action of the agitation/activation protocols. Moreover, the PUI and ECROT activation methods were shown to be superior to the use of EDTA solely, particularly in the apical third. CLINICAL SIGNIFICANCE: The findings of this study reinforce the need for clinical use of additional methods to complement cleaning. Therefore, it is important for professionals to have knowledge and command of these protocols to obtain more satisfactory results.
Assuntos
Cavidade Pulpar/ultraestrutura , Ácido Edético/administração & dosagem , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular/administração & dosagem , Preparo de Canal Radicular/métodos , Irrigação Terapêutica/métodos , Ápice Dentário , Dente Pré-Molar , Humanos , Mandíbula , Camada de Esfregaço , UltrassomRESUMO
To develop a novel strategy for sealing and obturating dental root canals by tooth-like tissue regeneration, premolars with mature root apices were freshly collected, and root canals were prepared by following the clinical protocols in vitro. The teeth were immersed in supersaturated calcium and phosphate solution containing gallic acid and fluoride. At certain intervals, the dental roots were taken out, and their mineral precipitates were characterised by scanning electron microscopy, energy-dispersive spectroscopy mapping, X-ray diffraction and transmission electron microscopy. The cytocompatibility of the mineralizing products were evaluated with rabbit bone-marrow-derived mesenchymal stem cells in vitro. Results showed that the precipitates were mainly composed of fluoridated hydroxyapatite with ahexagonal prism morphology. Fluoridated hydroxyapatite initially nucleated and grew from the root canal dentine surface to the root canal centre. The fluoridated hydroxyapatite precipitate and root canal dentine intergraded together such that the interface became hardly distinguishable. The fluoridated hydroxyapatite precipitate grew into and obturated the dentinal tubules. In the root canal, the regenerated fluoridated hydroxyapatite densely packed and bundled together with a c-axis extension. After 7 days of mineralisation, the root canal was completely obturated, and the apical foramen was sealed. The mineralizing products had good biocompatibility with the cells, and the cells grew well on the mineralized surface. Biomimetic mineralisation strategy provides a novel means to regenerate tooth-like tissue to seal the root canal system permanently other than by passive synthetic material filling.
Assuntos
Materiais Biomiméticos/farmacologia , Cavidade Pulpar/metabolismo , Durapatita/farmacologia , Teste de Materiais , Células-Tronco Mesenquimais/metabolismo , Calcificação de Dente/efeitos dos fármacos , Animais , Materiais Biomiméticos/química , Cavidade Pulpar/ultraestrutura , Restauração Dentária Permanente , Durapatita/química , Feminino , Humanos , Masculino , Microscopia Eletrônica de Transmissão , Coelhos , Obturação do Canal Radicular , Raiz Dentária/metabolismo , Raiz Dentária/ultraestrutura , Difração de Raios XRESUMO
OBJECTIVE: This study aimed to evaluate the ability of swept-source optical coherence tomography (OCT) to detect internal anatomy of maxillary premolars in comparison with dental operating microscope (DOM) and cone beam computed tomography (CBCT). BACKGROUND DATA: The ability of OCT to observe the pulp horn during cavity preparation and assess the remaining dentin thickness (RDT) has been demonstrated, whereas validation of OCT in comparison with other imaging techniques seems required. METHODS: Ten extracted human maxillary premolars were sectioned perpendicular to the tooth axis from the occlusal surface at approximately 2 mm increments. OCT and DOM were performed after each cut, and microfocus X-ray computed tomography (micro-CT; reference standard) and CBCT were conducted before sectioning and after the first and second cuts. Three examiners evaluated all images for presence of the pulp horn/pulp chamber, isthmus, lateral canals, and the number of root canals. RDT was determined from OCT, micro-CT, and CBCT images. Correlations were analyzed with Pearson's correlation coefficient. RESULTS: OCT had a sensitivity and specificity of 0.90 and 0.80 in detecting the pulp horn/pulp chamber and 0.84 and 0.71 in detecting the isthmus, respectively. The three techniques showed strong correlations in detecting the number of root canals compared with micro-CT. OCT and DOM did not detect lateral canals. For RDT values, strong correlations were observed between micro-CT and CBCT, micro-CT and OCT, and CBCT and OCT (p < 0.01 for all). CONCLUSIONS: Under the present experimental condition, OCT accurately measured RDT and detected internal tooth anatomy such as the pulp horn, isthmus, and root canals.
Assuntos
Dente Pré-Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/ultraestrutura , Tomografia de Coerência Óptica , Microtomografia por Raio-X , Dente Pré-Molar/ultraestrutura , Humanos , Sensibilidade e Especificidade , Técnicas de Cultura de TecidosRESUMO
AIM: Evaluate the prevalence of mesiolingual canal prevalence orifice in mesiobuccal roots of maxillary first molars using five methods of visualization. MATERIALS AND METHODS: About 73 first permanent maxillary molars were analyzed. Visual clinical analysis of the presence of the fourth canal was performed using a straight end-odontic exploratory probe (EXDG16®) and a K10 manual file (SybronEndo®). Dental elements that were not located on the fourth canal were analyzed with the aid of a magnifying glass (Zeiss®) with a 2.5-fold increase and those teeth in which the fourth canal was not found went through the examination with clinical surgical microscope (OPTO®) with magnification of 20 times with both the explorer and endodontic file. Next, a periapical radiography of the teeth was performed in the teeth in which the mesiolingual canal was not yet found to observe the presence or absence of the fourth canal. Afterward, the teeth in which the canal was not yet located were scanned using the microtomography equipment (SkyScan®), at 100 kV and 100 µA, with an isotropic resolution of 16 µm. RESULTS: The mesiolingual canal was located in 70 teeth (95.8%) and in only 3 teeth it was not identified. CONCLUSION: The visual method in the fourth canal search has limitations, whereas the composite magnifying glass, the clinical surgical microscopy, and the computerized microtomography are efficient methods for locating the fourth canal in the upper first molars. CLINICAL SIGNIFICANCE: The anatomical complexity of the first maxillary molars is one of the factors that leads to high failure rates in the endodontic treatments of this group of teeth. In most clinical situations, the mesiolingual canal goes unnoticed by professionals, since conventional radiographs do not always allow the visualization of all root canals. Determining an effective method for locating the mesiolingual canal is of paramount importance to the success of endodontic treatment.
Assuntos
Variação Anatômica , Cavidade Pulpar/anatomia & histologia , Maxila/anatomia & histologia , Dente Molar/anatomia & histologia , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/ultraestrutura , Endodontia , Humanos , Radiografia Dentária , Microtomografia por Raio-XRESUMO
INTRODUCTION: The aim of this study was to investigate the effects of endodontic sealer types and ultrasound on smear layer removal after post space preparation. METHODS: Thirty-six bovine incisors were chemomechanically instrumented and randomly divided into 3 groups (n = 12) according to the endodontic sealer (AH Plus [Dentsply DeTrey, Konstanz, Germany], Apexit Plus [Ivoclar Vivadent AG, Schaan, Fürstentum Liechtenstein], or iRoot SP [Innovative Bioceramix, Vancouver, BC, Canada]) used during root canal obturation, and the groups were further subdivided randomly into 3 subgroups (n = 4) based on the post dowel irrigation systems (ultrasound, regular rinse, or control) used. The samples were examined under a scanning electron microscope and were scored for debris and tubule openings using a 3-scale grading system. The Friedman test, Wilcoxon signed rank test, Kruskal-Wallis analysis, and Mann-Whitney U test were used to statistically analyze the results (α = 0.05). RESULTS: Samples in the AH Plus group were more easily debrided than those in the iRoot SP group (P < .05). The best tubule opening condition was presented in samples in the AH Plus group, whereas those in the iRoot SP group presented the worst (P < .05). The regular rinse and ultrasonic groups were similarly good at smear layer removal and tubule opening (P > .05) compared with the control group (P < .05). The samples using AH Plus in combination with ultrasound or syringe rinsing showed the best cleaning result among all of the subgroups (P < .05). CONCLUSIONS: AH Plus presented the easiest removal from the post space, whereas iRoot SP presented the most difficult removal. Ultrasound improved the cleaning efficacy of post dowels as did the regular rinse.
Assuntos
Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Animais , Bovinos , Cavidade Pulpar/cirurgia , Cavidade Pulpar/ultraestrutura , Microscopia Eletrônica de Varredura , Técnica para Retentor Intrarradicular , Ultrassom/métodosRESUMO
The aim of this study was to evaluate the antimicrobial action of different endodontic pastes against Enterococcus faecalis ATCC 29212, isolated from the urinary tract, and compare the action with E. faecalis ATCC 4083, isolated from the root canal. For this purpose, dentin blocks were infected for 21 days with both bacteria at different time-intervals to ensure there would be no cross contamination. After this period, blocks were immersed in the test medications for 7 days, according to the following groups: CH/S, CH/P, CH/CMCP, CH/CHX, CH/DAP and TAP. Images of the samples were captured with a confocal microscope and the percentage of live cells was computed by means of the Bioimage program. The ATCC 29212 strain was shown to be more resistant to CH/SS, Calen, CH/DAP, and TAP than the ATCC 4083 strain. The antimicrobial action of the medications against each strain were divergent concerning the order of susceptibility. The authors concluded that the strains behaved in a different manner: in general, those extracted from the urinary tract were more resistant to the tested medications. Therefore, when E. faecalis must be used for in vitro research in endodontics, we suggest the use of ATCC 4083 strain to obtain results that are closer to the clinical reality.
Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Hidróxido de Cálcio/farmacologia , Clorexidina/farmacologia , Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Animais , Biofilmes/classificação , Bovinos , Cavidade Pulpar/ultraestrutura , Enterococcus faecalis/classificação , Enterococcus faecalis/ultraestrutura , Microscopia Confocal , Microscopia Eletrônica de VarreduraRESUMO
INTRODUCTION: Conventional endodontic treatment includes instrumentation of the canals in most cases to size #25/.06 or larger, which changes the original canal wall anatomy. In recent years, energy-driven equipment, such as photon-induced photoacoustic streaming (Fotona LLC, Dallas, TX) and a multisonic GentleWave system (Sonendo Inc, Laguna Hills, CA), have been introduced to facilitate cleaning of minimally instrumented canals or even uninstrumented canals. The purpose of this study was to examine root canal wall anatomy in premolar teeth cleaned by a noninstrumentation method after #10 K-file patency examination. METHODS: Twenty-four freshly extracted human premolars were accessed, and patency was established by a #10 K-file. Seventeen teeth were treated by the GentleWave system using 3% sodium hypochlorite, and 7 untreated teeth served as negative controls. The dentin surface in the coronal, middle, and apical thirds of the root canal was examined by scanning electron microscopy after tooth splitting. The canal wall structures were assessed using a predefined scale of 4 parameters: calcospherites, surface irregularities, dentinal tubule openings, and tissue debris. RESULTS: A clean surface of mineralized dentin was exposed with no organic tissue remnants or debris left in the root canal system, including the isthmus areas between the 2 canals. The uninstrumented root canals showed an irregular dentin structure in many areas, including previously unreported fingerlike projections. The isthmus areas had no or only a few dentinal tubule openings. The dentin structures were well preserved in the test group, whereas in the untreated control teeth tissue debris covered most of the dentin surface. CONCLUSIONS: Root canal wall dentin in premolars cleaned with a noninstrumentation method showed a wide structural variety, especially in the middle and apical region. No organic tissue remnants or dentin debris were detected.
Assuntos
Dente Pré-Molar/ultraestrutura , Cavidade Pulpar/ultraestrutura , Dentina/ultraestrutura , Humanos , Microscopia Eletrônica de Varredura , Preparo de Canal Radicular , Ápice Dentário/ultraestruturaRESUMO
El tratamiento endodóntico debe considerar que los dientes presentan una morfología del sistema de canales radiculares con alta variabilidad y complejidad. por lo tanto, el conocimiento acabado de la anatomía radicular y la planificación del procedimiento utilizando sistemas imagenológicos previos a la realización del tratamiento endodóntico, como la tomografía computarizada 3D (CBTC), mejoran el pronóstico, aumentando las probabilidades de éxito. el objetivo de este reporte es mostrar la secuencia de una resolución clínica de un primer premolar inferior (diente 4.4) con una anatomía compleja, utilizando el CBTC tanto en el diagnóstico como en la planificación.
Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Dente Pré-Molar/diagnóstico por imagem , Imageamento Tridimensional/métodos , Cavidade Pulpar/diagnóstico por imagem , Raiz Dentária/ultraestrutura , Raiz Dentária/diagnóstico por imagem , Dente Pré-Molar/ultraestrutura , Processamento de Imagem Assistida por Computador , Cavidade Pulpar/ultraestruturaRESUMO
AIM: This study aimed to evaluate the efficacy of Intracanal calcium hydroxide removal with different techniques. MATERIALS AND METHODS: Seventy-five freshly extracted, non-carious, single canalled lower first premolars, having anatomic characteristics similar to each other, extracted for the orthodontic purpose were collected. After the root canal preparation, Calcium hydroxide was placed into the working length using lentulo spiral instrument till the medicament was visible at the apex. The specimens were segregated into three groups; Group 1: Rotary Files, Group 2: EndoVac system and Group 3: Ultrasonics. The evaluation was done with SEM in the coronal and apical third of the roots with a magnification of 1000x. The statistical analysis was done using statistical packages for social sciences (SPSS) software, version 20.0 for Windows (SPSS Inc., Chicago, IL). A p-value of less than 0.05 was considered significant statistically. RESULTS: Maximum removal of Ca(OH)2 was analyzed in the EndoVac system (2.90 ± 0.12) followed by the rotary files (1.76 ± 0.26) and least was seen with Ultrasonics (1.32 ± 0.14). The p-value of 0.001 was seen between the coronal and apical third with the EndoVac system which is statistically significant. The significant difference statistically was observed between Rotary Files vs. Ultrasonics at apical third and with the EndoVac system vs. Ultrasonics at coronal third as well as at the apical third with p-value 0.001. CONCLUSION: It can be concluded that the EndoVac technique was effective in removing Ca(OH)2 medicament from the coronal and apical third of the root canal significantly. CLINICAL SIGNIFICANCE: Calcium hydroxide removal before the obturation was of priority as the Ca(OH)2 remnants have a negative impact of the ability for sealing the obturation material. Therefore, having a complete knowledge regarding the effective technique is much important.
Assuntos
Hidróxido de Cálcio , Cavidade Pulpar/ultraestrutura , Microscopia Eletroquímica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular/métodos , Humanos , Preparo de Canal Radicular/instrumentação , Irrigação Terapêutica/métodos , Ultrassom/instrumentação , Ultrassom/métodosRESUMO
OBJECTIVES: This study was to compare the efficacy of EndoActivator, EndoVac, PUI, and LAI methods in removing the smear layer from root canals. MATERIALS AND METHODS: Eighty single-rooted mandibular premolars were decoronated to a standardized length of 15 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer) and irrigated with 5.25% NaOCl at 37 °C. Teeth were divided into six groups (two control groups [n = 10] and four test groups [n = 15]) according to the final irrigation activation/delivering technique (sonic irrigation [EndoActivator], passive ultrasonic irrigation [PUI], negative apical pressure [EndoVac], and laser activated irrigation [LAI]). Root canals were then split longitudinally and observed with field emission scanning electron microscopy to evaluate the presence of smear layer at 1, 3, 5, and 8 mm from the apex. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The EndoActivator was significantly more efficient than PUI, LAI, and control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System removed statistically significantly more smear layer than all groups at 1 mm from the apex. At 5 mm from the apex, EndoActivator and EndoVac removed more smear layer than LAI and control groups. At 5 and 8 mm from the apex, PUI and EndoVac did not differ statistically, but both performed statistically better than the control groups. CONCLUSION: In our study, none of the activation/delivery systems completely removed the smear layer from the root canal walls; nevertheless, EV and EA showed, respectively, statistically significant better results at 1, 3, 5, and 8 mm and 3, 5, and 8 mm from the apex.