A influência do eugenol na microdureza de duas resinas compostas comerciais / The influence of eugenol on the microhardness of two commercial composite resins

Objetivo: avaliar, in vitro, a dureza superficial e profunda de dois tipos diferentes de resina composta, quandoem contato com o cimento de óxido de zinco e eugenol (IRM®). Métodos: foram selecionadas as resinasCharisma® e Vittra® e confeccionados 80 corpos de prova, sendo 40 para cada marca de compósito, queforam divididos em oito grupos (n=10) conforme o contato (imediato, 7 dias, 14 dias) ou não (grupo controle)com o eugenol. Colocou-se num pote dappen uma porção de IRM e um espécime de resina pronto, que,após a presa do material restaurador temporário e a remoção do exemplar colocado, gerou o molde pararealização das amostras em contato com o eugenol, sendo armazenado em água em temperatura ambiente,para os subgrupos 7 e 14 dias. Em sequência, foi inserido um único incremento de resina composta e polimerizadopor 40 segundos, gerando os espécimes que foram armazenados em local seco para serem submetidosao teste de microdureza Vickers sob uma carga de 300 gramas, com tempo de penetração de 10 segundos.Os dados obtidos foram analisados pelo teste ANOVA, a um nível de significância de p<0,05. Resultados:somente o grupo da resina Charisma® que teve contato imediato com eugenol não atingiu 80% de durezaprofunda em relação à superficial. Entretanto, para todos os grupos analisados, tanto a dureza superficialquanto a profunda aumentaram após o contato com o eugenol em relação ao grupo controle. Conclusão: oeugenol não influenciou negativamente a dureza das resinas compostas.(AU)

Objective: to evaluate, in vitro, the superficial and deep hardness of two different types of composite resin when in contact with zinc oxide eugenol cement (IRM). Method: Charisma® and Vittra® resins were selected and 80 specimens were made, 40 for each composite brand that were divided into eight groups (n = 10) according to contact (immediate, 7 days, 14 days) or no (control group) with eugenol. A portion of IRM and a ready-made resin specimen were placed in a dappen pot, which after setting the temporary restorative material and removing the placed specimen, generated the template for making the samples in contact with eugenol, being stored in water in room temperature for subgroups 7 and 14 days. In sequence, a single increment of composite was inserted and polymerized resin for 40 seconds, generating specimens that were stored in a dry place to be submitted to the Vickers microhardness test under a load of 300 grams, with a penetration time of 10 seconds. The data obtained were analyzed by the ANOVA test, at a significance level of p <0.05. Results: only the Charisma® resin group that had immediate contact with eugenol did not reach 80% deep hardness in relation to superficial hardness. However, for all groups analyzed, both superficial and deep hardness increased after contact with eugenol compared to the control group. Conclusion: eugenol did not negatively influence the hardness of composite resins.(AU)

Moisture adsorption isotherms and quality of seeds stored in conventional packaging materials and hermetic Super Bag.

Seed moisture content (SMC) is an important attribute to seed quality. Maintaining seed dryness throughout supply chain (The Dry Chain) prevents seed germination and quality losses. Ambient relative humidity (RH) and temperature affect seed moisture and thereof seed moisture isotherm. Present study was conducted to compare the moisture adsorption isotherms of wheat, maize, cotton and quinoa seeds packed in hermetic Super Bag and traditional packaging materials including paper, polypropylene (PP), jute and cloth bags. Seeds were incubated at 60, 70, 80 and 90% static RH. Nearly straight line moisture isotherms for all crop seeds were obtained in Super Bag. Seed moisture contents increased in traditional packaging materials with increasing RH. At higher level of RH, moisture contents increased slightly (1-2%) in Super Bag, whereas this increase was much higher in traditional packaging materials (≈9% higher than original SMC at 90% RH). In second study, seeds were dried to 8 and 14% initial seed moisture contents using zeolite drying beads and were stored in hermetic and conventional packaging materials for a period of 18 months. For all crop seeds, germination was severely affected in all packaging materials both at 8 and 14% initial SMC except storage in Super Bag at 8% SMC. Wheat seed stored in Super Bag at 8% SMC almost maintained initial germination while germination of cotton, maize and quinoa seeds declined 7%, 14% and 30% respectively in Super Bag at 8% SMC. Seed storage in Super Bag can help to prevent the significant increase in seed moisture at higher RH as is evident from moisture isotherm study, thus helps to preserve quality of maize, wheat, cotton and quinoa seeds by maintaining The Dry Chain throughout the storage period.

Avaliação in vitro da influência de cimentos endodônticos na resistência de união sobre estrutura dentinária da câmara pulpar de dentes restaurados imediatamente e mediatamente após obturação / In vitro evaluation of the influence of endodontic cements on bond strength on the dentin structure of the pulp chamber of teeth restored immediately and immediately after filling

Este estudo teve por finalidade avaliar a influência dos cimentos endodônticos com um protocolo de irrigação na resistência de união sobre a estrutura dentinária das paredes da câmara pulpar de dentes bovinos restaurados imediatamente e após 7 dias do tratamento endodôntico. Foram avaliados os cimentos endodônticos: Cimento à base de resina epoxy (AH Plus ­ Dentsply, DeTrey, Konstanz- Alemanha) e Cimento de óxido de zinco e eugenol (Endofill ­ Dentsply Ind.com. LTDA ­ Brasil). Para a realização das restaurações foi utilizado o sistema adesivo Single Bond 2® (3M/ESPE) e a resina composta Z 350TM (3M/ESPE). 60 faces vestibulares da câmara pulpar de dentes bovinos foram distribuídos aleatoriamente em 4 grupos experimentais (G1-AHPlus Imediato; G2-AHPlus Mediato; G3-OZE Imediato; G4-OZE Mediato) e 2 controles (G5- NaOCl + EDTA Imediato e G6-NaOCl + EDTA Mediato). O protocolo de irrigação endodôntica deu-se através da imersão dos espécimes em solução de hipoclorito de sódio a 2.5% por 30 minutos e em EDTA 17% por 3 minutos. Os cimentos testados estiveram em contato com a parede dentinária pelo tempo de presa inicial, seguido de limpeza com algodão embebido em álcool 70% por 1 minuto. Os grupos experimentais de restauração mediata foram mantidos em estufa a 37ºC por 7 dias. Após o corte e a obtenção dos palitos de +/-1,0 mm² foi aplicado o teste de microtração na Máquina de Ensaios Universal e, em seguida, observados em microscópio óptico para classificação da fratura. Os valores da resistência de união foram submetidos ao teste não-paramétrico Wilcoxon-Mann-Whitney comparando dois a dois grupos a um nível de significância de 5%. Os resultados mostraram que o grupo G5 obteve menor valor de resistência de união, com diferença estatisticamente significativa (p<0,05) para os demais. O padrão de fratura mais observado nos grupos foi a coesiva em camada híbrida. Conclui-se que a associação NaOCl + EDTA diminui a resistência de união nas restaurações imediatas e que os cimentos endodônticos não alteraram a resistência de união nos períodos testados (AU).

This study aimed to evaluate the influence of endodontic sealer with an irrigation protocol on the bond strength on the dentinal structure of the pulp chamber walls of bovine teeth restored immediately and after 7 days of endodontic treatment. Endodontic sealer were evaluated: epoxy resin-based sealer (AH Plus - Dentsply, DeTrey, Konstanz- Germany) and zinc oxide and eugenol sealer (Endofill - Dentsply Ind.com. LTDA - Brazil). To perform the restorations, the Single Bond 2® adhesive system (3M / ESPE) and the composite resin Z 350TM (3M / ESPE) were used. 60 vestibular faces of the pulp chamber of bovine teeth were randomly assigned to 4 experimental groups (G1-AHPlus Immediate; G2-AHPlus Mediato; G3-OZE Immediate; G4-OZE Mediato) and 2 controls (G5- NaOCl + EDTA Immediate and G6- NaOCl + EDTA Mediato). The endodontic irrigation protocol was carried out by immersing the specimens in 2.5% sodium hypochlorite solution for 30 minutes and in 17% EDTA for 3 minutes. The tested sealers were in contact with the dentin wall for the initial setting time, followed by cleaning with cotton soaked in 70% alcohol for 1 minute. The experimental groups of mediated restoration were kept in an oven at 37ºC for 7 days. After cutting and obtaining the +/- 1.0 mm² toothpicks, the microtensile test was applied to the Universal Testing Machine and then observed under an optical microscope to classify the fracture. The bond strength values were subjected to the non-parametric Wilcoxon-Mann-Whitney test comparing two to two groups at a significance level of 5%. The results showed that the G5 group had a lower bond strength value, with a statistically significant difference (p <0.05) for the others. The most observed fracture pattern in the groups was cohesive in a hybrid layer. It is concluded that the association NaOCl + EDTA decreases the bond strength in immediate restorations and that endodontic sealer did not change the bond strength in the tested periods (AU).

Solubility, porosity and fluid uptake of calcium silicate-based cements

Abstract Objective: To evaluate the absorption/fluid uptake, solubility and porosity of White mineral trioxide aggregate (MTA) Angelus, Biodentine (BIO), and zinc oxide-eugenol (ZOE). Material and Methods: Solubility was evaluated after immersion in distilled water for 7 and 30 days. Porosity was evaluated using digital inverted microscope, scanning electron microscope (SEM) and micro-computed tomography (micro-CT). For the fluid uptake test, specimens were immersed in Hank's balanced salt solution (HBSS) for 1, 7, 14 and 28 days. Fluid absorption, solubility and porosity of the materials were measured after each period. Statistical evaluation was performed using one-way analysis of variance (ANOVA) and Tukey tests, with a significance level at 5%. Results: After 7 and 30 days, BIO showed the highest solubility (p<0.05). All methods demonstrated that MTA had total porosity higher than BIO and ZOE (p<0.05). Micro-CT analysis showed that MTA had the highest porosity at the initial period, after its setting time (p<0.05). After 7 and 30 days, ZOE had porosity lower than MTA and BIO (p<0.05). Absorption was similar among the materials (p>0.05), and higher fluid uptake and solubility were observed for MTA in the fluid uptake test (p<0.05). Conclusions: BIO had the highest solubility in the conventional test and MTA had higher porosity and fluid uptake. ZOE had lower values of solubility, porosity and fluid uptake. Solubility, porosity and fluid uptake are related, and the tests used provided complementary data.

Evaluation of physical-mechanical properties, antibacterial effect, and cytotoxicity of temporary restorative materials

Abstract The objective of this study was to compare selective physical-mechanical properties, antibacterial effects and cytotoxicity of seven temporary restorative materials (TRM): five resin-based materials [Bioplic (B), Fill Magic Tempo (FM), Fermit inlay (F), Luxatemp LC (L) and Revotek LC (R)], and zinc oxide-eugenol cement (IRM) and glass ionomer cement (GIC) as the controls. Material and methods The physical-mechanical properties were evaluated by determining microleakage (ML), ultimate tensile strength (UTS) and Shore D hardness (SDH). In addition, the polymerization rate (Pr-1), depth of cure (DC), water sorption and solubility (WS/SL) were evaluated. The antimicrobial effects of the materials were assessed by biofilm accumulation of Streptococcus mutans (BT) and the direct contact test (DCT) by exposure to Enterococcus faecalis for 1 and 24 h, and cytotoxicity by MTT assay. The data were analyzed by ANOVA or Kruskall-Wallis tests, and a complementary post-hoc method (p<0.05). Results Group B, followed by FM and GIC had significantly lower percentages of microleakage in comparison with the other groups; Groups FM and L showed the highest WS, while Groups R and FM showed the significantly lowest SL values (p<0.05). Group R showed the statistically highest UTS mean and the lowest DC mean among all groups. Group F showed the lowest S. mutans biofilm accumulation (p=0.023). Only the Group L showed continued effect against E. faecalis after 1 h and 24 h in DCT. The L showed statistically lower viability cell when compared to the other groups. Conclusions These findings suggest the antibacterial effect of the temporary materials Fill Magic and Bioplic against S. mutans, while Luxatemp showed in vitro inhibition of S. mutans biofilm accumulation and E. faecalis growth. Regarding the cell viability test, Luxatemp was the most cytotoxic and Fill Magic was shown to be the least cytotoxic.

Evaluation of physicochemical properties of root-end filling materials using conventional and Micro-CT tests

Abstract Objective To evaluate solubility, dimensional stability, filling ability and volumetric change of root-end filling materials using conventional tests and new Micro-CT-based methods. Material and Methods Solubility (loss of mass) after 7 and 30 days, and dimensional stability (in mm) were evaluated in accordance with Carvalho-Junior, et al. 7 (2007). The filling ability and volumetric change (in mm3) were evaluated by Micro-CT (Bruker-MicroCT, Kontich, Belgium) using resin models with cavities 3 mm deep and 1 mm in diameter. The cavities were filled with materials to evaluate filling ability, and then scanned by Micro-CT. After 7 and 30 days immersed in distilled water, the filled cavities were scanned again to evaluate the volumetric change. MTA Angelus (MTA), Biodentine (BIO) and zinc oxide-eugenol cement (ZOE) were evaluated. Data were submitted to analysis of variance (ANOVA) and Tukey's test with 5% significance level. Results The results suggested correlated or complementary data between the proposed tests. At 7 days, BIO showed higher solubility and at 30 days, showed higher volumetric change in comparison with MTA (p<0.05). With regard to volumetric change, the tested materials were similar (p>0.05) at 7 days. At 30 days, they presented similar solubility. BIO and MTA showed higher dimensional stability than ZOE (p<0.05). ZOE and BIO showed higher filling ability (p<0.05). Conclusions ZOE presented a higher dimensional change, and BIO had greater solubility after 7 days. BIO presented filling ability and dimensional stability, but greater volumetric change than MTA after 30 days. Micro-CT can provide important data on the physicochemical properties of materials complementing conventional tests.

A Case of Recurrent Urticaria Due to Formaldehyde Release from Root-Canal Disinfectant.

Although formaldehyde is well known to cause type 4 hypersensitivity, immunoglobulin E (IgE)-mediated hypersensitivity to formaldehyde is rare. Here, we report a case of recurrent generalized urticaria after endodontic treatment using a para-formaldehyde (PFA)-containing root canal sealant and present a review of previous studies describing cases of immediate hypersensitivity reactions to formaldehyde. A 50-year-old man visited our allergy clinic for recurrent generalized urticaria several hours after endodontic treatment. Prick tests to latex, lidocaine, and formaldehyde showed negative reactions. However, swelling and redness at the prick site continued for several days. The level of formaldehyde-specific IgE was high (class 4). Thus, the patient was deemed to have experienced an IgE-mediated hypersensitivity reaction caused by the PFA used in the root canal disinfectant. Accordingly, we suggest that physicians should pay attention to type I hypersensitivity reactions to root canal disinfectants, even if the symptoms occur several hours after exposure.

Microfiltración apical in vitro causada por las técnicas de obturación con cono único, System B y condensación lateral clásica / In vitro apical microleakage causade by single-cone, System B and cold lateral condensation obturation techniques

La obtención de un sellado hermético en la obturación del conducto radicular es una etapa coadyuvante del éxito endodóntico. Objetivo: Comparar la microfi ltración apical in vitro, calidad de relleno y presencia de espacios vacíos en conductos radiculares obturados con los métodos de obturación cono único, condensación lateral clásica y System B. Material y métodos: Noventa raíces mesiales de molares inferiores fueron instrumentados con ProTaper a un calibre F3 y asignados aleatoriamente para su obturación a tres grupos (n = 30 raíces), grupo 1: condensación lateral clásica con gutapercha #30.02, grupo 2: cono único con gutapercha F3 y grupo 3: System B con gutapercha #30.02; en todas las técnicas se usó una mezcla de óxido de zinc eugenol como sellador.Obturados los conductos las muestras se sumergieron en azul de metileno al 0.5 por ciento, se centrifugaron a 3,200 rpm durante cinco minutos, se diafanizarony se llevaron al microscopio estereoscópico a 12.5x para la mediciónde microfi ltración apical, calidad de relleno y presencia de espacios vacíospor un observador calibrado. Resultados: No se encontraron diferencias significativas en la microfi ltración apical entre el grupo de condensación lateral clásica y System B (p > 0.05) siendo el cono único la técnica que presenta mayor fi ltración. La técnica que ofrece la menor cantidad de espacios vacíos y mejor calidad de relleno es System B. Conclusiones:El método System B y condensación lateral clásica dejan una baja microfiltración apical y adecuada calidad de relleno comparada con la que sepresenta con cono único utilizando como sellador óxido de zinc eugenol...

Dissolution of a mineral trioxide aggregate sealer in endodontic solvents compared to conventional sealers

Abstract The aim of this study is to evaluate the solubility of a Mineral Trioxide Aggregate sealer (MTA-Fillapex) compared with five other sealers, calcium hydroxide (Sealapex), resin (Realseal), zinc oxide-eugenol (Tubli-Seal), and two epoxy resins (AH-26 and AH-Plus), in chloroform and eucalyptoil in static and ultrasonic environments. Samples of each sealer were prepared (n = 180) and then divided into 12 groups that were immersed in solvents for 5 and 10 min in static and ultrasonic environments. The mean weight loss was determined, and the values were compared using Student's t-test, One-way ANOVA, and Tukey's HSD post-hoc test (p < 0.05). In chloroform, MTA-Fillapex, AH-26, and Sealapex displayed moderate solubility with no significant difference in dissolution (p = 0.125); however, their dissolution was significantly lower than that of AH-Plus (p < 0.001), which was almost fully dissolved after 10 minutes. Realseal was significantly less soluble than all sealers (p < 0.001). In eucalyptoil, MTA-Fillapex showed low solubility, as all of the sealers did, but Tubli-Seal was significantly more soluble than other sealers (p < 0.001). Using ultrasonic activation resulted in a significantly higher dissolution rate in chloroform for all sealers except MTA-Fillapex after 10 min (p = 0.226). In eucalyptoil, ultrasonic activation significantly increased the dissolution rate of all sealers except MTA-Fillapex after 5 and 10 min, Sealapex at 10 min, and AH-Plus at 5 min (p > 0.05). In conclusion, MTA-Fillapex was not sufficiently dissolved in either solvent. Ultrasonic activation had limited effectiveness on MTA-Fillapex dissolution, whereas it significantly increased the efficiency of solvents in dissolving a number of endodontic sealers.

Characterization of Cement Particles Found in Peri-implantitis-Affected Human Biopsy Specimens.

PURPOSE: Peri-implantitis is a disease characterized by soft tissue inflammation and continued loss of supporting bone, which can result in implant failure. Peri-implantitis is a multifactorial disease, and one of its triggering factors may be the presence of excess cement in the soft tissues surrounding an implant. This descriptive study evaluated the composition of foreign particles from 36 human biopsy specimens with 19 specimens selected for analysis. The biopsy specimens were obtained from soft tissues affected by peri-implantitis around cement-retained implant crowns and compared with the elemental composition of commercial luting cement. MATERIALS AND METHODS: Nineteen biopsy specimens were chosen for the comparison, and five test cements (TempBond, Telio, Premier Implant Cement, Intermediate Restorative Material, and Relyx) were analyzed using scanning electron microscopy equipped with energy dispersive x-ray spectroscopy. This enabled the identification of the chemical composition of foreign particles embedded in the tissue specimens and the composition of the five cements. Statistical analysis was conducted using classification trees to pair the particles present in each specimen with the known cements. RESULTS: The particles in each biopsy specimen could be associated with one of the commercial cements with a level of probability ranging between .79 and 1. TempBond particles were found in one biopsy specimen, Telio particles in seven, Premier Implant Cement particles in four, Relyx particles in four, and Intermediate Restorative Material particles in three. CONCLUSION: Particles found in human soft tissue biopsy specimens around implants affected by peri-implant disease were associated with five commercially available dental cements.

Capacidad de sellado coronario de dos cementos endodónticos a base de óxido de cinc y eugenol: un estudio ex vivo / Coronal sealing ability of two zinc-oxide and eugenol-based endodontic sealers: an ex vivo study

Objetivo: comparar, mediante un modelo de filtración bacteriana, la capacidad de sellado coronario de obturaciones realizadas con conos de gutapercha complementados con Kleppmetthasona (KMS; Klepp/Raysan, Buenos Aires, Argentina); y Pulp Canal Sealer EWT (PCS; Sybron-Endo, Glendora, Estados Unidos). Materiales y métodos: se utilizaron 24 (n=24) premolares humanos sanos extraídos. En todos los casos, los conductos radiculares fueron preparados por medio de instrumentos rotatorios ProTaper Universal (Dentsply/Tulsa Dental, Tulsa, OK, Estados Unidos) hasta un instrumento #F3. Se distribuyeron 20 de los dientes en dos grupos experimentales (Grupo I y Grupo II) de 10 (n=10) especímenes cada uno. En cada grupo se agregaron un especimen de control positivo (n=1) y un especimen de control negativo (n=1). En el grupo 1, los conductos se obturaron con un cono de gutapercha ProTaper de conicidad correspondiente al instrumento #F3 y se complementó mediante la condensación lateral de conos accesorios. El sellador utilizado fue KMS, a base de óxido de cinc y eugenol que incluye un corticoide en su composición. En el Grupo 2 se realizó el mismo procedimiento, pero se utilizó PCS, un sellador a base de óxido de cinc y eugenol convencional. Para cada especimen, el proceso de filtración bacteriana se realizó por medio de un sistema individual de doble cámara, cada uno de las cuales contenía el medio de cultivo. En todos los casos, el medio de la cámara superior se inoculó con un cultivo de Enterococcus faecalis y el sistema se incubó durante 60 días. En la cámara inferior, la filtración bacteriana se controló diariamente hasta la finalización del experimento. Los datos registrados se analizaron con la prueba de supervivencia de Kaplan-Meyer yla prueba de Fischer, con un nivel de significación de P<0.05. Resultados: todos los controles positivos demostraron filtración bacteriana dentro de las primeras 48 horas. No hubo filtración en ninguno de los controles negativos.

Reacción del tejido óseo de la rata a un sellador endodóntico a base de óxido de cinc y eugenol con acetato de hidrocortisona / Response of the bone tissue of the rat to a zin-oxide and eugenol/hydrocortisone acetate-based endodontic sealer

Objetivos: analizar comparativamente la respuesta del tejido óseo de la rat a la implantación de Kleppmethasona (KMS), un sellador endodóntico a base de óxido de cinc y eugenol que contiene un corticoide en su composición y Pulp Canal Sealer EWT (PCS), un sellador a base de óxido de cinc y eugenol convencional. Materiales y métodos: se implantaron en ambas tibias de 12 ratas, tubos de silicona obturados a ras en los dos extremos con una preparación fresca de Kleppmethasona (KMS; Klepp/Raysan SA) o Pulp Canal Sealer (PCS; Sybron-Endo) (control positivo). Como grupo negativo se utilizó la pared lateral de los tuobs de silicona (SCN). Luego de los 14 y 94 días, los implantes fueron removidos, fijados en solución de formol al 10 por ciento y procesados para su estudio histológico. Resultados: a los 14 días posimplantación, el análisis histológico reveló una reacción inflamatoria severa compuesta por polimorfonucleares neutrófilos, linfocitos, plasmocitos, macrófagos, fibroblastos y vasos de neoformación en los especímenes que se hallaban en contgacto directo con KMS y PCS. A los 94 días, en los casos en contacto con KMS, la reacción inflamatoria se redujo sustancialmente y se observó un proceso de reparación con presencia de una cápsula fibrosa sin céluals inflamatorias y el desarrollo de nuevas trabéculas óseas. En los especímenes en contacto con PCS la reacción inflamatoria inicial se redujo, pero se observó la persistencia de algunas células inflamatorias. Sin embargo, esta situación no pareció impedir el desarrollo incipiente de nuevas trabéculas óseas. En contacto con el SCN la reacción de los tejidos a los 14 días fue considerada mínima en un solo caso. Al finalizar la experiencia, los tejidos circundantes se encontraban normales en todos los casos. A los 14 días se observaron diferencias significativas (p<0,05) entre KMS/PCS y los SCN, mientras que no las hubo (p>0,05) entre ambos selladores. A los 94 día...

Cement-associated signs of inflammation: retrospective analysis of the effect of excess cement on peri-implant tissue.

PURPOSE: Excess cement left in the peri-implant sulcus after the placement of prosthetic restorations risks inflammation in the peri-implant tissue. While many current studies deal with the question of how to avoid undetected excess cement, relatively little is known about the clinical consequences of this complication. This study analyzed the clinical findings associated with excess cement. Further, the influence of the sojourn time of undetected excess cement in the peri-implant pocket on clinical findings was investigated. MATERIALS AND METHODS: Within the scope of a retrospective clinical follow-up, the suprastructures that were originally cemented with a methacrylate cement were revised in 93 patients (171 implants). The patients were split into two groups according to the time between placement of the prosthetic restoration and revision. Group 1 (G1) had treatment revisions within 2 years of restoration placement (71 patients with 126 implants); in group 2 (G2), treatment revisions were conducted at a later time (22 patients with 45 implants). For the purpose of statistical analysis, both groups were further analyzed based on the presence/absence of excess cement at the time of revision. RESULTS: By definition, the average time to revision in G1 was shorter than in G2 (0.71 years versus 4.07 years). There was no significant difference in the frequency of excess cement at revision between G1 (59.5%) and G2 (62.2%). The clinical findings around the implants in G1 were significantly less severe than in G2 (bleeding on probing: G1 without excess cement--17.6%, G1 with excess cement--80%, G2 without excess cement--94.1%, G2 with excess cement--100%; suppuration: G1 without excess--0%, G1 with excess cement--21.3%, G2 without excess cement--23.3%, G2 with excess cement--89.3%). After removing the excess cement, cleaning and disinfecting the implant abutment and restoration, and using a different cement, significantly fewer signs of inflammation were found at further follow-up in both groups. CONCLUSIONS: Within the limitations of this retrospective observational study, excess cement was present in a high number of cement-retained implant restorations. Signs of inflammation were present in a large proportion of implants at short- to medium-term follow-up. At the time of restoration revisions, the clinical observation of previously undetected excess cement was associated with increased prevalence of inflammation. Removal of excess cement significantly reduced the signs of inflammation.

Treatment of a large cystlike inflammatory periapical lesion associated with mature necrotic teeth using regenerative endodontic therapy.

INTRODUCTION: Regenerative endodontic therapy is currently used to treat immature permanent teeth with necrotic pulp and/or apical periodontitis. However, mature teeth with necrotic pulp and apical periodontitis have also been treated using regenerative endodontic therapy. The treatment resulted in resolution of apical periodontitis, regression of clinical signs and symptoms but no apparent thickening of the canal walls, and/or continued root development. A recent study in an animal model showed that the tissues formed in the canals of mature teeth with apical periodontitis after regenerative endodontic therapy were cementumlike, bonelike, and periodontal ligament-like tissue with numerous blood vessels. These tissues are similar to the tissues observed in immature permanent teeth with apical periodontitis after regenerative endodontic therapy. METHODS: A 23-year-old woman had a history of traumatic injury to her upper anterior teeth when she was 8 years old. Subsequently, #8 developed pulp necrosis and an acute apical abscess and #7 symptomatic apical periodontitis. The apex of #8 was slightly open, and the apex of #7 was completely formed. Instead of nonsurgical root canal therapy, regenerative endodontic therapy was attempted, including complete chemomechanical debridement on #8 and #7. This was based on the premise that filling of disinfected root canals with the host's biological vital tissue might be better than filling with foreign materials. RESULTS: After regenerative endodontic therapy of #8 and #7, there was radiographic evidence of periapical osseous healing and regression of clinical signs and symptoms. The pulp cavity of #8 decreased in size, and the apex closed. The pulp cavity of #7 appeared to be obliterated by mineralized tissue. These indicated ingrowth of new vital tissue into the chemomechanically debrided canals. CONCLUSIONS: Regenerative endodontic therapy of mature teeth with apical periodontitis and apical abscess can result in the regression of clinical signs and/or symptoms and healing of apical periodontitis but no apparent thickening of the canal walls or continued root development. Filling of the disinfected canals with the host's vital tissue may be better than with foreign materials because vital tissue has innate and adaptive immune defense mechanisms.

Tratamento endodôntico em molar decíduo com fistula no palato - relato de caso / Endodontic treatment of deciduous molar with palatine fistula - case report

A realização da Endodontia em decíduos com comprometimento pulpar é importante, uma vez que a permanência destes na cavidade bucal servirá de guia para a erupção dos permanentes sucessores. Ocorre que quando a lesão endodôntica não é tratada e se estende além da polpa coronária pode surgir uma fístula, sinal clínico de que na região existe infecção em atividade. A incidência de fístula no palato em crianças é rara. O objetivo deste artigo foi relatar um caso clínico de tratamento endodôntico radical realizado em molar superior decíduo com presença de fístula. Paciente infantil, gênero feminino, 3 anos, apresentava inicialmente edema facial no lado esquerdo e dor de grande intensidade. O dente 64 tinha uma restauração com recidiva de cárie e polpa necrosada com fístula no palato, levando ao diagnóstico de abscesso dentoalveolar agudo. Foi feito como urgência cirurgia de acesso e localização dos condutos radiculares com uso de formocresol como medicação e o dente foi restaurado provisoriamente. Retorno após 7 dias, com sensível melhora do quadro clínico. Com respeito às técnicas de manejo do comportamento infantil, na sequência foi realizado um eficiente preparo biomecânico e obturação com cimento de óxido de zinco e eugenol. A restauração definitiva foi feita com resina composta após 7 dias. Controle após 8 meses não apresentou alterações clínicas ou radiográficas. A manutenção de elementos decíduos na arcada permite completar seu ciclo biológico e proporcionar condições apropriadas para o crescimento e desenvolvimento das bases apicais e do sucessor permanente.

Endodontics in deciduous teeth with compromised pulp is important, since their permanence in the oral cavity will guide the permanent successor eruption. When the endodontic lesion is not treated it extends beyond the coronary pulp and a fistula may appear indicating a clinical sign of infection activity in this site. The incidence of palatal fistula in children is rare. The aim of this paper was to report a clinical case of endodontic treatment performed in a deciduous superior molar presenting fistula. A 3-year-old female patient presented facial edema on the left side and great intensity pain. Dental element 64 was restored. However, it had recurrence of decay and pulpal necrosis with palatal fistula, leading to diagnosis of acute dentoalveolar abscess. As an urgency procedure, access surgery and location of radicular canals were made and formocresol used as an interappointment dressing in pulpectomy with temporary restoration. There was an improvement in her clinical state after 7 days. Respecting the management of infant behavior, it was performed an efficient biomechanical instrumentation and filling with zinc oxide eugenol cement. Definitive restoration was made with composite after 7 days. After 8 months there was no clinical or radiographic worsening. The permanence of deciduous teeth in the dental arches allows the end of their biological cycle and provides appropriate conditions to apical bases growing and development including the permanent successor teeth.

Influence of Endodontic Sealer Composition and Time of Fiber Post Cementation on Sealer Adhesiveness to Bovine Root Dentin

This study aimed to assess the influence of the type of endodontic sealer (salicylate resin-based sealer vs. two endodontic sealers) and the time of fiber post cementation after root filling on the post adhesion to bovine root dentin. Sixty bovine roots were assigned to six groups (n=10), considering an experimental design with two factors (factorial 3x2): endodontic sealer factor in three levels [epoxy resin-based sealer (AH Plus), eugenol-based sealer (Endofill), and salicylate resin-based sealer plus mineral trioxide aggregate - MTA (MTA Fillapex)] and time for post cementation factor in two levels (immediate post cementation or 15 days after root canal filling). After post cementation, 2-mm-thick slices were produced and submitted to push-out test. The failure modes were analyzed under a 40× stereomicroscope and scored as: adhesive at cement/dentin interface; adhesive at cement/post interface; cement cohesive; post cohesive; dentin cohesive; or mixed. Data were analyzed using two-way ANOVA and Tukey's post-hoc tests (α=0.05). When the fiber posts were cemented immediately after the root canal filling, the bond strengths were similar, independent of the endodontic sealer type. However, after 15 days, the epoxy resin-based sealer presented higher bond strength than the other sealers (p<0.05). Comparison between each sealer in different experimental times did not reveal any differences. The main failure type was adhesive at dentin/cement interface (89.4%). The time elapsed between the root canal filling and post cementation has no influence on post/root dentin adhesion. On the contrary, the type of endodontic sealer can influence the adhesion between fiber posts and root dentin.

Este estudo objetivou avaliar a influência do tipo de cimento endodôntico (um cimento à base de resina de salicilato e dois cimentos endodônticos) e do tempo decorrido entre a obturação do conduto e a cimentação do pino de fibra na adesão de pinos de fibra à dentina radicular bovina. Sessenta dentes bovinos foram divididos em seis grupos (n=10), considerando um desenho experimental de dois fatores (3x2): cimento endodôntico em três níveis [à base de resina epóxica (AH Plus), eugenol (Endofill) e resina de salicilato e MTA (MTA Fillapex)] e o tempo para cimentação em dois níveis (cimentação imediata e 15 dias pós a obturação). Após cimentação do pino de fibra, fatias com 2 mm de espessura foram obtidas e submetidas ao teste de push-out. Os padrões de falha foram analisados em estereomicroscópio (40×) e classificados em: adesiva na interface cimento/dentina, adesiva cimento/pino, coesiva do cimento, coesiva do pino, coesiva da dentina e mista. Os dados foram analisados através dos testes de ANOVA a dois fatores e post hoc de Tukey (α=0,05). Quando os pinos de fibra foram cimentados imediatamente após a obturação dos condutos, a resistência adesiva foi similar, independentemente do tipo de cimento endodôntico. Entretanto, após 15 dias, os dentes obturados com cimento resinoso à base de resina epóxica apresentaram os maiores valores de resistência adesiva (p<0,05). Os valores de resistência adesiva do mesmo cimento nos diferentes tempos experimentais não foram alterados. O principal tipo de falha foi adesiva na interface cimento/dentina (89,4%). O tempo decorrido entre a obturação dos condutos e a cimentação do pino não influenciou a adesão do pino de fibra à dentina radicular. Por outro lado, o tipo de cimento endodôntico influencia a adesão entre dentina radicular e pinos de fibra.

Long-term dose- and time-dependent effects of endodontic sealers in human in vitro osteoclastogenesis.

INTRODUCTION: This study evaluates the concentration and time-dependent effects of endodontic sealers' extracts (AH Plus [Dentsply DeTrey, Konstanz, Germany], GuttaFlow [Roeko, Colténe/Whaledent, Germany], Tubliseal [Kerr/Sybron, Romulus, MI], Sealapex [Kerr/Sybron, Romulus, MI], and RealSeal [SybronEndo, Orange, CA]) in the differentiation and function of both unstimulated and stimulated osteoclast precursors, simulating, respectively, immature/undifferentiated precursors and cells undergoing osteoclastogenesis. METHODS: The sealers were mixed according to the manufacturers' instructions, freshly extracted with culture medium (1.3 cm(2)/mL, 24 hours, 37°C, 5% CO2/air), and diluted (1:20, 1:100, 1:500, and 1:2500). Human peripheral blood mononuclear cells were used as osteoclast precursor cells. After overnight attachment, peripheral blood mononuclear cell cultures were exposed to the sealers' extracts during 21 days in the absence (unstimulated) or presence (stimulated) of recombinant macrophage colony-stimulating factor and receptor for the activation of nuclear factor-κB ligand. Cultures performed in the absence of the extracts were used as the control. Cultures were characterized for osteoclastic differentiation and function. RESULTS: Extracts caused mostly inhibitory effects on osteoclastic cells, both in unstimulated and stimulated conditions, which were reflected by a decrease in tartrate-resistant acid phosphatase activity, the presence of actin rings, vitronectin and calcitonin receptors, the calcium phosphate resorbing ability, and the expression of osteoclastic genes. Also, the extracts induced alterations in the relative contribution of some intracellular signaling pathways involved in osteoclastogenic events. The sealers differed in the dose- and time-dependent profile. An adaptive cell response was noticed for the inhibitory effects after long-term exposure. CONCLUSIONS: Endodontic sealers affect the osteoclastic differentiation and activity, which is followed by an adaptive cell response. Our results suggest that the deleterious effect in the bone periapical tissues observed with the root canal sealers might involve, at least partially, a direct effect on the osteoclastic cells.

Spectrophotometric analysis of crown discoloration induced by MTA- and ZnOE-based sealers

Crown discoloration can be induced by root canal sealer remnants following root canal treatment. Objective: The aim of this study was to evaluate chromatic alterations in human tooth crowns induced by a Mineral Trioxide Aggregate-based sealer (MTA Fillapex®) and a commonly used ZnOE-based sealer (Roth-811). The tested null hypothesis was that the application of the materials did not induce clinically perceptible crown discoloration (Ho: CIE color difference ΔE<3.7). Material and Methods: Forty five fully developed, intact, mandibular third molars were sectioned 1 mm below the cemento-enamel junction. The pulp chambers were chemomechanically debrided via the cervical access. The specimens were randomly assigned into three groups Group 1: MTA Fillapex, Group 2: Roth 811, Group 3: Negative control (unfilled) and immersed in individually marked vials containing distilled water up to the cervix (37±1°C). The spectral reflectance lines were recorded by utilizing a UV-VIS spectrophotometer equipped with integration sphere in the visual spectrum at baseline, 1 week, 1 and 3 months after material placement. Data were transformed into values of the CIE L*a*b* color system and the corresponding ΔE values were calculated. Statistical analysis was performed using two-way mixed ANOVA models, at p=0.05 level of significance. Results: A statistically significant increase in a* and b* chromatic parameters of the MTA Fillapex Group was measured. However, ΔE values did not exceed the human eye perceptibility threshold (set at ΔE<3.7) during the experimental period (ΔEt3=2.88). In Roth-811 Group, a statistically significant decrease in L* and a statistically significant increase in a* and b* chromatic parameters was measured, during all observation periods. Resultant ΔE values exceeded the human eye perceptibility threshold after 1 week (ΔEt1=5.65). Conclusions: Application of MTA Fillapex in tooth crowns resulted in minimal color alterations, while Roth 811 induced severe discoloration, in vitro. It could be suggested that, in terms of aesthetics, the use of MTA Fillapex appears to be favorable.

Effect of root canal filling materials on dimensions of cone-beam computed tomography images

OBJECTIVE:To evaluate the discrepancy of root canal filling (RCF) measurements obtained from original root specimens and cone-beam computed tomography (CBCT) images. MATERIAL AND METHODS: Seventy-two human maxillary anterior teeth were prepared up to an ISO #50 K-File 1 mm short of the apical foramen. Thus, the teeth were randomly divided into 8 groups, according to the root canal filling material: Sealapex ®, Sealapex®+gutta-percha points, Sealer 26®, Sealer 26®+gutta-percha points, AH PlusTM, AH PlusTM+gutta-percha points, Grossman Sealer, and Grossman Sealer+gutta-percha points. After root canal preparation and RCF, CBCT scans were acquired and the specimens were sectioned in axial, sagittal and coronal planes. The RCF measurements were obtained in different planes and thicknesses to determine the discrepancy between the original root specimens (using a digital caliper) and the CBCT images (using the scanner’s proprietary software). One-way analysis of variance and Tukey tests were used for statistical analyses. The significance level was set at α=5%. RESULTS: Measurements of the different endodontic filling materials were 9% to 100% greater on the CBCT images than on the original root specimens. Greater RCF dimensions were found when only sealers were used, with statistically significant difference among the groups. CONCLUSIONS: RCF dimensions were greater on CBCT images than on the original root specimens, especially when only sealer was used.

Bond strength of different endodontic sealers to dentin: push-out test

OBJECTIVE: The aim of this in vitro study was to evaluate the bond strength of different root canal sealers to dentin. MATERIAL AND METHODS: Forty extracted single-rooted human teeth were examined and the coronal and middle thirds of the canals were prepared with a 1.50 mm post drill (FibreKor Post System, Pentron). The teeth were allocated in two experimental groups, irrigated with 2.5 percent NaOCl+17 percent EDTA or saline solution (control group) and instrumented using Race rotary files (FKG) to a size #40 at the working length. Then, the groups were divided into four subgroups and filled with Epiphany sealer (Group 1), EndoREZ (Group 2), AH26 (Group 3) and Grossman's Sealer (Group 4). After 2 weeks of storage in 100 percent humidity at 37ºC, all teeth were sectioned transversally into 2-mm-thick discs. Push-out tests were performed at a cross-head speed of 1 mm/min using a universal testing machine. The maximum load at failure was recorded and expressed in MPa. RESULTS: Means (±SD) in root canals irrigated with 2.5 percent NaOCl and 17 percent EDTA were: G1 (21.6±6.0), G2 (15.2±3.7), G3 (14.6±4.5) and G4 (11.7±4.1).Two-way ANOVA and Tukey's test showed the highest bond strength for the Epiphany's group (p< 0.01) when compared to the other tested sealers. Saline solution decreased the values of bond-strength (p<0.05) for all sealers. CONCLUSION: Epiphany sealer presented higher bond strength values to dentin in both irrigating protocols, and the use of 2.5 percent NaOCl and 17 percent EDTA increased the bond strength values for all sealers.