Influência da ativação ultrassônica e veículo no pH dentinário em dentes com reabsorção radicular externa simulada reparados com MTA / Influence of ultrasonic activation and mixing vehicle on dentinal pH in simulated external root resorptions repaired with MTA

Avaliar o efeito da ativação ultrassônica e do veículo do MTA no pH dentinário em dentes com reabsorção radicular externa simulada. Métodos: Uma cavidade foi preparada na superfície radicular de 46 dentes bovinos, as quais foram seladas com MTA preparado com 100% de água destilada (DW) ou com 80% DW e 20% de propilenoglicol (PG). Os dentes foram divididos em quatro grupos (n = 10), de acordo com o veículo e o protocolo de ativação ultrassônica utilizado durante a inserção do material (ativação ou sem ativação). O grupo controle (n = 6) foi deixado sem selamento. O pH foi mensurado após 15, 30 e 60 dias de imersão. Resultados: A ativação com ultrassom não alterou significativamente o pH (p>0,05). Os cimentos manipulados utilizando DW + PG apresentaram maior pH aos 15 dias, em relação ao MTA manipulado com DW (p<0,05). Conclusão: A associação de 80% de água destilada com 20% de propilenoglicol aumentou o pH dentinário, o que é positivo para o reparo de reabsorções radiculares (AU).

The aim of this study was to evaluate the effect of ultrasonic activation and MTA vehicle on dentinal pH in simulated external root resorptions. So, a cavity was prepared in the root of forty-six bovine teeth. They were filled with MTA mixed with 100% distilled water (DW) or MTA mixed with 80% DW and 20% propylene glycol (PG). Teeth were divided into four groups (n = 10), according to the vehicle (DW or PG) and ultrasonic protocol used for material insertion (activated or not). Control group (n = 6) was unfilled. The pH was assessed after 15, 30 and 60 days of immersion. As results of all that, activation with ultrasound did not significantly alter the pH (p > 0.05). The cements were mixed with either DW or DW + PG, with the later association presenting higher pH at 15 days of assessment than the former (p < 0.05). Thereby, it can be concluded that mixing MTA with 80% DW and 20% PG increased the dentinal pH, which is positive for root resorption repair (AU).

Solubility, porosity, dimensional and volumetric change of endodontic sealers

Abstract The aim of this study was to evaluate physical properties of endodontic sealers (AH Plus, MTA Fillapex and Endofill), by conventional and micro-CT tests. Dimensional stability was evaluated after immersion of materials in distilled water for 30 days. Solubility and volumetric change were evaluated after 7 and 30 days of immersion in distilled water. Solubility was evaluated by means of mass loss and volumetric change was assessed by micro-CT. Porosity was evaluated under a microscope after 7 days of immersion in distilled water, and by using micro-CT after setting and immersion in distilled water for 7 and 30 days. Statistical analysis was performed by ANOVA and Tukey's test with 5% significance level. MTA Fillapex presented the highest solubility (p<0.05), showing values above the ISO/ADA recommendations. MTA Fillapex presented higher volumetric and dimensional changes, followed by Endofill and AH Plus (p<0.05). Dimensional stability of the MTA Fillapex and AH Plus did not follow ISO/ADA standards. The highest total porosity was observed for MTA Fillapex (p<0.05). Endofill had higher total porosity than AH Plus according to microscope evaluation (p<0,05), and both sealers were similar in micro-CT assessment (p>0,05). In conclusion, MTA Fillapex presented higher solubility, dimensional and volumetric change besides porosity compared to the other evaluated sealers. The assessed physical properties of sealers are related, and the different tests provided complementary data. Micro-CT is a valuable method for assessment of physical properties of endodontic materials.

Resumo O objetivo deste estudo foi avaliar propriedades físicas de cimentos endodônticos (AH Plus, MTA Fillapex e Endofill), por meio de testes convencionais e micro-CT. A estabilidade dimensional foi avaliada após imersão dos materiais em água destilada por 30 dias. A solubilidade e a alteração volumétrica dos materiais foram avaliadas após 7 e 30 dias de imersão em água destilada. A solubilidade foi avaliada por meio de perda de massa e a alteração volumétrica foi avaliada por micro-CT. A porosidade foi avaliada por microscopia após 7 dias de imersão em água destilada e por micro-CT após a presa e imersão em água destilada por 7 e 30 dias. A análise estatística foi realizada por meio dos testes ANOVA e Tukey, com nível de significância de 5%. MTA Fillapex apresentou a maior solubilidade (p<0,05), com valores acima das recomendações ISO/ADA. As alterações volumétricas e dimensionais foram maiores para MTA Fillapex, seguido por Endofill e AH Plus (p<0,05). MTA Fillapex e AH Plus não cumpriram os padrões ISO/ADA em relação à estabilidade dimensional. Uma maior porosidade total foi observada para MTA Fillapex (p <0,05). Endofill apresentou maior porosidade total que o AH Plus pela avaliação em microscopia (p<0,05), e ambos os cimentos foram semelhantes na avaliação por micro-CT (p>0,05). Em conclusão, MTA Fillapex apresentou maior solubilidade, alteração dimensional e volumétrica, além de maior porosidade em relação aos demais cimentos avaliados. As propriedades físicas avaliadas estão relacionadas, e os diferentes testes forneceram dados complementares. Micro-CT é um método valioso para avaliação das propriedades físicas dos materiais endodônticos.

Tricalcium silicate-based cements: properties and modifications

Abstract: Mineral trioxide aggregate (MTA) has been widely used for different reparative procedures in endodontics. The extensive use of this cement for pulp capping, apexifications, apical surgeries, and revascularization is related to its ability to induce tissue repair and to stimulate mineralization. Several research studies have tested modifications in the composition of MTA-based cements in order to enhance their clinical performance. Novel formulations have been introduced in the market with the aim of increasing flowability. Important properties such as appropriate radiopacity and setting time, color stability, alkaline pH, release of calcium ions, and biocompatibility have to be considered in these new formulations. The latest research studies on the physical, chemical, and biological properties of tricalcium silicate-based cements are discussed in this critical review.

Push-out bond strength of different tricalcium silicate-based filling materials to root dentin

Abstract: The aim of this study was to evaluate the bond strength of different triccalcium silicate cements to retrograde cavity using a push out test. Thirty maxillary central incisors were shaped using #80 hand files and sectioned transversally. Root slices were obtained from the apical 4 mm after eliminating the apical extremity. The specimens were embedded in acrylic resin and positioned at 45° to the horizontal plane for preparation of root-end cavities with a diamond ultrasonic retrotip. The samples were divided into three groups according to the root-end filling material (n = 10): MTA Angelus, ProRoot MTA and Biodentine. A gutta-percha cone (#80) was tugged-back at the limit between the canal and the root-end cavity. The root-end cavity was filled and the gutta-percha cone was removed after complete setting of the materials. The specimens were placed in an Instron machine with the root-end filling turned downwards. The push-out shaft was inserted in the space previously occupied by the gutta-percha cone and push out testing was performed at a crosshead speed of 1.0 mm/min. There was no statistically significant difference in resistance to push out by the materials tested (p > 0.01). MTA Angelus and ProRoot MTA showed predominantly mixed failure while Biodentine exhibited mixed and cohesive failures. The tricalcium silicate-based root-end filling materials showed similar bond strength retrograde cavity.

Physicochemical Properties and Dentin Bond Strength of a Tricalcium Silicate-Based Retrograde Material

Abstract The aim of this study was to evaluate the physicochemical properties and the apical dentin bond strength of the tricalcium silicate-based Biodentine in comparison to white MTA and zinc oxide eugenol-based cement (ZOE). Setting time and radiopacity were evaluated according to ISO 6876:2012 specification. Final setting time, compressive strength and pH were also assessed. Material’s bond strength to the apical root canal dentin was measured by the push-out assay. Data were analyzed by ANOVA and Tukey-Krammer post-hoc test. Biodentine presented the shortest initial (16.2±1.48 min) and final setting time (35.4±5.55 min). Radiopacity of Biodentine (2.79±0.27 mmAl) does not agree with ISO 6876:2012 specifications. On the other hand, Biodentine showed higher compressive strength after 21 days (37.22±5.27 MPa) and higher dentin bond strength (11.2±2.16 MPa) in comparison to white MTA (27.68±3.56 MPa for compressive strength and 2.98±0.64 MPa for bond strength) (p<0.05). Both MTA and Biodentine produced an alkaline environment (approximately pH 10) (p>0.05) compared to ZOE (pH 7). It may be concluded that Biodentine exhibited faster setting, higher long-term compressive strength and bond strength to the apical dentin than MTA and ZOE.

Resumo O objetivo deste estudo foi avaliar as propriedades físico-químicas e a resistência de união à dentina apical do cimento Biodentine em comparação ao MTA branco e cimento à base de óxido de zinco e eugenol (OZE). O tempo de presa e a radiopacidade foram avaliados de acordo com as especificações ISO 6876:2012. O tempo de presa final, a resistência à compressão e o pH também foram avaliados. A resistência de união dos materiais à dentina apical do canal radicular foi avaliada por meio do ensaio push-out. Dados foram analisados por ANOVA e teste complementar de Tukey-Krammer. Biodentine apresentou o menor tempo de presa inicial (16,2±1,48 min) e final (35,4±5,55 min). Os valores de radiopacidade do Biodentine (2,79±0,27 mmAl) não estão de acordo com as especificações ISO 6876:2012. Por outro lado, este material apresentou maior resistência à compressão após 21 dias (37,22±5,27 MPa) e maiores valores de adesão à dentina (11,2±2,16 MPa) em comparação ao MTA branco (27,68±3,56 MPa de resistência à compressão e 2,98±0,64 MPa de resistência de união) (p>0.05). Ambos os materiais produziram ambiente alcalino (aproximadamente 10) (p>0.05) em comparação ao OZE (pH 7). Pode-se concluir que o Biodentine demonstrou endurecimento mais rápido e apresentou maior resistência à compressão e resistência de união à dentina apical do que MTA e OZE.