Schottky Junction Nanozyme Based on Mn-Bridged Co-Phthalocyanines and Ti3C2Tx Nanosheets Boosts Integrative Type I and II Photosensitization for Multimodal Cancer Therapy.

Cancer phototheranostics have the potential for significantly improving the therapeutic effectiveness, as it can accurately diagnose and treat cancer. However, the current phototheranostic platforms leave much to be desired and are often limited by tumor hypoxia. Herein, a Schottky junction nanozyme has been established between a manganese-bridged cobalt-phthalocyanines complex and Ti3C2Tx MXene nanosheets (CoPc-Mn/Ti3C2Tx), which can serve as an integrative type I and II photosensitizer for enhancing cancer therapeutic efficacy via a photoacoustic imaging-guided multimodal chemodynamic/photothermal/photodynamic therapy strategy under near-infrared (808 nm) light irradiation. The Schottky junction not only possessed a narrow-bandgap, enhanced electron-hole separation ability and exhibited a potent redox potential but also enabled improved H2O2 and O2 supplying performances in vitro. Accordingly, the AS1411 aptamer-immobilized CoPc-Mn/Ti3C2Tx nanozyme illustrated high accuracy and excellent anticancer efficiency through a multimodal therapy strategy in in vitro and in vivo experiments. This work presents a valuable method for designing and constructing a multifunctional nanocatalytic medicine platform for synergistic cancer therapy of solid tumors.

Multifunctional Au Modified Ti3C2-MXene for Photothermal/Enzyme Dynamic/Immune Synergistic Therapy.

Ti3C2-MXene-based composites provide multifunctional interfaces in diagnosis and treatment of tumors. Herein, we proposed a multifunctional nanoplatform based on Ti3C2-MXene-Au nanocomposites, which combines photothermal properties and peroxidase-like activity, accomplishing synergistic photothermal therapy (PTT) and enzyme dynamic therapy (EDT) accompanied by photoacoustic (PA) and thermal dual-mode imaging in vivo. Furthermore, PTT induces immunogenic cell death, and EDT promotes cell apoptosis, facilitating dendritic cell (DC) maturation and T cell infiltration into the tumor. On this basis, the antibody OX40 (αOX40) was utilized to further contribute immune therapy for reversing the immunosuppressive tumor microenvironment by activating CD4+ and CD8+ T cells. In summary, a triune of PTT/EDT/antitumor immune therapy is achieved by combining Ti3C2-MXene-Au nanocomposites and αOX40, which possesses several strong features of good biocompatibility, NIR-controlled targeting, significant cancer cell killing, and satisfactory biosafety in vitro and in vivo. Our work might highlight the promising application of MXene-based nanoplatforms for cancer therapy.

Efficacy of strontium supplementation on implant osseointegration under osteoporotic conditions: A systematic review.

STATEMENT OF PROBLEM: Strontium has been validated for potent bone-seeking and antiosteoporotic properties and elicits a potentially beneficial impact on implant osseointegration in patients with osteoporosis. However, the efficacy of strontium supplementation on improving new bone formation and implant osseointegration in the presence of osteoporotic bone is still unclear. PURPOSE: The purpose of this systematic review was to comprehensively assess the efficacy of strontium supplementation, encompassing oral intake and local delivery of strontium, on implant osseointegration in patients with osteoporosis. MATERIAL AND METHODS: Searches on electronic databases (MEDLINE or PubMed, Web of Science, EBSCO, Embase, and Clinicaltrials.gov) and manual searches were conducted to identify relevant preclinical animal trials up to June 2020. The primary outcomes were the percentage of bone-implant contact and bone area; the secondary outcomes were quantitative parameters of biomechanical tests and microcomputed tomography (µCT). RESULTS: Fourteen preclinical trials (1 rabbit, 1 sheep, and 12 rat), with a total of 404 ovariectomized animals and 798 implants, were eligible for analysis. The results revealed a significant 17.1% increase in bone-implant contact and 13.5% increase in bone area, favoring strontium supplementation despite considerable heterogeneity. Subgroup analyses of both bone-implant contact and bone area exhibited similar outcomes with low to moderate heterogeneity. Results of biomechanical and µCT tests showed that strontium-enriched implantation tended to optimize the mechanical strength and microarchitecture of newly formed bone despite moderate to generally high heterogeneity. CONCLUSIONS: Based on the available preclinical evidence, strontium supplementation, including local and systemic delivery, showed promising results for enhancing implant osseointegration in the presence of osteoporosis during 4 to 12 weeks of healing. Future well-designed standardized studies are necessary to validate the efficacy and safety of strontium supplementation and to establish a standard methodology for incorporating Sr into implant surfaces in a clinical setting.

ROS induced bactericidal activity of amorphous Zn-doped titanium oxide coatings and enhanced osseointegration in bacteria-infected rat tibias.

Titanium-based endosseous implants with high antibacterial and osseointegration activities are extremely required in clinics. To achieve this line, herein the doped coatings with three kinds of Zn doses were micro-arc oxidized (MAOed) on Ti. They were examined to reveal a bilayered structure, in which the outer layer consisted completely of the amorphism comprising elements of Ti, O and Zn with Zn doped in the form of weaken Zn-O bonds, and the underlying layer was partially crystallized with nanocrystalline TiO2 and Zn2TiO4 to embed an amorphous matrix. While the Zn doped doses of the surface amorphous layers increased with elevating the MAOed voltages, the weaken Zn-O bonds in the amorphism were identified to act as both the contributor of Zn2+ controllable release and the generator of reactive oxide species (ROS) on the coatings. The enhanced HO• and O2-• formation on the elevated voltage MAOed coatings caused serious break of the cell walls and plasma membranes of S. aureus. In parallel, the enhanced Zn2+ release and extracellular H2O2 formation led to the enhanced intracellular ROS level of S. aureus, further aggravating the damage of plasma membrane, resulting in bacteria death. On contrary to the overdose of Zn doped coating, the moderate doses of Zn doped coatings did not induce additional intracellular ROS and attenuate viability and proliferation of osteoblasts in vitro, and promoted osseointegration in both S. aureus-uninfected and infected rat tibias, which ascribed to the strong antibacterial activity and un-attenuated cell function of the coatings in the infected case. STATEMENT OF SIGNIFICANCE: (1) The Zn-doped coatings revealed a bilayered structure of the surface layer comprising the Ti, O and Zn constructed amorphism with Zn in the form of weaken Zn-O bonds, and the underlying layer comprising nanocrystalline TiO2 and Zn2TiO4 to embed amorphous matrix. (2) The weaken Zn-O bonds in the amorphism were identified to act as both the contributor of Zn2+ controllable release and the generator of ROS on the coatings. (3) The enhanced Zn2+ release and ROS formation on the coatings killed S. aureus by inducing serious break of their cell walls and plasma membranes. This effect in combination of un-attenuated osteoblast proliferation endowed the moderate Zn doped coatings with enhanced osseointegration in S. aureus-infected rat tibias.

Appraisal of Comparative Therapeutic Potential of Undoped and Nitrogen-Doped Titanium Dioxide Nanoparticles.

Nitrogen-doped and undoped titanium dioxide nanoparticles were successfully fabricated by simple chemical method and characterized using x-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive x-ray (EDX), and transmission electron microscopy (TEM) techniques. The reduction in crystalline size of TiO2 nanoparticles (from 20-25 nm to 10-15 nm) was observed by TEM after doping with N. Antibacterial, antifungal, antioxidant, antidiabetic, protein kinase inhibition and cytotoxic properties were assessed in vitro to compare the therapeutic potential of both kinds of TiO2 nanoparticles. All biological activities depicted significant enhancement as a result of addition of N as doping agent to TiO2 nanoparticles. Klebsiella pneumoniae has been illuminated to be the most susceptible bacterial strain out of various Gram-positive and Gram-negative isolates of bacteria used in this study. Good fungicidal activity has been revealed against Aspergillus flavus. 38.2% of antidiabetic activity and 80% of cytotoxicity has been elucidated by N-doped TiO2 nanoparticles towards alpha-amylase enzyme and Artemia salina (brine shrimps), respectively. Moreover, notable protein kinase inhibition against Streptomyces and antioxidant effect including reducing power and % inhibition of DPPH has been demonstrated. This investigation unveils the more effective nature of N-doped TiO2 nanoparticles in comparison to undoped TiO2 nanoparticles indicated by various biological tests. Hence, N-doped TiO2 nanoparticles have more potential to be employed in biomedicine for the cure of numerous infections.

Biosynthesis of TiO2 nanoparticles and their application for treatment of brain injury-An in-vitro toxicity study towards central nervous system.

In the current study, a facile green synthesis of TiO2 nanoparticles (NPs) utilizing the leaf extract of Lippia citriodora as a stabilizing and reducing agent was reported. The prepared TiO2 NPs were studied using XRD, UV, HRTEM, FTIR, Raman and EDS analysis. TEM analysis confirmed that the nanoparticles size is in 20-40 nm range. FTIR and UV-Visible spectra represented the TiO2 NPs formation. Similarly, the analysis of XRD and EDS validated the crystalline rutile structure of TiO2NPs formed. In addition, this investigation was shown to examine the TiO2NPs toxicity on the CNS central nervous system in vitro. In the extracted cell cultures from the rats ECB embryonic cortical brain, substantial decline in the neuroblasts has been noticed once after incubating with TiO2NPs for 24 h to 96 h (5 to 20 µg/ml). This study also demonstrates the decline of neuroblast proliferation. In the conclusion, our investigation illustrated evidently the TiO2NPs toxic effect on the neuronal cells and rat brain also mentioned about toxicity effects of TiO2 which were not yet described, for example the decline in vitro neuroblast proliferation.

Anti-inflammatory mechanism of various metal and metal oxide nanoparticles synthesized using plant extracts: A review.

Multiple types of inflammations caused by foreign pathogens or chemicals and mutations that upregulate inflammation enhancers kindle the need of developing new vectors for the treatment of inflammation. Nanoparticles have been used in various fields ranging from the food industry, cosmetic industry and agricultural industry to devices like sensors, solar cells, and batteries. Nanoparticles have been used in the medical and research fields due to their high penetration power even inside cells and have the excellent ligand-binding properties due to their high surface area to volume ratio. Mechanistic study of anti-inflammatory activities of various metal and metal oxide nanoparticles like silver, gold, zinc oxide, titanium dioxide, and selenium have been discussed in the following literature review. The present study focuses on the differential uptake of nanoparticles into cells and the anti-inflammatory mechanism adopted by the nanoparticles synthesized by green routes. It also gives a concise literature review of the various green sources used for the synthesis of nanoparticles and the mechanism of action of each nanoparticle.

Photonic cancer nanomedicine using the near infrared-II biowindow enabled by biocompatible titanium nitride nanoplatforms.

Light-activated photoacoustic imaging (PAI) and photothermal therapy (PTT) using the second near-infrared biowindow (NIR-II, 1000-1350 nm) hold great promise for efficient tumor detection and diagnostic imaging-guided photonic nanomedicine. In this work, we report on the construction of titanium nitride (TiN) nanoparticles, with a high photothermal-conversion efficiency and desirable biocompatibility, as an alternative theranostic agent for NIR-II laser-excited photoacoustic (PA) imaging-guided photothermal tumor hyperthermia. Working within the NIR-II biowindow provides a larger maximum permissible exposure (MPE) and desirable penetration depth of the light, which then allows detection of the tumor to the full extent using PA imaging and complete tumor ablation using photothermal ablation, especially in deeper regions. After further surface polyvinyl-pyrrolidone (PVP) modification, the TiN-PVP photothermal nanoagents exhibited a high photothermal conversion efficiency of 22.8% in the NIR-II biowindow, and we further verified their high penetration depth using the NIR-II biowindow and their corresponding therapeutic effect on the viability of tumor cells in vitro. Furthermore, these TiN-PVP nanoparticles were developed as a contrast agent for NIR-II-activated PA imaging both in vitro and in vivo for the first time and realized efficient photothermal ablation of the tumor in vivo within both the NIR-I and NIR-II biowindows. This work not only provides a paradigm for TiN-PVP photothermal nanoagents working in the NIR-II biowindow both in vitro and in vivo, but also proves the feasibility of PAI and PTT cancer theranostics using NIR-II laser excitation.

Mini Review of TiO2 -Based Multifunctional Nanocomposites for Near-Infrared Light-Responsive Phototherapy.

Phototherapy with the properties of specific spatial/temporal selectivity and minimal invasiveness has been acknowledged as one of the most promising cancer therapy types. Among all the photoactive substance for phototherapy, titanium dioxide (TiO2 ) nanomaterials are paid more and more attention due to their outstanding photocatalytic properties, prominent biocompatibility, and excellent chemical stability. However, the wide bandgap (3.0-3.2 eV) of TiO2 limits its absorption only to the ultraviolet (UV) light region. For a long time, UV light-stimulated TiO2 was applied in the phototherapy researches of tumors located in the skin layer, while it is unsatisfactory for most deep-tissue tumors. Due to the maximum penetration into tissue existing in the near-infrared (NIR) region, how to use NIR light to trigger photochemical reaction of TiO2 remains a big challenge. In this review, two strategies to develop and construct NIR-triggered TiO2 -based nanocomposites (NCs) for phototherapy are summarized, and the relevant mechanism and background knowledge of TiO2 -based phototherapy are also given in order to better understand the application value and current situation of TiO2 in phototherapy. Finally, the challenges and research directions of TiO2 in the future clinic phototherapy application are also discussed.

Titanium granules pre-treated with hydrogen peroxide inhibit growth of bacteria associated with post-operative infections in spine surgery.

PURPOSE: Post-operative infections are relatively common after posterior spine surgery, and there are several observations reflecting different infection complications related to various metals implanted. Here, we selected an array of different bacterial species that are often found in infections associated with orthopaedic implants and tested for inhibition by hydrogen peroxide-treated titanium (Ti-peroxy). METHODS: To study the possibility of using Ti-peroxy as an antimicrobial prophylaxis, we developed a protocol for standardized susceptibility testing of bacteria. RESULTS: Importantly, we found that the resulting Ti-peroxy was highly antimicrobial against all aerobic species tested, among others, Staphylococcus aureus and Pseudomonas aeruginosa. Proteus mirabilis was slightly more resistant than, for example, Klebsiella pneumoniae and enterococci. In contrast, anaerobic bacteria Cutibacterium acnes and Parvimonas micra were equally susceptible compared to staphylococci. CONCLUSIONS: Our findings suggest that the Ti-peroxy is a promising perioperative antimicrobial strategy that may be highly effective for prevention of post-operative infections. We therefore suggest application of hydrogen peroxide to implants prior to implantation. These slides can be retrieved under Electronic supplementary material.

Improved Treatment of Photothermal Cancer by Coating TiO2 on Porous Silicon.

In present society, the technology in various field has been sharply developed and advanced. In medical technology, especially, photothermal therapy and photodynamic therapy have had limelight for curing cancers and diseases. The study investigates the photothermal therapy that reduces side effects of existing cancer treatment, is applied to only cancer cells, and dose not harm any other normal cells. The photothermal properties of porous silicon for therapy are analyzed in order to destroy cancer cells that are more weak at heat than normal ones. For improving performance of porous silicon, it also analyzes the properties when irradiating the near infrared by heterologously junction TiO2 and TiO2NW, photocatalysts that are very stable and harmless to the environment and the human body, to porous silicon. Each sample of Si, PSi, TiO2/Psi, and TiO2NW/PSi was irradiated with 808 nm near-IR of 300, 500, and 700 mW/cm2 light intensity, where the maximum heating temperature was 43.8, 61.6, 67.9, and 61.9 degrees C at 300 mW/cm2; 54.1, 64.3, 78.8, and 68.9 degrees C at 500 mW/cm2; and 97.3, 102.8, 102.5, and 95 0C at 700 mW/cm2. The time required to reach the maximum temperature was less than 10 min for every case. The results indicate that TiO2/PSi thin film irradiated with a single near-infrared wavelength of 808 nm, which is known to have the best human permeability, offers the potential of being the most successful photothermal cancer therapy agent. It maximizes the photo-thermal characteristics within the shortest time, and minimizes the adverse effects on the human body.

Breaking the depth dependency of phototherapy with Cerenkov radiation and low-radiance-responsive nanophotosensitizers.

The combination of light and photosensitizers for phototherapeutic interventions, such as photodynamic therapy, has transformed medicine and biology. However, the shallow penetration of light into tissues and the reliance on tissue oxygenation to generate cytotoxic radicals have limited the method to superficial or endoscope-accessible lesions. Here we report a way to overcome these limitations by using Cerenkov radiation from radionuclides to activate an oxygen-independent nanophotosensitizer, titanium dioxide (TiO2). We show that the administration of transferrin-coated TiO2 nanoparticles and clinically used radionuclides in mice and colocalization in tumours results in either complete tumour remission or an increase in their median survival. Histological analysis of tumour sections showed the selective destruction of cancerous cells and high numbers of tumour-infiltrating lymphocytes, which suggests that both free radicals and the activation of the immune system mediated the destruction. Our results offer a way to harness low-radiance-sensitive nanophotosensitizers to achieve depth-independent Cerenkov-radiation-mediated therapy.

Fracture resistance of teeth submitted to several internal bleaching protocols.

AIM: The aim of this study was to evaluate the fracture resistance of teeth submitted to several internal bleaching protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP), 15% hydrogen peroxide with titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser or sodium perborate (SP). MATERIALS AND METHODS: After endodontic treatment, fifty bovine extracted teeth were divided into five groups (n = 10): G1-unbleached; G2-35HP; G3-37CP; G4-15HPTiO2 photoactivated by LED-laser and G5-SP. In the G2 and G4, the bleaching protocol was applied in 4 sessions, with 7 days intervals between each session. In the G3 and G5, the materials were kept in the pulp teeth for 21 days, but replaced every 7 days. After 21 days, the teeth were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until teeth fracture. The data were submitted to ANOVA and Tukey tests (α = 5%). RESULTS: The 35HP, 37CP, 15HPTiO2 and SP showed similar fracture resistance teeth reduction (p > 0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p < 0.05). CONCLUSION: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other. CLINICAL SIGNIFICANCE: There are several internal bleaching protocols using hydrogen peroxide in different concentrations and activation methods. This study evaluated its effects on fracture resistance in endodontically-treated teeth.

Does mechanical filtration of intraoperative cell salvage effectively remove titanium debris generated during instrumented spinal surgery? An in vitro analysis.

BACKGROUND CONTEXT: Instrumented fusion of the spine is a surgery commonly performed to stabilize vertebrae causing pain and to correct anatomic deformities. Such surgery can create substantial blood loss. Autotransfusion is a means to limit homologous blood transfusion in this setting. However, a dilemma is created when the high-speed drill used for bone removal comes in contact with implanted titanium spinal hardware. A clinician at this point is forced to decide between two options: to discontinue autotransfusion to avoid the potential transfusion of titanium fragments while risking blood loss and the need for homologous transfusion or to continue autotransfusion while risking transfusion of titanium fragments back into circulation. PURPOSE: To conclusively identify whether titanium fragments created by a high-speed drill are able to pass through standard autotransfusion microaggregate blood filters. STUDY DESIGN: A positive and negatively controlled experiment with blinded sample analysis. OUTCOMES MEASURES: The presence or absence of titanium alloy on a filter with detection by energy-dispersive X-ray spectroscopy (EDX). METHODS: A mock autotransfusion setup was devised for in vitro filtering. Six investigational and two control experiments were conducted. Titanium fragments generated by a high-speed drill were aspirated with saline and filtered with standard autotransfusion reservoirs and microaggregate blood filters. A final filter with a 1-µm pore size was placed distal to the blood filters. After filtration was complete, this final filter was analyzed using EDX. RESULTS: The presence of titanium was confirmed by EDX on five of six investigational filters. The positive and negative control filters were analyzed by EDX and tested positive and negative, respectively, for titanium. CONCLUSIONS: Standard 40 µm reservoir and blood microaggregate filters do not eliminate the smallest fragments of titanium generated by contact between a high-speed drill and a titanium hardware. The mass of titanium able to elude filtration is very small. The impact of transfusing blood contaminated with such a small mass of titanium is not known.

Effect of irrigation with Tetraclean on bacterial leakage of obturated root canals.

The purpose of the study presented here was to evaluate the effect of Tetraclean, Hypoclean, Chlor-XTRA, 2% chlorhexidine and 6% sodium hypochlorite/17% EDTA as a final irrigant on bacterial leakage of the root canal. One hundred and fifty-five extracted human maxillary central incisors were randomly divided into five experimental groups of 25 teeth each and two control groups of 15 teeth each. The root canals in each group were irrigated with 2 ml of the relevant irrigant between each filing. The root canals in group 5 were irrigated with 5 ml of 17% EDTA at the end of root canal preparation. The teeth in each group were obturated with gutta-percha and AH-26 sealer. Positive control teeth were obturated with a single gutta-percha cone without sealer, and negative controls were obturated in the same way as experimental groups. The coronal portion of each root was placed in contact with inoculum of Enterococcus faecalis in Brain Heart Infusion (BHI) culture media. Findings showed that the mean number of days for bacterial penetration in the Tetraclean group was greater than for other experimental groups. On the other hand, the Chlor-XTRA Vista group showed the fewest mean number of days for bacterial leakage.

Covalent TiO(2)/pectin microspheres with Fe(3)O(4) nanoparticles for magnetic field-modulated drug delivery.

Covalent TiO(2)-co-pectin microspheres containing Fe(3)O(4) nanoparticles were developed through an ultrasound-induced crosslinking/polymerization reaction between the glycidyl methacrylate from vinyl groups in TiO(2) and in pectin. ζ-potentials became less negative in the nanostructured microspheres, caused by the presence of both inorganic particles in the negatively charged pectin. The nanostructured pectin microspheres showed an amoxicillin release rate slower than that of pure pectin microspheres. The proposed microspheres were found to be a sustained release system of amoxicillin in the acid medium. Furthermore, the antibiotic release may be modulated by exposition of the microspheres to a remote magnetic field. In practical terms, the nanostructured microspheres could deliver a larger proportion of their initial load to specific site of action. The cytotoxic concentrations for 50% of VERO cells (CC(50)), calculated as the concentration required to reduce cell viability by 50% after 72h of incubation, for pectin-only microspheres and nanostructured pectin microspheres were 217.7±6.5 and 121.5±4.9µgmL(-1), respectively. The obtained CC(50) values indicated acceptable cytotoxic levels for an incubation period of 72h, showing that the pectin microspheres have a great pharmacological potential for uses in biological environments, even after the introduction of both Fe(3)O(4) and TiO(2).

Hepatoid adenocarcinoma of the stomach: an unusual case of elevated alpha-fetoprotein with prior treatment for hepatocellular carcinoma.

Hepatoid adenocarcinoma (HAC) is a rare type of extrahepatic carcinoma whose morphology is similar to that of hepatocellular carcinoma (HCC). Metachronous HCC and HAC in the same patient is extremely rare. The case of a 68-year-old man with chronic hepatitis B infection who had both HCC and HAC of the stomach is reported herein. Nine years previously this patient had been diagnosed with HCC and received a right lobectomy. HCC that recurred at the caudate lobe at 6 months after the operation was successfully treated with transarterial chemoembolization. The patient was followed up regularly thereafter without evidence of tumor recurrence for 9 years. In July 2010 his serum alpha-fetoprotein (AFP) level elevated from 6.5 ng/mL to 625.4 ng/mL, and he developed a probable single metastatic lymph node around the hepatic artery without intrahepatic lesions. Subsequent evaluation with upper endoscopy revealed a 4-cm ulcerative lesion on the antrum of the stomach. Subtotal gastrectomy was performed with lymph-node dissection. Histologic examination revealed a special type of extrahepatic AFP-producing adenocarcinoma-HAC with lymph-node metastasis-which indicates that HAC can be a cause of elevated AFP even in patients with HCC. HAC should be considered if a patient with stable HCC exhibits unusual elevation of AFP.

Use of fluid filtration method to evaluate the effect of master cone size on the apical seal of severely curved root canals.

The apical third of most root canals shows some degree of curvature, which is important in cleaning/shaping and obturation during root canal treatment. The present study evaluated the effect of master cone size on the apical seal of severely curved root canals. Thirty-eight mesial roots of human mandibular first molars were prepared using the crown-down technique. All samples were mature roots with closed apices, had no carious lesions or resorption, and had a canal curvature of > 45º to 60º. Two samples were used as a negative and positive control to evaluate the fluid filtration equipment, and the remaining 36 samples were equally divided into groups A, B, and C based on master cone size, namely, gutta-percha #20, #25, and #30, respectively. The fluid filtration method was used to evaluate microleakage. No significant difference in microleakage was observed among groups (P = 0.31). In conclusion, an increase in master cone size up to #30 does not significantly influence apical microleakage.

Dentin hypersensitivity after teeth bleaching with in-office systems. Randomized clinical trial.

PURPOSE: To comparatively and prospectively compare in a randomized clinical trial, dentin hypersensitivity after treatment with three in-office bleaching systems, based on hydrogen peroxide at different concentrations, with and without light source activation. METHODS: 88 individuals were included according to inclusion and exclusion criteria. Subjects were randomly divided into the following three treatment groups: Group 1 was treated with three 15-minute applications of hydrogen peroxide at 15% with titanium dioxide (Lase Peroxide Lite) that was light-activated (Light Plus Whitening Lase) with five cycles of 1 minute and 30 seconds each cycle, giving a total treatment time of 45 minutes; Group 2 was treated with three 10-minute applications of hydrogen peroxide at 35% (Lase Peroxide Sensy), activated by light (LPWL) same activation cycles than Group 1, with a total treatment time of 30 minutes; Group 3 was treated with only one application for 45 minutes of hydrogen peroxide at 35% (Whitegold Office) without light activation. Each subject underwent one session of bleaching on the anterior teeth according to the manufacturers' instructions. Dentin sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 7 and 30 days after treatment using a stimulus of an evaporative blowing triple syringe for 3 seconds on the upper central incisors from a distance of 1 cm. A Kruskal-Wallis test followed by Mann-Whitney test was performed for statistical analysis. RESULTS: All groups showed increased sensitivity immediately after treatment. Group 1 displayed less changes relative to baseline with no significant differences (P = 0.104). At 7 and 30 days after treatment, a comparison of VAS values indicated no significant differences between all groups (P = 0.598 and 0.489, respectively).

Comparison of influence of different manufacturing methods on the cleaning efficiency of rotary nickel-titanium files.

The purpose of this study was to evaluate and compare cleaning effectiveness of TwistedFile, GT series X, Revo-S, RaCe, Mtwo, and ProTaper Universal rotary files in curved canals. Seventy mesiobuccal canals of extracted human first maxillary molars were divided into seven groups of 10 samples each. Canals were prepared with six nickel-titanium (NiTi) rotary systems and manual K-Flexofile. Irrigation was performed with 2 mL 2.5% NaOCl solution after each file, and 5 mL 2.5% NaOCl was used for the final flush. After the roots were split longitudinally, the presence of debris and smear layer was visualized using scanning electron microscopic photomicrographs taken at coronal, middle, and apical third. Mean scores for debris and the smear layer were calculated and statistically analyzed for significance between groups using the Kruskal-Wallis nonparametric analysis of variance (P < 0.05) and Mann-Whitney U test (P < 0.001). There was no significant difference among the groups in terms of debris and smear layer scores (P > 0.05). Without considering the preparation method used, while no statistically significant difference was found between the coronal third and the middle third (P > 0.05), higher amount of debris and smear layer were found in apical third (P = 0.001). The new generation of NiTi rotary files including the Twisted File and GT Series X presented similar cleaning effectiveness compared with traditionally ground NiTi rotary files.