Effect of access design on intracoronal bleaching of endodontically treated teeth: An ex vivo study.

OBJECTIVES: To determine the effect of access design on intracoronal bleaching with 35% carbamide peroxide on discolored teeth. MATERIALS AND METHODS: Forty-two intact maxillary central incisors were selected, sectioned and artificially stained using whole blood. Color measurements were performed with a spectrophotometer: before staining (T1), after staining (T2), at 7 (T3), and 14 (T4) days postbleaching. After T1, specimens were stratified and divided randomly into two groups according to access design (N = 20): G1: contracted endodontic cavity (CEC) access performed with a #848-010M bur and G2: traditional endodontic cavity (TEC) access done with a #1157 bur. Canals were obturated, a cervical barrier was placed and 35% carbamide peroxide was sealed in the chamber for 7 days and replaced at 7 days for an additional 7 days. Data were collected based on CIELAB-CIE1976 (L* a* b* ) system. Repeated measures SNK anova was used to evaluate the effects of access design and time on color change (ΔE* ) and luminosity (L* ) (α < 0.05). RESULTS: For CEC, L* was significantly different at all times points (P < .05). For TEC, L* values were significantly different at all time points (P < .05) except for T0 and T4, which were similar (P > .05). There was no statistical difference for ΔE* between CEC and TEC designs at any time point (P > .05). CONCLUSIONS: In general, teeth accessed with CEC or TEC designs showed statistically similar bleaching when using 35% carbamide peroxide. However, lightness values were only reestablished with bleaching through a TEC access design. CLINICAL SIGNIFICANCE: Despite the current trend to conserve tooth structure when performing endodontic access cavities, the use of conservative access designs for bleaching discolored maxillary central incisors affected the acceptability threshold when compared with a traditional access design. These smaller accesses might not be an alternative treatment option when internal bleaching in the esthetic zone is anticipated.

Coronal resistance to fracture of endodontically treated teeth submitted to light-activated bleaching.

OBJECTIVES: The aim of this study was to assess the fracture resistance of endodontically treated teeth submitted to bleaching with 38% hydrogen peroxide activated by light-emitting diode (LED)-laser system. METHODS: Fifty maxillary incisors were endodontically treated, received a zinc phosphate barrier and were embedded in acrylic resin until cemento-enamel junction. The specimens were distributed into five groups (n=10) according to the number of bleaching sessions: GI, no treatment (control); GII, one session; GIII, two sessions; GIV, three sessions and GV, four sessions. The whitening gel was applied to the buccal surface of the tooth and inside the pulp chamber for three times in each session, followed by LED-laser activation. Specimens were submitted to the fracture resistance test (kN) and data were submitted to the Tukey-Kramer multiple comparisons test. RESULTS: No significant difference (p>0.05) was found between GI (0.71+/-0.30) and GII (0.65+/-0.13), which presented the highest strength values to fracture. Groups III (0.35+/-0.17), IV (0.23+/-0.13) and V (0.38+/-0.15) showed lower resistance to fracture (p<0.01) when compared to GI and GII. CONCLUSIONS: The fracture resistance of endodontically treated teeth decreased after two sessions of bleaching with 38% hydrogen peroxide activated by LED-laser system.

Ultrastructural analysis of root canal dentine irradiated with 980-nm diode laser energy at different parameters.

OBJECTIVE: The purpose of this in vitro study was to investigate using the scanning electron microscope (SEM) the ultrastructural morphological changes of the radicular dentine surface after irradiation with 980-nm diode laser energy at different parameters and angles of incidence. BACKGROUND DATA: There have been limited reports on the effects of diode laser irradiation at 980 nm on radicular dentin morphology. MATERIALS AND METHODS: Seventy-two maxillary canines were sectioned and roots were biomechanically prepared using K3 rotary instruments. The teeth were irrigated with 2 mL of distilled water between files and final irrigation was performed with 10 mL of distilled water. The teeth were then randomly divided into five groups (n = 8 each) according to their diode laser parameters: Group 1: no irradiation (control); group 2: 1.5 W/continuous wave (CW) emission (the manufacturer's parameters); group 3: 1.5 W/100 Hz; group 4: 3 W/CW; and group 5: 3 W/100 Hz. Laser energy was applied with helicoid movements (parallel to the canal walls) for 20 sec. Eight additional teeth for each group were endodontically prepared and split longitudinally and irradiation was applied perpendicularly to the root surface. RESULTS: Statistical analysis showed no difference between the root canal thirds irradiated with the 980-nm diode laser, and similar results between the parameters 1.5 W/CW and 3 W/100 Hz (p > 0.05). CONCLUSION: When considering different output powers and delivery modes our results showed that changes varied from smear layer removal to dentine fusion.

Ultrastructural evaluation of radicular dentin after Nd:YAG laser irradiation combined with different chemical substances.

This aticle sought to evaluate the dentin morphology after irradiation by a Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser, using different chemical substances to irrigate radicular canals: distilled water, 17% ethylenediaminetetraacetic acid plus Cetavlon (EDTAC), 1% sodium hypochlorite, and 2% chlorhexidine. Groups were subdivided according to the protocol of laser application (n=9). The specimens were analyzed by scanning electron microscopy (SEM). No differences were found in dentin morphology when different root thirds were examined. Regardless of the chemical substance used, alterations were more evident in groups in which the surfaces were dried before laser irradiation. Fusion areas, craters, carbonization, and partially exposed tubules were verified. When the irradiation was performed in water, the smear layer was incorporated into the laser-modified surface. Among the specimens irrigated with EDTAC and laser-treated, partial obliteration of dentin tubules due to the laser action was verified; in addition, there was no remaining smear layer on the surfaces. Samples irrigated with sodium hypochlorite followed by laser irradiation demonstrated similar morphology to the samples in the chlorhexidine group, with some fusion areas present and no exposed dentin tubules or fissures. The irradiation from an Nd:YAG laser in the presence of EDTAC solution provided a more favorable surface pattern compared to the other experimental conditions, due to the removal of the contaminated layer and the posterior sealing of dentin tubules.

Effectiveness of root canal debris removal using passive ultrasound irrigation with chlorhexidine digluconate or sodium hypochlorite individually or in combination as irrigants.

AIM: The aim of this in vitro study was to evaluate the cleaning capacity of different auxiliary chemical substances energized with ultrasound in radicular dentin using morphologic analysis. METHODS AND MATERIALS: Twenty-eight single-canal, mandibular incisors were prepared with the Hero 642 canal preparation system following the sequence: 25/12, 30/06, 35/02, and 40/02, 1 mm from the apex. The specimens were then divided into four groups of seven teeth. During biomechanical preparation the teeth were irrigated with 2 ml of distilled water between files. Each group of specimens (n=7) received a final irrigation with 100 ml of the following irrigants that were activated with ultrasound for 3 minutes: Group 1- distilled water; Group 2- 0.2% chlorhexidine digluconate (CHX); Group 3- 2.5% sodium hypochlorite (NaOCl); and Group 4-the filtrate obtained after combining 0.2% CHX and 2.5% NaOCl. The apical portions of the root canals from each group were then submitted to histological processing and analyzed using optical microscopy. RESULTS: Results showed statistical differences between the groups (p<0.01). Groups 1 and 2 (distilled water and 0.2% CHX respectively) were statistically similar in terms of a greater amount of debris, whereas 2.5% NaOCl and the filtrate were more efficient in removal of debris. CONCLUSION: There is no additional benefit in terms of debris removal from root canal walls by irrigating with the filtrate obtained from the combination of NaOCl and CHX when compared to using NaOCl alone. CLINICAL SIGNIFICANCE: The findings of this study suggest the time and expense of preparing and using a combination of NaOCl and CHX is not warranted compared to using NaOCl alone for root canal irrigation.

In vitro evaluation of endodontic debris removal as obtained by rotary instrumentation coupled with ultrasonic irrigation.

The cleaning capacity of rotary Ni-Ti instrumentation using Profile GT files, coupled with irrigation energised by ultrasound, was evaluated. Thirty-six human mandibular incisors were instrumented in vitro using the crown-down technique with the Profile GT system to 1 mm from the anatomical apex to a size 30.04 taper file. The instrumented teeth were then divided randomly into four groups where various final irrigations were used: Group I: 100 ml of 1% NaOCl with a Luer-Lok syringe (control group); Group II, Group III and Group IV: final irrigation with 100 ml of 1% NaOCl energised by ultrasound for 1, 3 and 5 min, respectively. After biomechanical preparation, the apical thirds of the roots were submitted to histological processing and examination. The specimens were analysed at 40x magnification and the images submitted to morphometric analysis with an integration grid. anova showed a statistically significant difference (P < 0.01) between the irrigation techniques. Group I (Luer-Lok syringe) showed the highest percentage of debris (35.81 +/- 4.49) and was statistically different from the other groups energised by ultrasound: Group II (27.28 +/- 4.49), Group III (24.39 +/- 5.72) and Group IV (18.46 +/- 5.25). It was concluded that rotary instrumentation using Ni-Ti files associated with final irrigation of 1% NaOCl energised by ultrasound leads to better debris removal from the apical third of mesio-distally flattened root canal.

Effect of eugenol-based endodontic cement on the adhesion of intraradicular posts.

The present study evaluated, in vitro, the influence of an eugenol-based endodontic sealer (EndoFill) on the adhesion of intra-radicular posts cemented with a resin-based cement (Enforce) ou a zinc phosphate cement. Twenty-four single-rooted maxillary canines were divided into 2 groups (n=12) and obturated with either gutta-percha points plus EndoFill or gutta-percha points alone (no cement). In each group, half of intracanal posts (n=6) were cemented with Enforce resin-based cement and half with zinc phosphate cement. Specimens were submitted to pull-out test in an Instron machine and tensile force was applied at a crosshead speed of 0.5 mm/min until post dislodgement. The maximum forces required for post removal was recorded (N) and means were submitted to statistical analysis by Kruskal-Wallis test (p<0.01). Posts cemented with zinc phosphate cement were significantly more retentive (353.4 N) than those cemented with Enforce (134.9 N) (p<0.01). Regarding the influence of the eugenol-based cement (EndoFill) on post retention, there was statistically significant difference (p<0.01) only between the groups cemented with Enforce, i.e., in the canals filled with EndoFill + guta-percha there was lower bond strength than in the canals filled with gutta-percha points alone (101.5 and 168.2 N, respectively). In conclusion, the zinc-phosphate-based cement showed greater post retention than the resin-based cement. The findings of this study suggest that the eugenol-containing sealer interfered with the adhesive properties of the resin-based cement.

Smear layer removal and chelated calcium ion quantification of three irrigating solutions.

The purpose of this study was to evaluate, by scanning electron microscopy (SEM), smear layer removal and quantify, by atomic absorption spectrophotometry, the amount of calcium ion present in the chelating solutions after their use. Sixteen extracted canines were instrumented using the step-back technique and were assigned to 3 groups according to the irrigating solution used: G1: 1 mL 17% EDTAC between each file; G2: 1 mL 17% CDTA; G3: 1 mL 17% EGTA. The solutions were collected after use. The teeth were cleaved longitudinally, evaluated under SEM and assessed for smear layer by blinded examiners and scored from 1 to 4. In order to quantify calcium ion release, the collected solutions were examined by atomic absorption spectrophotometry. Freidman's test was used for statistical analysis of SEM values and showed that canals irrigated with 17% EDTAC and 17% CDTA had significantly less smear layer throughout the canals than 17% EGTA (p<0.01). For analysis of the collected solutions, Tukey's test was used and showed that EDTAC and CDTA had a greater amount of calcium ions (22.8+/-7.54 and 60.6+/-20.67 microg/mL, respectively) compared to EGTA (70.5+/-14.2 microg/mL) (p<0.01). The association both methodologies may contribute to the understanding of how these solutions act in the root canal.

Removal of calcium hydroxide from Weine Type II systems using photon-induced photoacoustic streaming, passive ultrasonic, and needle irrigation: a microcomputed tomography study.

OBJECTIVE: This study compared the effectiveness of Er:YAG laser-activated irrigation (PIPS), passive ultrasonic irrigation (PUI) with EndoUltra and standard needle irrigation (SNI) in the removal of calcium hydroxide [Ca(OH)2] from the mesial roots of Weine Type II mandibular molars. MATERIAL AND METHODS: Thirty mandibular molars were screened by µCT for the presence of mesial roots with complex intra-canal anatomy and a common apical foramen. The teeth were enlarged to a standardized 25/.06 preparation and filled with Ca(OH)2 paste. Specimens were divided into three groups (n=10) according to the technique used for Ca(OH)2 removal: PIPS, at 15 Hz and 20 mJ using a 9 mm long, 600 µm diameter tip; PUI using a 15/.02 tip; and SNI (30 Ga. side-vented needle). Equal volumes of 8.25% NaOCl and 17% EDTA were used in all groups. µCT was used to measure the initial amount of Ca(OH)2 present and to assess the residual volume of Ca(OH)2 following each irrigation protocol. Data were analyzed using Tukey HSD and Kruskal-Wallis tests (α=5%). RESULTS: The mean volume of Ca(OH)2 before removal was significantly higher in the coronal third than in the middle and apical third (p<0.001). Ca(OH)2 was similarly removed from the coronal and middle thirds with the three methods used (p>0.05). PIPS (median 0%; IQR: 0-0) showed significant higher Ca(OH)2 removal in the apical third than PUI (median 100%, IQR: 85-100) and SNI (median 47%; IQR: 16-72) (p<0.001). CONCLUSIONS: PIPS laser-activation was more effective for the removal of Ca(OH)2 from mesial roots of mandibular molars with Weine Type II canal configurations than PUI with EndoUltra and SNI.

Evaluation of hollow fiberoptic tips for the conduction of Er:YAG laser.

OBJECTIVE: The use of Er:YAG laser operating in the 3 microm range with adjustable power and pulses has become popular for dental and medical practice due to its high photoablative capacity, surgical precision and antimicrobial action. BACKGROUND DATA: The existing fiberoptic tips irradiate lasers parallel to the long axes of the tooth limiting its efficiency in the root canal. METHODS: We evaluated hollow fiberoptic tips obtained from silicate glass as a means of Er:YAG laser conduction in dental procedures. The fiber tips were molded from capillary tubes with different profiles so that their ends would have cylindric, conical or spherical shapes. The performance of the three fibers as a means of propagation of Er:YAG (lambda = 2.94 microm) laser radiation was compared to that of a solid sapphire fiber at 10 Hz and 200 mJ and of 20 Hz and 500 mJ. The profiles of frontal and lateral burning were visualized on thermal paper. RESULTS: Analysis of these profiles demonstrated that the sapphire tip and the hollow fiber of cylindric section did not differ significantly in the profiles of frontal burning, and no lateral burning was detected. The fibers of the conical and spherical sections, although presenting attenuation in the frontal output power, showed a larger burning area in the frontal profile, in addition to producing lateral burning. CONCLUSIONS: The results indicate that commercial hollow fiberoptics have advantages such as easy manufacture of the different tip shapes, great adaptability, low cost, and a low loss of transmission.

Effectiveness of manual and rotary instrumentation techniques for cleaning flattened root canals.

The cleaning capacity of manual and rotary instrumentation techniques in mesial-distal flattened canals was studied by morphometric analysis. Twenty human mandibular incisors were divided into two groups of 10 teeth each: group 1, crown-down technique with rotary instrumentation using ProFile .04; group 2, crown-down technique with manual instrumentation using K-files. The teeth were evaluated with an optic microscope that was coupled to a computer to determine the percentage of root canal area with debris. The nonparametric Mann-Whitney U test showed a statistically significant difference at the level of 1% between the techniques. The manual technique was more efficient in cleaning mesial-distal flattened root canals than the rotary technique, although neither completely cleaned the root canal.

Influence of the spatulation of two zinc oxide-eugenol-based sealers on the obturation of lateral canals.

The objective of this research was to evaluate, in vitro, the importance of the correct manipulation of endodontic sealers, correlating it with flow rate and with the consequent obturation of root canals. Twenty-four human canines were prepared, 1 mm from the apex, with K-files up to size 50, by means of the step-back technique. Six lateral canals were then drilled in each tooth, with size 10 file fixed to a low-speed handpiece. The teeth were randomly divided into 4 groups, and root canals were obturated either with the Endométhasoneregister mark or target sealer or Grossman sealer, prepared at ideal or incorrect clinical consistency. After obturation by means of the lateral condensation technique, the teeth were radiographed and evaluated as to the number of sealed lateral canals. Statistical analysis revealed significant differences (p < 0.001) between the tested sealers, and indicated the higher capacity of the well-manipulated Grossman sealer to fill lateral canals. It can be concluded that the flow rate of a sealer and its correct manipulation are very important for the satisfactory obturation of lateral canals.

Removal of calcium hydroxide from Weine Type II systems using photon-induced photoacoustic streaming, passive ultrasonic, and needle irrigation: a microcomputed tomography study

ABSTRACT Objective This study compared the effectiveness of Er:YAG laser-activated irrigation (PIPS), passive ultrasonic irrigation (PUI) with EndoUltra and standard needle irrigation (SNI) in the removal of calcium hydroxide [Ca(OH)2] from the mesial roots of Weine Type II mandibular molars. Material and Methods Thirty mandibular molars were screened by µCT for the presence of mesial roots with complex intra-canal anatomy and a common apical foramen. The teeth were enlarged to a standardized 25/.06 preparation and filled with Ca(OH)2 paste. Specimens were divided into three groups (n=10) according to the technique used for Ca(OH)2 removal: PIPS, at 15 Hz and 20 mJ using a 9 mm long, 600 µm diameter tip; PUI using a 15/.02 tip; and SNI (30 Ga. side-vented needle). Equal volumes of 8.25% NaOCl and 17% EDTA were used in all groups. µCT was used to measure the initial amount of Ca(OH)2 present and to assess the residual volume of Ca(OH)2 following each irrigation protocol. Data were analyzed using Tukey HSD and Kruskal-Wallis tests (α=5%). Results The mean volume of Ca(OH)2 before removal was significantly higher in the coronal third than in the middle and apical third (p<0.001). Ca(OH)2 was similarly removed from the coronal and middle thirds with the three methods used (p>0.05). PIPS (median 0%; IQR: 0-0) showed significant higher Ca(OH)2 removal in the apical third than PUI (median 100%, IQR: 85-100) and SNI (median 47%; IQR: 16-72) (p<0.001). Conclusions PIPS laser-activation was more effective for the removal of Ca(OH)2 from mesial roots of mandibular molars with Weine Type II canal configurations than PUI with EndoUltra and SNI.

Influence of Hero Apical instruments on cleaning ovoid-shaped root canals.

The cleaning capacity of Hero 642 nickel-titanium files, complemented by the Hero Apical instruments in flattened roots, was determined by histological analysis, considering the area of action of the instruments on the coronal walls and the presence of remaining debris. Twenty-four single-canal, human mandibular incisors were divided into three groups and prepared as follows: GI, instrumented with Hero 642 NiTi files 30/.06, 25/.06, 20/.06, 25/.06, and 30/.06; GII, instrumented as GI followed by Hero Apical size 30/.06; GIII, instrumented as GI followed by Hero Apical sizes 30/.06 and 30/.08, then returning to 30/.06 with pendulum movements. The apical thirds were prepared for histological processing, analyzed at 40× magnification and the images were examined morphometrically. Statistical analysis showed that GIII presented the best results for removing debris (5.22% ± 4.13), with more contact between the instruments and the root canal walls (19.31% ± 0.15). This differed statistically from GI (14.04% ± 4.96 debris removal, with 42.96% ± 7.11 instrument contact) and GII (12.62% ± 5.76 debris removal, with 35.01% ± 0.15 instrument contact). Root canal preparation with Hero 642, complemented by Hero Apical instruments (30/.06 and 30/.08, then re-instrumented with Hero Apical 30/.06 using pendulum movements), was more efficient for debris removal and allowed more contact of the instruments with the root canal walls. GII presented the worst results.

Dentin permeability of the apical third in different groups of teeth.

This ex vivo study evaluated dentin permeability of the root canal in the apical third of different human groups of teeth. Eighty teeth were used, 8 from each dental group: maxillary and mandibular central incisors, lateral incisors and canines, maxillary first premolars (buccal and palatal roots), mandibular first premolars, and maxillary and mandibular second premolars, totalizing 88 roots that were distributed in 11 groups. The root canals were instrumented, irrigated with 1% NaOCl and 15% EDTA. Roots were immersed in 10% copper sulfate for 30 min and then in 1% rubeanic acid alcohol solution for the same period; this chemical reaction reveals dentin permeability by the formation of copper rubeanate, which is a dark-colored compound. Semi-serial 100-µm-thick cross-sections were obtained from the apical third of the roots. Five sections of each apical third were washed, dehydrated, cleared and mounted on glass slides for examination under optical microscopy. The percentage of copper ion infiltration and the amount of tubular dentin were quantified by morphometric analysis. The penetration of copper ions in the apical third ranged from 4.60 to 16.66%. The mandibular central and lateral incisors presented the highest dentin permeability (16.66%), while the maxillary canines and mandibular second and first premolars presented the lowest dentin permeability (4.60%, 4.80% and 5.71%, respectively; p<0.001). The other teeth presented intermediate permeability. In conclusion, dye penetration into dentin tubules at the apical region is strongly dependent on the group of teeth evaluated.

Ultra-structural changes at the apical stop irradiated with CO2 laser.

OBJECTIVE: This study evaluated ultra-structural dentine changes at the apical stop after CO(2) laser irradiation used during biomechanical preparation. BACKGROUND: Most studies evaluating the sealing efficiency of CO(2) lasers have been carried out after apical root canal resections and retro-filling procedures. METHODS: Sixty human canines were prepared with #1 to #6 Largo burs. The apical stops were established at 1 mm (n = 30) and 2 mm (n = 30) from the apex. Final irrigation was performed with 1% NaOCl and 15% EDTA followed by 20 ml of distilled and deionized water. Specimens were subdivided into three subgroups (n = 10 for each stop distance): GI- no radiation (n = 20); GII- 3W potency (n = 20), GIII- 5W potency (n = 20). After preparation, specimens were evaluated by scanning electron microscopy, with ultra-structural changes classified according to a scoring system based on six qualitatively different outcomes. RESULTS: Statistical analysis using the Mann-Whitney test confirmed more intense results for the specimens irradiated at 5 W potency than at 3 W (p < 0.0001). The Kruskal-Wallis test indicated that when using the same potencies (3 or 5 W) at 1 and 2 mm from the apex, there were no statistically significant differences in ultra-structural changes. CONCLUSIONS: Our results showed that ultra-structural changes ranged from smear layer removal to dentine fusion. As laser potency was increased from 3 to 5 W, ultra-structural changes included extensive fused lava-like areas sealing the apical foramen.

Permeability of different groups of maxillary teeth after 38% hydrogen peroxide internal bleaching.

This study evaluated the influence of internal tooth bleaching with 38% hydrogen peroxide (H2O2) on the permeability of the coronal dentin in maxillary anterior teeth and premolars. Seventy teeth (14 per group) were used: central incisors (CI), lateral incisor (LI), canines (C), first premolars (1PM) and second premolars (2PM). Pulp chamber access and transversal sectioning at 2 mm from the cementoenamel junction were performed and the specimens were divided into 2 groups (n= 7): a) no treatment and b) bleaching with 38% H2O2. The bleaching agent was applied to the buccal surface and to the pulp chamber for 10 min. This procedure was repeated 3 times. The specimens were processed histochemically with copper sulfate and rubeanic acid, sectioned longitudinally, and digitalized in a scanner. The area of stained dentin was measured using Image Tool software. Data were analyzed statistically by ANOVA and Tukey's HSD test (alpha=0.05). There was statistically significant difference (p<0.001) among the untreated groups, CI (0.23 +/- 0.26) having the lowest permeability and LI (10.14 +/- 1.89) the highest permeability. Among the bleached groups, dentin permeability was increased in all groups of teeth except for 2PM. It may be concluded that bleaching with 38% H2O2 affected dentin permeability near the pulp chamber in maxillary anterior teeth and in first and second premolars.

Effect of 980-nanometer diode laser on root canal permeability after dentin treatment with different chemical solutions.

This study evaluated the effect of 980-nm diode laser at different parameters on root canal dentin permeability associated with different irrigants. Seventy-five canines were sectioned at 15 mm from the apex, prepared mechanically up to #40 .02 instrument, and irrigated with 2 mL distilled water. Final irrigation (10 mL) was used as follows: (1) distilled water; (2) 1% NaOCl; (3) 17% ethylenediaminetetraacetic acid + a cationic surfactant cetyltrimethylammonium bromide (EDTAC). Laser was applied at 1.5 or 3.0 W as either continuous wave or pulsed wave (100 Hz). The teeth were then processed histochemically, the percentage of copper ion penetration into the dentin of the canal walls was counted, and the data were analyzed statistically with the Tukey-Kramer test (alpha < .01). When laser was associated with water, an increase in permeability was found, whereas permeability decreased when associated with EDTAC. Dentin permeability after laser irradiation was directly dependent on the solution used for final irrigation.

Oral undifferentiated high-grade pleomorphic sarcoma: report of a case.

The current World Health Organization classification considers the existence of an undifferentiated unclassifiable category of pleomorphic sarcomas, defined as a group of pleomorphic high-grade sarcomas. Undifferentiated high-grade pleomorphic sarcoma represents about 5% of all soft tissue sarcomas in adults and occurs more commonly in the extremities. In the oral cavity, undifferentiated pleomorphic sarcoma is extremely rare. We report a case of undifferentiated high-grade pleomorphic sarcoma located in the floor of the mouth in a man 56 years old. Microscopically, spindle-shaped cells with accented pleomorphism arranged in a storiform pattern, several bizarre giant cells, and frequent atypical mitoses were observed. The tumor cells were positive only for vimentin, with focal positivity for CD68. The patient was treated by surgery and postoperative radiation therapy, and after 25 months, no recurrence was observed.

Chemical analysis of the flocculate formed by the association of sodium hypochlorite and chlorhexidine.

OBJECTIVE: The association of chlorhexidine (CHX) and sodium hypochlorite (NaOCl) to enhance their chemical properties during root canal biomechanical preparation can lead to a brown flocculate being formed. Therefore, this study evaluated the metals present in their association by atomic absorption spectrophotometry, and evaluated a possible reagent that could dissolve the flocculate, allowing its clinical use. STUDY DESIGN: Five concentrations of CHX and NaOCl were mixed (2.5% NaOCl + 0.2% CHX, 2% CHX + 0.5% NaOCl, 2% CHX + 5% NaOCl, 0.2% CHX + 0.5% NaOCl, and 0.2% CHX + 5% NaOCl). Methanol and hexane, acetic acid, and vinegar were evaluated to dissolve the flocculate. RESULTS: A flocculate was formed with all proportions and concentrations. Spectrophotometry analysis showed the presence of Ca, Fe, and Mg. CONCLUSION: It can be concluded that the association proposed led to the formation of brown flocculate regardless of concentration and proportion.