In vitro inflammatory modulation of bioceramic endodontic sealer in macrophages stimulated by bacterial lipopolysaccharide.

AIM: To evaluate the effects of AH Plus (Dentsply), Sealer 26 (Dentsply), and Sealer Plus BC (Produtos Médicos e Odontológicos) on cytotoxicity and inflammation in macrophage cultures exposed to bacterial lipopolysaccharide (LPS). METHODOLOGY: After initial setting, the sealers were conditioned with serum-free culture medium for 24 h (1 ml/cm2 ). Macrophages from the RAW 264.7 strain were exposed to sealer extracts in a 1:16 ratio in a culture medium with or without LPS. Cell morphology, viability, mitochondrial activity, oxidative stress and gene expression of interleukin 1ß (IL-1ß) and tumour necrosis factor-alpha (TNF-α) were evaluated. Data on mitochondrial activity, oxidative stress and TNF-α were analysed using a two-way analysis of variance (anova) test, followed by the Student-Newman-Keuls post-test. IL-1ß data were analysed using one-way anova, followed by SNK, and the t-test was used for intragroup comparison. The significance level was set at 5%. RESULTS: In the absence of LPS, only AH Plus and Sealer 26 showed a reduction in cell density, while in the presence of LPS, Sealer 26 had the lowest density compared to the other groups. In terms of mitochondrial activity, at 24 and 48 h, Sealer Plus BC had significantly higher mean values than Sealer 26 and AH Plus (p < .05). Sealer 26 exhibited the lowest levels of oxidative stress and IL-1ß and TNF-α expression, regardless of the presence of LPS (p < .05). CONCLUSIONS: Although all sealers interfere with the response of macrophages to LPS, contact with epoxy resin-based sealers can impair cell activity in vitro, while bioceramic sealer seems to favour the inflammatory functions of these cells.

Effect of canal preparation with XP-endo Shaper and ProTaper Next on root canal geometry and dentin thickness of mandibular premolars with radicular grooves and two canals: a micro-CT study.

OBJECTIVES: This study aimed to evaluate the effects of different shaping protocols on the root canal geometry and remaining dentin thickness of mandibular premolars with radicular grooves (RG) and two canals by means of micro-CT. MATERIALS AND METHODS: Mandibular premolars with RG and two canals were matched based on their similar morphological dimensions and assigned to 2 experimental groups according to the canal preparation (n=8): XP-endo Shaper (XPS) and ProTaper Next (PTN) systems. Before and after preparation, morphometric measurements of the volume, surface area, structure model index, area, perimeter, roundness, major and minor diameters, as well as untouched canal walls, canal transportation, and dentin wall thickness were evaluated. Data were statistically compared within and between groups using the independent sample t test (α=5%). RESULTS: XPS revealed less changes in volume, surface area, area, perimeter, and major and minor diameters (P<0.05). There was no significant difference in structure model index (SMI), roundness, and percentage of untouched canal walls between groups (P>0.05). XPS resulted in less apical canal transportation and a higher remaining dentin thickness toward the RG compared to PTN in lingual canals (P<0.05). CONCLUSIONS: XPS revealed fewer changes in root canal geometry as well as lower transportation and a greater remaining dentin thickness in the lingual canals toward the RG compared to PTN. CLINICAL RELEVANCE: Internal and external anatomical characteristics of mandibular premolars might have an influence on biomechanical preparation. Considering the risk of perforation, the canal preparation using XPS appears to be more conservative compared to PTN.

Effect of a 12-methacryloyloxy-dodecyl-pyridinium-bromide-containing adhesive with different post types on the long-term bond strength to dentin.

The use of matrix metalloproteinase (MMPs) inhibitors, such as 12-methacryloyloxy-dodecyl-pyridinium-bromide (MDPB), might improve the adhesion of glass-fiber (GF) and polyfiber (PF) posts to root dentine. This study assessed the effect of an MDPB-containing adhesive on the long-term bond strength of GF or PF posts to bovine dentine. Bovine endodontically treated roots were randomly divided into six groups, according to the post type and adhesive system used, as follows: GF serrated post + MDBP-free adhesive; GF serrated post + MDPB-containing adhesive; GF smooth post + MDBP-free adhesive; GF smooth post + MDPB-containing adhesive; PF post + MDBP-free adhesive; PF post + MDPB-containing adhesive. Specimens were stored in water for 6 months, thermocycled (500 cycles wk-1 ), and submitted to the pull-out test and failure pattern analysis. The cement-dentin interface was evaluated using scanning electron microscopy. The pull-out data were analyzed using anova and Tukey's test (α = 0.05). No significant interaction between the type of post and the adhesive system was found. Polyfiber posts showed lower bond strength than GF posts, whether serrated or smooth, and the bond strength of the serrated and smooth GF posts was not significantly different. Adhesive failures were predominant in all groups. The type of retainer influenced the bond strength, and MDPB-containing adhesive did not improve the long-term bond strength of posts to dentine.

Nd:YAG laser in occlusal caries prevention of primary teeth: a randomized clinical trial.

Dental caries is still the most prevalent chronic disease affecting human populations. Among the preventive treatments performed, it has been reported that laser irradiation combined with topical fluoride can induce an even greater increase in enamel caries resistance. The aim of this study was to evaluate the Nd:YAG laser, with or without fluoride, in occlusal caries prevention of the primary dentition. A double-blind split-mouth study design was used. Fifty-two children with high caries risk (7.6 ± 1.4 years) were selected and received the following: G1--the first molar was a negative control, and the second received a resin sealant; G2--the first molar was a negative control, and the second received laser irradiation (50 mJ, 10 Hz, 0.5 W); G3--the first molar received only acidulate phosphate fluoride (APF), and the second received APF + laser; G4--fisrt molar received only fluoride varnish, and the second received fluoride varnish + laser. Patients were followed up to 12 months to evaluate the presence of white-spot lesions and/or caries cavities by three calibrated observers. Thirty-five patients completed the study. Significant differences were found between the treatment and control groups (p < 0.05). The laser-alone and resin sealant resulted in statistically lower caries formation than the negative control group (p < 0.05). Nd:YAG laser irradiation in primary teeth effectively prevented occlusal caries in pits and fissures when used alone with lower energy over a 1-year period.

Thermal effects and morphological aspects of varying Er:YAG laser energy on demineralized dentin removal: an in vitro study.

The aim of this study was to evaluate thermal changes, dentin ablation removal capacity, and morphological aspects of sound and demineralized human dentin surface irradiated with different output energies of an erbium: yttrium-aluminium-garnet (Er:YAG) laser. Eighty sound human tooth specimens were assigned into two groups: demineralized dentin and sound dentin (control group). The dentin groups were subdivided into four subgroups (n = 10) according to the irradiation energy used (120, 160, 200, or 250 mJ) at a constant frequency level of 6 Hz, in focused mode, and under refrigeration. Quantitative analysis of the sound and carious dentin ablation was performed using light microscopy (LM) by measuring (mm) the remaining demineralized tissue with the Axion Vision™ software. Qualitative analysis was performed using the images obtained with a scanning electron microscope (SEM), and the temperature increase was recorded with an infrared digital thermometer. The Er:YAG laser promoted a gradual increase in temperature for all groups, and no difference was observed between the sound and demineralized dentin. The groups of 200 and 250 mJ showed the highest values, yet a variation in temperature did not exceed 5 °C. The energy output of 120 mJ selectively removed demineralized tissue when compared to 250 mJ, while also providing more regular surfaces in the cavity preparation. It was concluded that the temperature increase during sound and demineralized dentin removal had a strong positive correlation with the Er:YAG laser energy level output. However, the higher energies used did not present selectivity to the demineralized tissue, and the parameters used did not cause an increase in temperature over 5 °C.

Knowledge, Perception, and Experience of Dentists About Teledentistry.

OBJECTIVES: This study aimed to evaluate the level of knowledge, perception, and experience of teledentistry amongst Brazilian dentists with the ongoing COVID-19 pandemic. METHODS: Between June and July 2020, an online questionnaire was used to collect information on the demographic and professional profiles of dentists and their levels of knowledge, perception, and attitudes towards teledentistry. Descriptive statistics were reported as percentages, and Chi-squared test was used to compare responses amongst general practitioners, specialists, and those with varying levels of professional experience. RESULTS: This study included 575 dentists, the majority of whom were from the southeast region of Brazil (73.4%) and had a specialist degree (70.4%). Approximately 42.4% of the study sample had graduated more than 10 years ago, 39.3% between 2 and 10 years ago, and 18.3% up to 2 years ago. In general, the majority of dentists exhibited only a superficial awareness of the resolution that regulates teledentistry in Brazil. A greater number of specialists were aware of the resolution (P = .007) and felt confident performing teledentistry (P = .000) compared to general practitioners, whilst those with more experience (graduated more than 10 years ago) exhibited greater knowledge (P = .012) and preparation (P = .000). More than 60% of the dentists, regardless of dental specialty and clinical experience, had no knowledge of providing prescriptions via teledentistry. The majority of general practitioners (89.5%) and specialists (81.4%) had no previous experience using teledentistry. CONCLUSIONS: The findings of this study suggest that Brazilian dentists are inadequately prepared for the implementation of teledentistry.

Calcium hydroxide paste removal strategies and bond strengths of epoxy- and silicate-based sealers.

This study evaluated the syringe/needle (SN), passive ultrasonic irrigation (PUI) and XP-endo Finisher (XP) in the removal of Ca(OH)2 -based paste and the bond strength (BS) values of an epoxy resin (AH Plus) and silicate (MTA)-based sealers to root dentin. Eighty lower premolars were assigned: control group (CT), SN, PUI and XP, and subdivided according to the sealer (n = 10) for BS. SN has the lowest removal followed by PUI and XP. AH Plus had higher BS for CT compared with SN in all root thirds. CT and XP presented similar BS in the apical and middle thirds and higher than SN and PUI. For MTA, similar BS was observed in the cervical and apical thirds, and in the middle third, CT, PUI and XP presented similar values and higher than SN. PUI and XP methods presented higher efficiency in the Ca(OH)2 removal, and the residual Ca(OH)2 provides a reduction in BS of the AH Plus.

Effect of erbium:yttrium-aluminum-garnet laser energies on superficial and deep dentin microhardness.

This study evaluated the microhardness of superficial and deep dentin irradiated with different erbium:yttrium-aluminum-garnet (Er:YAG) laser energies. Seventy-two molars were bisected and randomly assigned to two groups (superficial dentin or deep dentin) and into six subgroups (160 mJ, 200 mJ, 260 mJ, 300 mJ, 360 mJ, and control). After irradiation, the cavities were longitudinally bisected. Microhardness was measured at six points (20 microm, 40 microm, 60 microm, 80 microm, 100 microm, and 200 microm) under the cavity floor. Data were submitted to analysis of variance (ANOVA) and Fisher's tests (alpha = 0.05). Superficial dentin presented higher microhardness than deep dentin; energy of 160 mJ resulted in the highest microhardness and 360 mJ the lowest one. Values at all points were different, exhibiting increasing microhardness throughout; superficial dentin microhardness was the highest at 20 microm with 160 mJ energy; for deep dentin, microhardness after irradiation at 160 mJ and 200 mJ was similar to that of the control. The lowest energy increased superficial dentin microhardness at the closest extent under the cavity; deep dentin microhardness was not altered by energies of 160 mJ and 200 mJ.

Comparative Effect of Rotary Microbrush Combined with Different Chemical Irrigants on Root Dentin Microhardness, Roughness and Bond Strength to an Epoxy-based Sealer.

PURPOSE: This study evaluated the effect of 17% EDTA, 10% citric acid (CA), and 2% chlorhexidine (CHX) activated with a rotary microbrush (CanalBrush) on root dentin microhardness, roughness, and epoxy-based sealer bond strength. MATERIALS AND METHODS: One hundred sixty single-rooted bovine incisors were instrumented and divided into 8 groups according to treatment: 1. 17% EDTA; 2. 17% EDTA+2% CHX; 3. 10% CA; 4. 10% CA+2% CHX; 5. 17% EDTA with CanalBrush; 6. 17% EDTA+2% CHX with CanalBrush; 7. 10% CA with CanalBrush; and 8. 10% CA+2% CHX with CanalBrush. Ten roots in each group were split into halves and submitted to microhardness and roughness analyses (n = 10). Following endodontic filling with AH Plus sealer, 10 roots in each group underwent push-out bond strength testing (n = 10). Data were analyzed using two-way ANOVA and Tukey's tests (α = 0.05). RESULTS: All groups had similar microhardness values (p > 0.05) which was higher in the apical third than in the middle and cervical thirds (p < 0.05). The CanalBrush groups had higher roughness than the no-activation groups (p < 0.05), with significantly higher roughness in the cervical third than in the apical third (p < 0.05). All groups exhibited similar bond strength (p > 0.05), with the cervical third being higher, followed by the middle and apical thirds (p < 0.05). CONCLUSIONS: Microbrush activation had a direct impact on dentin roughness and did not influence the dentin microhardness or the retention of epoxy-based sealer to the root canal.

Antibacterial Activity of a New Ready-To-Use Calcium Silicate-Based Sealer.

The aim of this study was to evaluate the antibacterial potential of a calcium silicate-based sealer (Bio-C Sealer, Angelus) against common bacteria in primary and secondary endodontic infections. Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus mutans were exposed to fresh Bio-C Sealer for 24 h by the agar diffusion method (n=5). Additionally, the antibacterial activity was investigated against E. faecalis and S. mutans biofilms (48 h old) grown in discs with 4 mm in diameter and 2 mm in height. (n=3) of set discs of Bio-C Sealer (Angelus), EndoFill (Dentsply-Mallefer), Sealer 26 (Dentsply), AH Plus (Dentsply), Sealapex (Sybron-Endo) and EndoSequence BC Sealer (Brasseler). The antibacterial activity was evaluated by colony forming unity (CFU) counting using ImageJ software. Data were compared by one-way ANOVA followed by Holm-Sidak test (a=5%). Fresh Bio-C Sealer exhibited antimicrobial activity against all bacteria evaluated by agar diffusion method, except for S. mutans. Set discs of all endodontic sealers tested showed similar CFU values for E. faecalis (p>0.05). S. mutans in biofilms showed higher susceptibility to EndoFill compared with the other sealers (p<0.05). In conclusion, the results indicate that fresh Bio-C Sealer does not inhibit S. mutans growth, but exhibits antibacterial activity against E. faecalis, S. aureus, P. aeruginosa and E. coli. After setting, the Bio-C Sealer exhibits an antimicrobial potential comparable to that of the other sealers evaluated in E. faecalis biofilm, but lower than that of EndoFill for S. mutans biofilm.

Chlorhexidine and proanthocyanidin enhance the long-term bond strength of resin-based endodontic sealer.

The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.

Effects of EDTA gel and chlorhexidine gel on root dentin permeability.

The aim of this study was to evaluate the effect of 24% ethylenediaminetetraacetic acid (EDTA) gel and 2% chlorhexidine gel (CHX) in dentin permeability and smear layer removal from root canals instrumented with NiTi rotary system using histochemical staining and scanning electron microscopy (SEM) analysis. Overall, 43 premolars were classified into two experimental groups, EDTA (n = 20) and CHX (n = 20), and a negative control (NC) (n = 3). All specimens were instrumented and the irrigant solutions were used after each file change. The EDTA group received a final rinse with 5-ml 1% NaOCl followed by a 5-ml 0.9% saline solution; the CHX group received a final rinse with 10-ml 0.9% saline solution; and the negative control group received a final rinse with only 0.9% saline solution. Fifteen teeth from each group were prepared for histochemical staining and evaluation of dentin permeability using the image-scanning software Axion Vision (v.4.8.2). Five remaining teeth were prepared for analysis using SEM for morphological analysis. The study found that 24% EDTA gel increased the permeability of dentin in all thirds evaluated and also demonstrated an increased cleaning ability, with dentinal walls free of smear layer and open dentinal tubules, as compared to 2% CHX gel. It was concluded that EDTA was efficient in cleaning the dentinal tubules and increased dentin permeability.

Assessment of thermal alteration during class V cavity preparation using the Er:YAG laser.

OBJECTIVE: The aim of this study was to evaluate in vitro the pulp thermal alterations during class V cavity preparations using the Er:YAG laser and high-speed water flow. MATERIALS AND METHODS: Forty human teeth were selected and prepared for the thermocouple adaptation in the pulp chamber. The specimens were assigned to four groups: (1) laser 300 mJ/3 Hz, (2) laser 300 mJ/4 Hz, (3) high-speed 9 mL/min water flow, and (4) high-speed 100 mL/min water flow. The temperature was measured before the beginning and at the end of the preparation, as well as during the procedures. The groups were analyzed by scanning electron microscopy. RESULT: Data analysis disclosed temperature reduction at high-speed drilling with the high-speed total water flow group, and these values were statistically different from the other groups. The results of the 9-mL/min water flow group were similar to those of the 300-mJ/3-Hz group and different from the 300-mJ/4-Hz laser group. CONCLUSION: The laser promoted a greater increase in temperature only when compared with high-speed handpiece and water flow rate of 100 mL/min.

Evaluation of Mechanical Properties of Glass Fiber Posts Subjected to Laser Surface Treatments.

OBJECTIVE: The aim of this study was to evaluate the influence of laser irradiation on flexural strength, elastic modulus, and surface roughness and morphology of glass fiber posts (GFPs). BACKGROUND DATA: Laser treatment of GFPs has been introduced to improve its adhesion properties. MATERIALS AND METHODS: A total of 40 GFPs were divided into 4 groups according to the irradiation protocol: GC-no irradiation, GYAG-irradiation with erbium:yttrium-aluminum-garnet [Er:YAG], GCR-irradiation with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG), and GDI-irradiation with diode laser. The GFP roughness and morphology were evaluated through laser confocal microscopy before and after surface treatment. Three-point bending flexural test measured flexural strength and elastic modulus. Data about elastic modulus and flexural strength were subjected to one-way ANOVA and Bonferroni test (p < 0.05). The effect of roughness was evaluated using the linear mixed effects model and Bonferroni test (p < 0.05). RESULTS: Laser treatment changed surface roughness in the groups GCR (p = 0.000) and GDI (p = 0.007). The mean flexural strength in GYAG (995.22 MPa) was similar to that in GC (980.48 MPa) (p = 1.000) but different from that in GCR (746.83 MPa) and that in GDI (691.34 MPa) (p = 0.000). No difference was found between the groups GCR and GDI (p = 0.86). For elastic modulus: GYAG (24.47 GPa) was similar to GC (25.92 GPa) (p = 1.000) but different from GCR (19.88 GPa) (p = 0.002) and GDI (17.20 GPa) (p = 0.000). CONCLUSIONS: The different types of lasers, especially Er,Cr:YSGG and 980 ηm diode, influenced the mechanical properties of GFPs.

1064-nm Nd:YAG and 980-nm Diode Laser EDTA Agitation on the Retention of an Epoxy-Based Sealer to Root Dentin.

Root canal irrigants are used to minimize the negative effects of smear layer on endodontic sealer retention. The aim of this study was to evaluate the efficacy of agitation of 17% ethylenediaminetetraacetic acid (EDTA) with ultrasonic, 1064-nm Nd:YAG and 980-nm diode laser on the retention of an epoxy-based sealer to the root canal walls. Forty single-rooted bovine teeth were instrumented with ProTaper rotary system and divided into four groups according to the final irrigation protocol (n = 10): (1) 17% EDTA (control); (2) 17% EDTA with 50-s ultrasonic agitation; (3) 17% EDTA with 50-s diode laser (2-W) agitation; and (4) 17% EDTA with 50-s Nd:YAG (1.5-W) laser agitation. After endodontic filling with gutta-percha F5 master cone and Sealer 26, the roots were sectioned at the cervical, middle, and apical root thirds to obtain 1.5-mm slices. Push-out tests were performed using a universal testing machine at a 1 mm/min crosshead speed. Data were analyzed using two-way ANOVA and Tukey's tests (α=0.05). Apical root thirds had significant higher retention values than cervical and middle thirds (p < 0.05). EDTA with 1064-nm Nd:YAG or 980-nm diode laser presented the highest retention values and was significantly different from EDTA with ultrasonic agitation and EDTA only (p < 0.05). Adhesive failures were predominant to EDTA only group. Mixed failures were predominant to all agitation groups. 1064-nm Nd:YAG and 980-nm diode laser EDTA agitation enhanced the retention of the epoxy-based sealer to the root canal walls compared with that due to EDTA only or EDTA with ultrasonic agitation.

Effect of root canal filling techniques on the bond strength of epoxy resin-based sealers.

The aim of this study was to evaluate the effects of different root canal filling techniques on the bond strength of epoxy resin-based sealers. Sixty single-rooted canines were prepared using ProTaper (F5) and divided into the following groups based on the root filling technique: Lateral Compaction (LC), Single Cone (SC), and Tagger Hybrid Technique (THT). The following subgroups (n = 10) were also created based on sealer material used: AH Plus and Sealer 26. Two-millimeter-thick slices were cut from all the root thirds and subjected to push-out test. Data (MPa) was analyzed using ANOVA and Tukey's test (α = 0.05). The push-out values were significantly affected by the sealer, filling technique, and root third (p < 0.05). AH Plus (1.37 ± 1.04) exhibited higher values than Sealer 26 (0.92 ± 0.51), while LC (1.80 ± 0.98) showed greater bond strength than THT (1.16 ± 0.50) and SC (0.92 ± 0.25). The cervical (1.45 ± 1.14) third exhibited higher bond strength, followed by the middle (1.20 ± 0.72) and apical (0.78 ± 0.33) thirds. AH Plus/LC (2.26 ± 1.15) exhibited the highest bond strength values, followed by AH Plus/THT (1.32 ± 0.61), Sealer 26/LC (1.34 ± 0.42), and Sealer 26/THT (1.00 ± 0.27). The lowest values were obtained with AH Plus/SC and Sealer 26/SC. Thus, it can be concluded that the filling technique affects the bond strength of sealers. LC was associated with higher bond strength between the material and intra-radicular dentine than THT and SC techniques.

Effect of thermoplastic filling techniques on the push-out strength of root sealing materials.

This study evaluates the effect of two thermoplastic obturation systems (MicroSeal and Obtura II) on bond strength of different sealers to intraradicular dentin. Sixty root canals of human canines were prepared using ProTaper rotary files (crown-down technique) and irrigated with 2.5% sodium hypochlorite and 17% EDTA. The root canals were filled by MicroSeal, Obtura II, or lateral compaction techniques using AH Plus and Epiphany SE. 1.5 mm thick root slices were subjected to the push-out test. ANOVA and Tukey's test showed that the bond strength values (MPa) observed in the groups obturated with MicroSeal (2.96 ± 2.72) and Obtura II (2.68 ± 2.18) did not significantly differ from each other (p > 0.05) but were significantly higher than that observed in the group obturated with lateral condensation (2.01 ± 1.48; p < 0.05). There were no statistically significant differences in strength (p > 0.05) among the root canal thirds (cervical: 2.44 ± 2.03; middle: 2.50 ± 2.27; and apical: 2.70 ± 2.34). Adhesive failures were predominant (60%) in all groups. In conclusion, MicroSeal and Obtura II techniques, using AH plus sealer, increased the resistance to displacement of the filling material, when compared with lateral compaction. Moreover, when used with Epiphany SE, these obturation systems did not affect the bond strength of the material to root dentin.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability.

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey's tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

Effect of Nd:YAG (1064-nm) and Diode Laser (980-nm) EDTA Agitation on Root Dentin Ultrastructure Properties.

OBJECTIVE: The purpose of this study was to analyze the effects of agitation of 17% ethylenediaminetetraacetic acid (EDTA) with 1064 nm Nd:YAG and 980 nm diode laser on root dentin microhardness and superficial roughness (with confocal laser scanning microscopy [CLSM]). BACKGROUND DATA: Root canal irrigants are used in an attempt to minimize the negative effects of smear layer. MATERIALS AND METHODS: Twenty-five bovine roots were sectioned longitudinally and divided into five groups (n=10 each): (1) deionized water, (2) 17% EDTA, (3) 17% EDTA with 60 sec manual agitation, (4) 17% EDTA with 50 sec diode laser (2 W) agitation, and (5) 17% EDTA with 50 sec Nd:YAG (1.5 W) laser agitation. Microhardness and superficial roughness values were calculated before and after the procedures at the cervical, middle, and apical root thirds. Microhardness was statistically analyzed using two way ANOVA, paired t test, and Tukey's tests (α=0.05). Roughness was statistically analyzed using Kruskal-Wallis, paired t test, and Student-Newman-Keuls tests (α=0.05%). RESULTS: Statistically significant differences in microhardness and roughness were observed between the deionized water group and others. EDTA with 1064 nm Nd:YAG or 980 nm diode laser presented the lowest microhardness and the highest roughness values and was significantly different from EDTA with manual agitation and EDTA only (p<0.05). However, there were no differences in microhardness or dentin roughness between the root thirds (p>0.05). CLSM analysis showed that the control samples exhibited smoother surfaces than that of the EDTA groups. CONCLUSIONS: Nd:YAG 1064 nm and 980-nm diode laser EDTA agitation caused greater reduction in microhardness and increased roughness of root dentin than EDTA only or EDTA with manual agitation.

Chemical and Morphological Changes of Primary Teeth Irradiated with Nd:YAG Laser: An Ex Vivo Long-Term Analysis.

OBJECTIVE: The aim of this study was to assess any long-term chemical and morphological Nd:YAG laser modifications on irradiated primary enamel. BACKGROUND DATA: Previous studies on irradiated primary human enamel employed methodologies that evaluated the short-term effects only. METHODS: One hundred and eighty-six irradiated (with and/or without fluoride) primary enamel teeth from high-caries-risk children, which were exfoliated over a 1-year period, were collected, and the sample surface area was submitted for scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and X-ray energy-dispersive spectrometry (EDS). The subsurface was analyzed by Knoop microhardness and light microscopy (LM). Data were analyzed by one way ANOVA and Tukey tests (α=0.05) and Kruskall-Wallis and Tukey tests (α=0.05). RESULTS: FTIR analysis revealed a higher concentration of phosphate and carbonate in the irradiated (0.987±0.064) and lower concentration in the control groups (1.477±0.310). SEM analysis showed that the control samples exhibited a slightly smoother surface than the irradiated groups. The EDS analysis did not show any differences in the amount of calcium, phosphorus, or fluoride among the groups. The microhardness analysis revealed that sealant (249.86±7.15) and laser irradiation (262.44±22.69) led to higher hardness values than the negative control group (128.35±25.19). LM indicated significantly reduced caries formation in the laser (5.35±5.38%) and the laser plus acidulated phosphate fluoride (APF) groups (10.35±0.88%) compared with the negative control group (72.56±12.86%). CONCLUSIONS: Even with the limitations of the present study, these results suggest that Nd:YAG irradiation clinically modified the chemical composition of the enamel surface regardless of fluoride concentration, which successfully inhibited demineralization of primary tooth enamel over a 1-year period without significant morphological changes.