Evaluation of the interaction between sodium hypochlorite and several formulations containing chlorhexidine and its effect on the radicular dentin--SEM and push-out bond strength analysis.

The aim of the current study was to evaluate the presence of debris and smear layer after endodontic irrigation with different formulations of 2% chlorhexidine gluconate (CHX) and its effects on the push-out bond strength of an epoxy-based sealer on the radicular dentin. One hundred extracted human canines were prepared to F5 instrument and irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Fifty teeth were divided into five groups (n = 10), according to the final irrigation protocol with different 2% CHX formulations: G1 (control, no final rinse irrigation), G2 (CHX solution), G3 (CHX gel), G4 (Concepsis), and G5 (CHX Plus). In sequence, the specimens were submitted to scanning electron microscopy (SEM) analysis, in the cervical-medium and medium-apical segments, to evaluate the presence of debris and smear layer. The other 50 teeth were treated equally to a SEM study, but with the root canals filled with an epoxy-based endodontic sealer and submitted to a push-out bond strength test, in the cervical, middle, and apical thirds. G2, G3, G4, and G5 provided higher precipitation of the debris and smear layer than G1 (P < 0.05), but these groups were similar to each other (P > 0.05), in both segments. The values obtained in the push out test did not differ between groups, independent of the radicular third (P > 0.05). The CHXs formulations caused precipitation of the debris and smear layer on the radicular dentin, but these residues did not interfere in the push-out bond strength of the epoxy-based sealer.

The efficacy of the self-adjusting file and ProTaper for removal of calcium hydroxide from root canals.

OBJECTIVE: The goal of this study was to evaluate the efficacy of the Self-Adjusting File (SAF) and ProTaper for removing calcium hydroxide [Ca(OH)2] from root canals. MATERIAL AND METHODS: Thirty-six human mandibular incisors were instrumented with the ProTaper system up to instrument F2 and filled with a Ca(OH)2-based dressing. After 7 days, specimens were distributed in two groups (n=15) according to the method of Ca(OH)2 removal. Group I (SAF) was irrigated with 5 mL of NaOCl and SAF was used for 30 seconds under constant irrigation with 5 mL of NaOCl using the Vatea irrigation device, followed by irrigation with 3 mL of EDTA and 5 mL of NaOCl. Group II (ProTaper) was irrigated with 5 mL of NaOCl, the F2 instrument was used for 30 seconds, followed by irrigation with 5 mL of NaOCl, 3 mL of EDTA, and 5 mL of NaOCl. In 3 teeth Ca(OH)2 was not removed (positive control) and in 3 teeth canals were not filled with Ca(OH)2 (negative control). Teeth were sectioned and prepared for the scanning electron microscopy. The amounts of residual Ca(OH)2 were evaluated in the middle and apical thirds using a 5-score system. RESULTS: None of the techniques completely removed the Ca(OH)2 dressing. No difference was observed between SAF and ProTaper in removing Ca(OH)2 in the middle (P=0.11) and the apical (P=0.23) thirds. CONCLUSION: The SAF system showed similar efficacy to rotary instrument for removal of Ca(OH)2 from mandibular incisor root canals.

Effect of final irrigation protocols on microhardness and erosion of root canal dentin.

The aim of this study was to evaluate the effect of final irrigation protocols (17% EDTA, BioPure MTAD, SmearClear, and QMiX) on microhardness and erosion of root canal dentin. Fifty roots were sectioned transversely at the cement-enamel junction and each root was sectioned horizontally into 4-mm-thick slices. The samples were divided into five groups (n = 10) according to the final irrigation protocol: G1: distilled water (control group); G2: 17% EDTA; G3: BioPure MTAD; G4: SmearClear; and G5: QMiX. The dentin microhardness was then measured with a load of 25 g for 10 s. Initially, the reference microhardness values were obtained for the samples without any etching. The same samples were then submitted to the final irrigation protocols. A new measure was realized and the difference between before and after the procedures was the dentin microhardness reduction. In sequence, the specimens were submitted to SEM analysis to verify the dentinal erosion. The Kruskal Wallis and Dunn tests (α = 5%) were used to compare the results. The dentin microhardness decreased for all final irrigation protocols. There was no significant difference between groups 2, 3, 4, and 5 (P > 0.05), but this groups presented significant dentin microhardness reduction than G1 (P < 0.05). In G2, occurred the highest incidence of dentinal erosion (P < 0.05). 17% EDTA, BioPure MTAD, SmearClear, and QMiX promoted significant dentin microhardness reduction. Dentinal tubules erosion was promoted by 17% EDTA.

Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer.

The aim of the present study was to evaluate the efficacy of QMiX, SmearClear, and 17% EDTA for the debris and smear layer removal from the root canal and its effects on the push-out bond strength of an epoxy-based sealer by scanning electron microscopy (SEM). Forty extracted human canines (n = 10) were assigned to the following final rinse protocols: G1-distilled water (control), G2-17% EDTA, G3-SmearClear, and G4-QMiX. The specimens were submitted to a SEM analysis to evaluate the presence of debris and smear layer, respectively, in the apical or cervical segments. In sequence, forty extracted human maxillary canines with the root canals instrumented were divided into four groups (n = 10) similar to the SEM analysis study. After the filling with AH Plus, the roots were transversally sectioned to obtain dentinal slices. The specimens were submitted to a push-out bond strength test using an electromechanical testing machine. The statistical analysis for the SEM and push-out bond strength studies were performed using the Kruskal-Wallis and Dunn tests (α = 5%). There was no difference among the G2, G3, and G4 efficacy in removing the debris and smear layer (P > 0.05). The efficacy of these groups was superior to the control group. The push-out bond strength values of G2, G3, and G4 were superior to the control group. The ability to remove the debris and smear layer by SmearClear and QMiX was as effective as the 17% EDTA. The final rinse with these solutions promoted similar push-out bond strength values.

The efficacy of the self-adjusting file and ProTaper for removal of calcium hydroxide from root canals

OBJECTIVE: The goal of this study was to evaluate the efficacy of the Self-Adjusting File (SAF) and ProTaper for removing calcium hydroxide [Ca(OH)2] from root canals. MATERIAL AND METHODS: Thirty-six human mandibular incisors were instrumented with the ProTaper system up to instrument F2 and filled with a Ca(OH)2-based dressing. After 7 days, specimens were distributed in two groups (n=15) according to the method of Ca(OH)2 removal. Group I (SAF) was irrigated with 5 mL of NaOCl and SAF was used for 30 seconds under constant irrigation with 5 mL of NaOCl using the Vatea irrigation device, followed by irrigation with 3 mL of EDTA and 5 mL of NaOCl. Group II (ProTaper) was irrigated with 5 mL of NaOCl, the F2 instrument was used for 30 seconds, followed by irrigation with 5 mL of NaOCl, 3 mL of EDTA, and 5 mL of NaOCl. In 3 teeth Ca(OH)2 was not removed (positive control) and in 3 teeth canals were not filled with Ca(OH)2 (negative control). Teeth were sectioned and prepared for the scanning electron microscopy. The amounts of residual Ca(OH)2 were evaluated in the middle and apical thirds using a 5-score system. RESULTS: None of the techniques completely removed the Ca(OH)2 dressing. No difference was observed between SAF and ProTaper in removing Ca(OH)2 in the middle (P=0.11) and the apical (P=0.23) thirds. CONCLUSION: The SAF system showed similar efficacy to rotary instrument for removal of Ca(OH)2 from mandibular incisor root canals. .

Efetividade antibacteriana de soluções irrigadoras e sistema Endox Plus no tratamento de canais radiculares / Antibacterial effectiveness of irrigating solutions and Endox Plus system in the treatment of root canals

O objetivo deste estudo foi avaliar a efetividade antibacteriana de soluções irrigadoras e do sistema Endox Plus no preparo de canais radiculares. Capítulo 1 - Para comparar a efetividade antibacteriana da solução de hipoclorito de sódio (NaOCl), MTAD BioPure e do Sistema Endox Plus durante o preparo biomecânico, foram utilizadas 70 raízes de dentes humanos unirradiculados contaminadas com cepa de E. faecalis (ATCC 29212) e incubadas por 21 dias. Os espécimes foram divididos em cinco grupos: GI- Sistema Endox Plus, GII- NaOCl 2.5 % /MTAD, GIII- NaOCl 2,5% /EDTA, GIV- solução salina (controle positivo), GV- Controle negativo (sem instrumentação/irrigação). Foi realizada a análise microbiológica das amostras por meio de diluições seriadas e a contagem das UFCs. Os dados obtidos foram analisados estatisticamente por ANOVA e Tukey post-hoc (p < 0,05). Todos os espécimes mostraram crescimento bacteriano após o período de contaminação com similar contagem de UFC/mL log, sem diferença estatística entre os grupos. Após os procedimentos houve uma redução da quantidade de bactérias em todos os grupos, exceto no controle negativo. Não houve diferenças estatísticas significantes entre os GI e GIV. Os grupos II e III não mostraram crescimento bacteriano, mostrando diferença estatística com os outros grupos. Na coleta final, houve um aumento na contagem bacteriana nos grupos I, II, III e IV, sem diferença significativa entre eles. Porém, houve diferença na proliferação bacteriana quando comparados com a coleta pós-preparo. O sistema Endox Plus demonstrou a menor efetividade antibacteriana quando comparado às soluções de NaOCl 2,5% /MTAD e NaOCl 2,5% /EDTA e, todos os procedimentos avaliados permitiram a proliferação bacteriana após 7 dias, mostrando a permanência da infecção no SCR. Capítulo 2 - Foi avaliada a atividade antibacteriana das soluções irrigadoras MTAD BioPure, Chlor-XTRA e CHX-Plus pelo teste de contato direto sobre biofilme de E. faecalis em dentina bovina. Foram 48 corpos-de-prova de 5mm x 5mm x 0,7mm que foram esterilizados. Após formação de biofilme com a cepa de E. faecalis (ATCC 29212) por 15 dias foi realizado o teste antibacteriano por contato direto. Os tempos de contato foram de 1 e 3 minutos. A análise microbiológica foi realizada por meio da contagem das UFC/mL após cada um dos períodos experimentais, como no capítulo 1. Chlor-XTRA foi capaz de eliminar biofilme de E. faecalis após 1 e 3 minutos de contato, com diferença estatística significante entre os demais grupos (p < 0,05). MTAD Biopure possui a menor atividade antibacteriana quando comparado às soluções de Chlor-XTRA e CHX-Plus. ChlorXTRA foi o irrigante que se mostrou eficaz sobre biofilme de E. faecalis

The aim of this study is to evaluate the antimicrobial effectiveness of irrigating solutions and the Endox Plus system in the treatment of the root canals. Chapter I- In order to compare the antimicrobial effectiveness of sodium hypochlorite solution (NaOCl), MTAD Biopure and Endox Plus system during chemomechanical preparation, were used 70 single-rooted human teeth, which were contaminated with the strain of E. faecalis (ATCC 29212) and incubated for 21 days. The specimens were divided into five groups: GI- Endox Plus system, GII- NaOCl 2.5% /MTAD, GIII- NaOCl 2.5% /EDTA, GIV- saline solution (positive control), GV- negative control (without instrumentation/irrigation). Microbiological analysis of the samples consisted in evaluation of the CFUs. The data obtained were statistically analyzed by ANOVA tests and Tukey post-hoc (p<0.05). The specimens showed bacterial growth after the initial incubation period with similar counting of CFU/mL log, with no statistical difference among the groups. After the procedures there was a decrease of the amount of bacteria in all groups, except in the negative control. There were no statistically differences between the GI and GIV. The GII and GIII didn't show bacterial growth, showing statistical differences with the other groups. In the final sample, bacterial counts increased in groups I, II, III, IV, with no statistically significant differences among the groups, but there was a difference when compared to the post-instrumentation sample. The Endox Plus system presented the lowest antibacterial effectiveness when compared to the solutions of NaOCl 2.5% /MTAD y NaOCl 2.5% /EDTA and all the evaluated procedures allowed the recovery of bacteria 7 days after treatment, demonstrating persistence of infection in the root canal system. Chapter II- The antibacterial activity of the irrigating solutions MTAD Biopure, Chlor-XTRA and CHX-Plus was evaluated with the test of direct contact over the biofilm of the E. faecalis in bovine root dentine. There were used roots of bovine incisors to obtain segments of root canal for the preparation of 48 dentine sections 5mm x 5mm x 0.7 mm, which were sterilized later. After biofilm formation with the strain of E. faecalis (ATCC 29212) the antibacterial direct contact test was taken for 15 days. The contact times were of 1 and 3 minutes. The microbiological analysis consisted in evaluation of the number of UFC/mL after each of the experimental periods as in Chapter I. Chlor-XTRA was able to eliminate E. faecalis biofilm after 1 and 3 minutes of contact, with a statistically significant difference among the other groups (p < 0,05). MTAD Biopure has the lowest antibacterial activity when compared to solutions Chlor-XTRA e CHX-Plus. Chlor-XTRA was the irrigant that proved to be effective against E. faecalis biofilm