Effects of three γ-alkylidene-γ-lactams on the formation of multispecies biofilms.

This study evaluated the inhibitory effects of lactams on Streptococcus mutans, Enterococcus faecalis, and Candida glabrata multispecies biofilm formation. γ-Alkylidene-γ-lactams 1, 2, and 3 [solubilized in 3.5% dimethyl sulfoxide (DMSO)] were tested. Glass coverslips were conditioned with either the lactams or 3.5% DMSO (control) for 1 h, inoculated with microbial cultures, and incubated for 48 h. To assess the effect of the lactams on biofilm formation, the following parameters were determined: the biofilm biomass (by both crystal violet staining and protein determination); the amount of insoluble polysaccharides of the extracellular matrix; and the number of viable and total cells [by both colony-forming unit counting and quantitative real-time PCR (qPCR)]. Data were analysed using one-way anova and post-hoc Tukey tests. Lactams 1, 2, and 3 promoted a statistically significant reduction in the amount of biofilm biomass, but only lactam 3 resulted in a statistically significant reduction in the number of attached viable E. faecalis. Both total protein content and the amount of extracellular polysaccharides decreased significantly. The effects of γ-alkylidene-γ-lactams 1, 2, and 3 on the inhibition of multispecies biofilm formation were evident by their ability to reduce the amount of protein and extracellular polysaccharides.

Effect of milk renewal on human periodontal ligament fibroblast viability in vitro.

Milk has been studied extensively and has gained wide acceptance as a suitable storage medium capable of maintenance of avulsed teeth that cannot be replanted immediately. The objective of this study was to evaluate whether the renewal of milk as a storage medium every 24 h for up to 120 h is able to increase its ability to maintain human periodontal ligament fibroblasts (PDLF) viability in vitro. Plates with confluent PDLF were soaked in minimum essential medium (MEM) at 37°C (positive control) and in skimmed milk (22 wells) and water (negative control) for 24, 48, 72, 96, and 120 h at 5 and 20°C. The skimmed milk was renewed every 24 h in 11 of the wells of each plate. After these periods, cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by Kruskal-Wallis and Scheffé tests (α = 5%). At 24 h, milk and MEM performed similarly. However, from 48 h onwards, MEM was significantly better than renewed and not renewed milk at both temperatures. Regardless of temperature (5 or 20°C), renewal of milk with fresh milk did not affect its ability to maintain PDLF viability.

Effect of medicaments used in endodontic regeneration on the morphological characteristics of bovine radicular dentin: Experimental immature tooth model.

The purpose of this study was to evaluate the effect of different combinations of irrigating solutions and intracanal dressings in the pretreatment of bovine radicular dentin, using an experimental immature tooth model. Eighty healthy bovine teeth, simulated with incomplete rhizogenesis, were randomly distributed according to the protocols of root canal dentin pretreatment for a regenerative endodontic procedure (n = 10): Control (irrigation with distilled water); SH (irrigation with 1.5% Sodium Hypochlorite); EDTA (irrigation with 17% EDTA); SH/EDTA (irrigation with 1.5% SH + 17% EDTA); SH/CH/EDTA (irrigation with 1.5% SH + calcium hydroxide paste +17% EDTA); SH/MTAP/EDTA (irrigation with 1.5% SH + modified triple antibiotic paste + EDTA 17%); SH/TAP/EDTA (irrigation with 1.5% SH + triple antibiotic paste +17% EDTA) and SH/DAP/EDTA (irrigation with 1.5% SH + double antibiotic paste + EDTA 17%). After the completion of the protocol, the demineralization, the exposure of collagen fibers, and the dentin erosion was evaluated under scanning electron microscopy (SEM), by applying a score system (1-3) to classify the observed features. Statistical analysis was performed (Kruskal-Wallis and Dunn Multiple Comparison tests-p < .05). SH/TAP/EDTA and SH/DAP/EDTA groups presented the highest rates of demineralization in both the coronal and middle thirds of the root (p < .05). In the SH/MTAP/EDTA group, the samples presented moderate demineralization. The samples from the SH/CH/EDTA group presented similar findings to the control group (p < .05). Conventional triple antibiotic (TAP) and double antibiotic (DAP) pastes promoted more pronounced morphological changes on the dentin surface.

Oxygen Saturation in the Dental Pulp of Maxillary and Mandibular Molars - Part 2.

This study determined the oxygen saturation (SaO2) in dental pulp of healthy maxillary and mandibular molars. Mean of SaO2 was evaluated in 112 maxillary and mandibular molars using pulse oximetry. Quantitative variables were described by mean and standard deviation. Variables with symmetric distribution were compared by Student t test and Mann-Whitney test. Pearson's correlation coefficient was used to correlate quantitative variables. Analysis of variance was used to assess differences in SaO2 levels between the molar groups, followed by post-hoc Tukey. The significance level established at p<0.05. Mean of oxygen saturation for the 112 molar dental pulps was 85.09%. There was no significant correlation (r=-0.007; p=0.977) between the mean of SaO2 of molar pulps with patient´s indicator finger (92.89%). There was a significant difference (p=0.037) between the mean of SaO2 of the first (85.76%) and second maxillary molars (81.87%), and it was not significant (p=0.1775) between the first and second mandibular molars. Maxillary molars had lower pulpal SaO2 (83.59%) than mandibular molars (86.89%) (p=0.018). The mean of the patient's response time to the cold stimulus was 1.12 s (maxillary molars 1.25 s and mandibular molars 0.99 s)(p=0.052). There was no significant correlation between the time response of the patient to the cold stimulus and the SaO2 for molars. The mean oxygen saturation level was 85.09%. The mandibular molars presented higher SaO2 level than maxillary molars.

Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1.

The aim of this study was to determine oxygen saturation levels in the dental pulp of maxillary premolars in different age groups. A total of 120 human maxillary premolars with normal dental pulps were selected covering the following age groups: 20-24, 25-29, 30-34, 35-39 and 40-44 years (n=24 each group). Oxygen saturation was assessed using pulse oximetry. Analysis of variance was used to assess differences in oxygen saturation levels and Tukey's test was used to identify the age groups that differed from each other. Significance was set at 0.05. Mean oxygen saturation of 120 premolars was 86.20% considering all age groups. Significantly reduced levels were found in the oldest group compared to the other groups: 40 to 44 years - 80.00% vs. 89.71, 87.67, 88.71, and 84.80% for age groups 20-24, 25-29, 30-34, 35-39 years, respectively. The mean oxygen saturation levels were similar between 20 and 39 years of age (86.20%) in the whole sample, but reduced significantly in the 40-44-year age group, suggesting that older patients present lower oxygen saturation results even in the absence of pulp tissue injury.

Effectiveness of EDTA and Modified Salt Solution to Detach and Kill Cells from Enterococcus faecalis Biofilm.

INTRODUCTION: Disruption of the matrix of endodontic biofilms will aid in their removal from a root canal. Therefore, the aim of this study was to investigate the efficacy of EDTA and a modified salt solution (MSS) to detach bacteria from biofilms. METHODS: Forty-eight-hour-old Enterococcus faecalis biofilms were grown on glass coverslips and then treated for 1 hour by immersion in 17% EDTA or MSS. Phosphate-buffered saline served as a negative control. Then, residual biofilm cells on the substrate and the detached cells in the supernatant were collected. Viability was verified by the colony-forming unit (CFU) counting method. Propidium monoazide (PMA) treatment in conjunction with quantitative polymerase chain reaction (qPCR) was also performed to detect the presence of E. faecalis 16S ribonucleic RNA genes. Data were analyzed using 1-way analysis of variance and Tukey or Kruskal-Wallis and Dunn tests. The Pearson R test evaluated the correlation between results from CFU and PMA (α = 5%). RESULTS: qPCR showed that EDTA detached 99% of biofilm cells, and MSS detached 94% of biofilm cells (both P < .001). In contrast to EDTA, MSS was highly antimicrobial. The treatment promoted an ample log 7 reduction of the attached cells (P < .001), and almost no live cells were detected in the supernatant (P < .001). Positive correlations between CFU and qPCR with PMA were observed (r = 0.959 and r = 0.729). CONCLUSIONS: EDTA detached cells in biofilms with a minor antimicrobial effect. Besides a great antimicrobial effect, MSS also detached biofilm cells. These dispersals of biofilms give insights into new endodontic biofilm removal strategies.

A laboratory assessment of bacterial leakage in MTA apical plugs exposed to phosphate-buffered saline.

This study evaluated the influence of the exposure of mineral trioxide aggregate (MTA) - with and without calcium chloride (CaCl2) -to phosphate-buffered saline (PBS) on apical microleakage. Sixty root segments were divided into 4 experimental groups (n=15). Apical cavities were filled with MTA with or without CaCl2, and the root canals dressed with a moistened cotton pellet or PBS: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+ 10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. After 2 months, E. faecalis penetration was analyzed along the apical plugs. Samples were observed weekly for 70 days, and leakage was detected by turbidity of the medium in contact with the root segment. Teeth in the control groups (n=2) were either made completely impermeable or kept without an apical plug. The Kaplan-Meier method was used to analyze survival and the Logrank test was used to compare the survival curves (p<0.05). All specimens in the positive control group showed evidence of leakage within 24h, while none in the negative control group showed leakage up to 70 days. There was no statistically significant difference among the experimental groups (p=0.102). The use of PBS as intracanal dressing may improve MTA sealing ability, but cannot prevent bacterial leakage. The addition of CaCl2 to the MTA did not improve MTA sealing ability.

Effect of Ultrasonic Activation of Irrigants on Smear Layer Removal.

INTRODUCTION: The objective of this study was to evaluate the efficacy of passive ultrasonic irrigation (PUI) with 17% EDTA and 1% NaOCl solutions on smear layer removal. METHODS: Root canal preparations of 32 human teeth were performed with the ProTaper system. Next, they were longitudinally fractured to permit quantitation of smear layer creation from the cervical, middle, and apical thirds of the roots by using scanning electron microscopy. After reassembling the fractured tooth halves, they were divided into 4 groups according to different final irrigation protocols: group1, EDTA + NaOCl; group 2, EDTA with PUI + NaOCl; group 3, EDTA + NaOCl with PUI; and group 4, EDTA + NaOCl, both with PUI. After irrigation, the tooth halves were separated to permit imaging the same areas by scanning electron microscopy, and a percentage of opened dentinal tubules in irrigated areas as a percent of the total area was obtained. The results were submitted to Kruskal-Wallis, analysis of variance, and Bonferroni tests (α = 0.05). RESULTS: The cervical third of the samples from all groups showed higher percentage of smear layer removal and open dentinal tubule areas, followed by the middle and apical thirds. Among the irrigation groups, there were statistically significant differences in cervical third between group 2 and group 4 samples, with the highest and lowest percentage of smear layer removal, respectively. CONCLUSIONS: PUI by using 1% NaOCl and ultrasonic tip placed within 1 mm of the apical foramen did not show higher efficacy in smear layer removal compared with conventional irrigation.

Oxygen Saturation in the Dental Pulp of Maxillary and Mandibular Molars - Part 2

Abstract This study determined the oxygen saturation (SaO2) in dental pulp of healthy maxillary and mandibular molars. Mean of SaO2 was evaluated in 112 maxillary and mandibular molars using pulse oximetry. Quantitative variables were described by mean and standard deviation. Variables with symmetric distribution were compared by Student t test and Mann-Whitney test. Pearson's correlation coefficient was used to correlate quantitative variables. Analysis of variance was used to assess differences in SaO2 levels between the molar groups, followed by post-hoc Tukey. The significance level established at p<0.05. Mean of oxygen saturation for the 112 molar dental pulps was 85.09%. There was no significant correlation (r=-0.007; p=0.977) between the mean of SaO2 of molar pulps with patient´s indicator finger (92.89%). There was a significant difference (p=0.037) between the mean of SaO2 of the first (85.76%) and second maxillary molars (81.87%), and it was not significant (p=0.1775) between the first and second mandibular molars. Maxillary molars had lower pulpal SaO2 (83.59%) than mandibular molars (86.89%) (p=0.018). The mean of the patient's response time to the cold stimulus was 1.12 s (maxillary molars 1.25 s and mandibular molars 0.99 s)(p=0.052). There was no significant correlation between the time response of the patient to the cold stimulus and the SaO2 for molars. The mean oxygen saturation level was 85.09%. The mandibular molars presented higher SaO2 level than maxillary molars.

Resumo Este estudo determinou o nível de saturação de oxigênio (SaO2) em polpas dentais hígidas de molares. O nível de SaO2 foi avaliado em 112 molares superiores e inferiores usando oxímetro de pulso. As variáveis quantitativas foram descritas pela média e desvio padrão. As variáveis com distribuição simétrica foram comparadas pelo teste t de Student e teste de Mann-Whitney. O coeficiente de correlação de Pearson foi utilizado para correlacionar variáveis quantitativas. A análise de variância foi utilizada para avaliar as diferenças nos níveis de SaO2 entre os grupos de molares, seguido de Tukey pós-hoc. A significância foi estabelecida em 0,05. O nível médio de SaO2 para as polpas de 112 molares foi de 85,09%, não havendo correlação com a média de SaO2 do dedo indicador do paciente (92,89%). Houve diferença significativa entre o nível médio de SaO2 dos primeiros molares superiores (85,76%) e os segundos molares superiores (81,87%) e não foi significativo entre os primeiros e os segundos molares inferiores. Os molares superiores apresentaram menor nível de SaO2 (83,59%) do que os molares inferiores (86,89%). A média do tempo de resposta do paciente ao estímulo com frio foi de 1,12 s (molares superiores 1,25 segundos e molares inferiores 0,99 segundos). Não houve correlação significativa entre o tempo de resposta do paciente ao estímulo com frio e o nível de saturação de oxigênio para os molares. Em resumo, o nível médio de saturação de oxigênio foi de 85,09%. Os molares inferiores apresentaram maior nível de SaO2 do que os molares superiors

Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1

Abstract The aim of this study was to determine oxygen saturation levels in the dental pulp of maxillary premolars in different age groups. A total of 120 human maxillary premolars with normal dental pulps were selected covering the following age groups: 20-24, 25-29, 30-34, 35-39 and 40-44 years (n=24 each group). Oxygen saturation was assessed using pulse oximetry. Analysis of variance was used to assess differences in oxygen saturation levels and Tukey's test was used to identify the age groups that differed from each other. Significance was set at 0.05. Mean oxygen saturation of 120 premolars was 86.20% considering all age groups. Significantly reduced levels were found in the oldest group compared to the other groups: 40 to 44 years - 80.00% vs. 89.71, 87.67, 88.71, and 84.80% for age groups 20-24, 25-29, 30-34, 35-39 years, respectively. The mean oxygen saturation levels were similar between 20 and 39 years of age (86.20%) in the whole sample, but reduced significantly in the 40-44-year age group, suggesting that older patients present lower oxygen saturation results even in the absence of pulp tissue injury.

Resumo Este estudo determinou os níveis de saturação de oxigênio (SaO2) em polpas dentárias de pré-molares superiores em diferentes faixas etárias. Foram selecionados 120 pré-molares superiores humanos com polpas dentárias normais, abrangendo os seguintes grupos etários: 20-24, 25-29, 30-34, 35-39 e 40-44 anos (n=24 para cada grupo). A saturação de oxigênio foi avaliada utilizando oximetria de pulso. A análise de variância foi utilizada para avaliar diferenças nos níveis de saturação de oxigênio, e o teste de Tukey foi utilizado para identificar os grupos etários que diferiam uns dos outros. A significância foi estabelecida em 0,05. A saturação média de oxigênio foi de 86,20% considerando todos os grupos etários. Níveis significativamente reduzidos foram encontrados no grupo de indivíduos de maior idade em comparação aos outros grupos: 40 a 44 anos - 80,00% vs. 89,71, 87,67, 88,71 e 84,80% para os grupos etários 20-24, 25-29, 30-34, 35-39 anos. Os níveis médios de saturação de oxigênio foram semelhantes entre os 20 e os 39 anos de idade (86,20%), mas reduziram-se significativamente na faixa etária de 40-44 anos, sugerindo que os pacientes mais idosos apresentam menor saturação de oxigênio mesmo na ausência de lesão do tecido pulpar.

In vivo host interactions with mineral trioxide aggregate and calcium hydroxide: inflammatory molecular signaling assessment.

INTRODUCTION: Mineral trioxide aggregate (MTA) and calcium hydroxide [Ca(OH)(2)] are promising biomaterials for stimulating dentinogenesis and cementogenesis. This research was undertaken to understand how MTA and CA(OH)(2) participate in the inflammatory, healing, and biomineralization processes. In this part of the study, we evaluated inflammatory signaling molecules promoted by in vivo host interaction with MTA and Ca(OH)(2). METHODS: Human dentin tubes were filled with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), Ca(OH)(2), or kept empty. After 12 hours and 1, 3, 7, 15, 30, and 60 days of implantation in subcutaneous tissues in the backs of mice, the tubes and surrounding tissues were retrieved for cytokine level quantification and histological and immunohistochemical analysis. RESULTS: MTA and Ca(OH)(2) induced proinflammatory cytokine up-regulation for up to 3 days. Moreover, interleukin-10 overexpression was noted on the tissue in contact with the biomaterials during the acute phase of the inflammatory reaction. Immunohistochemical analyses showed an increased expression of myeloperoxidase, nuclear factor kappa B (NF-κB), cyclooxygenase-2, inducible nitric oxide synthase enzymes, and vascular endothelial growth factor on day 1 for all groups. CONCLUSIONS: MTA and Ca(OH)(2) increased the activation of the NF-κB signaling system on day 1 for all groups. This finding can be associated with a proinflammatory and pro-wound healing environment, which was promoted earlier by MTA.

A phosphate-buffered saline intracanal dressing improves the biomineralization ability of mineral trioxide aggregate apical plugs.

INTRODUCTION: Recently, it was shown that the biomineralization process promoted by the interaction of mineral trioxide aggregate (MTA) with dentin in phosphate-buffered saline (PBS) positively influenced the push-out bond strength of the cement. This study investigated if the use of a PBS intracanal dressing promotes the biomineralization process of MTA apical plugs using an ex vivo apexification model. METHODS: White MTA was introduced into single-rooted teeth with standardized artificially created open apices to form 5-mm-thick apical plugs. The specimens were randomly divided into the following three groups of 10 samples each: group 1: the remaining canal space was filled with PBS as an intracanal dressing; group 2: the root segments were introduced in plastic vials containing floral foams with 20 mL of PBS; and group 3: the root segments were placed in the floral foams with 20 mL of PBS and a PBS intracanal dressing was used. After 2 months, the samples were processed for scanning electron microscopic observations. Data were analyzed by using the Kruskall-Wallis test. RESULTS: In group 1, the formation of an interfacial layer (IL) with intratubular mineralization (ITM) was more evident at the cervical third; however, no mineralization was revealed at the apical third. In group 2, there was no IL and/or ITM formation at the cervical third, but samples denoted IL and ITM formation at the apical third. Group 3 displayed the formation of IL and ITM at the different levels. CONCLUSION: It was concluded that the use of a PBS intracanal dressing promotes the biomineralization process at the inner side of MTA apical plugs.

The biomineralization ability of mineral trioxide aggregate and Portland cement on dentin enhances the push-out strength.

INTRODUCTION: Recently, it was shown that the interaction of each of mineral trioxide aggregate (MTA) and Portland cement with dentin in phosphate-buffered saline (PBS) promotes a biomineralization process that leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface. This study analyzes the influence of the biomineralization process on the push-out strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), MTA Branco (Angelus Soluções Odontológicas, Londrina, PR, Brazil), MTA BIO (Angelus Soluções Odontológicas), or Portland cement with and without calcium chloride. METHODS: Dentin discs with standardized cavities were filled with ProRoot MTA, MTA Branco, MTA BIO, white Portland cement + 20% bismuth oxide (PC1), or PC1 + 10% of calcium chloride (PC2). The specimens were randomly divided into two groups: cement in contact with a wet cotton pellet for 72 hours or immersed in PBS for 2 months. The bond strengths were measured with the Instron Testing machine (Model 4444; Instron Corp, Canton, MA), and the fractured surfaces on the root walls were observed by scanning electron microscopy. RESULTS: All samples immersed in PBS displayed a significantly greater resistance to displacement than that observed for the samples in contact with a wet cotton pellet for 72 hours (p < 0.05). MTAs displayed a significantly greater resistance to displacement than Portland cements. CONCLUSION: It was concluded that the biomineralization process positively influenced the push-out bond strength of the cements, particularly the MTA groups.

Tratamento do biofilme intracanal de Enterococcus faecalis com suspensões de diferentes nanopartículas e irrigantes convencionais / Treatment of the Enterococcus faecalis root canal biofilm with nanoparticle suspensions and conventional irrigants

Objetivo: O objetivo deste estudo foi avaliar e comparar a efetividade das soluções de hipoclorito de sódio (NaOCl) 1% e 5%, clorexidina (CHX) 2%, suspensões de nanopartículas de prata (Np Ag) 1% e nanopartículas de óxido de zinco (Np ZnO) 26% contra o biofilme de E. faecalis. Material e Métodos: Setenta e seis dentes humanos unirradiculados foram modelados, montados em um aparato específico e esterilizados. Após, 100 μL de uma suspensão de E. faecalis foi inserida nos canais, sendo renovada diariamente por 7 dias. Quatro segmentos radiculares foram analisados por meio de microscopia eletrônica de varredura (MEV) para confirmar a presença do biofilme. Os segmentos radiculares remanescentes foram divididos aleatoriamente em 6 grupos (n = 12), de acordo com a solução irrigadora empregada: G1) solução salina 0,85% (controle); G2) NaOCl 1%; G3) NaOCl 5%; G4) CHX 2%; G5) suspensão de Np Ag 1%; e G6) suspensão de Np ZnO 26%. Concluída a irrigação, a susceptibilidade do biofilme às soluções irrigadoras (n = 10) foi determinada pelo método de plaqueamento e contagem de unidades formadoras de colônias (UFC). Uma análise por meio de MEV foi conduzida em 2 segmentos de cada grupo para visualização da estrutura do biofilme. O conjunto de dados, representados pelos valores médios de UFC para cada grupo, foi analisado estatisticamente pelos testes Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: A efetividade das soluções de NaOCl 5% e Np Ag 1% contra o biofilme intracanal de E. faecalis foi superior comparada à solução salina 0,85% (p < 0,05). NaOCl 5% reduziu 100% das UFC comparado ao grupo controle, seguido pela suspensão de Np Ag 1% (97,6%), Np ZnO 26% (96,1%), NaOCl 1% (94,1%) e CHX 2% (93,1%). Conclusão: Com base na metodologia aplicada, as soluções de NaOCl 5% e Np Ag 1% apresentaram excelente efetividade contra o biofilme de E. faecalis estabelecido no canal radicular...

Host-mineral trioxide aggregate inflammatory molecular signaling and biomineralization ability.

INTRODUCTION: The biological processes underlying the ability of mineral trioxide aggregate (MTA) to promote hard-tissue deposition and wound healing remain unclear. To further study these processes, specific signaling molecules related to the inflammatory response and the biomineralization process were analyzed to assess host-MTA interactions in vivo. METHODS: For cytokine level quantification and immunohistochemical analysis, human dentin tubes were filled with ProRoot MTA (Dentsply, Tulsa Dental, OK) or kept empty and were implanted in subcutaneous tissues in the backs of mice. Dentin tubes were retrieved and subsequently observed using a scanning electron microscope. RESULTS: MTA induced a time-dependent proinflammatory cytokine up-regulation up to 3 days. Immunohistochemical analyses showed an up-regulated expression of myeloperoxidase, nuclear factor-kappa B, activating protein-1, cyclooxygenase-2, inducible nitric oxide synthase, and vascular endothelial growth factor on day 1. Scanning electron microscopic examination revealed the presence of apatite-like clusters on collagen fibrils over the surface of tubes containing MTA. With the increase in time after implantation, a more extensive mineralization showing a compact layer of apatite was observed. CONCLUSION: MTA induced a proinflammatory and pro-wound healing environment. The biomineralization process occurred simultaneously at the biomaterial-dentin-tissue interface, with the acute inflammatory response. This promoted the integration of the biomaterial into the environment.

Biomineralization ability and interaction of mineral trioxide aggregate and white portland cement with dentin in a phosphate-containing fluid.

INTRODUCTION: Mineral trioxide aggregate (MTA) has been shown to be bioactive because of its ability to produce biologically compatible carbonated apatite. This study analyzed the interaction of MTA and white Portland cement with dentin after immersion in phosphate-buffered saline (PBS). METHODS: Dentin disks with standardized cavities were filled with ProRoot MTA, MTA Branco, MTA BIO, white Portland cement + 20% bismuth oxide (PC1), or PC1 + 10% of calcium chloride (PC2) and immersed in 15 mL of PBS for 2 months. The precipitates were weighed and analyzed by scanning electron microscopy (SEM) and x-ray diffraction. The calcium ion release and pH of the solutions were monitored at 5, 15, 25, and 35 days. The samples were processed for SEM observations. Data were analyzed by using analysis of variance or Kruskall-Wallis tests. RESULTS: Our findings revealed the presence of amorphous calcium phosphate precipitates with different morphologies. The apatite formed by the cement-PBS system was deposited within collagen fibrils, promoting controlled mineral nucleation on dentin, observed as the formation of an interfacial layer with tag-like structures. CONCLUSIONS: All the cements tested were bioactive. The cements release some of their components in PBS, triggering the initial precipitation of amorphous calcium phosphates, which act as precursors during the formation of carbonated apatite. This spontaneous precipitation promotes a biomineralization process that leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface.

A laboratory assessment of bacterial leakage in MTA apical plugs exposed to phosphate-buffered saline / Avaliação laboratorial da infiltração bacteriana em plugs apicais de mta expostos ao tampão fosfato-salino

O presente estudo avaliou a influência da exposição do agregado de trióxido mineral (MTA) – com e sem cloreto decálcio (CaCl2) – ao tampão fosfato-salino (PBS) sobre a microinfiltração apical. Sessenta segmentos radiculares foram divididos em 4 grupos experimentais (n=15). As cavidades apicais foram preenchidas com MTA, com ou sem CaCl2, e os canais radiculares receberam uma bolinha de algodão umedecida ou PBS, como medicação intracanal: 1) MTA/bolinha de algodão umedecida; 2) MTA/PBS; 3) MTA+10%CaCl2/ bolinha de algodão umedecida; 4) MTA+10% CaCl2/PBS. Após 2 meses, a penetração de E. faecalis ao longo dos plugs apicais foi avaliada. As amostras foram observadas semanal -mente durante 70 dias e a infiltração detectada através da turbidez do meio em contato com os segmentos radiculares. Dentes pertencentes aos grupos controle (n=2) foram mantidos completamente impermeáveis ou sem plug apical. A análise de sobrevivência e a comparação das curvas foram realizadas por meio dos testes Kaplan-Meier e Log-rank (p<0.05), respectiva -mente. Todas as amostras do grupo controle positivo apresentaram evidência de infiltração dentro de 24h, enquanto nenhuma amostra do grupo controle negativo apresentou infiltração aolongo dos 70 dias. Não houve diferença significativa entre os grupos experimentais (p=0.102). O uso do PBS como medicação intracanal pode melhorar a capacidade de selamento do MTA,mas não é capaz de impedir a infiltração bacteriana. A adição de CaCl2 ao MTA não melhora sua capacidade de selamento.

This study evaluated the influence of the exposure of mineral trioxide aggregate (MTA) - with and without calcium chloride(CaCl2) -to phosphate-buffered saline (PBS) on apical microleakage. Sixty root segments were divided into 4 experimental groups (n=15). Apical cavities were filled with MTA with or without CaCl2, and the root canals dressed with a moistened cotton pellet or PBS: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. After 2months, E. faecalis penetration was analyzed a long the apical plugs. Samples were observed weekly for 70 days, and leakage was detected by turbidity of the medium in contact with the root segment. Teeth in the control groups (n=2) were either made completely impermeable or kept without an apical plug. The Kaplan–Meier method was used to analyze survival and the Log-rank test was used to compare the survival curves (p<0.05). All specimens in the positive control group showed evidence of leakage within 24h, while none in the negative control group showed leakage up to 70 days. There was no statisticall y significant difference among the experimental groups (p=0.102).The use of PBS as intracanal dressing may improve MTA sealing ability, but cannot prevent bacterial leakage. The addition of CaCl2 to the MTA did not improve MTA sealing ability.