Prevalence of postoperative pain after endodontic treatment using low and high concentrations of sodium hypochlorite: a systematic review and meta-analysis.

OBJECTIVES: To determine the prevalence of postoperative pain after endodontic treatment using low (LC) and high (HC) concentrations of sodium hypochlorite (NaOCl). MATERIALS AND METHODS: Six databases and the grey literature were searched to identify randomized clinical trials that evaluated postoperative pain after endodontic treatment using NaOCl. NaOCl concentrations were dichotomized into 'LC' (0.5% to 3%) and 'HC' (≥ 5%) and a proportion meta-analysis was applied to determine the postoperative pain prevalence: overall and according to pain intensity and postoperative time. The prevalence of patients using pain control medication was also determined. A significance level of 5% and a random effect model were applied for data analysis. Between-study heterogeneity was assessed by I2 index. Risk of bias (RoB) was assessed using the Cochrane Risk-of-Bias 2.0 tool. The certainty of evidence was assessed using the GRADE approach. RESULTS: Ten studies were included in the review and eight in the meta-analysis. The overall prevalence of postoperative pain was 45% in LC and 39% in HC. The prevalence of pain in LC and HC after 24 h was 25% and 40%, respectively. After 48 h, the prevalence decreased to 10% in LC and 25% in HC. 'Absent pain' was the most prevalent score. The prevalence of patients who used medication was 9% in LC and 15% in HC. Three studies were classified as 'high RoB', five as 'low RoB', and two as 'some concerns'. The certainty of evidence was very low. CONCLUSIONS: The overall prevalence of postoperative pain after endodontic treatment using LC and HC of NaOCl was 45% and 39%, respectively. CLINICAL RELEVANCE: Postoperative pain is common after endodontic treatment using NaOCl, but tends to decrease over time.

Effect of dental tissue thickness on the measurement of oxygen saturation by two different pulse oximeters.

This study aimed to evaluate the influence of different dental tissue thickness on the measurement of oxygen saturation (SpO2) levels in high (HP) and low (LP) blood perfusion by comparing the values obtained from two different pulse oximeters (POs) - BCI and Sense 10. Thirty freshly extracted human teeth had their crowns interposed between the POs and an optical simulator, which emulated the SpO2 and heart beats per minute (bpm) at HP (100% SpO2/75 bpm) and LP (86% SpO2/75 bpm) modes. Afterwards, the palatine/lingual surfaces of the dental crowns were worn with diamond drills. The reading of SpO2 was performed again using the POs alternately through the buccal surface of each dental crown. Data were analyzed by the Wilcoxon, Mann-Whitney and Kendall Tau-b tests (α=5%). The results showed significant difference at the HP and LP modes in the SpO2 readouts through the different dental thicknesses with the use of BCI, and at the LP mode with the use of Sense 10, which had a significant linear correlation (p<0.0001) and lower SpO2 readout values in relation to the increase of the dental thickness. Irrespective of tooth thickness, Sense 10 had significantly higher readout values (p<0.0001) than BCI at both perfusion modes. The interposition of different thicknesses of enamel and dentin influenced the POs measurement of SpO2, specially at the low perfusion mode. The POs were more accurate in SpO2 measurement when simulated perfusion levels were higher.

Effect of dental tissue thickness on the measurement of oxygen saturation by two different pulse oximeters

Abstract This study aimed to evaluate the influence of different dental tissue thickness on the measurement of oxygen saturation (SpO2) levels in high (HP) and low (LP) blood perfusion by comparing the values obtained from two different pulse oximeters (POs) - BCI and Sense 10. Thirty freshly extracted human teeth had their crowns interposed between the POs and an optical simulator, which emulated the SpO2 and heart beats per minute (bpm) at HP (100% SpO2/75 bpm) and LP (86% SpO2/75 bpm) modes. Afterwards, the palatine/lingual surfaces of the dental crowns were worn with diamond drills. The reading of SpO2 was performed again using the POs alternately through the buccal surface of each dental crown. Data were analyzed by the Wilcoxon, Mann-Whitney and Kendall Tau-b tests (α=5%). The results showed significant difference at the HP and LP modes in the SpO2 readouts through the different dental thicknesses with the use of BCI, and at the LP mode with the use of Sense 10, which had a significant linear correlation (p<0.0001) and lower SpO2 readout values in relation to the increase of the dental thickness. Irrespective of tooth thickness, Sense 10 had significantly higher readout values (p<0.0001) than BCI at both perfusion modes. The interposition of different thicknesses of enamel and dentin influenced the POs measurement of SpO2, specially at the low perfusion mode. The POs were more accurate in SpO2 measurement when simulated perfusion levels were higher.

Resumo Este estudo avaliou a influência de diferentes espessuras de esmalte e dentina na medição dos níveis de saturação de oxigênio (SpO2) em alta (HP) e baixa (LP) perfusão sanguínea, comparando os valores obtidos em dois oxímetros de pulso (OPs) diferentes, BCI e Sense 10. Trinta dentes recém-extraídos de humanos tiveram suas coroas interpostas entre os OPs e um simulador óptico, que simulava a SpO2 e os batimentos cardíacos por minuto (bpm) nos modos de HP (100% SpO2 / 75 bpm) e LP (86% SpO2 / 75 bpm). Após, as superfícies palatinas / linguais dos dentes foram desgastadas com brocas de diamantadas. A leitura da SpO2 foi realizada novamente usando os dois OPs alternadamente através da face vestibular de cada coroa dental. Os dados foram analisados ​​pelos testes Wilcoxon, Mann-Whitney e Kendall Tau-b (α = 5%). Os resultados mostraram diferença significativa nos modos HP e LP nas leituras de SpO2 através das diferentes espessuras dentárias com o uso do BCI, e no modo LP com o uso do Sense 10, que teve correlação linear significativa (p <0,0001) e menores valores de leitura de SpO2 em relação ao aumento da espessura dentária. Independentemente da espessura do dente, o Sense 10 apresentou valores de leitura significativamente maiores (p <0,0001) do que o BCI em ambos os modos de perfusão. A interposição de diferentes espessuras de esmalte e dentina influenciaram a mensuração da SpO2 pelos OPs, especialmente no modo de baixa perfusão. Os POs foram mais precisos na mensuração da SpO2 quando os níveis simulados de perfusão foram maiores.

Evaluation of the Pulp Oxygen Saturation Reading after Tooth Bleaching: A Randomized Clinical Trial.

Objectives: The purpose of this clinical trial was to evaluate the influence of in-office dental bleaching on the pulp oxygen saturation (SpO2p) reading. Material and Methods. SpO2p was measured using a pulse oximeter in 112 upper and lower anterior teeth (canines and incisors) of patients submitted to bleaching. Whitegold Office 35% (WGO) (upper and lower left hemiarch) and Whiteness HP Auto Mixx 35% (WHP) (upper and lower right hemiarch) bleaching agents were used. SpO2 measurements (teeth and index finger) were taken before and after each of the three application sessions of the agents. In the 4th session, in which no bleaching gel was used, only SpO2 was measured. Before and after the bleaching sessions, a colorimetric device performed the teeth color reading. The waiting time between sessions was 7 days. Data were analyzed by the Friedman, Kruskal-Wallis, and Mann-Whitney U tests (α = 0.05). Color change (ΔE) data were correlated (Spearman's Rho test) with the SpO2p levels. Results: Neither of the two bleaching agents showed significant differences between the readings when evaluated individually (WGO, P=0.780, and WHP, P=0.494). When taken together, the results showed significant difference between the readings performed, with higher median values after bleaching sessions: before (97.3) and after (98.6) 1st session; before (98.3) and after (98.3) 2nd session; before (98.3) and after (99.0) 3rd session; and after 1 week (98.3). The dental groups formed by maxillary lateral incisors (P=0.012) and mandibular incisors (P < 0.001) showed a significant difference. Spearman's Rho test showed a nonsignificant and weak correlation between ΔE and SpO2p in most comparisons. Conclusions: The in-office dental bleaching influenced the SpO2p reading, regardless of the dental group evaluated or the bleaching agent used. Clinical Relevance. This study provides information about the influence of in-office tooth whitening on the pulp SpO2p levels. The observation of pulp vitality during and after the use of bleaching agents is important for the follow-up of patients undergoing tooth whitening. The use of a pulse oximeter may be a viable and painless alternative to perform this monitoring. The clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC; registration number: https://clinicaltrials.gov/ct2/show/RBR-68xbth).

A second attempt at pulp revascularisation on an immature traumatised anterior tooth: a case report with two-year follow-up.

This report describes the second attempt at pulp revascularisation, using an association between 2% chlorhexidine (CHX) and calcium hydroxide (CH) as intracanal dressing, in an immature traumatised anterior tooth with pulp necrosis. A 21-year-old woman complained of pain and dental crown darkening of a permanent maxillary right central incisor. Her medical records presented a history of dental trauma, and at age 15, the first attempt at revascularisation was performed, using triple antibiotic paste (TAP) as the intracanal dressing. Recent radiographs then showed a periapical lesion associated with an immature root, which demonstrated the failure of the first attempt. The second pulp revascularisation was performed, using an association between CHX and CH as intracanal medication. The case was followed up for 24 months. Observations showed evidence of root development, dentinal wall thickening and periapical healing. In this case, the association between CHX and CH showed favourable results as an intracanal medication.

Correlation between Bond Strength to Dentin and Sealers Penetration by Push-Out Test and CLSM Analysis.

This study correlated the bond strength (BS) and dentin penetration of different sealers by push-out test and Confocal Laser Scanning Microscopy (CLSM) analysis. Forty-five root canals were prepared according to the crown-down technique and filled with gutta-percha associated to the following sealers (n=15): Endofill, AH Plus and MTA Fillapex. Five canals of each group were filled with the sealers added with 0.1% Rhodamine B dye. Next, the specimens were transversely sectioned and submitted to the push-out test (n=10) and CLSM analysis (n=5). The BS data showed the following means (MPa) and standard deviation: AH Plus (4.17±1.86); MTA Fillapex (3.13±1.96) and Endofill (2.10±1.03). Statistical analysis (two-way ANOVA, α=0.05) showed significant difference among sealers (p<0.001) and root canal thirds (p<0.001). The BS results of Endofill and MTA Fillapex were statistically similar (p>0.05), however, they were statistically different from AH Plus (p<0.001). The regional analysis of BS showed similarity between middle and apical thirds (p>0.05), and both were different from coronal portion (p<0.001). CLSM analysis verified tags formation in all groups and higher penetration of the specimens filled with AH Plus (p<0.05). The Kendall test (correlation between BS to dentin and sealer penetration into dentinal tubules) and the Pearson test (between failures pattern and sealer penetration into dentinal tubules) did not show correlation between the variables evaluated for all the tested sealers (p>0.05). AH Plus group had higher BS to dentin, and deeper tags formation than the other sealers. There was no significant correlation between BS and intratubular penetration of the tested sealers.

Effect of Bleaching and Ca(OH)2 Dressing on the Bond Strength of Fiberglass Posts to Root Dentine.

OBJECTIVE: The purpose of this study was to evaluate the effect of the intracoronary bleaching and calcium hydroxide (Ca(OH)2) dressing use, on the bond strength (BS) of fiberglass posts to root dentine. MATERIALS AND METHODS: After root canal filling of 40 bovine incisors, a 2-mm thick cervical plug was fabricated 2 mm below the cementum-enamel junction. Seven days later, teeth were randomly distributed into four groups (n = 10), as follows: G1 no bleaching, followed by immediate post cementation; G2 bleaching and immediate post cementation; G3 bleaching, dressing with Ca(OH)2 for 7 days, and post cementation; and G4 bleaching, no dressing, and post cementation after 7 days. The roots were transversally cut into 1-mm thick slices to perform the push-out test (0.5 mm/min). Failure modes were assessed under scanning electron microscopy. STATISTICAL ANALYSIS: The analysis of variance (two-way ANOVA) was performed, followed by the supplementary Tukey multiple comparison test (a = 5%). RESULTS: No significant difference for BS was observed among groups. Considering the different root thirds, G1 had higher BS values for the cervical third in comparison with the apical one (p < 0.05). The most frequent failure modes were adhesive between cement/dentine (G1); cohesive at the post (G2 and G3), and mixed (G4). CONCLUSIONS: The BS of the fiberglass posts to root dentine was not affected by the intracoronary bleaching and the use of Ca(OH)2 dressing.

Comparison of two observational methods, scanning electron and confocal laser scanning microscopies, in the adhesive interface analysis of endodontic sealers to root dentine.

OBJECTIVES: To compare the accuracy of confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) during the analysis of the adhesive interface integrity and intratubular penetration of root canal sealers to radicular dentine. MATERIALS AND METHODS: Twenty roots of human maxillary incisors were prepared and distributed into two groups (n = 10), followed by filling with gutta-percha and Endofill (G1) or AH Plus (G2). After 7 days, roots were sectioned and analyzed under CLSM and SEM. Score systems were used to evaluate the adhesive interface integrity (0-4) and sealer intratubular penetration (0-3). Data were submitted to Wilcoxon-Mann-Whitney and Kendall correlation statistical tests (α = 5%). RESULTS: In the adhesive interface analysis, CLSM was similar (P = 0.157) to SEM for Endofill; however, the results were different for AH Plus (P = 0.029). Intratubular penetration had significant difference between observational methods for both sealers (P < 0.0001). Correlation analysis between SEM and CLSM for adhesive interface was moderate for Endofill and low for AH Plus. Intratubular penetration was low for both sealers. CONCLUSION: SEM and CLSM analysis had similar results when sealers were compared, with a more homogeneous adhesive interface, and greater intratubular penetration for AH Plus. Comparison between observational methods demonstrated low positive correlation for adhesive interface and intratubular penetration analysis. CLINICAL RELEVANCE: A proper interface formed between sealer and dentine is very important for final quality of root canal filling. Observational methods which allow an accurate analysis of this interface must be selected to assess such features.

Bacterial penetration into filled root canals exposed to different pressures and to the oral environment-in vivo analysis.

OBJECTIVES: The study aims to correlate the depth of bacterial penetration into filled root canals with the time of exposure to the oral environment and different pressures. MATERIALS AND METHODS: One-hundred and twenty-two root canals of male Beagle dog teeth were prepared and filled. The root canals were distributed into three groups, according to the pressure applied: (A) no pressure, (B) 30 kPa, and (C) 60 kPa. Then, the root canals were exposed to the oral environment, establishing sub-groups considering the time intervals of exposure: (1) 45 days and (2) 120 days (n = 17). Sub-groups had positive and negative controls (n = 5). The animals were sacrificed, and the specimens were prepared for histological analysis. RESULTS: There was no significant difference in the bacterial penetration among groups A, B, and C at 45 days (P = 0.903) and 120 days (P = 0.211). No statistically significant difference was found (P = 0.608) between the exposure time intervals. Most of the specimens from experimental groups exposed for 120 days presented moderate inflammatory infiltrate. CONCLUSIONS: Pressures of 30 and 60 kPa did not affect sealing ability of root canal filling. The time of exposure did not influence bacterial penetration, which was limited to the first 4 mm of the root canals exposed for 120 days. CLINICAL RELEVANCE: This animal study demonstrated that disinfection of the first millimeters of root canals could be considered before retreatment of their entire length. However, clinical studies in humans should be conducted before validation of this protocol.

Effect of Milk Renewal on Cell Viability In Vitro at Different Time Frames.

The purpose of this study was to evaluate if the renewal of milk as a storage medium, every 12, 24 and 48 h, is able to increase its ability to maintain human periodontal ligament fibroblasts (PDLF) viability over time. PDLF were soaked in Minimum Essential Medium at 37 °C (MEM-37) (positive control), tap water (Water) (negative control) and in skimmed milk (44 wells) at 5 °C and 20 °C. The skimmed milk was renewed every 12 h (Milk-12), 24 h (Milk-24) and 48 h (Milk-48) in 11 wells of each plate, and the milk in the remaining 11 wells of each plate was maintained in situ (not renewed milk) (NRM). After 24, 48, 72, 96 and 120 h, cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by Kruskal-Wallis, Scheffé and Mann-Whitney tests (a=5%). At 5 °C, only Milk-48 was significantly better than NRM. At 20 °C, NRM was more effective than Milk-12 and Milk-24 in all time periods. In relation to the temperature (5 °C or 20 °C), renewal of milk at 5 °C was better in maintaining cell viability than the renewal at 20 °C. In conclusion, the renewal of milk was able to increase its ability to maintain cell viability only when performed every 48 h in milk maintained at 5 °C.

Effect of Milk Renewal on Cell Viability In Vitro at Different Time Frames

Abstract The purpose of this study was to evaluate if the renewal of milk as a storage medium, every 12, 24 and 48 h, is able to increase its ability to maintain human periodontal ligament fibroblasts (PDLF) viability over time. PDLF were soaked in Minimum Essential Medium at 37 °C (MEM-37) (positive control), tap water (Water) (negative control) and in skimmed milk (44 wells) at 5 °C and 20 °C. The skimmed milk was renewed every 12 h (Milk-12), 24 h (Milk-24) and 48 h (Milk-48) in 11 wells of each plate, and the milk in the remaining 11 wells of each plate was maintained in situ (not renewed milk) (NRM). After 24, 48, 72, 96 and 120 h, cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by Kruskal-Wallis, Scheffé and Mann-Whitney tests (a=5%). At 5 °C, only Milk-48 was significantly better than NRM. At 20 °C, NRM was more effective than Milk-12 and Milk-24 in all time periods. In relation to the temperature (5 °C or 20 °C), renewal of milk at 5 °C was better in maintaining cell viability than the renewal at 20 °C. In conclusion, the renewal of milk was able to increase its ability to maintain cell viability only when performed every 48 h in milk maintained at 5 °C.

Resumo O objetivo deste estudo foi avaliar se a renovação do leite, a cada 12, 24 e 48 h, é capaz de aumentar sua capacidade de manter a viabilidade de fibroblastos do ligamento periodontal humano (FLPH) ao longo do tempo. FLPH foram conservados em Meio Essencial Mínimo a 37 °C (MEM-37) (controle positivo), água da torneira (água) (controle negativo) e em leite desnatado (44 poços) a 5 °C e 20 °C. O leite desnatado foi renovado a cada 12 h (leite-12), 24 h (leite-24) e 48 h (leite-48) em 11 poços de cada placa, e em outros 11 poços de cada placa o leite foi deixado in situ (leite não renovado) (LNR). Depois de 24, 48, 72, 96 e 120 h, a viabilidade celular foi determinada pelo ensaio colorimétrico à base de sal tetrazólio (MTT). Os dados foram analisados estatisticamente pelos testes de Kruskal-Wallis, Scheffé e Mann-Whitney (α=5%). A 5 °C, somente o leite-48 foi significantemente melhor do que o LNR. A 20 °C, LNR foi mais efetivo do que o leite-12 e leite-24 em todos os períodos de tempo. Em relação à temperatura (5 °C ou 20 °C), a renovação do leite a 5 °C foi melhor na manutenção da viabilidade celular do que a renovação a 20 °C. Concluindo, a renovação do leite foi capaz de aumentar sua habilidade em manter a viabilidade celular apenas quando realizada a cada 48 h no leite mantido a 5 °C.

Fibroblast Viability after Storage at 20 °C in Milk, Hank's Balanced Salt Solution and Coconut Water.

The objective of this study was to evaluate the effectiveness of various storage media at 20 °C in maintaining the viability of human periodontal ligament fibroblasts (HPLF) over time. HPLF were maintained at 20 °C in skim milk (SM), whole milk (WM), freshly prepared Hank's balanced salt solution (HBSS), Save-A-Tooth(r), natural coconut water (NCW), coconut water industrialized (ICW) and tap water (negative control) for 3, 6, 24, 48, 72, 96 and 120 h. Cells maintained in Minimal Essential Medium (MEM-37) at 37 °C served as a positive control. Cell viability was determined by MTT assay. Statistical analysis was performed by Kruskal-Wallis test and Scheffe test (α = 5%). From 24 h, NCW was significantly better in maintaining cell viability than all other tested storage media (p<0.05). SM and WM were significantly better than HBSS for up to 72 h. Save-A-Tooth(r) and ICW were the worst conservation storage media. In conclusion, the effectiveness of the tested storage media to maintain the viability of the periodontal ligament cells was as follows, in a descending order: NCW > MEM-37> SM and IM> HBSS> ICW > Save-A-Tooth(r)> tap water.

Fibroblast Viability after Storage at 20 °C in Milk, Hank's Balanced Salt Solution and Coconut Water

Abstract The objective of this study was to evaluate the effectiveness of various storage media at 20 °C in maintaining the viability of human periodontal ligament fibroblasts (HPLF) over time. HPLF were maintained at 20 °C in skim milk (SM), whole milk (WM), freshly prepared Hank's balanced salt solution (HBSS), Save-A-Tooth(r), natural coconut water (NCW), coconut water industrialized (ICW) and tap water (negative control) for 3, 6, 24, 48, 72, 96 and 120 h. Cells maintained in Minimal Essential Medium (MEM-37) at 37 °C served as a positive control. Cell viability was determined by MTT assay. Statistical analysis was performed by Kruskal-Wallis test and Scheffe test (α = 5%). From 24 h, NCW was significantly better in maintaining cell viability than all other tested storage media (p<0.05). SM and WM were significantly better than HBSS for up to 72 h. Save-A-Tooth(r) and ICW were the worst conservation storage media. In conclusion, the effectiveness of the tested storage media to maintain the viability of the periodontal ligament cells was as follows, in a descending order: NCW > MEM-37> SM and IM> HBSS> ICW > Save-A-Tooth(r)> tap water.

Resumo O objetivo deste estudo foi avaliar a efetividade de vários meios de conservação a 20 °C em manter a viabilidade de fibroblastos do ligamento periodontal humano (FLPH) ao longo do tempo. FLPH foram conservados a 20 °C em leite desnatado (LD), leite integral (LI), solução salina balanceada de Hank (HBSS) recém preparada, Save-A-Tooth(r) (Save), água de coco natural (ACN), água de coco industrializada (ACI) e água de torneira (água - controle negativo) por 3, 6, 24, 48, 72, 96 e 120 h. Células conservadas em Meio Essencial Mínimo (MEM-37) a 37 °C serviram como controle-positivo. A viabilidade celular foi determinada pelo ensaio MTT. A análise estatística dos dados foi realizada pelos testes Kruskal-Wallis e Scheffé (α=5%). A partir de 24 h, ACN foi significantemente melhor em manter a viabilidade celular do que todos os outros meios testados (p<0,05). LD e LI foram significantemente melhores do que a HBSS por até 72 h. Save e ACI foram os piores meios de conservação. Concluindo, a efetividade dos meios de conservação testados em manter a viabilidade das células do ligamento periodontal foi a seguinte em ordem decrescente: ACN > MEM-37 > LD e LI > HBSS > ACI > Save > água.

Potencial capacidade de selamento de um novo cimento à base de própolis, utilizado como tampão apical, comparado ao MTA / Potential sealing ability of a new propolis based cement, used as a buffer apical, compared to MTA

Objetivo: o principal objetivo desse estudo foi avaliar e comparar a capacidade de selamento de um cimento ex-perimental à base de própolis (EPC) e do agregado de trióxido mineral (MTA), empregados na forma de tampão apical, utilizando o sistema de infltração de glicose. Em se-guida, um teste de infltração bacteriana foi utilizado para avaliar a capacidade de selamento do EPC. Métodos: para o teste de infltração de glicose, trinta segmentos radiculares (12mm) foram divididos aleatoriamente em dois grupos experimentais (n = 15) de acordo com o cimento utilizado na confecção do tampão apical, conforme se-gue: G1 = MTA; G2 = EPC. Os segmentos radiculares foram preparados e a quantidade de glicose infltrada foi mensurada, seguindo uma reação enzimática, e quantif-cada por meio de um espectrofotômetro. Os dados foram analisados pelo teste t de Student (p < 0,05). Para o teste de infltração bacteriana, outros 15 dentes foram submeti-dos aos procedimentos de apexifcação, preenchidos com EPC e montados em um aparato específco. O número de espécimes infiltrados foi observado, semanalmente, durante 70 dias. Resultados: o EPC foi signifcativamente superior ao MTA (p < 0,001). A capacidade de selamento do EPC foi 100% e 60% efciente nos testes de infltração de glicose e bactérias, respectivamente. Conclusão: o cimento experimental à base de própolis, na forma de tam-pão apical, promoveu superior capacidade de selamento, comparado ao MTA, e excelente desempenho em ambos os testes de infiltração.

Avaliação ex vivo da infiltração coronária em canais obturados com MTA FILLAPEX e AH Plus / Ex vivo evaluation of coronal leakage in root canals filled with MTA FILLAPEX and AH Plus

O objetivo deste estudo foi avaliar a infiltração coronária em canais obturados com AH Plus e MTA FILLAPEX. Trinta pré-molares unirradiculados foram divididos aleatoriamente em 2 grupos (n = 15) de acordo com o cimento obturador utilizado: G1: MTA FILLAPEX e G2: AH Plus. O teste de infiltração do corante nanquim foi conduzido sob pressão de 60 KPa, por 8 min. Após diafanização, foi avaliada a penetração do corante nos terços radiculares. Houve infiltração em 8 e 7 amostras dos G1 e G2, respectivamente. Em nenhuma amostra do G2, o corante atingiu o terço apical. Em quatro amostras do G1, o corante foi visualizado no terço apical. O AH Plus demonstrou uma qualidade de selamento superior ao MTA FILLAPEX.

The aim of this study was evaluate the coronal leakage in root canals filled with AH Plus and MTA FILLAPEX. Thirty single-rooted premolars were randomly divided into two experimental groups (n = 15) according to the sealer used: G1: MTA FILLAPEX and G2: AH Plus. The dye leakage test ink was conducted under pressure of 60 kPa for 8 min. After diaphanization, the dye penetration was evaluated by root thirds. Results: Eight samples form G1 and seven samples from G2 showed infiltration. In any sample from G2, the dye reached the apical third. In four samples from G1, the dye was visualized in the apical third. The AH Plus showed a superior sealing quality of the MTA FILLAPEX.

Adhesive interface and bond strength of endodontic sealers to root canal dentine after immersion in phosphate-buffered saline.

This study evaluated the bond strength (BS) and the adhesive interface of four endodontic sealers to root canal dentine, before, and after immersion in phosphate buffered saline (PBS) to simulate an in vivo environment. Eighty roots were instrumented using ProTaper rotatory files, under irrigation with 17% EDTA and 1% NaOCl. Posteriorly were divided into four groups (n = 20) according to the sealer used: Endofill, AH Plus, Sealapex, and MTA Fillapex. Each group was divided into two subgroups (n = 10) and stored at 37°C immersed in water for 7 days and in PBS for 60 days. From each subgroup, 1 mm thick sections were obtained. One section of each region (coronal, middle, and apical) was submitted to the push-out test and failures were observed. Twelve sections of each subgroup (four from each region) were evaluated under SEM. Three-way ANOVA evaluation for BS showed significant differences between groups and regions (P < 0.0001), but not between subgroups (P > 0.05). AH Plus had significantly higher BS than the others sealers, regardless of the analyzed subgroup (Tukey's test, P < 0.5). The most common failures were adhesive to dentine and cohesive of the sealer. The SEM evaluation (Kruskal-Wallis, Mann-Whitney) showed homogeneous adhesive interface formed and sealer tags in all groups with significant statistical differences with AH Plus, regardless of PBS immersion. AH Plus was superior to the other sealers for both BS and quality of interface formation. Immersion in PBS did not interfere on BS or adhesive interface of the sealers tested.

The sealing ability of MTA apical plugs exposed to a phosphate-buffered saline.

OBJECTIVE: The aim of this study was to evaluate the influence of exposure of the mineral trioxide aggregate (MTA) - with and without calcium chloride (CaCl2) - to phosphate-buffered saline (PBS) on the apical microleakage using a glucose leakage system. MATERIAL AND METHODS: Sixty root segments were randomly divided into 4 experimental groups (n=15). After resecting the apical segments and enlarging the canals with Gates-Glidden drills, the apical cavities were filled with MTA with or without CaCl2 and the root canals were dressed with a moistened cotton pellet or PBS, as follows: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. All root segments were introduced in floral foams moistened with PBS. After 2 months, all root segments were prepared to evaluate the glucose leakage along the apical plugs. The amount of glucose leakage was measured following an enzymatic reaction and quantified by a spectrophotometer. Four roots were used as controls. The data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05). RESULTS: There were no differences between groups 1 and 2 (p>0.05), and 3 and 4 (p>0.05). The addition of CaCl2 to the MTA significantly decreased its sealing ability (p<0.05). CONCLUSION: The interaction with PBS did not improve the MTA sealing ability. The addition of CaCl2 to the MTA negatively influenced the apical seal.

The sealing ability of MTA apical plugs exposed to a phosphate-buffered saline

OBJECTIVE: The aim of this study was to evaluate the influence of exposure of the mineral trioxide aggregate (MTA) - with and without calcium chloride (CaCl2) - to phosphate-buffered saline (PBS) on the apical microleakage using a glucose leakage system. MATERIAL AND METHODS: Sixty root segments were randomly divided into 4 experimental groups (n=15). After resecting the apical segments and enlarging the canals with Gates-Glidden drills, the apical cavities were filled with MTA with or without CaCl2 and the root canals were dressed with a moistened cotton pellet or PBS, as follows: 1) MTA/cotton pellet; 2) MTA/PBS; 3) MTA+10%CaCl2/cotton pellet; 4) MTA+10%CaCl2/PBS. All root segments were introduced in floral foams moistened with PBS. After 2 months, all root segments were prepared to evaluate the glucose leakage along the apical plugs. The amount of glucose leakage was measured following an enzymatic reaction and quantified by a spectrophotometer. Four roots were used as controls. The data were analyzed using Kruskal-Wallis and Mann-Whitney tests (p<0.05). RESULTS: There were no differences between groups 1 and 2 (p>0.05), and 3 and 4 (p>0.05). The addition of CaCl2 to the MTA significantly decreased its sealing ability (p<0.05). CONCLUSION: The interaction with PBS did not improve the MTA sealing ability. The addition of CaCl2 to the MTA negatively influenced the apical seal. .

Assessment of pulp blood flow in primary and permanent teeth using pulse oximetry.

Pulse oximetry (PO) is a well-accepted non-invasive method for assessing vascular health, based on oxygen saturation (SaO(2) ) measurements. The objectives of this study were to design and build a custom-made PO dental sensor holder, to evaluate the effectiveness of PO in determining pulp blood flow in primary and permanent teeth, and to compare the SaO(2) levels obtained in teeth and on the little finger of patients. The PO sensor adapted to the custom-made sensor holder is termed as a device to position and hold the PO sensor. This study evaluated SaO(2) readings obtained in the pulp of 123 teeth of 84 children aged 4-13years. The teeth were divided into three groups: group I - primary teeth: 23 central incisors and 28 canines; group II - permanent teeth: 25 central incisors and 28 canines; and group III - endodontically treated teeth (control): 12 permanent central incisors and seven primary central incisors. The pulp blood flow and SaO(2) were measured and were compared with readings of the patient's finger. Data were analyzed by paired t-tests and Pearson's analysis method. The PO was able to identify all the clinically normal pulps contained in the sample, and all the endodontically treated teeth (controls) showed no response. The mean SaO(2) values were 85.27% in the teeth and 92.85% in the fingers. In conclusion, PO readings were effective in determining pulp blood flow in primary and permanent teeth. However, there was no correlation between the SaO(2) values in the fingers and in the teeth of the patients (P<0.05).