Identification and classification of pulp calcifications in posterior teeth according to dental condition using digital panoramic radiography and cone beam computed tomography.

OBJECTIVE: To compare digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) in the detection and classification of pulp calcifications in posterior teeth in relation to tooth condition and its location. METHODS: 250 patients with simultaneous DPR and CBCT scans were selected from a dental image bank. For each posterior tooth, its condition was registered (healthy, restored, or decayed). The presence of calcifications was assessed and classified according to location (coronal or radicular) and type (total obliteration, partial obliteration, narrowing, and no calcification). Chi-square and McNemar tests were used to compare DPR and CBCT results, with a significance level of 5%. DPR diagnostic values were calculated using CBCT as reference. RESULTS: Decayed and restored teeth showed a significantly (p < 0.001) higher prevalence of pulp calcifications than healthy teeth in both imaging exams. There was a significant discrepancy between the imaging modalities in the identification of calcifications (p < 0.001), especially for radicular calcifications of maxillary teeth (DPR = 55.2%; CBCT = 30.9%). In the case of coronal calcifications, there was a greater discrepancy between CBCT and DPR in the mandibular teeth (10.7%) than in the maxillary teeth (7.7%). Overall, DPR presents higher sensitivity (0.855) than specificity (0.483) for pulp calcifications detection. CONCLUSION: DPR considerably overestimates pulp calcifications in posterior teeth, as compared to CBCT. A higher prevalence of pulp calcifications is related to decayed and restored teeth.

Could Low-dose Cone-beam CT be Used for Endodontic Intraoperative Diagnosis?

INTRODUCTION: Cone-beam computed tomography (CBCT) allows three-dimensional evaluation and has high diagnostic accuracy of endodontic conditions. Considering that the most indicated protocol for endodontics should have smaller field-of-view and higher spatial resolution, a higher radiation dose may be associated. Thus, this study evaluated the accuracy of an optimized CBCT protocol for the detection of intraoperative endodontic complications. METHODS: An image phantom was custom-made with a human mandible covered with Mix-D and forty mandibular first molars. The teeth were subdivided into 4 groups of endodontic complications which were simulated. All teeth were individually inserted into the left second molar socket of the phantom and CBCT images were acquired with OP 300 unit adjusted to a field-of-view of 6 × 4 cm, 90kVp, and 2 dose protocols: low and high. Furthermore, a titanium implant, a tooth with endodontic treatment, and a cobalt-chromium post were inserted into the empty sockets adjacent to the teeth of interest and additional images were acquired. Four endodontists evaluated the images and indicated the presence of endodontic complications on a 5-point scale. Sensitivity, specificity, and area under the receiver operating characteristic curve were obtained. The different groups were compared by ANOVA and Tukey tests (α = 0.05). RESULTS: In most conditions, irrespective of the presence of metallic materials, the values of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve did not differ significantly (P > .05) between the dose protocols. CONCLUSIONS: Optimized CBCT protocols should be considered for the detection of intraoperative endodontic Diagnostic complications.

Association between single-nucleotide polymorphisms in serotonin receptor 2A and melatonin receptor 1A genes and pain after root canal treatment.

AIM: This study aimed to investigate whether single-nucleotide polymorphisms (SNPs) in the genes encoding 5-HTR2A (5-Hydroxytryptamine (serotonin) receptor 2A) and MTNR1A (melatonin receptor 1A) may contribute to postoperative pain perception after root canal treatment. We hypothesised that SNPs in HTR2A and MTNR1A genes were associated with postoperative pain after root canal treatment. METHODOLOGY: This genetic cohort study enrolled patients with single-rooted teeth diagnosed with pulp necrosis and asymptomatic apical periodontitis before root canal treatment. Root canal treatment was performed in one session using a standardized protocol. Postoperative pain and tenderness were assessed using a visual analogue scale (recorded every day for 7 days and on the 14th and 30th days after root canal treatment). Genomic DNA was extracted from saliva and used to genotype the SNPs in HTR2A (rs4941573 and rs6313) and MTNR1A (rs6553010, rs6847693 and rs13140012) using real-time polymerase chain reaction. Genotypes were compared using univariate and multivariate Poisson regression with generalized estimating equations (p < .05). RESULTS: In total, 108 patients were enrolled in this study. The SNPs rs6553010 (MTNR1A), rs4941573 and rs6313 (HTR2A) were associated with an increased risk of developing pain after root canal treatment (p < .05). CONCLUSIONS: This study suggests that SNPs in HTR2A and MTNR1A influence pain response after root canal treatment.

Cytotoxicity and Inflammatory Mediators Release by Macrophages Exposed to Real Seal XT and Sealapex Xpress.

This study evaluated the cytotoxicity of Sealapex Xpress and Real Seal XT and their effect on macrophage activation. J774.1 macrophages were incubated with Sealapex Xpress and Seal Real XT (0.1, 1.0, and 10 mg/mL) for 24 and 48 h. Cell viability was assessed by the MTT assay and macrophage activation was measured by pro- and anti-inflammatory cytokine production using ELISA. Data were analyzed using one-way ANOVA and Tukey's post-test (a=0.05). Cell viability was not affected with 0.1 or 1.0 mg/mL of extracts of Sealapex Xpress and Real Seal XT at 24 and 48 h (p>0.05), but was significantly lower when cells were exposed to 10 mg/mL of both sealers (p<0.05). Sealapex Xpress inhibited the production of TNF-a, whereas Real Seal XT induced TNF-a secretion at 24 h (p<0.05). IL-6 production was induced by Real Seal XT, but not by Sealapex Xpress (p<0.05). Real Seal XT and Sealapex Xpress induced the secretion of anti-inflammatory IL-10. IL-4 was not detected in any group. In conclusion, both sealers had low toxicity but differentially activated macrophages. Macrophage activation by Sealapex Xpress was characterized by inhibition of TNF-a and induction of IL-10, whereas Real Seal XT induced IL-6 solely.

Cytotoxicity and inflammatory mediators release by macrophages exposed to real seal xt and sealapex xpress

Abstract This study evaluated the cytotoxicity of Sealapex Xpress and Real Seal XT and their effect on macrophage activation. J774.1 macrophages were incubated with Sealapex Xpress and Seal Real XT (0.1, 1.0, and 10 mg/mL) for 24 and 48 h. Cell viability was assessed by the MTT assay and macrophage activation was measured by pro- and anti-inflammatory cytokine production using ELISA. Data were analyzed using one-way ANOVA and Tukey's post-test (a=0.05). Cell viability was not affected with 0.1 or 1.0 mg/mL of extracts of Sealapex Xpress and Real Seal XT at 24 and 48 h (p>0.05), but was significantly lower when cells were exposed to 10 mg/mL of both sealers (p<0.05). Sealapex Xpress inhibited the production of TNF-a, whereas Real Seal XT induced TNF-a secretion at 24 h (p<0.05). IL-6 production was induced by Real Seal XT, but not by Sealapex Xpress (p<0.05). Real Seal XT and Sealapex Xpress induced the secretion of anti-inflammatory IL-10. IL-4 was not detected in any group. In conclusion, both sealers had low toxicity but differentially activated macrophages. Macrophage activation by Sealapex Xpress was characterized by inhibition of TNF-a and induction of IL-10, whereas Real Seal XT induced IL-6 solely.

Resumo O objetivo deste estudo foi avaliar in vitro a citotoxicidade dos cimentos endodônticos Sealapex Xpress e Real Seal XT pelo ensaio de MTT e a ativação de macrófagos J774.1. Os cimentos endodônticos Sealapex Xpress e Real Seal XT foram pesados e os extratos foram obtidos a partir da diluição em meio de cultura DMEM por 48 horas (10mg/mL, 1mg/m, e 0,1 mg/mL). A viabilidade celular foi avaliada pelo ensaio MTT e a produção de citocinas (TNF-a, IL-6 e IL-10) foi investigada pelo ensaio imunoenzimático (ELISA) em células de linhagem (macrofagos J774.1). Os dados obtidos foram analisados utilizando-se análise de variância de uma via e pós-teste de Tukey (a=0,05). A viabilidade celular após 24 ou 48 horas não foi afetada nas concentrações de 0,1 ou 1 mg/mL dos dois cimentos estudados (p>0,05). Por outro lado, na concentração 10 mg/mL, a viabilidade celular foi significativamente mais baixa (p <0,05). Observou-se que o Sealapex Xpress inibiu a produção de TNF-a, enquanto o Real Seal XT induziu a secreção de TNF-a às 24 h (p<0,05). A produção de IL-6 foi induzida pelo Real Seal XT, mas não pelo Sealapex Xpress (p<0,05). A secreção da citocina anti-inflamatória IL-10 foi induzida tanto pelo Real Seal XT quanto pelo Sealapex Xpress. IL-4 não foi detectada em nenhum grupo. Em conclusão, os dois cimentos obturadores apresentaram baixa toxicidade, mas ativaram os macrófagos de modo distinto. A ativação pelo Sealapex Xpress foi caracterizada pela inibição do TNF-a e indução da IL-10, enquanto o Real Seal XT induziu somente IL-6.

Happiness among dentists: a multi-scale, multi-national study from 21 countries.

OBJECTIVES: The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries. MATERIALS AND METHODS: The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant. RESULTS: The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS. CONCLUSION: Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

The Effect of Diode and Er,Cr:YSGG Lasers on the Bond Strength of Fiber Posts.

Background: Laser irradiation modifies the topography and composition of dentin surface aiming to increase the retention of bonded posts. Objective: To assess the effect of dentin irradiation with Er,Cr:YSGG or diode lasers on the bond strength of fiber posts using self-adhesive resin cement. Materials and methods: Sixty bovine root canals were root-canal treated, post spaces were prepared, and subsequently fiber posts were cemented. The samples were distributed according to the surface treatment: distilled water (control), Er,Cr:YSGG (1.5 W, 20 sec), or diode (1.5 W, 20 sec) lasers. Bond strengths were assessed by pull-out (n = 10) or push-out testing (n = 10). Pearson's correlation was calculated. Failure mode after testing and the depth of tags in the dentinal tubules were analyzed by confocal laser microscopy. Data were submitted to analysis of variance and Tukey's test. A p < 0.05 was considered significant. Results: In the push-out test, Er,Cr:YSGG laser had significantly different higher values (5.43 ± 0.10 MPa) compared to the control (4.79 ± 0.05 MPa). Diode laser values were not significantly different from the other groups (5.12 ± 0.27 MPa). In the pull-out test, there were no significant differences between Er,Cr:YSGG (6.86 ± 2.16 MPa) and diode (8.43 ± 1.77 MPa) lasers, and both had significant differences compared to the control (4.18 ± 1.29 MPa). No correlation was found. Adhesive failures were predominant in all groups, and no significant differences in tag penetration among the groups were found. Conclusions: The Er,Cr:YSGG laser increases the bond strength of resin cement and fiber post to dentin in both tests, compared to control group without laser treatment. Diode laser only enhanced bonding for pull-out test.

Do Contaminating Substances Influence the Rheological Properties of Root Canal Sealers?

INTRODUCTION: This study evaluated the effect of residual substances derived from irrigant solutions and intracanal medications on the rheological properties of a silicone, gutta-percha, and bioactive glass-based sealer in comparison with an epoxy resin-based sealer. METHODS: Thin films of contaminants (0.5 µL) (3% sodium hypochlorite [NaOCl], chlorhexidine digluconate [CHX], 17% EDTA, calcium hydroxide, 40% citric acid, or distilled water [DW]) were applied along with freshly mixed GuttaFlow Bioseal (GFB; Coltene/Whaledent, Langenau, Germany) or AH Plus Jet (Dentsply DeTrey, Konstanz, Germany) on the lower plate of a dynamic rheometer. Rheological measurements were performed in oscillating mode at the strain amplitude, angular frequency, and constant temperature of 0.01%, 10 rad/s, and 37°C, respectively. Samples without contaminants served as controls. All measurements were performed 5 times. The Kolmogorov-Smirnov test and 1-way analysis of variance followed by the Student-Newman-Keuls test were performed to analyze the results (P < .05). RESULTS: The contaminants did not alter the setting time of GFB compared with the controls; however, CHX and calcium hydroxide decreased its complex viscosity (ƞ*) (P < .05). The setting time of AH Plus Jet was increased by DW, CHX, citric acid, and EDTA (P < .05). All contaminants decreased its ƞ* at the setting point (P < .05). NaOCl led to the greatest alteration of its rheological parameters. CONCLUSIONS: Irrigant solutions and intracanal medications adversely affected at least 1 of the tested rheological properties of both sealers, except for DW and 3% NaOCl, which did not alter any rheological property of GFB.

Analysis of reciprocating system real-time torque variation during root canal preparation.

OBJECTIVE: This study monitored real-time torque variation of the WaveOne Gold (WOG) and Reciproc Blue (RB) during root canal preparation of mandibular molars. Thirty-six mandibular molars were prepared with WOG Primary 25.07 (WOGP, n = 36) and the RB R25 25.08 (RBR25, n = 36) for the mesial canals, whereas WOG Large 45.05 (WOGL, n = 18) and RB R40 40.06 (RBR40, n = 18) for the distal. Canal preparation was divided into thirds and the torque, maximum torque and time, were recorded. RESULTS: The RBR25 instruments exhibited higher maximum torque in the apical third in contrast to the WOGP instruments (p < 0.05). The intragroup analysis found a significant difference in maximum torque between the cervical and apical thirds, and the middle and apical thirds (p < 0.05) for both instruments (RBR25 and WOGP). The WOGP group had the shortest preparation time (p < 0.05). There were no significant differences between the WOGL and RBR40 for any of the parameters evaluated (p > 0.05). The RBR25 had the highest torque when compared to the WOGP. Both instruments exhibited higher torque in the apical third and there were no significant differences between the instruments in the distal canal.

Effect of radiotherapy on the chemical composition of root dentin.

BACKGROUND: The radiotherapy can directly affect the bond strength of the adhesive materials, interfering in the prognosis of restorative treatments, which may be caused by chemical changes in dentin structure. METHODS: Twenty inferior homologues premolars were distributed in 2 groups (in vitro study) (n = 10): nonirradiated and irradiated. The specimens were submitted to the analysis of phosphate (ν1 PO43- ;ν2 PO43- ;ν4 PO43- ), carbonate (ν3 CO32- ), amide I, CH2 , amide III, and amide I/III ratio by confocal Raman spectroscopy. Data were submitted to statistical analysis (T test, P < .05). RESULTS: In intracanal dentin, the irradiated group had lower ν4 PO43- values (1.23 ± 0.06) compared to nonirradiated group (1.40 ± 0.18) (P < .05), with no difference for ν1 PO43- and ν2 PO43 peaks (P > .05). The irradiated (1.56 ± 0.06) had lower carbonate, amide III (1.05 ± 0.19), and amide I/III ratio values (0.19 ± 0.06) compared to nonirradiated group (1.42 ± 0.10, 1.28 ± 0.24, and 0.31 ± 0.10, respectively) (P < .05). For medium dentin irradiated group (1.30 ± 0.12) had lower phosphate values compared to nonirradiated group (1.48 ± 0.22) (P < .05). In cementum, there was no statistical difference between the groups. CONCLUSION: The radiotherapy was able to cause changes in ν4 PO43- , carbonate, and amide III peaks of root dentin.

Effect of laser activated bleaching on the chemical stability and morphology of intracoronal dentin.

OBJECTIVES: To evaluate the effect of the bleaching with 35% hydrogen peroxide either activated or not by a 970nm diode laser on the chemical stability and dentin surface morphology of intracoronary dentin. METHODS: Twenty-seven slabs of intracoronary dentin specimens (3×3mm) were distributed into three groups (n=9), according to surface treatment: HP - 35% hydrogen peroxide (1×4'), DL - 970nm diode laser (1×30"/0,8W/10Hz), HP+DL - 35% HP activated with 970nm diode laser (1×30"/0,8W/10Hz leaving the gel in contact to the surface for 4' after activation). Three Raman spectra from each fragment were obtained to calculate the mean intensity of peaks of inorganic component (a.u.), organic collagen content (a.u.), and the ratio of inorganic/organic content, before and after treatment. Analyses of the samples by confocal laser microscopy were performed to evaluate the surface roughness, percentage of tubules, perimeter and area percentage of tubules, before and after treatment. Data were analyzed by Kruskal-Wallis, Dunn's, and Wilcoxon test (P<0.05). RESULTS: Data analysis showed that HP+DL did not change the inorganic content peaks 8.31 [29.78] or the inorganic/organic ratio 3.37 [14.67] (P>0.05). Similarly, DL did not affect the chemical stability of the dentin surface (P>0.05). However, HP significantly increased inorganic content peaks 10.87 [22.62], as well as the inorganic/organic ratio 6.25 [27.78] (P<0.05). Regarding the morphological alterations, all surface treatments increase tubules exposure; HP treatment significantly increases perimeter and area percentage; and HP+DL increases surface roughness. CONCLUSIONS: Bleaching HP combined with DL offers an improvement in terms of intracoronal dentin surface protection, yielding better maintenance of dentin chemical stability and morphology.

The local administration of parathyroid hormone encourages the healing of bone defects in the rat calvaria: Micro-computed tomography, histological and histomorphometric evaluation.

OBJECTIVE: To evaluate the effect of a single-dose local administration of PTH on bone healing in rat calvarial bone defects by means of micro-computed tomography, histological and histomorphometric analysis. DESIGN: Critical-size cranial osteotomy defects were created in 42 male rats. The animals were randomly divided into 3 groups. In the C Group, the bone defect was only filled with a blood clot. In the S Group, it was filled with a collagen sponge and covered with bovine cortical membrane. In the PTH Group, the defect was filled with a collagen sponge soaked with PTH and covered with bovine cortical membrane. The groups were further split in two for euthanasia 15 and 60days post-surgery. Data was statistically analyzed with t-tests for independent samples or the nonparametric Mann-Whitney test when applicable. Intragroup comparisons were analyzed with paired t-tests (p<0.05). RESULTS: Micro-CT analysis results did not demonstrate statistically significant intergroup differences. At 15days post-surgery, the histomorphometric analysis showed that the PTH Group exhibited a significantly higher percentage of bone formation compared with the S Group. At 60days post-surgery, a higher percentage of new bone was observed in the PTH group. CONCLUSION: The results suggest that the local administration of PTH encouraged the bone healing in critical-size calvarial defects in rats.

Efficacy of Different Cone-beam Computed Tomographic Protocols in the Identification of Mesiobuccal Canals of Maxillary First Molars: A Tomographic and Ex Vivo Study.

INTRODUCTION: Complementary methods of anatomic diagnosis, including cone-beam computed tomographic (CBCT) imaging, may be useful in the diagnosis of mesiobuccal (MB) canals of maxillary molars. METHODS: Thirty-five maxillary first molars were subjected to ex vivo analysis and 4 CBCT protocols: i-CAT Classic (Imaging Sciences International, Hatfield, PA) (ICC group), i-CAT Next Generation (Imaging Sciences International) (ICN group), PreXion 3D (PreXion, San Mateo, CA) (16.8-second acquisition time; PX1 group), and PreXion 3D (33.5-second acquisition time; PX2 group). The images were evaluated by 2 calibrated endodontists who kept records following protocols previously published in the literature. Micro-computed tomographic imaging was used as the control. RESULTS: The correct identification of anatomic variations of MB roots was 54.3% (n = 19) in the ICC group, 65.7% (n = 23) in the ICN group, and 80.0% (n = 28) in the PX1 and PX2 groups. The probability of agreement between the ICC and the control groups was significantly different from the probability of agreement with the PX1 (P < .05) and PX2 (P < .05) groups. The other groups showed no significant differences compared with the control group. There was no difference in the probability of agreement between the tomographic protocols and the ex vivo results. CONCLUSIONS: The PX1 and PX2 groups were more effective for the diagnosis of MB canals. PX1 is the most suitable because it results in a shorter radiation time and diagnostic imaging similar to PX2. The single-canal anatomy was the most prevalent in the study.

Zinc Oxide Nanoparticles Enhance Physicochemical Characteristics of Grossman Sealer.

INTRODUCTION: Metallic antibacterial nanoparticles have been shown to provide distinct antibacterial advantage and antibiofilm efficacy when applied in infected root canals. The purpose of this study was to evaluate the influence of incorporating zinc oxide nanoparticles (ZnO-Np) on the physicochemical properties of Grossman sealer. METHODS: Grossman sealer was prepared according to its original formula. Additionally, 4 experimental sealers were prepared by replacing the zinc oxide component of the powder with ZnO-Np (average size of 20 nm) in different amounts (25%, 50%, 75%, and 100%). Characterization of the setting time, flow, solubility, dimensional changes, and radiopacity were performed according to American National Standards Institute (ANSI)/American Dental Association (ADA) Specification 57. Scanning electron microscopic and energy-dispersive X-ray spectroscopic analyses were conducted to assess the ultrastructural and chemical characteristics of experimental sealers subjected to the solubility test. Statistical analyses were performed with analysis of variance and post hoc Tukey-Kramer tests with a significance level of 5%. RESULTS: A statistically significant difference in the setting time was observed among groups (P < .05), but only 25% ZnO-Np sealer complied with ANSI/ADA requirements. There was a significant difference in the flow characteristics between the control and 25% and 75% ZnO-Np experimental sealers (P < .05), but all sealers conformed to ANSI/ADA standardization; 25% ZnO-Np sealer showed significantly less solubility (1.81% ± 0.31%) and dimensional change (-0.34% ± 0.12%) than other sealers (P < .05). All sealers showed ultrastructural changes with increasing solubility. CONCLUSIONS: ZnO-Np decreased the setting time and dimensional changes characteristic of Grossman sealer; 25% ZnO-Np improved the physicochemical properties of Grossman sealer in accordance with ANSI/ADA requirements.

Shaping Ability of Single-file Systems with Different Movements: A Micro-computed Tomographic Study.

INTRODUCTION: This study aimed to perform a rigorous sample standardization and also evaluate the preparation of mesiobuccal (MB) root canals of maxillary molars with severe curvatures using two single-file engine-driven systems (WaveOne with reciprocating motion and OneShape with rotary movement), using micro-computed tomography (micro-CT). METHODS AND MATERIALS: Ten MB roots with single canals were included, uniformly distributed into two groups (n=5). The samples were prepared with a WaveOne or OneShape files. The shaping ability and amount of canal transportation were assessed by a comparison of the pre- and post-instrumentation micro-CT scans. The Kolmogorov-Smirnov and t-tests were used for statistical analysis. The level of significance was set at 0.05. RESULTS: Instrumentation of canals increased their surface area and volume. Canal transportation occurred in coronal, middle and apical thirds and no statistical difference was observed between the two systems (P>0.05). In apical third, significant differences were found between groups in canal roundness (in 3 mm level) and perimeter (in 3 and 4 mm levels) (P<0.05). CONCLUSION: The WaveOne and One Shape single-file systems were able to shape curved root canals, producing minor changes in the canal curvature.

Bond strength of epoxy resin-based root canal sealer to human root dentin irradiated with Er,Cr:YSGG laser.

OBJECTIVE: The aim was to evaluate the influence of Er,Cr:YSGG laser irradiation associated with different final irrigation protocols on the bond strength of epoxy resin-based root canal sealer to root dentin, on the dentin/filling material interface and in the temperature variation during irradiation. METHODOLOGY: Ninety-six maxillary canines were prepared with K3 rotary system up to #45/0.02 instrument, irrigating with distilled water between files. The specimens were randomly assigned to three groups-final irrigation (distilled water, 1% NaOCl, and 17% EDTAC) and four subgroups (n = 8)-laser parameters (non-irradiated, 2 W/20 Hz, 3 W/20 Hz, and 4 W/20 Hz). During irradiation, the temperatures were measured on the outer root dentin wall in the three thirds, and root apex. Canals were filled with lateral condensation of AHPlus sealer and gutta-percha cones. Two slices from each third were submitted to a push-out test in Instron machine and the failure mode was analyzed. One slice from each third was analyzed by confocal laser microscopy to evaluate the percentage of the perimeter of the root canal cross-section with sealer tags and depth of tags. Data were analyzed by ANOVA, Kruskal-Wallis, and Tukey's tests (P < 0.05). RESULTS: Er,Cr:YSGG laser irradiation increased sealer bond strength to dentin, regardless of the final irrigation. The highest values were obtained for 3 W (4.02 ± 1.32) and 4 W (4.18 ± 0.98) powers and different from the non-irradiated group (2.64 ± 0.58) (P < 0.05). The 2 W irradiation produced similar results to 3 W and 4 W when associated with 17% EDTA. Final irrigation with 17% EDTAC provided higher bond strength (4.01 ± 1.02) compared with distilled water (3.11 ± 1.09) and 1% NaOCl (3.47 ± 1.18) (P < 0.05). The cervical third (4.01 ± 1.21) presented significantly higher bond strength than the apical third (3.04 ± 0.89). There was a greater percentage of adhesive and mixed failure. In the groups irradiated with 3 W [21.1 (14.1-27.7)] and 4 W [17.8 (11.9-23.7)], a greater depth of filling material tags was observed compared with the non-irradiated group [12.9 (9.0-20.0)]. The greatest percentage of canal perimeter with sealer tags was observed in the irradiated groups, with no difference among them (P > 0.05). The temperature rise was proportional to the increase of laser power. CONCLUSIONS: Er,Cr:YSGG laser irradiation increased the bond strength of an epoxy resin-based sealer to root dentin, with greater formation of sealer tags for all tested powers, especially when combined with 17% EDTAC final irrigation; temperature rise during irradiation remained below the critical threshold biologically accepted. Lasers Surg. Med. 48:985-994, 2016. © 2016 Wiley Periodicals, Inc.

Evaluation of the Shaping Characteristics of ProTaper Gold, ProTaper NEXT, and ProTaper Universal in Curved Canals.

INTRODUCTION: This study evaluated the shaping characteristics of the ProTaper Gold system (PTG; Dentsply Maillefer, Ballaigues, Switzerland) and compared it with that of the ProTaper Next (PTN, Dentsply Maillefer) and ProTaper Universal (PTU, Dentsply Maillefer) systems using micro-computed tomographic imaging. METHODS: Twenty-four mandibular first molars with 2 separate mesial canals were matched anatomically using micro-computed tomographic scanning (SkyScan1174v2; Bruker-microCT, Kontich, Belgium) with a voxel size of 19.6 µm. Canals were prepared with PTG, PTU, or PTN rotary systems to F2 or X2 instruments, respectively, and scanned again. Coregistered images were evaluated for 2- and 3-dimensional morphometric measurements of canal transportation, centering ability, untouched canal walls, and remaining dentin thickness. Data were statistically compared using Kruskal-Wallis and 1-way analysis of variance tests (α = 5%). RESULTS: Overall, PTN showed significantly higher percentage values of static voxels than PTG and PTU systems (P < .05). Surface area, perimeter, and minor diameter were higher in the PTG and PTU groups than in the PTN group (P < .05). No difference was observed in form factor, roundness, major diameter, aspect ratio, or structure model index (P > .05). PTG (0.11 ± 0.05 mm) and PTN (0.09 ± 0.05 mm) produced significantly less transportation than PTU (0.14 ± 0.07 mm) (P < .05), and the percentage decrease in dentin thickness was significantly lower for PTG (22.67 ± 2.96) and PTN (17.71 ± 5.93%) (P ≥ .05) than PTU (29.93 ± 6.24%) (P < .05). CONCLUSIONS: PTG and PTN produced less transportation and maintained more dentin than PTU. PTN had less canal wall contact than PTG and PTU, but all file systems were able to instrument moderately curved mesial root canals of mandibular molars without clinically significant errors.

Swimming Activity Prevents the Unloading Induced Loss of Bone Mass, Architecture, and Strength in Rats.

We investigated whether swimming activity associated with a three-week period of hypoactivity could prevent the deleterious effects of disuse on the tibias of tail-suspended rats. Forty Wistar rats were divided into five groups: (HS) permanently hindlimb suspension rats; (HS + Swim) rats submitted to unloading interrupted by swimming exercise; (HS + WB) hindlimb suspension rats with interruption for regular weight bearing for the same length of time as the HS+Swim rats; (Control) control rats that were allowed regular cage activities; and (Control + Swim) control rats that underwent swimming exercise. At the end of the experiment, bone mineral density, bone strength, and trabecular quantification were analyzed. The hindlimb-suspended rats exhibited bone quality loss (significant decrease in BMD, bone strength, and deterioration of trabecular and cortical bone architecture; decrease in BV/TV, TbN, TbTh, ConnD, CtV, and CtTh; and increase in TbSp) when compared to control rats. In contrast, trained rats showed a significant increase of 43% in bone mass, 29% in bone strength, 58% in trabecular thickness, 85% in bone volume, 27% in trabeculae number, and 30% in cortical volume, when compared to the hindlimb-suspended rats. We conclude that swimming activity not only ameliorates but also fully prevents the deleterious effects on bone quality in osteopenic rats.

Cytotoxicity evaluation of a copaiba oil-based root canal sealer compared to three commonly used sealers in endodontics.

BACKGROUND: The constant development of new root canal sealers has allowed the solution of a large number of clinical cases in endodontics, however, cytotoxicity of such sealers must be tested before their validation as filling materials. The aim of this study was to evaluate the cytotoxic effect of a new Copaiba oil-based root canal sealer (Biosealer [BS]) on osteoblast-like Osteo-1 cells. MATERIALS AND METHODS: The experimental groups were formed according to the culture medium conditioned with the tested sealers, as follows: Control group (CG) (culture medium without conditioning); Sealer 26 (S26) - culture medium + S26; Endofill (EF) - culture medium + EF; AH Plus (AHP) - culture medium + AHP; and BS - culture medium + BS (Copaiba oil-based sealer). The conditioned culture medium was placed in contact with 2 × 10(4) cells cultivated on 60 mm diameter Petri dishes for 24 h. Then, hemocytometer count was performed to evaluate cellular viability, using Trypan Blue assay. The normal distribution of data was tested by the Kolmogorov-Smirnov test and the values obtained for cellular viability were statistically analyzed (1-way ANOVA, Tukey's test - P < 0.05), with a significance level of 5%. RESULTS: S26, EF and AHP presented decreased cellular viability considerably, with statistical significance compared with CG (P < 0.05). BS maintained cellular viability similar to CG (P > 0.05). CONCLUSION: The Copaiba oil-based root canal sealer presented promising results in terms of cytotoxicity which indicated its usefulness as a root canal sealer.

Influence of drying protocol with isopropyl alcohol on the bond strength of resin-based sealers to the root dentin.

INTRODUCTION: This study compared the bond strength, interfacial ultrastructure, and tag penetration of resin-based sealers applied to smear-free radicular dentin using 70% isopropyl alcohol as the active final rinse. METHODS: Eighty root canals were prepared and assigned to 2 groups (n = 40) according to the drying protocol: paper points or 70% isopropyl alcohol. Then, roots were divided into 4 subgroups (n = 10) with respect to the sealer and obturation material: AH Plus (Dentsply De Trey GmbH, Konstanz, Germany) and gutta-percha (AH/GP), Hybrid Root SEAL (Sun Medical, Tokyo, Japan) and gutta-percha (HR/GP), Epiphany SE (Pentron Clinical Technologies, Wallingford, CT) and gutta-percha (EP/GP), and Epiphany SE and Resilon (EP/RS). Roots were sectioned, and the push-out test was performed. Failure modes were examined under stereomicroscopy and sealer penetration into the dentinal tubules under scanning electron microscopy. Data were statistically analyzed by 2-way analysis of variance post hoc Tukey tests with a significant level of 5%. RESULTS: Overall, canals dried with isopropyl alcohol showed significantly higher bond strength values (2.11 ± 1.74 MPa) than with paper points (1.81 ± 1.73 MPa) (P < .05). The HR/GP group showed lower bond strength than the AH/GP group (P < .05) but higher than the EP/GP and EP/RS groups (P < .05). The most frequent type of failure was cohesive in the AH/GP and HR/GP groups and adhesive in the EP/GP and EP/RS groups. Scanning electron microscopic evaluation revealed better adaptation of the adhesive interface in the AH/GP and HR/GP groups in comparison with the EP/GP and EP/RS groups. CONCLUSIONS: A final rinse with EDTA and 70% isopropyl alcohol improved the bond strength and penetration of the sealers into dentinal tubules of the root.