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1.
Int Endod J ; 2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34743355

RESUMO

The purpose of this narrative review is to discuss the scientific milestones that led to the current understanding of the root dentinal microcrack phenomenon based on the interplay between the usage of micro-computed tomography (micro-CT) as an analytical tool alongside a close-to-mouth experimental model. In 2009, reports on the development of dentinal microcracks in extracted teeth after root canal preparation triggered an awareness of the potential for vertical root fractures (VRFs) of endodontically treated teeth could be developed from defects created by the mechanical stress of nickel-titanium preparation systems on dentine. This assumption was taken for granted, even though no cause-effect relationship had been scientifically demonstrated. Since then, several studies using the sectioning method with extracted teeth have been published and the large discrepancy among their outcomes soon become evident. Moreover, the high frequency of reported dentinal microcracks largely contrasted with the clinical incidence of VRFs, raising doubts on their methodological reliability. Using micro-CT technology, it was demonstrated by several studies that, in extracted teeth, dentinal defects already existed before the endodontic procedures, indicating that the initial reports framed a non-existing cause-effect relationship between canal preparation and dentinal microcracks. Although these new findings contributed to a better comprehension of this phenomenon, the misconception that microcracks were the starting point for VRFs was only surpassed with a new in situ approach using fresh cadavers. Surprisingly, microcracks were not identified in sound teeth. As a conclusion, dentinal microcracks in extracted teeth are considered a non-natural occurrence observed only in a laboratory setup as a consequence of dehydration and storage conditions. Thus, dentinal microcracks shall not be considered as the starting point for VRFs as they do not manifest in non-extracted teeth. Identifying dentinal microcracks as a laboratory phenomenon highlights the impact of recent scientific developments to disclaim the clinical relevance of laboratory-obtained outcomes.

2.
Int Endod J ; 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34601728

RESUMO

AIM: To evaluate the influence of traditional and conservative access cavity preparations on the remaining dentine thickness in the coronal third of mesial canals of extracted mandibular molars prepared with reciprocating instruments using micro-computed tomography as the analytical tool. METHODOLOGY: Seventy extracted mandibular molars were scanned at a pixel size of 19 µm. From this initial sample, 20 teeth were selected, pair-matched and distributed into two groups (n = 10) according to the access cavity preparation: traditional (TradAC) or conservative (ConsAC). The root canals were sequentially enlarged with Reciproc Blue R25 (size 25, 0.08v taper) and R40 (size 40, 0.06v taper) instruments. A new scan was performed and the postoperative stacks were coregistered with their respective preoperative datasets. A colour-coded cross sections of the roots were created and used to identify and measure the smallest dentine thickness related to both MB and ML canals at 1.0-mm intervals from the furcation level of up to 5 mm in the apical direction, in both mesial and distal aspects of the roots, before and after preparation. The statistical analyses were performed with paired-samples t-test, independent-samples Student T-test and Chi-Square test with a significance level of 5%. RESULTS: At all levels of both groups, dentine thickness before preparation was greater than after preparation (p < .05). No difference in the percentage of dentine reduction was observed between TradAC and ConsAC groups (p > .05), but a significantly greater reduction was observed to the distal aspect of the roots (p < .05). After root canal preparation, dentine thinner than 0.5 mm was observed mostly along the distal aspect of the root (10% to 15%) of the MB and ML canals, with no influence of the access cavity type on its incidence to either mesial (X2  = 1.66; p = .2) or distal (X2  = 0.40; p = .5) directions. In the TradAC group, dentine thickness in most slices was greater than 1.0 mm after preparation (n = 124) whilst, in the ConsAC, it ranged from 0.5 to 1.0 mm (n = 136). CONCLUSION: Traditional or conservative access cavity preparation in extracted mandibular molars did not influence the remaining dentine thickness in the coronal third of mesial canals enlarged with thermomechanically treated nickel-titanium reciprocating instruments.

3.
Int Endod J ; 54(10): 1948-1956, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34181754

RESUMO

AIM: To evaluate an ultrasonic-based experimental model (US), to assess the setting time of AH Plus® , Bio-C Sealer® and MTA Fillapex® , and compare the results obtained with ANSI/ADA specifications (2012). METHODS: To determine the setting time according to the ANSI/ADA specification, moulds measuring 10 mm (diameter) × 2 mm (thickness) were used, and for the US tests a transducer (1 MHz) and an oscilloscope were used. Fourier-transform infrared spectroscopy (FTIR) was used to evaluate the changes on chemical structure at the different setting times found by the US and ANSI/ADA methods. After checking the normal distribution, setting time data were analysed using unilateral analysis of variance with Tukey-HSD post-test to compare the methods. RESULTS: AH Plus® and Bio-C Sealer® had longer mean setting time values for the US method than for the ANSI/ADA (p < .05), whilst for MTA Fillapex® no significant difference was found between the methods (p < .05). FTIR spectra demonstrated that at the setting time determined by the US method, AH Plus® and Bio-C Sealer® were in a more advanced stage of polymerization than at the ANSI/ADA, whilst there was no significant difference for MTA Fillapex® . CONCLUSIONS: The use of US was effective for setting time determination and measured longer values than ANSI/ADA specification for AH Plus® and Bio-C Sealer® , identifying the entire (and not only superficial) setting of the endodontic sealers.


Assuntos
Materiais Restauradores do Canal Radicular , Resinas Epóxi , Teste de Materiais , Modelos Teóricos , Ultrassom
4.
Int Endod J ; 54(9): 1647-1652, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33932037

RESUMO

AIM: To assess the impact of mechanical overinstrumentation of root canals in extracted teeth on the development of dentinal microcracks in the apical portion of the root by means of micro-computed tomographic (micro-CT) analysis. Root canal preparation short of the canal terminus and at the apical foramen (AF) were used as controls. METHODOLOGY: Twenty 2-rooted maxillary premolars with two canals were selected, scanned in a micro-CT device and the root canals prepared sequentially using Reciproc M-Wire R25 instruments to working lengths: 1 mm short of the AF (AF - 1 mm), at the AF (AF), and overinstrumentation (AF + 1 mm). A micro-CT scan of each specimen was performed after each time point. After reconstruction and co-registration procedures, the images were screened from the cementoenamel junction to the apex (n = 55 352) to identify the presence of dentinal microcracks in the apical third of the root. RESULTS: After the analyses of 55 352 slices, dentinal microcracks were visualized in 12.45% of the images (6892 slices), with 5.73% (3174 slices) in the cervical, 3.57% (1976 slices) in the middle and 3.15% (1740 slices) in the apical third. All dentinal microcracks observed at all time points (AF - 1 mm, AF and AF + 1 mm) were already present in the corresponding images before canal instrumentation. Therefore, no new microcracks were detected, regardless of the working length used for canal instrumentation. CONCLUSION: Reciprocating root canal preparation either short, at or beyond the AF (overinstrumentation) did not create dentinal microcracks in the roots of extracted 2-rooted maxillary premolars.


Assuntos
Preparo de Canal Radicular , Ápice Dentário , Cavidade Pulpar , Humanos , Ápice Dentário/diagnóstico por imagem , Colo do Dente , Extração Dentária , Microtomografia por Raio-X
5.
Int Endod J ; 54(9): 1653-1658, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33977555

RESUMO

AIM: To compare the bond strength of an epoxy resin-based sealer and two calcium silicate-based sealers (CSS) to gutta-percha discs using a new method. METHODOLOGY: Round discs of gutta-percha (n = 60), measuring 10 mm in diameter and 2 mm in thickness, were placed on a glass plate and a drop of each sealer (AH Plus, EndoSequence BC Sealer and EndoSeal MTA) was placed on their surface. Another identical disc was placed onto the first one and a standardized weight (0.0981 N) applied over them using a specially developed apparatus. Ten samples prepared for each sealer were submitted to a microshear bond strength test accomplished by a specially designed set-up coupled to a universal testing machine. The Kruskal-Wallis test followed by a post hoc procedure was used to compare groups considering the preliminary analysis of the raw data had indicated the nonadherence to a Gaussian distribution (Shapiro-Wilk, p < .05). Alpha error was set at 5%. RESULTS: Overall, no premature failure occurred. All sealers had some degree of adhesiveness to gutta-percha discs but with a significant difference amongst them (Kruskal-Wallis, p = .019). The epoxy resin-based sealer (AH Plus) had significantly higher median shear bond strength values (1.43 MPa; 1.40-1.83) compared to EndoSeal MTA (0.53 MPa; 0.46-0.73) (p = .021) and EndoSequence BC Sealer (0.45 MPa; 0.34-0.46) (p = .023), whilst the lowest median value was observed with EndoSequence BC Sealer (0.45 MPa; 0.34-0.46) (p < .05). CONCLUSIONS: CSS sealers had weaker bonding to gutta-percha when compared to the epoxy resin-based AH Plus sealer. The proposed methodology is an innovative and reproducible method for testing the bond strength of root canal sealers to gutta-percha.


Assuntos
Colagem Dentária , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Resinas Epóxi , Guta-Percha , Teste de Materiais , Obturação do Canal Radicular , Silicatos
6.
Braz Oral Res ; 35: e021, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33605352

RESUMO

The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey's test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.


Assuntos
Preparo de Canal Radicular , Titânio , Instrumentos Odontológicos , Desenho de Equipamento , Teste de Materiais , Estresse Mecânico , Torque
7.
Aust Endod J ; 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33523574

RESUMO

This systematic review and meta-analysis evaluated whether epoxy resin-based root canal sealers present an increased solubility than calcium silicate-based root canal sealers. A systematic search was performed in the following databases: PubMed, Science Direct, Scopus, Web of Science and Open Grey. The inclusion criteria consisted of in vitro studies that compared the solubility of epoxy resin-based and calcium silicate-based sealers. The quality assessment and data extraction of the selected articles were performed. The meta-analysis of the pooled data and the subgroups according to the root thirds were carried out using the RevMan software (P < 0.05). After the duplicate removal and eligibility criteria assessment, a total of 22 studies were included all of them were considered as having a low risk of bias. The meta-analysis demonstrated overall lower solubility of AH Plus. AH Plus presented lower solubility than Bio-C Sealer, BioRoot RCS, MTA Fillapex, Sealer Plus and Total Fill BC Sealer.

8.
Materials (Basel) ; 14(2)2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33466619

RESUMO

The aim of this in vitro study was to evaluate the dentinal tubule penetration of two calcium silicate-based sealers used in warm vertical compaction (WVC) obturation technique in comparison with the single cone (SC) technique by confocal laser scanning microscopy (CLSM). The null hypothesis was that both obturation techniques produced similar sealer penetration depths at 1 and 5 mm from the apex. Forty-four mandibular single-rooted premolars were randomly divided into four equally experimental groups (n = 10) and two control groups (n = 2) according to the type of sealer (Bio-C Angelus, Londrína, PR, Brazil or HiFlow Brasseler, Savannah, GA, USA) with either SC or WVC. The sealers were mixed with a fluorescent dye Rhodamine B (0.1%) to enable the assessment under the CLSM. All the specimens were sectioned horizontally at 1 and 5 mm from the apex. The maximum penetration depth was calculated using the ImageJ Software (ImageJ, NIH). Data were analyzed by Mann-Whitney U and Kruskal-Wallis tests (p < 0.05). A significant difference was shown between the four groups at 1 mm (p = 0.0116), whereas similar results were observed at 5 mm (p = 0.20). WVC allowed better diffusion for both sealers at 1 mm (p = 0.01) and 5 mm (p = 0.034). The maximum penetration of the Bio-C and HiFlow sealers was more important at 5 mm with the two obturation techniques. Within the limitations of this study, WVC enhanced the penetration of calcium silicate-based sealers into the dentinal tubules in comparison with the SC technique at both levels.

9.
J Endod ; 47(1): 100-104, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33045262

RESUMO

INTRODUCTION: This study assessed the number of mesial and distal canals of mandibular molars in which the R-Pilot pathfinding reciprocating instrument reached the working length (WL) during macro glide path procedure. Fracture and deformation rates were also evaluated. METHODS: One hundred fifty-six root canals of 52 teeth were scouted to the length of the apical foramen. Then the R-Pilot instrument was positioned at the canal orifice and activated. The instrument was moved by using a pecking motion and light apical pressure. This procedure was repeated in an attempt to reach the WL. The type of fracture and/or instrument deformation was assessed by scanning electron microscopy, whereas the roots with fractured instruments were scanned through micro-computed tomography. The percentage frequency distribution of fractures, deformations, and root canals in which the R-Pilot reached the WL were recorded and statistically compared by using the Pearson's χ2 test with α = 5%. RESULTS: R-Pilot instruments reached the WL in 139 root canals (89.10%), and χ2 test showed a significant difference between the observed frequencies and the expected frequencies (χ2 = 95.41, P = .000). The observed frequencies of fractures (2.56%) and deformations (1.92%) were also significantly lower than the expected (fracture: χ2 = 140.41, P = .000; deformation: χ2 = 144.23, P = .000). Fractures occurred mostly at the apical and curved parts of the root canals. CONCLUSIONS: R-Pilot reached the WL in 89.10% of the root canals of mandibular molars with fracture and deformation rates of 2.56% and 1.92%, respectively.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Ápice Dentário , Microtomografia por Raio-X
10.
J Endod ; 47(2): 309-314, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33096193

RESUMO

INTRODUCTION: The aim of this study was to evaluate the influence of rotary (ProTaper Next [PTN; Dentsply Maillefer, Ballaigues, Switzerland] and ProTaper Gold [PTG, Dentsply Maillefer]) and reciprocating (WaveOne Gold [WOG, Dentsply Maillefer]) systems in dentinal microcrack generation after the preparation of curved root canals using micro-computed tomographic analysis. METHODS: Twenty-four human mandibular molars with curved roots were scanned in a micro-computed tomographic device using an isotropic resolution of 6.78 µm and randomly assigned into 1 of 3 experimental groups (n = 8) according to the root canal instrumentation system used (PTN, PTG, or WOG). Then, the root canals were prepared up to PTN X2, PTG F2, and WOG Primary instruments in the PTN, PTG, and WOG groups, respectively. After canal preparation, each specimen was scanned again. Pre- and postoperative cross-sectional images of the roots (N = 35,304) were analyzed to identify the presence of dentinal microcracks. RESULTS: Overall, 26% of the images presented dentinal defects (n = 9188). Dentinal microcracks were observed in 24.6%, 26%, and 27.4% of the postinstrumentation images from the PTN, PTG, and WOG groups, respectively. However, all of these dentinal microcracks were already present in the corresponding preoperative images. No new microcracks were generated after the preparation of curved root canals of mandibular molars using the aforementioned systems. CONCLUSIONS: Root canal instrumentation with PTN, PTG, and WOG systems did not induce the formation of new dentinal microcracks.


Assuntos
Cavidade Pulpar , Ouro , Estudos Transversais , Cavidade Pulpar/diagnóstico por imagem , Dentina/diagnóstico por imagem , Humanos , Preparo de Canal Radicular , Microtomografia por Raio-X
11.
Clin Oral Investig ; 25(4): 1899-1906, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32789655

RESUMO

OBJECTIVES: To present and explore the potential of an animal-based experimental model developed to determine the set of root canal sealers in vivo. The setting of AH Plus, BioC Sealer, TotalFill BC Sealer, and Sealapex was determined using either ISO 6876 or the novel in vivo method proposed in this study. MATERIAL AND METHODS: The in vitro setting time of the sealers tested was determined in accordance with ISO 6876:2012. In determining the in vivo set, 24 adult Wistar rats were followed up for two evaluation periods: 1 and 4 weeks. Their upper-right incisor was extracted, and its pulp tissue was removed. The root canal was then filled from retrograde with one of the 4 sealers, and the tooth was re-implanted and fixed with a layer of a flowable composite resin. After 1 or 4 weeks of the surgical procedures, the animals were euthanized, and their incisors were extracted. Two-mm-thick slices of the middle third of the tooth root were obtained and assessed with a Gillmore device, to determine whether or not the sealer had set. RESULTS: The following in vitro results were obtained by using ISO 6876 methodology: AH Plus set after a mean time of 423 ± 20 min and 476 ± 35 min, in metal and plaster molds, respectively. BioC Sealer set after 7 days (in dental plaster molds), whereas TotalFill BC Sealer and Sealapex did not set even after 25 days in both tested conditions (metal or dental plaster molds). Using the novel in vivo methodology, AH Plus, BioC Sealer, and TotalFill BC Sealer set after both 7 and 30 days. In contrast, Sealapex did not set at either time point. CONCLUSIONS: AH Plus and BioC Sealer set under both in vitro and in vivo test conditions. TotalFill BC Sealer did not set under in vitro conditions but did after 1 week under in vivo conditions. Sealapex did not set under either in vitro or in vivo conditions. CLINICAL RELEVANCE: The influence of the testing conditions on the setting results is a clear indication that new in vivo experimental models should be useful in future studies on Bioceramics root canal sealers.


Assuntos
Materiais Restauradores do Canal Radicular , Animais , Compostos de Cálcio , Cavidade Pulpar , Resinas Epóxi , Teste de Materiais , Modelos Teóricos , Ratos , Ratos Wistar , Silicatos
12.
Clin Oral Investig ; 25(6): 3641-3649, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33236240

RESUMO

OBJECTIVES: This study evaluated the danger zone (DZ) in mesial roots of mandibular molars and the correlation between anatomical references of the DZ and some anatomical landmarks including tooth/root length, depth of mesial and distal grooves, and inter-canal orifices distance. MATERIAL AND METHODS: Twenty-eight mesial roots of mandibular molars with 2 independent canals were scanned and divided into 2 groups according to root length. The anatomical landmarks were correlated (Pearson or Spearman coefficients) with root level, thickness, and position of the DZ and also compared (independent samples t or Mann-Whitney tests) between the 2 groups at α = 5%. RESULTS: No statistical difference was observed between groups regarding DZ parameters and depth of mesial and distal grooves (P > 0.05). Orifice distance in group 2 (4.49 ± 0.75 mm) was significantly greater than group 1 (3.76 ± 0.89 mm) (P < 0.05). Significant correlations (P < 0.05) were found between (i) DZ level and root/tooth length (r = 0.54 and 0.49, respectively), (ii) DZ thickness and distal groove depth (r = - 0.45), and orifice distance (r = 0.38), and (iii) DZ position and depth of mesial (r = 0.39) and distal (r = 0.40) grooves. Other variables such as root length and distal groove depth (r = 0.28), and orifice distance and mesial groove depth (r = 0.36) were also correlated (P < 0.05). CONCLUSIONS: The length of tooth/root, the distance of canal orifices, and the depth of mesial/distal grooves of mesial roots of mandibular molars might be predictive factors for the root level, position, and thickness of the DZ. CLINICAL RELEVANCE: The length, distance of mesial canal orifices, and the depth of mesial and distal grooves of the mesial roots of mandibular molars might be moderate predictive factors for the root level, position, and thickness of the DZ.


Assuntos
Mandíbula , Raiz Dentária , Cavidade Pulpar/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
13.
Braz. oral res. (Online) ; 35: e021, 2021. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1153624

RESUMO

Abstrac The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey's test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.


Assuntos
Titânio , Preparo de Canal Radicular , Estresse Mecânico , Teste de Materiais , Torque , Instrumentos Odontológicos , Desenho de Equipamento
14.
J Endod ; 46(10): 1485-1494, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32721485

RESUMO

INTRODUCTION: This study aimed to compare the mechanical and metallurgical properties and shaping ability of different rotary systems using a multimethod approach. METHODS: New NeoNiti A1 (Neolix SAS, Châtres-La-Forêt, France), HyFlex EDM One File (Coltène/Whaledent, Altstätten, Switzerland), ProTaper Gold F2 (Dentsply Maillefer, Ballaigues, Switzerland), and ProTaper Universal F2 (Dentsply Maillefer) rotary instruments were tested regarding cyclic fatigue, torsional resistance, design, and morphologic characteristics using scanning electron microscopy, metal alloy characterization using differential scanning calorimetry, and energy-dispersive X-ray spectroscopy. Additionally, their shaping ability on the preparation of 48 canals of maxillary molars was evaluated using micro-computed tomographic technology. Mechanical and metallurgical analyses were compared using analysis of variance post hoc Tukey tests, whereas the independent Student t test was used to compare the shaping ability of the ProTaper systems or the thermomechanically treated instruments. The significance level was set at 5%. RESULTS: The highest cyclic fatigue was observed with the NeoNiti and HyFlex EDM instruments (P > .05), whereas HyFlex EDM had the highest angular rotation to fracture (P < .05). Scanning electron microscopic/energy-dispersive X-ray spectroscopic analyses confirmed similarities in the instruments' design and an almost equiatomic composition of the systems. Differential scanning calorimetry showed that ProTaper Gold had higher transformation temperatures than ProTaper Universal, whereas a similar transformation was observed between NeoNiti and HyFlex. Micro-computed tomographic analysis revealed that, despite the fact that none of the systems was able to prepare all root canal walls, no statistical differences were observed in either ProTaper systems (P > .05) or the thermomechanically treated instruments (P > .05). CONCLUSIONS: Apart from differences in the mechanical tests and metallurgical characterization, systems with comparable instrument dimensions and preparation protocols showed a similar percentage of untouched surface areas in the root canal preparation of maxillary molars.


Assuntos
Níquel , Titânio , Ligas , Ligas Dentárias , Desenho de Equipamento , Falha de Equipamento , França , Humanos , Teste de Materiais , Preparo de Canal Radicular , Estresse Mecânico
15.
J Endod ; 46(8): 1136-1143, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32413441

RESUMO

INTRODUCTION: The aim of this study was to evaluate the cyclic fatigue resistance of 3 replicalike rotary instruments compared with their original brand systems using continuous rotation and optimum torque reverse (OTR) kinematics. METHODS: New F1 rotary instruments (n = 20 per group) from ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) and ProTaper Gold (Dentsply Maillefer) original brand systems were compared with 3 replicalike instruments (U-File [Dentmark, Ludhiana, India], Super Files [Shenzhen Flydent Medical, Shenzhen, China], and Super Files Blue [Shenzhen Flydent Medical]) regarding cyclic fatigue resistance. In each group, the selected instruments were randomly distributed into 2 subgroups (n = 10) according to the kinematics. In the rotary group (ROT), the instruments were activated with a continuous clockwise rotation (300 rpm, 1.5 Ncm), whereas in the OTR group, asymmetric oscillatory motion was performed setting the OTR function at 300 rpm and adjusting the torque limit at the minimum level using the TriAuto ZX2 motor (J Morita, Kyoto, Japan). The time to fracture was recorded and statistically compared according to the kinematics (ROT × OTR) and the instrument type (replicalike × original brand) using the independent sample t test (α = 0.05). Additionally, the metal alloy characterization of each system was performed by differential scanning calorimetry and energy-dispersive X-ray spectroscopy. RESULTS: Statistical analysis revealed significantly higher time to fracture for all rotary systems tested in OTR motion compared with continuous rotation (P < .05) with a mean percentage increase ranging from 52.1% (ProTaper Gold) to 156.7% (U-File). The replicalike instruments showed a significantly higher time to fracture compared with the respective original brand instruments in either ROT or OTR motion (P < .05). Replicas presented austenitic temperatures above the ones displayed by the original brands and an almost equiatomic ratio between nickel and titanium elements. CONCLUSIONS: OTR motion significantly improved the fatigue resistance of both original and replicalike systems. The replicas showed higher cyclic fatigue resistance than original brand instruments and higher transition temperatures to the austenitic phase.


Assuntos
Ligas Dentárias , Falha de Equipamento , Fenômenos Biomecânicos , China , Instrumentos Odontológicos , Desenho de Equipamento , Índia , Preparo de Canal Radicular , Rotação , Estresse Mecânico , Titânio
16.
J Endod ; 46(6): 707-729, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32334856

RESUMO

INTRODUCTION: Negotiation, glide path, and preflaring are essential steps in root canal shaping procedures. This report aimed to discuss the terminology, basic concepts, and clinical considerations of negotiation, glide path, and preflaring procedures and the influence of these steps on root canal shaping. METHODS: This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (number CRD42019127021). A comprehensive literature search was performed by 2 independent reviewers using a selected search strategy in 2 electronic databases (PubMed and Scopus) until January 28, 2019. A further search was performed manually in endodontic journals. Studies investigating or comparing at least 1 shaping property resulting from root canal instrumentation with a glide path or preflaring in human extracted teeth or clinical studies were included. RESULTS: The literature shows that the definition of glide path and preflaring procedures remains controversial, which requires an elaboration in the American Association of Endodontists' Glossary of Endodontic Terms. After the removal of irrelevant and duplicated articles, 98 articles were included. The impact of glide path preparation and preflaring on working length determination, apical file size determination, canal transportation, separation of endodontic files, shaping time, dentinal microcrack formation, and extrusion of debris was discussed. Because of heterogeneity among the included studies, quantitative synthesis was not performed for most of the parameters. CONCLUSIONS: An evidence-based guideline is needed to define and correlate the basic concepts and current applications of each step of contemporary advancements in root canal instruments. Glide path preparation reduces the risk of debris extrusion, has no influence on the incidence of dentinal crack formation, and improves the preservation of the original canal anatomy. The creation of a glide path may have no impact on Reciproc files (VDW, Munich, Germany) in reaching the full working length. Preflaring increases the accuracy of working length determination. Further randomized clinical trials are required to evaluate the effect of a glide path and preflaring on root canal treatment outcomes.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Desenho de Equipamento , Alemanha , Humanos , Dente Molar , Negociação , Ápice Dentário
17.
J Evid Based Dent Pract ; 19(3): 221-235, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31732099

RESUMO

OBJECTIVES: The aim of the present systematic review was to evaluate if epoxy resin-based root canal sealers present superior push-out bond strength compared to calcium silicate-based root canal sealers. METHODS: The inclusion criteria consisted of in vitro studies that compared the push-out bond strength of epoxy resin-based and calcium silicate-based sealers. A systematic search was performed in the following databases for articles published until February 2018: PubMed, ScienceDirect, Scopus, Web of Science, and OpenGrey. The quality assessment and data extraction of the selected articles were performed. A meta-analysis of the pooled data and the subgroups according to the root thirds was carried out using the RevMan software (P < .05). RESULTS: The search resulted in 2292 studies. After the duplicate studies were removed and the title and abstract were read, 20 studies were selected and 17 were considered as having a low risk of bias. The pooled meta-analysis comparing epoxy resin-based (n = 467) and paste-to-paste calcium silicate-based root canal sealers (n = 467) demonstrated higher mean push-out bond strength values (P < .001) for the epoxy resin-based root canal sealers; the heterogeneity among studies was 85% (I2). The comparisons between epoxy resin-based (n = 358) and premixed ready-to-use calcium silicate-based root canal sealers (n = 358) also demonstrated a significant difference between the sealers (P < .05), with an I2 of 95%. The subgroup analysis showed that only in the middle third, were increased bond strength values for epoxy resin-based sealer observed (P < .001), with an I2 of 94%. CONCLUSIONS: The epoxy resin-based sealer demonstratedhigher push-out bond strength than paste-to-paste calcium silicate-based root canal sealer regardless of the root third assessed. In addition, the epoxy resin-based sealer exhibited increased push-out bond strength in comparison with premixed ready-to-use calcium silicate-based root canal sealer when evaluating the middle third.


Assuntos
Colagem Dentária , Materiais Restauradores do Canal Radicular , Compostos de Cálcio , Dentina , Resinas Epóxi , Humanos , Teste de Materiais
18.
Br Dent J ; 227(3): 228-234, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31399682

RESUMO

Objectives To evaluate the effectiveness of passive ultrasonic irrigation (PUI) compared with non-activated irrigation (NAI) on periapical healing and root canal disinfection.Data source A comprehensive search without restrictions was performed in the following systematic electronic databases: PubMed, Scopus, Cochrane, Web of Science, ScienceDirect and OpenGrey. Additional studies were sought through hand-searching in the main endodontic journals.Data selection We included clinical trials that compared PUI and NAI clinical success and root canal disinfection outcomes. The risk of bias was assessed based on the Cochrane Collaboration common scheme for bias assessment. The power analysis of each study was calculated based on the disinfection rates and sample size, and the evidence was qualified using the GRADE tool.Data synthesis A total of 346 non-duplicated studies were retrieved in the systematic search. One study that assessed the clinical success rate through periapical radiographic healing evaluation and two studies that evaluated root canal disinfection through bacterial growth were considered eligible. These three studies were classified as low risk of bias. The study evaluating radiographic treatment outcome showed no statistical difference (P >0.05). The studies demonstrated large variability among methodology and, in general, low power and moderate evidence. Inconclusive results were reported regarding root canal disinfection when comparing PUI to NAI strategies.Conclusions Based on the findings, there was no evidence of effectiveness improvement on periapical healing and bacterial disinfection that supports the use of PUI over the NAI in clinical practice.


Assuntos
Cavidade Pulpar , Irrigantes do Canal Radicular , Desinfecção , Humanos , Preparo de Canal Radicular , Tratamento do Canal Radicular , Irrigação Terapêutica , Ultrassom
19.
J Endod ; 45(9): 1135-1141, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31350048

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the ability of the XP-endo Shaper instrument (FKG Dentaire, La Chaux-de-Fonds, Switzerland) during the removal of root fillings from oval-shaped canals. M-Wire Reciproc and Reciproc Blue systems (VDW, Munich, Germany) were used as reference instruments for comparison, and micro-computed technology was used as an analytical tool. METHODS: Thirty mandibular incisors with oval-shaped canals were matched based on similar anatomic features of the canal (eg, volume, aspect ratio, and 3-dimensional configuration) after scanning procedures. The canals were prepared with M-Wire Reciproc R25 instruments and filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) using the continuous wave of condensation technique. Then, the sample was allocated into 3 experimental groups (n = 10) according to the retreatment protocol used: M-Wire Reciproc, Reciproc Blue, and XP-endo Shaper. M-Wire Reciproc R25, Reciproc Blue R25, and XP-endo Shaper instruments were used to remove the root fillings. Apical enlargement was performed with M-Wire Reciproc R40, Reciproc Blue R40, and BioRace BR5 (FKG Dentaire) instruments. Each sample was scanned after each endodontic procedure. The volume of remaining root filling material was quantified before and after apical enlargement. The percentage volumes of root filling reduction in relation to the instrumented canals at both time points (before and after apical enlargement) were calculated and considered for statistical analysis. Data were analyzed statistically with a significance level of 5%. RESULTS: Reciproc Blue presented significantly lower removal of filling material compared with the XP-endo Shaper (Tukey test, P < .05). No difference was detected either between M-Wire Reciproc and Reciproc Blue (Tukey test, P > .05) or M-Wire Reciproc and XP-endo Shaper (Tukey, P > .05). The increase of apical enlargement significantly improved the removal of root fillings from the root canals (P < .05); this effect was similar for all systems (time point × file system, P > .05). CONCLUSIONS: The XP-endo Shaper instrument showed a higher percentage of root filling removal, but no differences were observed comparing M-Wire Reciproc with the XP-endo Shaper or Reciproc Blue. The increase of apical enlargement improved the removal of root fillings in all groups. None of them was able to render root canals completely free from root fillings.


Assuntos
Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Instrumentos Odontológicos , Cavidade Pulpar , Alemanha , Guta-Percha , Humanos , Retratamento , Preparo de Canal Radicular , Microtomografia por Raio-X
20.
Braz Dent J ; 30(1): 31-35, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30864644

RESUMO

The aim of this study was to evaluate whether amplifying the volume and/or time of contact of NaOCl affects the fracture strength of endodontically treated bovine teeth. Four bovine incisors from 10 animals were allocated into 4 groups using a split-mouth design. Root canals were instrumented using a sequence of 4 manual stainless steel files and irrigated with a 5.25% alkalized NaOCl solution. The total volume and time of irrigation, per sample, varied among the groups as following: standard volume and time of contact - 15 mL/11.5 min; volume raise - 30 mL/11.5 min; time of contact raise - 15 mL/19 min; and volume and time of contact raise - 30 mL/19 min. Samples were subjected to a fracture resistance assay. At p=0.05, two-way ANOVA statistically scrutinized the results. Effect size of NaOCl time of contact and volume were also calculated (η2). The variation in time (p=0.000), volume of irrigation (p=0.000) and the combination of both (p=0.038) negatively influenced the fracture resistance. Standard volume and time of irrigation showed the highest fracture strength while isolated increase in volume or time reduced in 25% and 37%, respectively, the fracture resistance; the simultaneous increase in volume and time of irrigation promoted a reduction of 47%. Effect size of NaOCl time of contact was superior (0.746) than the volume (0.564). Raising the volume and/or time of a 5.25% alkalized NaOCl solution reduces the fracture resistance of endodontically treated bovine teeth.


Assuntos
Tratamento do Canal Radicular , Hipoclorito de Sódio/química , Fraturas dos Dentes , Animais , Bovinos , Análise do Estresse Dentário , Incisivo , Hipoclorito de Sódio/administração & dosagem , Irrigação Terapêutica/métodos
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