Assessment of tooth discoloration induced by root canal filling materials in pediatric dentistry.

This study investigated the potential for tooth discoloration of root canal filling pastes used in pediatric dentistry. Sixty bovine incisors were sectioned 2 mm apical to the cementoenamel junction and allocated into 6 groups (n = 10) according to the type of filling material used: G1- Zinc oxide-eugenol sealer; G2- Zinc oxide-eugenol and iodoform paste; G3- Calcium hydroxide (CH) and zinc oxide paste; G4- CH, zinc oxide, and iodoform paste; G5- CH and iodoform paste; and G6- Control. Polyethylene glycol 400 was used as a vehicle for CH-containing pastes. Color measurements were taken at specific intervals: preceding endodontic treatment (T0) and at successive points of 1 month (T1), 2 months (T2), 3 months (T3), and 1 year (T4) after the placement of the filling material. The color change (∆E) was calculated using the CIELab formula. Statistical analysis was performed using ANOVA, followed by Tukey's post hoc test (α = 5%). Significant differences were observed among the filling materials and time intervals (p <0.001). All groups exhibited color changes over time, except G1 and G5, which showed color changes only after 1 year. G1 and G2 demonstrated the highest ∆E values, with a statistically significant difference observed only at T2 when compared to G3 (p = 0.008). Root canal filling materials used in primary teeth have the potential to induce tooth discoloration.

Spectrophotometric analysis of crown discoloration induced by MTA- and ZnOE-based sealers.

UNLABELLED: Crown discoloration can be induced by root canal sealer remnants following root canal treatment. OBJECTIVE: The aim of this study was to evaluate chromatic alterations in human tooth crowns induced by a Mineral Trioxide Aggregate-based sealer (MTA Fillapex®) and a commonly used ZnOE-based sealer (Roth-811). The tested null hypothesis was that the application of the materials did not induce clinically perceptible crown discoloration (Ho: CIE color difference ΔE<3.7). MATERIAL AND METHODS: Forty five fully developed, intact, mandibular third molars were sectioned 1 mm below the cemento-enamel junction. The pulp chambers were chemomechanically debrided via the cervical access. The specimens were randomly assigned into three groups Group 1: MTA Fillapex, Group 2: Roth 811, Group 3: Negative control (unfilled) and immersed in individually marked vials containing distilled water up to the cervix (37±1°C). The spectral reflectance lines were recorded by utilizing a UV-VIS spectrophotometer equipped with integration sphere in the visual spectrum at baseline, 1 week, 1 and 3 months after material placement. Data were transformed into values of the CIE L*a*b* color system and the corresponding ΔE values were calculated. Statistical analysis was performed using two-way mixed ANOVA models, at p=0.05 level of significance. RESULTS: A statistically significant increase in a* and b* chromatic parameters of the MTA Fillapex Group was measured. However, ΔE values did not exceed the human eye perceptibility threshold (set at ΔE<3.7) during the experimental period (ΔEt3=2.88). In Roth-811 Group, a statistically significant decrease in L* and a statistically significant increase in a* and b* chromatic parameters was measured, during all observation periods. Resultant ΔE values exceeded the human eye perceptibility threshold after 1 week (ΔEt1=5.65). CONCLUSIONS: Application of MTA Fillapex in tooth crowns resulted in minimal color alterations, while Roth 811 induced severe discoloration, in vitro. It could be suggested that, in terms of aesthetics, the use of MTA Fillapex appears to be favorable.

Spectrophotometric analysis of crown discoloration induced by MTA- and ZnOE-based sealers

Crown discoloration can be induced by root canal sealer remnants following root canal treatment. Objective: The aim of this study was to evaluate chromatic alterations in human tooth crowns induced by a Mineral Trioxide Aggregate-based sealer (MTA Fillapex®) and a commonly used ZnOE-based sealer (Roth-811). The tested null hypothesis was that the application of the materials did not induce clinically perceptible crown discoloration (Ho: CIE color difference ΔE<3.7). Material and Methods: Forty five fully developed, intact, mandibular third molars were sectioned 1 mm below the cemento-enamel junction. The pulp chambers were chemomechanically debrided via the cervical access. The specimens were randomly assigned into three groups Group 1: MTA Fillapex, Group 2: Roth 811, Group 3: Negative control (unfilled) and immersed in individually marked vials containing distilled water up to the cervix (37±1°C). The spectral reflectance lines were recorded by utilizing a UV-VIS spectrophotometer equipped with integration sphere in the visual spectrum at baseline, 1 week, 1 and 3 months after material placement. Data were transformed into values of the CIE L*a*b* color system and the corresponding ΔE values were calculated. Statistical analysis was performed using two-way mixed ANOVA models, at p=0.05 level of significance. Results: A statistically significant increase in a* and b* chromatic parameters of the MTA Fillapex Group was measured. However, ΔE values did not exceed the human eye perceptibility threshold (set at ΔE<3.7) during the experimental period (ΔEt3=2.88). In Roth-811 Group, a statistically significant decrease in L* and a statistically significant increase in a* and b* chromatic parameters was measured, during all observation periods. Resultant ΔE values exceeded the human eye perceptibility threshold after 1 week (ΔEt1=5.65). Conclusions: Application of MTA Fillapex in tooth crowns resulted in minimal color alterations, while Roth 811 induced severe discoloration, in vitro. It could be suggested that, in terms of aesthetics, the use of MTA Fillapex appears to be favorable.

Zinc oxide-eugenol paste retained in gingival mucosa after primary teeth pulpectomy.

AIM: Long-term follow-up evaluations of pulpectomy in primary teeth have revealed retention of ZOE filling particles in the periapical area even after root resorption. CASE REPORT: This paper reports a case of a child submitted to pulpectomy with ZOE paste in primary teeth. After 28 months, the filling particles remained, having migrated to the alveolar bone from the gingival vestibular mucosa during permanent dentition eruption. Aesthetics required periodontal surgical removal of the paste particles. Primary teeth submitted to pulpectomy should be evaluated carefully both clinically and radiographically to verify radicular and ZOE filling paste resorption. The consequences of retained particles during permanent dentition eruption are unknown.

Chronic maxillary sinusitis associated with dental impression material.

A 62-year-old man was referred for routine treatment of hyperplasia of the mucosa in the anterior lower jaw. An oroantral fistula was detected in the right superior alveolar ridge. The patient had no complaints. Plain radiographs showed a radiopaque foreign body in the posterior region associated with opacification of the maxillary sinus. Computed tomography showed the same hyperdense foreign body located in the posterior lower part of the sinus and an abnormal soft tissue mass in the entire right maxillary sinus. When asked about sinusitis, the patient mentioned occasional episodes of pus taste and intermittent crises of headache lasting for one week. The patient has been edentulous for 20 years. Sinus debridement was performed and the oroantral fistula was closed. The clinical suspicion of the presence of zinc oxide-eugenol paste was confirmed by microscopical and chemical analysis. After 6 months of follow-up, the fistula continued to be closed and sinusitis did not recur. This clinical case of maxillary chronic sinusitis illustrates a different odontogenic origin.

Influence of eugenol-containing temporary restorations on the microleakage of total-etch and self-etching adhesive systems / Influência de restaurações temporárias contendo eugenol na microinfiltração de sistemas adesivos convencional e autocondicionante

Purpose: This in vitro study evaluated the influence of zinc oxide-eugenol temporary cement (ZOE-TC) on the sealing ability of composite restorations using two adhesive systems. Methods: Standard Class V cavities were prepared in 20 bovine incisors and restored with either ZOE-TC (IRM®) or eugenol-free cement (Cavit®) (n=10/temporary cement type). After 7 days, five teeth per material group were restored using Single Bond® (SB) and five using Adper Prompt® (AP). The cavities were filled with composite (Filtek Z-250), thermal cycled (500 cycles), immersed in basic fuchsine solution, and longitudinally sectioned. Dye penetration was evaluated using optical-microscopy and scored. Data were analyzed by Kruskal-Wallis test (P = 0.05). Results: Overall, leakage in dentin was similar to that in enamel. In enamel margins, only the group with Cavit® cement associated with AP presented significant higher leakage. In dentin margins, AP exhibited higher leakage than the groups restored with SB; there was no significant difference between eugenol-free cement and ZOE-TC. Conclusion: In general, SB showed better marginal sealing than AP, and ZOE-TC did not increase dye leakage. Eugenol in the temporary cement did not affect the marginal sealing of adhesive restorations.

Objetivo: Este estudo in vitro avaliou a influência de um cimento restaurador temporário à base de óxido de zinco-eugenol (CT-OZE) no selamento marginal de restaurações diretas, utilizando dois sistemas adesivos. Metodologia: Cavidades classe V foram preparadas em 20 incisivos bovinos e restauradas com dois cimentos temporários, CT-OZE (IRM®) ou cimento livre de eugenol (Cavit®) (n=10/cimento temporário). Após sete dias, cinco dentes de cada grupo de cimento temporário foram restaurados utilizando o sistema Single Bond® (SB) e os demais cinco com o sistema Adper Prompt® (AP). As cavidades foram restauradas com resina composta (Filtek Z-250), termocicladas (500 ciclos), imersas em fucsina básica e longitudinalmente seccionadas. A penetração do corante foi avaliada em microscópio ótico. Os dados foram analisados por teste de Kruskal-Wallis (P = 0,05). Resultados: A infiltração em dentina foi similar à do esmalte. Em esmalte, o grupo com Cavit® e AP apresentou infiltração significativamente maior. Em dentina, AP exibiu maior infiltração que SB, e não houve diferença entre CT-OZE e Cavit®. Conclusão: Em geral, SB produziu melhor selamento marginal que AP, e CT-OZE não aumentou a penetração de corante. A presença de eugenol no material restaurador temporário não afetou o selamento marginal de restaurações adesivas.

Histological evaluation of MTA as a root-end filling material.

AIM: To assess the histological response associated with grey mineral trioxide aggregate (GMTA) and zinc oxide eugenol (ZOE) as root-end filling materials in teeth where the root canals were not filled and the coronal access cavities were not restored. METHODOLOGY: Periapical lesions were developed in 24 premolar teeth in three dogs. The root canals were prepared and half of them were dried, filled and the coronal access restored (closed). The remaining teeth were not root filled and no coronal restoration was placed (open). Apical root-end resections were performed 3 mm from the apex, and root-end cavities were prepared with ultrasonic tips. These were randomly filled with either ZOE or GMTA in the same number of specimens using MAPSYSTEM device. After 180 days the animals were killed and blocks of tissues removed and processed for histological examination. Periradicular tissue reaction was evaluated, including severity of inflammation and cementum formation. Statistical analysis was performed using anova analysis and Tukey's test. RESULTS: A significant difference was found between the levels of inflammation in the periradicular tissues of the GMTA/closed group, compared with the ZOE/open and ZOE/closed groups (P < 0.05) but not between GMTA/closed and GMTA/open groups. Cementum formation was not found over any ZOE specimens but over MTA in all specimens. No microorganisms were found in the interface between the material and the dentinal walls. CONCLUSIONS: GMTA was associated with less periapical inflammation and tissue response when used as a root-end filling material, even when no root filling or coronal restoration was present.

Angioedema neurótico: reporte de un caso clínico / Neurotic angioedema: report of a case

Las reacciones alérgicas abarcan manifestaciones clínicas variadas, que pueden ir de leve (como la que describiremos en este artículo), reacciones retardadas que pueden ocurrir hasta 48 horas después de la exposición al alergeno; hasta las reacciones inmediatas de hipersensibilidad - anafilaxis, las cuales se desarrollan en segundos y ponen en peligro la vida del paciente. Aunque el angioedema es una ocurrencia poco común en el consultorio dental, puede convertirse en una situación embarazosa para el odontólogo. El artículo tiene por finalidad presentar un caso clínico de angioedema neurótico de labio superior, su manejo y los aspectos que deben ser considerados para evitar dichas reacciones. Igualmente, el artículo pretende motivar a los odontólogos a reforzar los conocimientos en el manejo de urgencias médicas

Estudo histológico da ação do formocresol de Buckley's em dentes decíduos humanos pulpotomizados e selados com pasta de Oxido de Zinco e Eugenol / Histological study of deciduous teeth submitted to pulpotomy and treated with Buckley's formocresol and sealed with zinc oxide eugenol paste

Foram estudadas as alterações histológicas que ocorrem em dentes decíduos quando da pulpotomia com formocresol e técnica dos cinco minutos com formocresol ou não na pasta seladora. Em ambos tratamentos verificou-se alterações pulpares caracterizados por necrose de coagulação, inflamação e áreas de reabsorção interna. No tratamento onde se empregou formocresol na pasta seladora, notou-se mais necrose, presença de tecido eosinófilo e subjacente conjuntivo fibroso

Influence of endodontic materials on the bonding of composite resin to dentin.

We assessed the bond strength of a composite resin to dentin that had been in contact with different materials. Flat dentin surfaces in freshly extracted human teeth were covered for 15 min or 48 h with a 1-mm layer of a variety of materials. The products were mechanically removed and a composite resin cylindrical specimen bonded to the dentin surface using the Prisma universal bond system. After 7 days immersion at 37 degrees C in water, the tensile bond strength was tested. The results were compared with those on dentin surfaces not in contact with any endodontic material. Statistical analysis showed that some materials (Grossmans Cement, IRM, Maisto's slowly resorbable paste) reduced the strength of the bond or even precluded bonding. It is necessary to develop techniques that will eliminate this when restoring endodontically treated teeth.

Periapical tissue response to two calcium hydroxide-containing endodontic sealers.

One-hundred twenty root canals of dog teeth were cleaned, shaped, and obturated with gutta-percha and sealers using a lateral condensation technique. The sealers used were Sealapex, CRCS, and zinc oxide-eugenol. The animals were killed after 30 or 180 days and the specimens were examined histologically. Sealapex and CRCS caused a periapical tissue response similar to that found with the zinc oxide-eugenol. An ingrowth of connective tissue infiltrated with chronic inflammatory cells was noticed in cases where the filling material reached the apical stops. Regardless of sealer used, deposition of new hard tissue along the apical root canal walls was observed, which caused the partial closure of the apical opening. In the Sealapex and CRCS groups, sealer particles were found at a considerable distance from the apices. All overfilled specimens caused chronic inflammatory reactions in the periapical tissues.