Assessment of Drying Protocol on the Bond Strength and Tag Penetration of Two Different Sealers to the Root Dentin: An In Vitro Study.

Accomplishment of an ideal root canal treatment is attributed to various essential factors such as proper instrumentation, chemomechanical preparation, obturation and post endodontic restoration. The main aim of this study is to test the null hypothesis that is the moisture condition of root dentin would not affect the bond strength and sealer penetration. This is an in vitro study conducted in Department of Conservative Dentistry and Endodontics, M A Rangoonwala Dental College, Pune, India over a period of two years (from 2021 to 2023). One hundred and twenty single-rooted Premolars with fully formed apices and similar root morphology were obtained and stored in 0.1% thymol solution. The specimens were randomly assigned to 3 broad experimental groups (n=40) according to the drying protocol such as Group A- Paper points (P), Group B- diode laser (L) and Group C- isopropyl alcohol (A). For each drying protocol, the specimens were further assigned to 2 subgroups (n=20) with respect to the sealers used: AH Plus (AH) and Apexit Plus sealers (APx). The effect of drying protocol using paper points, isopropyl alcohol and diode-lasers on the bond strength and tag penetration of two different sealers to the root dentin was evaluated. Maximum overall push-out Bond strength was seen in group AH+L and least in group APx+ L. Inter-site push-out bond Strength was highest in the coronal third followed by the middle and least in the apical third of all the groups. Maximum over all depth of penetration was seen in group AH+L and minimum in group APx+L. AH plus sealer showed better bond strength, sealer penetration and adaptation to the dentinal walls compared to Apexit plus sealer, irrespective of the drying protocol followed. All the drying protocols used did not show statistically significant results in the apical thirds of root canals of all the groups.

Decoloración coronaria inducida por la utilización de Biodentine y MTA blanco en procedimientos de regeneración pulpar: estudio ex vivo / Coronal discoloration induced by the use of Biodentine and white MTA in pulp regeneration procedures: an ex-vivo study

Se comparó el grado de decoloración de la corona clínica en piezas dentarias anteriores humanas ex-traídas, sometidas a procedimientos de regeneración endodóntica, utilizando MTA blanco o sustituto bioac-tivo de la dentina (Biodentine) como barrera cervical, en presencia de coágulo sanguíneo como andamio. En total se prepararon 24 piezas dentarias anterio-res superiores humanas que fueron divididas en dos grupos control (GC) y dos grupos experimentales (GE). Cada uno incluía 6 piezas dentarias. En los GE se colo-có sangre humana fresca en el interior del conducto, y se confeccionó una barrera de Biodentine (GE3) o MTA (GE4). En los GC se colocó una torunda de algo-dón estéril saturada con solución fisiológica estéril, y se confeccionó una barrera de Biodentine (GC1) o MTA (GC2). El color se evaluó de acuerdo con el espa-cio de color CIE L* a* b* utilizando imágenes fotográfi-cas digitales estandarizadas en dos puntos de tiempo: día 0 (T0) y día 35 (T35). La descripción de los datos in-cluyó mediana (Md), primer cuartil (Q1), tercer cuartil (Q3), media y desviación estándar (DE). Se emplea-ron las pruebas de los rangos con signo de Wilcoxon (RSW) y ANOVA de una vía; p < 0,05 fue considerado significativo. Cuando se comparó ∆E se observaron diferencias significativas entre GC1 y el resto de los materiales (p < 0,05). ∆E fue menor en GC1 (media ± DE; 2,1 ± 1,6) que en los grupos restantes que no pre-sentaron diferencias significativas entre sí. En base a estos resultados, la estabilización del coágulo san-guíneo, como así la limpieza de la cavidad previa a la colocación del Biodentine y el uso de barreras cervi-cales, es imprescindible para evitar la coloración de la corona clínica (AU)

Discoloration remains an unfavorable complication of otherwise successful regenerative endodontic procedure of immature teeth with necrotic pulp. Objective: Compare the degree of discoloration of extracted human teeth after regenerative endodontic procedures, using MTA or Biodentine as a cervical barrier with a blood clot as a scaffold. In total 24 human upper anterior teeth were prepared and divided into two control groups (CG) and two experimental groups (EG). In the EG, fresh human blood was placed inside the root and a Biodentine (GE3) or MTA (GE4) barrier was made in. A sterile cotton swab saturated with sterile physiological solution was placed in the GCs and a Biodentine (GC1) or MTA (GC2) barrier was made in. The color was evaluated according to the CIE L* a* b* color space using standardized digital photographic images at two time points: day 0 (T0) and day 35 (T35). The description of the data included median (Md), first quartile (Q1), third quartile (Q3), means, and standard deviation (SD). Wilcoxon signed rank tests (RSW) and one-way ANOVA were used. p < 0.05 was considered significant. When ∆E was compared, significant differences were observed between GC1 and the rest of the materials (p < 0.05). ∆E was lower in CG1 (mean ± SD; 2.1 ± 1.6) than in the remaining groups, which did not present significant differences between them. There was no significant difference between tooth discolorations with materials in the presence of blood. However, in the absence of blood, Biodentine exhibited less tooth discoloration than MTA (AU)

Comparison of Fracture Resistance of Endodontically Treated Teeth Restored with FiberSite Postsystem and Glass Fiber, Combined with Different Root Canal Sealers.

This study is aimed at evaluating the effects of FiberSite and glass fiber postsystems on the fracture resistance of endodontically restored teeth, when combined with various root canal sealers. Forty human mandibular premolar teeth, each having a single root with anatomically comparable dimension and length, were selected. The teeth in each experimental group (n = 10) were instrumented, obturated, and restored with the following procedures: in group 1, AH Plus root canal sealer and a glass fiber post with a composite core; in group 2, AH Plus root canal sealer and a FiberSite postsystem; in group 3, Sure-Seal Root canal sealer and a glass fiber post with a composite core; and in group 4, Sure-Seal Root canal sealer and a FiberSite postsystem. The specimens were placed on a universal test machine. The fracture resistance of all specimens was tested using generic test equipment, and the value of the force in newton (N) during fracture was measured for each root. A statistical analysis was conducted through the Kruskal-Wallis test as well as the post hoc test. The tests showed a significant difference between groups 2 and 3, with group 3 producing load values that were significantly higher than group 2. In contrast, no significant differences were found to exist between the other groups. Regardless of postsystems, groups 3 and 4 showed higher mean fracture values (but no statistically significant differences) than groups 1 and 2.

Intratubular penetration of endodontic sealers depends on the fluorophore used for CLSM assessment.

Root canal filling aims at eliminating empty spaces into the root canal system using biologically compatible materials. Three-dimensional root canal obturation must prevent or minimize the reinfection caused by microorganisms' leakage. This study aimed at evaluating whether fluorophore (Rhodamine or Fluo-3) influences the CLSM images of intratubular penetration of four endodontic sealers. Eighty bovine teeth were prepared using K files up to a size #70 and irrigated with 2.5% sodium hypochlorite. All roots were divided into eight groups (n = 10) according to the sealer and fluorophore used: AH Plus/Rhodamine, AH Plus/Fluo-3, Sealer Plus/Rhodamine, Sealer Plus/Fluo-3, Sealer Plus BC/Rhodamine, Sealer Plus BC/Fluo-3, Endosequence/Rhodamine, and Endosequence/Fluo-3. All roots were filled using cold lateral compaction technique. After 7 days, the roots were transversely sectioned, and three slices, one of each canal third, were obtained. Intratubular penetration was evaluated using CLSM. Sealer Plus BC/Rhodamine and Endosequence BC/Rhodamine presented higher intratubular penetration than AH Plus/Fluo-3 and Sealer Plus/Fluo-3 (p ˂ .05). The intragroup analysis showed similar intratubular penetration, regardless of the root third, except for the apical third in AH Plus/Fluo-3 and Sealer Plus BC/Fluo-3 groups. The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones using CLSM. Bioceramic sealers should not be used associated with Rhodamine for CLSM evaluation. RESEARCH HIGHLIGHTS: The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones when CLSM is used for assessment. Bioceramic sealers should not be used associated with Rhodamine.

Remoción de hidróxido de calcio del canal radicular con irrigación manual, sónica y ultrasónica / Calcium hydroxide removal from the root canal by manual, sonic and ultrasonic irrigation

Introducción: Resulta fundamental la remoción por completo del hidróxido de calcio previo a la obturación del canal radicular que podría impedir la penetración de los selladores en los túbulos dentinarios. Objetivo: Determinar la efectividad de la eliminación de la medicación con hidróxido de calcio del canal radicular de dientes utilizando diferentes sistemas de irrigación. Métodos: Se irrigaron con hipoclorito de sodio 148 conductos radiculares rectos de dientes humanos. Se utilizó Ca(OH)2 mezclado con tinta negra para rellenar los canales radiculares y facilitar la visualización. Los dientes se dividieron en 5 grupos de acuerdo al protocolo de eliminación. En cada uno de los grupos, la extrusión apical se midió durante la etapa de irrigación por el método Huang X, después de la eliminación del Ca(OH)2, se seccionaron longitudinalmente y luego, en un portaobjetos, se observaron las muestras bajo un microscopio óptico. Finalmente, se analizó el contenido para cuantificar el grado de extrusión causado durante el procedimiento clínico. Se utilizó el test de ANOVA para el análisis estadístico Resultados: Se encontró diferencias significativas entre los grupos 1-2, 1-3, 1-4 y 1-5. El promedio de remanecía fue superior (66,4 por ciento). Los grupos 2 (41,6 por ciento) y 5 (34,8 por ciento) obtuvieron mayor eficacia en la remoción. ANOVA (α = 0,05) determina que no existieron diferencias significativas entre los 5 grupos. Conclusiones: Los dispositivos de activación ultrasónica mostraron una mayor eliminación de la medicación con hidróxido de calcio desde las paredes dentinarias a las técnicas manuales, sin embargo, demostró ser una terapia más invasiva debido a una mayor extrusión de detritus(AU)

Introduction: Root canal sealing should indispensably be preceded by complete calcium hydroxide removal, otherwise the latter might prevent the penetration of the sealers into the dentinal tubules. Objective: Determine the effectiveness of eliminating calcium hydroxide medication from the root canal of teeth using various irrigation systems. Methods: Preparation was conducted of 148 straight root canals of human teeth irrigating with sodium hypochlorite. The root canals were filled with Ca(OH)2 mixed with black ink to facilitate visualization. The teeth were divided into 5 groups in compliance with the removal protocol. Apical extrusion was measured in each group during the irrigation stage using the Huang X method. After Ca(OH)2 removal they were sectioned longitudinally and placed on a slide for observation of the samples under an optical microscope. Finally the content was analyzed to quantify the degree of extrusion obtained during the clinical procedure. The ANOVA test was used for statistical analysis. Results: Significant differences were found between the groups 1-2, 1-3, 1-4 and 1-5. Average remanence was above 66.4 percent. Groups 2 (41.6 percent) and 5 (34.8 percent) displayed higher removal efficacy. ANOVA (α = 0.05) did not determine any significant differences between the 5 groups. Conclusions: Ultrasonic activation obtained greater calcium hydroxide removal from the dentinal walls than manual techniques. However, it proved to be a more invasive therapy due to the greater detritus extrusion(AU)

Disinfection and surface changes of gutta-percha cones after immersion in sodium hypochlorite solution containing surfactant.

In this study, we evaluated the effectiveness of 1 and 5.25% NaOCl solutions, with or without surfactant, in disinfecting gutta-percha cones. Surface changes of the gutta-percha cones after disinfection were also assessed under scanning electron microscopy (SEM). One-hundred and eight gutta-percha cones previously contaminated with Enterococcus faecalis were left in contact for 30 s or 1 min with the following solutions (n = 12): 1% NaOCl; 1% NaOCl + 2% cetrimide; 5.25% NaOCl; 5.25% NaOCl + 2% cetrimide. Positive control group was composed by the remaining contaminated cones (n = 12), and the negative control group by noncontaminated cones (n = 12). The cones were kept in Eppendorf tubes containing Trypticase Soy Broth at 37°C for 24 hr, and then, the presence of turbidity was analyzed. Ten additional cones (n = 2) were observed under SEM to evaluate surface changes after 1 min of disinfection. The data analysis (Kruskal-Wallis test, α = 5%) demonstrated that regardless the presence of surfactant, the NaOCl solutions used were effective in the disinfection when cones were immersed for 1 min. However, at the 30-s period, only the 5.25% NaOCl solution was effective. SEM analysis demonstrated that NaOCl solutions promoted the formation of sodium chloride crystals on cones surface, less visible when the 1% NaOCl associated to surfactant was used. The addition of surfactant did not affect the disinfection capacity of NaOCl solutions. However, the surfactant has apparently inhibited the sodium chloride crystals deposition on the cones surface when associated to 1% NaOCl solution.

Detección mediante técnica de GCMS de alto contenido de Bisfenol A en cementos de uso endodóntico / Bisfenol a; endodoncia; obturación bisphenol a determination by gcms in resin-based root canal sealers

El bisfenol A (BPA, por sus siglas en inglés) es un producto químico utilizado en la producción de policarbonatos y resinas epoxi, cuyo uso está muy extendido en la industria. El BPA puede pasar al organismo por medio de la dieta, ya que sus moléculas tienen migración probable de los recipientes fabricados con este producto a los alimentos contenidos en dichos recipientes. La presencia de BPA en los materiales de uso odontológico está muy extendida. Una gran cantidad de productos están elaborados con resinas epoxi (procedentes de la reacción entre la epiclorohidrina y el bisfenol A). El presente estudio se analizaron cuatro cementos de uso endodóntico basados en resina (Ah 26(R), Ah Plus(R), TopSeal(R) y Simpliseal(R)) a través de un procedimiento de extracción líquido-sólido y análisis en cromatógrafo de gases acoplado a espectrometría de masas. Los resultados obtenidos muestran valores alarmantemente superiores a los 5x10-6% en peso que permite la Unión Europea para la migración de BPA desde el envase al alimento, obteniéndose unos valores de 7% (Simpliseal(R)); 22% (AH 26(R)); 46% (TopSeal(R)) y 74% (AH Plus(R)). El presente estudio es pionero en el estudio de la concentración de BPA en materiales endodónticos

Bisphenol A (BPA) is a compound used in the production of polycarbonates and epoxy resins and is widely used in the industry. BPA can be passed into the body through the diet, since its molecules can easily migrate from the containers made with BPA to the food in those containers. The presence of BPA in dental materials is very common. A large number of products are made with epoxy resins (from the reaction between epichlorohydrin and bisphenol A). This study analyzed four resin-based endodontic cements (Ah 26(R), Ah Plus(R), TopSeal(R) and Simpliseal(R)) using a liquid-solid extraction procedure and gas chromatograph analysis coupled to mass spectrometry. The results obtained show alarmingly higher values than the 5x10-6% by weight that the European Union allows for the migration of BPA from packaging to food, obtaining values of 7% (Simpliseal(R)), 22% (AH 26(R)), 46% (TopSeal(R)) and 74% (AH Plus(R)). This study is a pioneer in the investigation of the concentration of BPA in endodontic materials

Penetrability of a new endodontic sealer: A confocal laser scanning microscopy evaluation.

This study aimed to evaluate the penetration of a new endodontic sealer into the dentinal tubules. Twenty single-rooted teeth were selected. The crown was sectioned, and the canals were instrumented with a reciprocating system. Irrigation was performed with 2 mL of 2.5% sodium hypochlorite between each file change. After instrumentation, the root canals were irrigated with 2 mL of17% EDTA for 3 min followed by saline solution. The specimens were randomized into two groups (n =10) according to the endodontic sealer: AH Plus (AP) or Sealer Plus (SP). All specimens were filled using the lateral compaction technique. Rhodamine B dye (red) was incorporated to the sealers to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. The roots were sectioned 2, 4, and 6 mm from the apex and assessed by CLSM. The root canal level affected the penetration of the sealer, but no statistical significant differences were found between the two experimental groups (p > .05). SP presented similar dentinal penetration and perimeter integrity to the gold standard (AP). RESEARCH HIGHLIGHTS: Sealer Plus presents dentinal penetrability and perimeter integrity similar to the gold standard sealer (AH Plus), demonstrating excellent ability of filling areas of difficult access.

Revisión de las diferentes metodologías in vitro para el estudio de adaptación de los materiales de obturación en endodoncia / Review of the different in vitro methodologies for the study of adaptation of endodontic obturation materials

El éxito del tratamiento de endodoncia reside en una correcta limpieza y sellado tridimensional del sistema de conductos radiculares. En referencia al sellado, se han realizado numerosas investigaciones con el fin de encontrar el material ideal que evite la filtración tanto coronal como apical. Estos estudios in vitro se han llevado a cabo con una amplia gama de sistemas de medición, entre los que destacan los realizados con bacterias, glucosa, diferentes tintes o fluidos y técnicas microscópicas, ya sean ópticas o electrónicas de barrido (SEM). El objetivo de esta revisión bibliográfica es profundizar en las distintas técnicas de estudio que existen para la evaluación del sellado endodóntico y la filtración in vitro para tratar de establecer cuál es la más completa y capaz de aportar los resultados más reales y factibles, que pudieran extrapolarse a la práctica clínica

Success of endodontic treatment relies on the correct cleaning as well as on the three dimensional sealing of the root canal system. Regarding the sealing, many studies have been realized in order to find the ideal material that avoids coronal and apical filtration. This in vitro investigations have been carried out with a wide range of meassurement systems, among the ones are highlightables those dones with bacteria, glucose, different fluid dyes and micrhoscopic techniques, either optical or electronic scanning. The aim of this bibliographic review is to deep dive into the different techniques available for evaluating both in vitro sealing and filtration for try to stablish which is the most complete and accurate when providing results that night be extrapolated to clinical practice

Evaluation of 17% EDTA and 10% citric acid in smear layer removal and tubular dentin sealer penetration.

The purpose of this study was to compare the efficacy of different chelating solutions (17% EDTA and 10% citric acid) on the smear layer removal, and their effect on tubular dentin sealer penetration. Sixty root canals were prepared and distributed into four groups (n = 15) according to the final irrigation protocol: G1, final irrigation with 2.5 mL of distilled water; G2, final irrigation with 2.5 mL of 2.5% sodium hypochlorite solution; G3, final irrigation with 2.5 mL of 17% EDTA; and G4, final irrigation with 2.5 mL of 10% citric acid. Five specimens from each group were not filled to assess smear layer removal by scanning electron microscopy. Ten specimens from each group were filled for analysis of sealer penetration into dentinal tubules by confocal laser scanning microscopy. Smear layer removal (Kruskal-Wallis and Dunn's tests) and sealer penetration (F and Tukey's tests) were statistically analyzed with 95% of significance level. G3 and G4 had greater smear layer removal rates in the cervical and middle thirds, in comparison with G1 and G2 (p < .05). G3 and G4 had the highest percentages of sealer penetration in all thirds, in comparison with G1 and G2 (p < .05). Smear layer removal was effective only at the cervical and middle thirds when the chelating solutions were used. Sealer penetration into the dentinal tubules significantly increased in all root thirds when the specimens were treated with both chelating solutions.

Ensayo aleatorizado in vitro sobre la capacidad de obturación de sistemas con vástago en conductos curvos / In vitro randomized-trial on the sealing ability of carrier-based systems in curved root canals

Objetivo: Comparar el porcentaje de área de gutapercha, cemento y huecos en conductos curvos obturados con sistemas con vástago y evaluar la influencia de la activación del cemento durante su colocación. Metodología: 120 conductos curvos de molares mandibulares fueron preparados a un diámetro apical ProFile 30, 0.04. Se obturaron con los sistemas GuttaCore, GuttaFusion o condensación lateral y AHplus (n = 40). Se subdividieron los grupos (n = 20) y se colocó el cemento con activación sónica o no. El cemento se mezcló con Rodamina B para permitir el análisis mediante microscopía confocal. Se calculó el área de gutapercha, cemento y huecos a 3, 6 y 9 mm del ápice. Se realizó el análisis estadístico utilizando ANOVA de dos vías. Para la comparación por pares se realizó el test de Sidak. Resultados: Cuando se comparan los sistemas de gutapercha a 3 mm, GF mostró un mejor comportamiento. CL obtuvo los peores resultados. No se encontró influencia entre los sistemas de obturación y la activación del cemento. Cuando se comparó el porcentaje de huecos entre todos los grupos, los perores resultados fueron para CL a 6 y 9 mm. Conclusiones: Bajo las condiciones de este estudio, el área de gutepercha, cemento y huecos depende del sistema de obturación utilizado. El uso de activación del cemento no influye en la calidad de la obturación

Aim: To compare the percentage of gutta-percha, sealer and voids in curved root canals filled with different gutta-percha carrier-based systems and to assess the influence of activation of the cement during its placement. Methodology: 120 curved canals of mandibular molars were prepared to an apical size ProFile 30, 0.04. They were filled with either GuttaCore, GuttaFusion or lateral condensation and AHplus (n=40). Groups were subdivided (n=20) and sonic activation or not during the placement of the cement was carried out. Cements were labelled with Rhodamine-B dye to allow analysis under confocal microscopy. Percentage of gutta-percha, sealer and voids area were calculated at 3, 6 and 9 mm from the apex. Statistical analysis was performed using two-way ANOVA test. To compare between the obturation systems Sidak correction for multiple comparisons was applied. Results: When comparing the gutta-percha systems at the 3 mm level, GF revealed a better performance. At 6 and 9mm, LC obtained the worst results. An influence between the obturation systems and the activation of the cement was not found. When comparing the percentage of voids among all the groups, worst results were found for LC at 6 and 9 mm. Conclusions: Under the conditions of this study, gutta-percha, sealer area and voids were dependent on the obturation system. The use of activation of the cement do not influence the quality of root filling

Análisis morfométrico de conos de gutapercha Mtwo / Morphometric analysis of Mtwo gutta-percha cones

Objetivo: Evaluar cuantitativamente el calibre y la conicidad de los conos de gutapercha Mtwo (VDW, Munich, Alemania). Materiales y métodos: se seleccionaron al azar 50 conos de gutapercha marca Mtwo (VDW, Munich, Alemania) entre 300, provenientes de 5 cajas de conos surtidos #25 .06, #30 .05, #35 .04, #40 .04 y #25 .07. Fueron descartados aquellos que visualmente tenían algún defecto. Los elegidos se separaron en grupos de 10, según el número. Se midió cada cono en el vértice y a 1 mm, 2 mm, 3 mm, 4 mm y 5 mm, con un especímetro centesimal modelo 7301 (Mitutoyo, Japón). Se realizaron 300 determinaciones, que fueron efectuadas por dos operadores. Cuando hubo diferencias, se repitieron las mediciones hasta hallar coincidencia. Los datos fueron registrados en una planilla de Excel (Microsoft Corporation, Estados Unidos) diseñada al efecto. El análisis estadístico se llevó a cabo con prueba de hipótesis de dos colas, contrastando la media con el valor teórico. Resultados: se hallaron diferencias estadísticamente significativas para los conos #25 .06, en la determinación a 2 mm. En cuanto al resto de las mediciones, no hubo diferencias significativas. Conclusión: de acuerdo a los resultados obtenidos sobre la muestra analizada, en general los conos de gutapercha Mtwo respetan las espcificaciones ISO de fabricación.

Estudio analítico de MTA-Angelus(R) y Biodentine(R) con técnicas SPME-GCMS y AFM / Analytical studies of MTA Angelus and Biodentine materials by SPME-GCMS and AFM techniques

Introducción: El objetivo del estudio fue obtener información analítica sobre la pureza química y homogeneidad de los materiales de uso endodóntico MTA-Angelus® y Biodentine®. Material y métodos: Se analizaron ambos materiales mediante la técnica de microextracción en fase sólida (SPME), combinada con cromatografía de gases acoplada a espectrómetro de masas (GC-MS) para separar e identificar los compuestos orgánicos volátiles (COVs) contenidos. Por otro lado, utilizando microscopía de fuerza atómica (AFM) se estudió la topografía y rugosidad de las superficies de dientes tras la realización de obturaciones a retro in vitro con ambos cementos. Resultados: Se identificaron diversos COVs en ambos materiales mediante SPME GCMS. Entre los compuestos detectados, destacaron el alfa - metilestireno (presente en MTA-Angelus(R)) y el diclorometano (detectado tanto en MTA-Angelus(R) como en Biodentine(R)) que son potencialmente tóxicos y perjudiciales para la salud. Los resultados del estudio con AFM demostraron la existencia de diferencias en la superficie de los cementos. Las imágenes y rugosidad finales fueron más homogéneas en Biodentine®. Conclusiones: Los cementos endodónticos MTA-Angelus® y Biodentine® contienen ciertos compuestos perjudiciales para la salud. Se evidencia la necesidad de un control más exigente de los riesgos para la salud de estos. El estudio AFM mostró que Biodentine® presenta un superficie más homogénea (AU)

Introduction: The aim of this research was to obtain analytical information about the chemical purity and the homogeneity of the endodontic materials MTA Angelus(TM) and Biodentine(TM). Methods: On the one hand, solid phased microextraction-gas chromatography-mass spectrometry (SPME-GCMS) was carried out with MTAAngelus and Biodentine materials, isolating and identifying the contained volatile organic compounds (VOCs). On the other hand, atomic force microscopy (AFM) was used to study topography and roughness aspects on teeth after in vitro root end fillings with both materials. Results: First, several VOCs have been detected by SPME-GCMS in both materials. It is noteworthy alpha methylstirene (identified in MTA Angelus(TM)) or dichloromethane (detected both in MTA Angelus(TM) and Biodentine(TM)) due to its potential toxicity and harmful health effects. Secondly, AFM study showed differences among the surface materials. Final images and roughness results showed more homogeneous cement in the Biodentine product. Conclusions: Endodontic cements MTAAngelus and Biodentine contains some harmful health compounds. The need of a stricter health risks control of both materials became evident. AFM study demonstrated a more homogenous surface in Biodentine (AU)

Utilização do Agregado de Trióxido Mineral (MTA) em perfurações / Appication of Mineral Trioxide Aggregate (MTA) in perfurations

O Agregado Trióxido Mineral (MTA) é considerado um material de eleição em alguns tratamentos endodônticos por apresentar boa capacidade de vedamento, biocompatibilidade, sem efeitos adversos sobre os tecidos dentais, atividade bactericida, boa radiopacidade, capacidade de selamento na presença de sangue e capacidade de induzir a osteogênese e cementogênese. Devido a essas propriedades é considerado o material ideal para reparação de perfuração, apicificação, retrobturação e regeneração tecidual

The Mineral Trioxide Aggregate (MTA) is considered a material of choice in some endodontic treatments because it has good sealing ability, biocompatibility, no adverse effects on dental tissues, bactericidal activity, good radiopacity, sealing ability in t he presence of blood and ability to Induce osteogenesis and cementogenesis. Due to these properties it is considered the ideal material for repair of perforation, apicification, retrobturation and tissue regeneration

Efectividad de distintas técnicas de activación en la remoción de medicación de hidróxido de calcio de las paredes radiculares / Effectiveness of different activation techniques in the removal of calcium hydroxide medication from root canal walls

Objetivos: Investigar distintos protocolos de irrigación y soluciones para la remoción de hidróxido de calcio de las paredes radiculares mediante Microscopía Electrónica de Barrido (MEB). Metodología: Se seleccionó una muestra de 48 raíces palatinas de molares superiores. Los conductos fueron instrumentados, irrigados, secados y obturados con medicación a base de hidróxido de calcio. Los dientes fueron aleatoriamente asignados en 6 grupos, dependiendo de la técnica utilizada para activar hipoclorito sódico y Smear Clear para la remoción de la medicación intraconducto: Grupo 1, Irrigación positiva con jeringa (P), Grupo 2, Irrigación Ultrasónica (UI), Grupo 3, Irrigación por presión apical negativa (ANP), Grupo 4: Irrigación ultrasónica pasiva e irrigación por presión apical negativa (UI + ANP). Se incluyeron dos grupos control: Grupo 5: Grupo control positivo (C+), que fue obturado con hidróxido de calcio, pero no se eliminó del conducto, y Grupo 6: Grupo control negativo (C-), que no fue obturado con hidróxido de calcio. Todos los conductos fueron observados con microscopio electrónica de barrido (MEB). Se evaluó la presencia de material residual usando un sistema de medición en los tercios apical, medio y coronal. Los resultados fueron analizados estadísticamente mediante los test de Kruskal-Wallis y Bonferroni (p < 0,05). Resultados: Se encontraron diferencias estadísticamente significativas entre todos los grupos en todos los tercios a estudio (p < 0,05). El uso combinado de UI y ANP resultó en una remoción más eficiente de hidróxido de calcio de las paredes radiculares, independientemente del área analizada. Conclusiones: La utilización de irrigación ultrasónica pasiva e irrigación por presión apical negativa como activación final, sugiere una mejor limpieza de los conductos. Ninguna técnica es capaz de remover completamente el hidróxido de calcio de las paredes radiculares

Aim: To investigate different irrigation protocols and solutions to remove Ca(OH)2 from the root canal walls by using Scanning Electron Microscopy (SEM). Methodology. Forty-eight palatal roots from upper molars were selected. The root canals were instrumented, irrigated, dried and filled with a calcium hydroxide medication. Teeth were then randomly assigned to one of 6 groups depending on which technique was used to activate NaOCl and Smear Clear irrigants to remove medication: Group 1, Positive syringe irrigation (P); Group 2, Ultrasonic Irrigation (UI); Group 3, Apical Negative Pressure irrigation (ANP); Group 4, Passive Ultrasonic Irrigation and Apical Negative Pressure irrigation (UI + ANP). 2 control groups were also included: Group 5, positive control (C+), which were filled with calcium hydroxide that was not removed from the canal and Group 6, negative controls (C-), which were not filled with calcium hydroxide. All root canals were observed through SEM. Presence of residual material was evaluated using a score system for the coronal, middle, and apical portions. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests (P < 0.05). Results. There was a statistically significant difference among all groups at all root levels (P < 0.05). The combined use of UI and ANP irrigation resulted more efficient in the removal of calcium hydroxide from the root canal walls, irrespective of the area analyzed. Conclusions. The use of passive ultrasonic irrigation and apical negative pressure as a final activation is suggested to improve cleaning of the root canals. No technique is able to completely remove calcium hydroxide dressing from the root canal walls

Estudio comparativo del área de corte de los sistemas de instrumentación F360, i-Race, Protaper Next y Reciproc al microscopio estereoscópico con AutoCAD / Comparative study of cutting area of F360, i-Race, Protaper Next and Reciproc instrumentation systems to stereoscopic microscope with AutoCAD

Objetivos: Comparar área de corte, mantenimiento de anatomía y zonas no instrumentadas de F360, i-Race, P.Next y Reciproc con calibre #25. Material y métodos: 120 dientes unirradiculares rectos con un conducto (n=30). La LT fue calculada con lima H #10 dejándola al límite del foramen apical y restando 0,5mm. Dientes seccionados con pieza de mano y disco diamantado. Los cortes se observaron al microscopio estereoscópico. Los dientes se reconstruyeron con lima H #10 y superglue. Área de corte y mantenimiento de anatomía se estudiaron con AutoCAD, y zonas no instrumentadas con microscopio y AutoCAD. Análisis estadístico se realizó con Test de Levene, ANOVA, de Welch, de Tukey, de Bonferroni, de Games-Howell y Chi-Cuadrado de Pearson. Resultados: Varianzas iguales (Test de Levene, p>0,05) en tercios pudiendo utilizar ANOVA y observando diferencias significativas (p<0,05). Diferencias significativas entre F360 y P.Next y Reciproc en coronal, entre Reciproc y F360 en medio, y entre P.Next e i-Race y Reciproc en apical (tests de Tukey y de Bonferroni, p<0,05). Globalmente no se asumieron varianzas iguales y se utilizó el Test de Welch (p<0,05). Diferencias significativas entre F360 y Reciproc (Games-Howell, p<0,05). En el mantenimiento de la anatomía, se encontraron diferencias significativas (Chi-Cuadrado, p<0,05). En relación a las zonas no instrumentadas, no existieron diferencias significativas (Chi-Cuadrado, p<0,05). Conclusiones: Reciproc fue superior en el área de corte. P.Next y Reciproc fueron más eficaces en el mantenimiento de la anatomía. Respecto a las zonas no instrumentadas, no existieron diferencias significativas

Aim: Compare the cutting area, maintenance of anatomy and non-instrumented areas of F360, i-Race, P.Next and Reciproc with size #25. Methods: 120 straight single-rooted teeth with a canal (n=30). The LT was calculated with H-file #10 leaving the limit of the apical foramen and subtracting 0.5mm. Teeth were sectioned with piece of hand and diamond disc. The sections were observed at stereoscopic microscope. The teeth were reconstructed with H-file #10 and superglue. Cutting area and maintenance of anatomy were studied with AutoCAD 2013, and non-instrumented areas with microscope and AutoCAD. Statistical analysis was performed with Levene´s Test, ANOVA, Welch, Tukey, Bonferroni and Games-Howell and Pearson´s Chi-square. Results: Equal variances (Levene test, p>0.05) in thirds and can used ANOVA and significant differences were observed (p<0.05). Significant differences between F360 and P.Next and Reciproc in coronal, in middle between Reciproc and F360, and in apical between P.Next and i-Race and Reciproc (tests of Bonferroni and Tukey, p<0.05). Globally, equal variances were not assumed using the Welch Test (p<0.05). Significant differences between F360 and Reciproc (Games-Howell, p<0.05). In maintenance of anatomy, significant differences were found (Chi-Cuadrado, p<0.05). Conclusions: Reciproc was higher in the cutting area. P.Next and Reciproc were more effective in maintenance of anatomy. For non-instrumented areas, there were not significant differences

The effect of blood contamination on dislocation resistance of different endodontic reparative materials.

This study evaluated the retention characteristics of ProRoot mineral trioxide aggregate (MTA), RetroMTA, Supra MTA, and Biodentine biomaterials used to repair furcation perforations contaminated with blood. Furcal perforations measuring 1.3 mm in diameter and 2 mm in height were created in 96 mandibular first molar teeth, which were then randomly divided into the following two groups (n = 48): contaminated (+) or non-contaminated (-) with blood. The groups were subdivided into four groups (n = 12) according to the material used (ProRoot MTA, RetroMTA, Supra MTA, and Biodentine) to seal the perforations. The samples were allowed to set for 14 days and were then subjected to push-out testing. The results were analyzed using ANOVA, and the failure modes were examined using a surgical microscope. ProRoot MTA (+/-) and RetroMTA (+/-) exhibited superior bond strength values; in addition, there were no significant differences among these groups (P > 0.05). Biodentine (+) showed intermediate values that were sometimes statistically similar to the ProRoot MTA (+/-) and RetroMTA (+/-) groups (P > 0.05) and, at other times, the Biodentine (-) and Supra MTA (+/-) groups (P > 0.05). The lowest bond strength values were shown by the Biodentine (-) and Supra MTA groups (P > 0.05). "Adhesive failure mode" was the most frequently observed type for all tested materials. Blood contamination did not affect the dislocation resistance of materials.

Pulpotomy Medicaments used in Deciduous Dentition: An Update.

The aim of this paper was to review the history and the scientific literature published on pulpotomy medicaments and to present the findings of these studies. The review showed that pulpotomy of primary teeth has been treated with many different techniques and medicaments, that some of these approaches are controversial and that their results have presented variables of success rates in term of clinical, radiographic and histologic observation. It is important that all clinicians, particularly for pediatric dentists, be up to date with the recent trends in this area of dental treatment for children.

Revascularización con pasta tri-antibiótica. Revisión bibliográfica / Revascularization with tri-antibiotic paste. Literature review

Se presenta una revisión bibliográfica sobra la revascularización con pasta tri-antibiótica. Se analizan los diferentes protocolos y los resultados obtenidos en la literatura, comparándolos y eligiendo los materiales y protocolos más actuales. Definimos un protocolo de actuación frente al tratamiento de dientes inmaduros no vitales. Se comparan la apexificación con la revascularización, definiendo las ventajas y las desventajas de ambos tratamientos (AU)

We are presenting a bibliografic review about tri-antibiotic revascularization. We have analized different protocols and results in the literature, comparing them and chosing the best and the newest tecniques, and finally we defined an ultimate treatment of necrotic immature teeth. We compared apexification and revascularization, stating their advantages and disadvantages of both treatments (AU)

Cimento experimental bioativo à base de glicerol salicilato contendo α -fosfato tricálcico para uso endodôntico / Bioactive cement experimental glycerol based salicylate containing α tricalcium phosphate for endodontic use

O tratamento de canal ideal compreende a desinfecção e selamento do sistema de canais radiculares, de forma a impedir a reinfecção e permitir o reparo dos tecidos periapicais. Para isso é necessário o emprego de materiais que promovam um perfeito selamento, o que até o presente momento não foi completamente alcançado. O objetivo do presente estudo in vitro foi desenvolver um cimento endodôntico à base de resina de glicerol salicilato e α-fosfato tricálcico (αTCP), que apresente potencial de estimular a deposição mineral. Os cimentos foram formulados a partir de 70% em massa de uma resina de glicerol salicilato, obtida a partir da reação de transesterificação do salicilato de metila com o glicerol, e 30% em massa de carga inorgânica, composta de hidróxido de cálcio e αTCP, em diferentes proporções: 30% Ca(OH)2, 25% Ca(OH)2 + 5% αTCP, 20% Ca(OH)2 + 10% αTCP, 15% Ca(OH)2 + 15% αTCP. A resina sintetizada foi caracterizada por cromatografia de exclusão por tamanho, ressonância magnética de prótons e espectroscopia Raman. Os cimentos foram caracterizados quanto ao tempo de presa, degradação in vitro, potencial de alcalinização do meio, citotoxicidade e capacidade de estimular a deposição mineral. A resina de glicerol salicilato foi obtida por meio da reação de transesterificação, com 72% de rendimento. Os grupos avaliados apresentaram um tempo de presa de 240 min a 405 min e capacidade de alcalinizar o meio...

Dental root canal treatment comprises the disinfection and complete filling of root canals in order to prevent the reinfection and allows the healing of periapical tissues. The use of materials that promotes an effective sealing has no achieved at the moment. The aim of this in vitro study was to develop a root canal sealer based on a glycerol salicylate resin and α-tricalcium phosphate (αTCP) that presents potential to stimulate mineral deposition. Sealers were formulated based on 70wt% of a glycerol salicylate resin, obtained by transesterification of methyl salicylate and glycerol, and 30wt% of inorganic filler, composed by calcium hydroxide and αTCP, in different proportions: 30% Ca(OH)2, 25% Ca(OH)2 + 5% αTCP, 20% Ca(OH)2 + 10% αTCP, 15% Ca(OH)2 + 15% αTCP. Synthesized resin was characterized by proton nuclear magnetic resonance spectroscopy, size exclusion chromatography and Raman spectroscopy. Sealers were characterized based on setting time, in vitro degradation over time, pH, cytotoxicity and mineral deposition. The glycerol salicylate resin was obtained by transesterification reaction, with 72% yield. Sealers presented setting time ranging from 240 min to 405 min, and basic pH over 8.21 after 28 days. Higher αTCP concentration leads to sealers with low solubility. Cell viability after 48 h in direct contact with sealers was similar to a commercial sealer (AH Plus) used as reference...