Antônio Miranda da Cruz Filho

Evaluation of physico-chemical properties of Portland cements and MTA

The purpose of this study was to evaluate the hydrogenionic potential and electrical conductivity of Portland cements and MTA, as well as the amount of arsenic and calcium released from these materials. In Teflon molds, samples of each material were agitated and added to plastic flasks containing distilled water for 3, 24, 72 and 168 h. The results were analyzed with a Kruskal-Wallis non-parametric test for global comparisons and a Dunn-Tukey test for pairwise comparisons. The results revealed no significant differences in the pH of the materials (p > 0.05). The electrical conductivity of the cements were not statistically different (p > 0.05). White non-structural cement and MTA BIO released the largest amount of calcium ions into solution (p < 0.05), while arsenic release was insignificant in all of the materials (p > 0.05). The results indicated that the physico-chemical properties of Portland cements and MTA were similar. Furthermore, all materials produced an alkaline environment and can be considered safe for clinical use because arsenic was not released. The electrical conductivity and the amount of calcium ions released into solution increased over time.

Radiopacity evaluation of Portland and MTA-based cements by digital radiographic system

Objective The aim of the present study was to evaluate the radiopacity of Portland and MTA-based cements using the Digora TM digital radiographic system. Material and Methods The performed tests followed specification number 57 from the American National Standard Institute/American Dental Association (2000) for endodontic sealing materials. The materials were placed in 5 acrylic plates, especially designed for this experiment, along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The set was radiographed at a 30 cm focus-object distance and with 0.2 s exposure time. After the radiographs were taken, the optical laser readings of radiographs were performed by Digora TM system. Five radiographic density readings were performed for each studied material and for each step of the aluminum scale. Results White ProRoot MTA (155.99±8.04), gray ProRoot MTA (155.96±16.30) and MTA BIO (143.13±16.94) presented higher radiopacity values (p<0.05), while white non-structural Portland (119.76±22.34), gray Portland (109.71±4.90) and white structural Portland (99.59±12.88) presented lower radiopacity values (p<0.05). Conclusions It was concluded that MTA-based cements were the only materials presenting radiopacity within the ANSI/ADA specifications.

Conventional Treatment of Maxillary Incisor Type III Dens Invaginatus with Periapical Lesion: A Case Report

Dens invaginatus is a developmental dental anomaly clinically characterized by a palatine furrow that can be limited to the coronal pulp or may extend to the radicular apex. The purpose of this paper was to present a clinical case of type III dens invaginatus, identified on the maxillary right central incisor in anterior periapical radiographs, in which the tooth was submitted to conventional endodontic treatment. The results obtained after five years of clinical and radiographic followup demonstrated that conventional endodontic treatment is a clinically viable alternative in cases of type III dens invaginatus.

Temperature variation on the external root surface during intracanal Er:YAG laser irradiation.

OBJECTIVE To evaluate the temperature changes on the roots external surface during Er:YAG laser irradiation with different tips and pulse repetition rates. BACKGROUND DATA There have been limited reports that correlate temperature variations with Er:YAG laser irradiation using different tips and pulse repetition rates. MATERIALS AND METHODS Sixty roots of central incisors were sectioned 10 mm from the apex, biomechanically prepared, embedded in acrylic resin, and randomly distributed into six groups: the teeth in group I, group II, and group III were irradiated with an Opus 20 laser with a sapphire tip at 8, 10, and 15 Hz, respectively; the teeth in group IV, group V, and group VI were irradiated with the fiberoptic tip of a Kavo Key laser at 6, 10, and 15 Hz, respectively. Laser irradiation was applied for 20 sec to all teeth and temperature changes were recorded with thermocouples in the root surfaces. RESULTS There were significant differences (p < 0.05) among pulse repetition rates: 6 and 8 Hz (2.36 degrees +/- 0.91 degrees C), 10 Hz (4.92 degrees +/- 1.60 degrees C), and 15 Hz (8.23 degrees +/- 2.78 degrees C); and radicular thirds: apical (8.33 degrees +/- 2.69 degrees C), middle (4.70 degrees +/- 1.60 degrees C), and cervical (2.48 degrees +/- 0.83 degrees C). No significant differences were seen between the two types of laser tips used (p > 0.05). CONCLUSION The temperature changes on root external surfaces remained above the critical threshold (13 degrees C) during Er:YAG laser irradiation, except for irradiation with 15 Hz in the apical third. However, the type of Er:YAG laser tip used (sapphire or fiberoptic) did not affect the temperature variation.

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 Dunns tests) and sealer penetration (F and Tukeys 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.

Volume of sealer in the apical region of teeth filled by different techniques: a micro-CT analysis

The volume of sealer in the apical 1 mm of teeth filled using different techniques was evaluated by micro-commuted tomography (micro-CT). Sixty-four maxillary central incisors were prepared using NiTi rotary instruments. Teeth were randomly distributed into four groups according to root canal sealers (AH Plus, Endofill, Sealapex, and Sealer 26) and subdivided into two subgroups according to the filling techniques (active and passive lateral condensation; n = 8 each). Subsequently, teeth were examined using the 1174 SkyScan micro-CT device. Images were reconstructed using the NRecon software, and the sealer volume (mm3) in the apical region was analyzed using the two-way ANOVA and post-hoc Student-Newman-Keuls test (α = 0.05). The lowest volume of sealer was observed in teeth filled with Sealapex (0.100 ± 0.009) and Endofill (0.103 ± 0.010). The highest volume was observed in teeth filled with AH Plus (0.112 ± 0.008) and Sealer 26 (0.109 ± 0.018) (p > 0.05). Regarding the filling technique, a lower sealer volume was observed using the active lateral condensation technique compared with that using the passive lateral condensation technique (0.100 ± 0.010 vs. 0.111 ± 0.012) (p < 0.05). Therefore, the lowest volume of sealer was observed in teeth filled with Sealapex and Endofill using the active lateral condensation technique.

Endodontic treatment of dental formation anomalies

Purpose: Dental fusion is defined as the union of two dental germs at some stage of their development. The aim of this article is to report the endodontic treatment of two clinical cases of dental fusion. Case description: In the first case, the patient was referred by an orthodontist for endodontic treatment of tooth 12, which was fused to 13. Surgical separation and later replacement of the involved elements in the dental arch was indicated. In the second case, the patient sought dental attendance due to spontaneous pain. In the radiographic exam, gemination in tooth 11 and fusion of 21 with a supernumerary tooth was observed. The fused teeth were endodontically treated, and patients were referred to other dental specialties to reestablish esthetics and function. Conclusion: The dentist must be able to diagnose, differentiate and treat these dental anomalies adequately, with the goal of maintaining patients’ oral health.