Carlos Menezes Aguiar

Evaluation of the integrity of dental sealants by optical coherence tomography

OBJECTIVES The purpose of the present research was to demonstrate images of failures into the structure of pit and fissure sealants using optical coherence tomography (OCT). METHODS Five human third molars were selected and the sealant ALPHA SEAL LIGHT/DFL was applied according to the manufacturer instructions. For evaluation of the structure of pit and fissure sealants, twenty OCT images of each tooth were performed before and after application of sealant. A total of 200 images were evaluated. A home built spectral OCT system used was operating in spectral domain (SD-OCT), at 840 nm and a measured spatial resolution of 10 μm. The system is based on the Michelson interferometer set-up and is controlled by the software OCT 800--Complex Square/LabView, that collects data and generates the image. The occlusal surfaces were scanned in a bucco-lingual direction and tomographic images parallel to long axis of tooth were obtained. After the achievement of the images by OCT, the crown of each tooth was sectioned in a occlusogingival direction (buccolingually). Images from each section were obtained and evaluated by an optical microscope. OCT and microscopic images were compared. RESULTS Representative images showed that OCT image provides the insight into sealant material. It was possible to clearly identify the internal structure of sealant and the subjacent enamel. Sealant and enamel are very well distinguished, and failures at the interior and at surface are well detected. SIGNIFICANCE OCT could generate images of the features of fissures, bubbles and failures in the adaptation of sealants, opening up possibilities in the future to monitoring sealant application and retention in short and long term.

Photodynamic therapy in combating the causative microorganisms from endodontic infections.

Photodynamic therapy (PDT) is presented as a promising antimicrobial therapy that can eliminate microorganisms present in endodontic infections. This treatment is based on the use of a nontoxic photosensitizing agent followed by irradiation of a resonant light source being capable of generating highly reactive species that are harmful to microorganisms. The purpose of this paper is to review the dental literature about the main factors that encompass the use of PDT combined with endodontic treatment for decontamination of the root canal system. A literature search was performed using the following index databases: PubMed, ISI Web of Knowledge and MedLine, between 2000 and 2014, looking for studies regarding antimicrobial action of PDT and its application to endodontic therapy. It was observed that despite numerous promising results, it is still necessary to establish different parameters so that PDT can be used with maximum effectiveness in eliminating microorganisms that cause endodontic infections.

Evaluation of the centreing ability of the ProTaper Universal™ rotary system in curved roots in comparison to Nitiflex™ files

The aim of the present study was to assess the centreing ability of the ProTaper Universal rotary system in curved roots in comparison to Nitiflex files, by means of preoperative and postoperative imaging of a cross-section of the apical third. Twenty mesiobuccal canals of human first mandibular molars with a degree of curvature ranging from 35 degrees to 60 degrees were divided into two groups of 10 specimens each: group 1, ProTaper Universal rotary system; group 2 (control), Nitiflex files. All instruments produced morphological alterations. The Students t-test and Kruskal-Wallis test showed that the differences were not statistically significant, except for the specimens instrumented by Nitiflex file #30. The ProTaper Universal showed the capacity for producing centered preparations in curved and thin root canals with low proportions of apical deviation.

In vitro antimicrobial activity of 0.5%, 1%, and 2.5% sodium hypochlorite in root canals instrumented with the ProTaper Universal system.

OBJECTIVE The purpose of this in vitro study was to evaluate the antimicrobial activity of 0.5%, 1% and 2.5% sodium hypochlorite in root canals instrumented with the ProTaper Universal system. STUDY DESIGN Fifty human mandibular premolar teeth with single root canals were infected with a mixture of C. albicans, P. aeruginosa, E. faecalis, and S. aureus. The specimens were randomly divided into 5 groups with 10 root canals each according to the irrigant used: group 1: 0.5% NaOCl; group 2: 1% NaOCl; group 3: 2.5% NaOCl; group 4 (positive control): 0.85% sterile saline solution; group 5 (negative control, without microorganisms): 0.85% sterile saline solution. All root canals were instrumented with the ProTaper Universal system. The assessment of the antimicrobial action of the irrigant was performed before the biomechanical preparation (0), and after instrumentation with S1 (1), S2 (2), F1 (3), F2 (4), and F3 (5) files. RESULTS All positive control samples showed microbial growth, whereas negative control samples showed no microbial growth before the biomechanical preparation and after the instrumentation with S1, S2, F1, F2, and F3 files. The microorganisms were eliminated after the instrumentation with S1 file in all tested irrigants, except for 1 sample in S1 at 0.5% NaOCl which showed positive growth. There was no significant statistical difference (P = 1.000) among the tested irrigants. CONCLUSION Sodium hypochlorite, at all tested concentrations, was effective in eliminating C. albicans, P. aeruginosa, E. faecalis, and S. aureus in combination with the NiTi rotary instrumentation with the ProTaper Universal system.

Comparison of Smear Layer Removal Using the Nd:YAG Laser, Ultrasound, ProTaper Universal System, and CanalBrush Methods: An In Vitro Study

INTRODUCTION The aim of this study was to compare the efficacy of the Nd:YAG laser, ultrasound, the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland), and the CanalBrush (Coltene Whaledent, Langenau, Germany) methods for the removal of the smear layer from the apical third of root canals. METHODS Fifty distal root canals from extracted human mandibular first molars were instrumented up to ProTaper Universal F5 and divided randomly into 5 groups (n = 10) according to the following final irrigation agitation techniques: no agitation (control), ProTaper Universal file, ultrasound, CanalBrush, and Nd:YAG laser. Specimens were observed under a scanning electron microscope. The presence of the smear layer was evaluated using a 3-grade scoring system. The data were analyzed with Cohen kappa, Kruskal-Wallis, and Mann-Whitney U tests. A level of significance of .05 was adopted. RESULTS The ultrasound group performed significantly better than the rest of the groups; 56.6% of the specimens revealed no smear layer, 44.4% showed the presence of a moderate smear layer, and no heavy smear layers were observed. In the Nd:YAG laser group, 30% of the specimens presented with no smear layer, 70% showed the presence of a moderate smear layer, and no heavy smear layers were observed. In contrast, a heavy smear layer was observed on the surfaces of the root canals in the CanalBrush (23.4%), ProTaper Universal (13.4%), and control (86.6%) groups. Statistically significant differences were observed (P < .05). CONCLUSIONS None of the agitation methods completely removed the smear layer. However, the ultrasound method performed significantly better followed by the Nd:YAG laser, the CanalBrush, and the ProTaper Universal system. Agitation of the irrigant improved smear layer removal in the apical third of the canal.

Assessment of canal walls after biomechanical preparation of root canals instrumented with protaper universalTM rotary system

Objective: The aim of this study was to examine the instrumented walls of root canals prepared with the ProTaper Universal™ rotary system. Material and Methods: Twenty mesiobuccal canals of human first mandibular molars were divided into 2 groups of 10 specimens each and embedded in a muffle system. The root canals were transversely sectioned 3 mm short of the apex before preparation and remounted in their molds. All root canals were prepared with ProTaper Universal™ rotary system or with Nitiflex™ files. The pre and postoperative images of the apical thirds viewed with a stereoscopic magnifier (×45) were captured digitally for further analysis. Data were analyzed statistically by Fishers exact test and Chi-square test at 5% significance level. Results: The differences observed between the instrumented and the noninstrumented walls were not statistically significant (p<0.05). Conclusions: The Nitiflex™ files and the ProTaper Universal™ rotary system failed to instrument all the root canal walls.

Radiological evaluation of the morphological changes of root canals shaped with ProTaper™ for hand use and the ProTaper™ and RaCe™ rotary instruments

This study evaluated, by means of the radiography examination, the occurrence of deviations in the apical third of root canals shaped with hand and rotary instruments. Sixty mandibular human molars were divided into three groups. The root canals in group 1 were instrumented with ProTaper (Dentsply/Maillefer, Ballaigues, Switzerland) for hand use, group 2 with ProTaper and group 3 with RaCe. The images obtained by double superimposition of the pre- and postoperative radiographs were evaluated by two endodontists with the aid of a magnifier-viewer and a fivefold magnifier. Statistical analysis was performed using the Fisher-Freeman-Halton. The instrumentation using the ProTaper for hand use showed 25% of the canals with a deviation in the apical third, as did the ProTaper, while the corresponding figure for the RaCe (FKG Dentaire, La-Chaux-de-Fonds, Switzerland) was 20%, but these results were not statistically significant. There was no correlation between the occurrence of deviations in the apical third and the systems used.

Arsenic content in Portland cement: A literature review

Portland cement (PC) is a hydraulic binding material widely used in the building industry. The main interest in its use in dentistry is focused on a possible alternative to mineral trioxide aggregate (MTA) because PC is less expensive and is widely available. In dentistry, PC has been used in dental procedures such as pulpotomy, pulp capping, repair of root perforation and root-end filling. The purpose of this article is review the dental literature about the PC, its composition with special attention to arsenic content, properties, and application in dentistry. A bibliographic research was performed in Bireme, PubMed, LILACS and Scopus data bases looking for national and international studies about the PC composition, properties and clinical use. It was observed that PC has favorable biological properties very similar to those of MTA. The PC has shown good cell proliferation induction with formation of a monolayer cell, satisfactory inflammatory response, inhibitory effect of prostaglandin and antimicrobial effect. Studies have shown that PC is not cytotoxic, stimulates the apposition of reparative dentin and permits cellular attachment and growth. Regarding arsenic presence, its levels and release are low. PC has physical, chemical and biological properties similar to MTA. Arsenic levels and release are low, therefore, unable to cause toxic effects.

Evaluation of the root dentine cutting effectiveness of the HERO 642®, HERO Apical® and HERO Shaper® Rotary Systems

Different HERO rotary systems were evaluated by pre- and postoperative images of a cross-section of their mesiobuccal root thirds with a stereoscopic magnifier (45x). Fifty mesiobuccal canals of human mandibular first molars were divided into five groups: 1--HERO 642; 2--HERO 642 and HERO Apical; 3--HERO Shaper; 4--HERO Shaper and HERO Apical; 5--NitiFlex files. The perimeter of the canal was calculated using Image Tool software (UTHSCA). Final, post-instrumentation perimeters were compared by Kruskal-Wallis test (P = 0.05). The distribution of the values of the final canal perimeter for each instrumentation method was not statistically significant in any of the thirds (P = 0.174, cervical third; P = 0.874, middle third; and P = 0.631, apical third). An increase in canal perimeter was observed in all groups. In the cervical third the greatest increase was Group 5; in the middle third, Group 4, and in the apical third, Group 2.

The efficacy of photodynamic therapy and sodium hypochlorite in root canal disinfection by a single-file instrumentation technique

AIM The aim of this in vitro study was to evaluate the efficacy of photodynamic therapy (PDT) and sodium hypochlorite (NaOCl) in root canal disinfection by a single-file instrumentation technique. MATERIAL AND METHODS Seventy human single-rooted mandibular premolars were infected with Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans, and divided into seven groups (n=10) according to the protocol of disinfection used. Group 1: 1% NaOCl; Group 2: 5.25% NaOCl; Group 3: saline+PDT; Group 4: 1% NaOCl+PDT; Group 5: 5.25% NaOCl+PDT; Group 6: positive control; Group 7: negative control. For PDT, methylene blue (15μg/mL) remained in the root canal for 2min, followed by irradiation with diode laser. Samples were collected before and after instrumentation and plated in specific media cultures, to assess the presence or absence of microbial growth and determine the average reduction of viable microorganisms. RESULTS 5.25% NaOCl+PDT resulted in the highest number of specimens with no microbial growth. Also, 1% NaOCl and 1% NaOCl+PDT exhibited similar antimicrobial effects. Saline+PDT was not able to eliminate all microorganisms. There was statistical significant differences between the groups and the microorganisms. CONCLUSION The association of 5.25% NaOCl with PDT was the most effective treatment against microorganisms from endodontic infection in root canals instrumented by a single-file instrumentation technique. This result shows that PDT can be useful to improve the root canal disinfection.