Hélio Pereira Lopes

Mechanical reduction of the bacterial population in the root canal by three instrumentation techniques

The in vitro reduction of the bacterial population in the root canal by the mechanical action of instrumentation and irrigation was evaluated. Root canals inoculated with a Enterococcus faecalis suspension were instrumented using hand Nitiflex files, Greater Taper (GT) files, and Profile 0.06 taper Series 29 rotary instruments. Irrigation was performed using sterile saline solution. Root canals were sampled before and after instrumentation. In the group of the Nitiflex files, samples were also taken after each file size. After serial dilution, samples were plated onto Mitis-Salivarius agar, and the colony forming units grown were counted. All techniques and instruments tested were able to reduce significantly the number of bacterial cells in the root canal. Instrumentation to a Nitiflex #30 was significantly more effective than GT files. There were no significant differences when comparing the effects of the Profile instrument #5 with either the GT files or the Nitiflex #30. Enlargement to a Nitiflex #40 was significantly more effective in eliminating bacteria when compared with the other techniques and instruments tested (p < 0.05). The results of this study showed that the instrumentation and irrigation can mechanically remove more than 90% of bacterial cells from the root canal.

Antimicrobial Activity and Flow Rate of Newer and Established Root Canal Sealers

Endodontic sealers that possess both optimum flow ability and antimicrobial properties may theoretically assist in the elimination of microorganisms located in confined areas of the root canal system. The antimicrobial effects and the flow rate of the following sealers were investigated and compared: Kerr Pulp Canal Sealer EWT, Grossmans Sealer, ThermaSeal, Sealer 26, AH Plus, and Sealer Plus. The agar diffusion test was used to assess the antimicrobial activity of the sealers. In the flow assay, the sealers were placed between two glass slabs and a weight of 500 g was placed on the top of the glass. The diameters of the formed discs were recorded. All root canal sealers tested showed some antimicrobial activity against most of the microorganisms. There were no significant differences between the materials tested (p > 0.05). All root canal sealers also flowed under the conditions of this study. Statistical analysis of the results revealed that AH Plus and Kerr Pulp Canal Sealer EWT had flow values significantly superior to the other sealers tested (p > 0.05). Taken together, these findings suggest that these sealers have the potential to help in the microbial control in the root canal system.

Coronal leakage of two root canal sealers containing calcium hydroxide after exposure to human saliva

This in vitro study evaluated the coronal leakage of human saliva into root canals filled by lateral condensation of gutta-percha using two root canal sealers containing calcium hydroxide. Obturated canals with gutta-percha and either Sealapex of Sealer 26 were mounted in an apparatus and then exposed to saliva. The number of days required for total recontamination of the root canal was recorded. Evaluation was conducted for 60 days. Thirty-five percent of the specimens of the Sealer 26 group showed entire recontamination at 60 days. Eighty percent of the root canals obturated with Sealapex showed complete recontamination at 60 days. Sealer 26 presented significantly less leakage than Sealapex (p < 0.01).

Recontamination of coronally unsealed root canals medicated with camphorated paramonochlorophenol or calcium hydroxide pastes after saliva challenge

This in vitro study evaluated the ability of some medications to prevent recontamination of coronally unsealed root canals by bacteria from saliva. The medications tested were camphorated paramonochlorophenol (CPMC) applied in cotton pellets in the pulp chamber; calcium hydroxide/saline solution paste filling the root canal; and calcium hydroxide/CPMC/glycerin paste also filling the root canal. Medicated canals were exposed to saliva, and the number of days required for total recontamination to occur was recorded. Canals medicated with CPMC in cotton pellets were thoroughly recontaminated within an average of 6.9 days. Canals filled with calcium hydroxide/saline solution and calcium hydroxide/CPMC/glycerin showed entire recontamination within an average of 14.7 and 16.5 days, respectively. Calcium hydroxide pastes were significantly more effective than CPMC (p < 0.05).

Scanning Electron Microscopic Investigation of the Surface of Gutta-Percha Cones after Cutting

The surface of auxiliary gutta-percha cones after cutting with different methods was evaluated. The tips of gutta-percha cones size fine were cut off using scissors, a razor blade against a glass slab, a razor blade combined with a calibrator, or a razor blade/calibrator followed by a further cutting with a razor blade against a glass slab. Samples were examined under scanning electron microscopy. Cutting with scissors and razor blade/calibrator produced significant irregularities in the cone surface. Cutting with razor blades against a glass slab, with or without previous use of a calibrator, allowed the development of a smooth gutta-percha cone surface.

The impact of using a pneumatic contra-angle device on the lifespan of M-Wire- and Blue-treated instruments

ObjectivesTo evaluate the cyclic fatigue resistance of Reciproc M-Wire R25 (VDW, Munich, Germany) and Reciproc R25 Blue instruments (VDW) driven by Direct® (VDW) contra-angle connected to an ordinary an air-driven motor or an electric motor and compare the results with those obtained by the Reciproc M-Wire R25 or Reciproc Blue R25 instruments driven by an electric torque-controlled motor using “RECIPROC ALL” preset program.Materials and methodsThirty Reciproc M-Wire R25 (25/0.08v) and 30 Reciproc Blue R25 (25/0.08v) instruments were used. Cyclic fatigue resistance was tested measuring the time to fracture and the number of cycles to fracture in an artificial stainless-steel canal with a 60° angle and a 5-mm radius of curvature. The Reciproc M-Wire and Reciproc Blue instruments were activated with a 6:1 reduction handpiece powered by a torque-controlled motor using “RECIPROC ALL” preset program, with Reciproc Direct® contra-angle powered by an ordinary air-driven motor or with Direct® contra-angle powered by an electric motor (n = 10). The fracture surface of all fragments was examined with a scanning electron microscope. The results were statistically analyzed using Student’s t test and one-way ANOVA at a significance level of P < 0.05.ResultsCyclic fatigue life and number of cycles to fracture were significantly higher for Reciproc Blue instruments than for Reciproc M-Wire instruments regardless of the activation mode (P < 0.05). Instruments driven by Direct® contra-angle powered by an electric or by an ordinary air-driven motor revealed significantly longer cyclic fatigue life and number of cycles to fracture than instruments driven by an electric torque-controlled motor using “RECIPROC ALL” preset program (P < 0.05).ConclusionsReciproc Blue instruments showed improved performance regarding fatigue resistance when compared to Reciproc M-Wire instruments. Instruments driven by Reciproc Direct® contra-angle showed higher cyclic fatigue life and number of cycles to fracture than instruments driven by an electric torque-controlled motor.Clinical relevanceRecently, Reciproc Direct®, the world’s first contra-angle handpiece with integrated reciprocating motion, has been launched in endodontic market. The present study showed improved cyclic fatigue life of endodontic instruments when activated by Reciproc Direct®.

Bending resistance and cyclic fatigue life of a new single-file reciprocating instrument WaveOne Gold

Objective: The present study aimed to evaluate the bending resistance and cyclic fatigue fracture resistance of a new single-file reciprocating instrument called WaveOne Gold. Reciproc and WaveOne instruments were used as references for comparison. Methods: Sixty 25-mm NiTi instruments (Reciproc R25, WaveOne Primary and WaveOne Gold Primary) were tested. Flexibility was determined by applying 45° bending tests using a universal testing machine (n=10). A custom-made device was used during cyclic fatigue test (n=10), comprising a stainless steel artificial canal measuring 1.4 mm in diameter, 19 mm in total length with an 86° angle and 6 mm radius of curvature. Possible deformations at the helical shaft and mode of fracture were evaluated using scanning electron microscopy analysis. Statistical analysis was performed using one-way analysis of variance. Post hoc pair-wise comparisons were performed using Tukey’s test for multiple comparisons (P<0.05). Results: WaveOne presented significantly higher bending resistance than the other tested systems (P<0.05), whereas Reciproc presented the lowest bending resistance (P<0.05). Reciproc revealed a significantly longer cyclic fatigue fracture resistance than the other systems (P<0.05). Conclusion: Although WaveOne Gold presented higher flexibility than WaveOne, no differences in the resistance to fatigue were observed between both systems. The Reciproc files were more flexible and resistant to fatigue for the angle of curvature of 86° and 6 mm radius than WaveOne and WaveOne Gold files.

Limas endodônticas manuais de aço inoxidável e de níquel-titânio: ensaio de torção até a fratura

Fratura por torcao; Limas endodonticas de aco inoxidavel e de NiTi; Limas endodonticas torcidas e usinadas.

Wettability of Irrigants used in Root Canal Treatment

This study assessed the contact angle and the surface tension of different chemical solutions used in the chemomechanical preparation of root canals in order to calculate its wettability. The tested irrigants were: 2.5% sodium hypochlorite (NaOCl); 2% chlorhexidine (CHX); BioPure MTAD?; and 0.9% sterile physiological saline solution, as the control. A goniometer was used to measure the contact angle and the surface tension. Then the wettability of each solution was calculated using Youngs equation. BioPure MTAD? showed significantly higher contact angle (p=0.002), compared to the other substances, which did not differ among themselves. As the surface tension, BioPure MTAD? showed significantly lower values (p=0.001). As for 2.5% sodium hypochlorite, 2% chlorhexidine, and the control, chlorhexidine presented lowest surface tension (p<0.01). BioPure MTAD? showed the best wettability in relation to the other tested irrigant, followed by two percent of CHX and 2.5% NaOCl.

Physico-chemical and Biological Properties of a New Portland Cement-based Root Repair Material

Published online: 21 December 2017 DOI 10.5152/eej.2017.17018 Objective: To propose bismuth carbonate, a radiopacifying agent, as a new endodontic root repair material that was added to Portland cement (PC) at 2 wt%, 5 wt%, 10 wt% and 15 wt%, and physicochemical and biological properties of each formulation were evaluated in comparison to MTA-Angelus. Methods: Mixed and powder samples were analysed by scanning electron microscopy (SEM) and X-ray power diffraction (XRD), and the semiquantitative constitution of the powder was determined by energy-dispersive spectrometer (EDS). Setting time was evaluated by Vicat needle and radiopacity analysed with digital X-ray. The pH of all tested materials was observed after immersion in water for 3, 24, 48, 72 and 168 h (or 7 days). Solubility and calcium release were measured after immersion in water for 24 h. A multiparametric assay XTT-NR-CVDE was used to evaluate the cytotoxicity of the materials in human periodontal ligament (HPDL) fibroblasts. HPDL fibroblasts were exposed to PC 15% and mineral trioxide aggregate (MTA), and the expression of proinflammatory cytokines (IL1A, IL6, IL8, TNF) and bone formation genes (ALP, COL1 , RUNX2) was evaluated by real-time PCR. Mineralisation of HPDL fibroblasts cocultured with PC, PC 15% and MTA was evaluated with Von Kossa staining. Results: PC-based groups presented more irregular and larger particles than MTA. PC and MTA showed similarities as observed by XRD and EDS. Setting time of PC-based groups was increased with the addition of bismuth carbonate. All tested materials were alkaline, and pH tended to reduce over time. All cements had solubility lower than recommended, with no difference between them (P>0.05) and showed calcium release. PC 15% had similar radiopacity when compared with MTA (P>0.05). Cell viability was higher for the tested materials than the positive control (P<0.001), but there was no difference when they were compared with negative control (P>0.05). Gene expression levels were similar for all tested groups (P>0.05). Analysed cements had positive Von Kossa staining. Conclusion: Overall, the addition of 15% of bismuth carbonate did not result in significant changes to its physicochemical and biological properties when compared with MTA, except for the setting time, and may be considered a potential substitute for MTA.