Matheus Albino Souza

Evaluation of chlorhexidine substantivity on human dentin: a chemical analysis.

INTRODUCTION The aim of this study was to investigate the substantivity of chlorhexidine (CHX) solution and gel within a root canal system for 24 hours, 30 days, and 90 days. METHODS Forty-five extracted human anterior teeth were used for this study. The samples were divided into 3 groups according to the chemical auxiliary substance used to perform the root canal preparation: group 1, 2% liquid CHX; group 2, 2% gel CHX; and group 3, distilled water (the control group). The working length was determined by inserting a #10 K-file into the canal up to the moment its tip was seen in the apex foramen and then withdrawing it 1 mm. The roots were prepared up to the instrument #45. Longitudinal grooves were carved on the free surfaces of the roots, providing 2 halves of each root and resulting in 30 samples per group. Each group was randomly divided into 3 subgroups (n = 10), and substantivity was evaluated after 24 hours, 30 days, and 90 days of incubation. The amount of CHX (in micrometers) was measured through reverse-phase high-performance liquid chromatography. Statistical analysis was performed by analysis of variance and the Tukey test for post hoc comparisons (α = 0.05). RESULTS The control group showed no substantivity. Significant amounts of CHX solution and gel remained retained in dentin substrates independent of the time of incubation (P < .05). CHX solution showed a higher substantivity than CHX gel, with the exception of groups incubated for 90 days. The decreasing amounts of retained CHX inside the canal were for 24 hours >30 days >90 days for CHX solution and 24 hours >30 days ≥ 90 days for CHX gel. CONCLUSIONS The results of this study indicate that CHX solution and gel are retained in root canal dentin for up to 90 days.

Effect of root canal sealers on bond strength of fibreglass posts cemented with self‐adhesive resin cements

AIM This study evaluated the effects of different root canal sealers on the bond strength of a fibreglass post cemented with self-adhesive resin cements. METHODOLOGY The root canals of 50 extracted maxillary single-rooted canine teeth were prepared with the crown-down technique and randomly divided into five groups according to the sealer used: group 1: control group, gutta-percha points only (no sealer); group 2: AH Plus (resin-based sealer); group 3: self-etch Epiphany (resin-based sealer); group 4: Sealer 26 (calcium hydroxide-based sealer); and group 5: Endomethasone (zinc oxide eugenol-based sealer). The root canals were filled with gutta-percha, the cold lateral compaction technique, except for group 3 where Resilon was used. Post spaces were prepared, and fibreglass posts were cemented with the self-adhesive cement RelyX Unicem. Bonded specimens were sectioned into 1-mm-thick slabs, and a push-out test was performed in a universal machine. Failure modes were observed and classified into five types: (i) adhesive between the post and resin cement; (ii) mixed, with resin cement covering 0-50% of the post diameter; (iii) mixed, with resin cement covering 50-100% of the post surface; (iv) adhesive between resin cement and root canal; and (v) cohesive in dentine. Data of bond strength were submitted to anova and Tukey test (α = 0.05). RESULTS No significant difference was detected between control group, AH Plus, Epiphany and Sealer 26 (P > 0.05). The Endomethasone group had significantly lower bond strength values than the other sealers (P < 0.05). The prevalence of mixed fractures and adhesive cement-dentine failure was verified in the eugenol-containing sealer group; in the control group, the resin-based and calcium hydroxide-based sealer groups, the predominant mode of failure was the mixed type. CONCLUSION Endomethasone interfered negatively with the bond to root dentine; however, AH Plus, Epiphany and Sealer 26 did not interfere in the bond strength of a fibreglass post cemented with self-adhesive resin cements.

Influence of ultrasonic activation on photodynamic therapy over root canal system infected with Enterococcus faecalis — an in vitro study

AIM The purpose of this study was to evaluate, in vitro, the influence of ultrasonic activation on photodynamic therapy over root canal system infected with Enterococcus faecalis. MATERIAL AND METHODS The root canals of 50 single-rooted human extracted teeth were enlarged up to a file 60, autoclaved, inoculated with Enterococcus faecalis and incubated for 30 days. The samples were divided into five groups (n=10) according to the protocol of decontamination: G1 (control group) - no procedure was performed; G2 - photosensitizer (0.01% methylene blue); G3 - ultrasonic activation of photosensitizer (0.01% methylene blue); G4 - photodynamic therapy with no ultrasonic activation; and G5 - photodynamic therapy with ultrasonic activation. Microbiological tests (CFU counting) and scanning electron microscopy (SEM) were performed to evaluate and illustrate, respectively, the effectiveness of proposed treatments. Data were subjected to one-way ANOVA followed by post hoc Tukey test (α=0.05). RESULTS The microbiological test demonstrated that G5 (photodynamic therapy with ultrasonic activation) showed the lowest mean contamination (3.17 log CFU/mL), which was statistically different from all other groups (p<0.05). G4 (photodynamic therapy) showed a mean of contamination of 3.60 log CFU/mL, which was statistically different from groups 1, 2 and 3 (p<0.05). CONCLUSION The use of ultrasonic activation on photodynamic therapy improved its potential for decontamination, resulting in the higher elimination Enterococcus faecalis from the root canal space.

Comparative Evaluation of Calcium Hypochlorite and Sodium Hypochlorite Associated with Passive Ultrasonic Irrigation on Antimicrobial Activity of a Root Canal System Infected with Enterococcus faecalis: An In Vitro Study

INTRODUCTION The purpose of this study was to compare in vitro the effectiveness of calcium hypochlorite (Ca[OCl]2) and sodium hypochlorite (NaOCl) associated with passive ultrasonic irrigation in root canals of bovine teeth infected with Enterococcus faecalis. METHODS The root canals of 60 single-rooted bovine extracted teeth were enlarged up to a file 45, autoclaved, inoculated with Enterococcus faecalis, and incubated for 30 days. The samples were divided into 6 groups (n = 10) according to the protocol for decontamination: G1: no treatment; G2: distilled water; G3: 2.5% NaOCl; G4: 2.5% Ca(OCl)2; G5: 2.5% NaOCl with ultrasonic activation; and G6: 2.5% Ca(OCl)2 with ultrasonic activation (US). Microbiological testing (colony-forming unit [CFU] counting) was performed to evaluate and show, respectively, the effectiveness of the proposed treatments. Data were subjected to 1-way analysis of variance followed by the post hoc Tukey test (α = 0.05). RESULTS Groups 1 and 2 showed the highest mean contamination (3.26 log10 CFU/mL and 2.69 log10 CFU/mL, respectively), which was statistically different from all other groups (P < .05). Group 6 (Ca[OCl]2 + US) showed the lowest mean contamination (1.00 log10 CFU/mL), with no statistically significant difference found in groups 3 (NaOCl), 4 (Ca[OCl]2), and 5 (NaOCl + US) (P < .05). CONCLUSIONS Ca(OCl)2 as well as passive ultrasonic irrigation can aid in chemomechanical preparation, contributing in a significant way to the reduction of microbial content during root canal treatment.

Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants

OBJECTIVE To evaluate the effect of GSE, NaOCl, CHX and QMix as an antimicrobial agents against Enterococcus faecalis and their influence on flexural and ultimate tensile strength of root canal dentine. METHODS Root canals were divided into five groups (n=10) according to the substances used: 2.5% NaOCl, 2% CHX, 6.5% GSE, Qmix and control group (distilled water) (DW). Final irrigation was done with 17% EDTA in all groups, except when DW was used. The number of colony-forming units was used to evaluate the antimicrobial activity. Dentine beams were used to assess the flexural strength after treatment with substances as described before (n=10). The UTS was evaluated after the treatment of root dentine hourglass shape sections with the same substances (n=30). RESULTS The lowest bacteria contamination was observed for CHX and GSE, while NaOCl and QMix showed an intermediate antimicrobial activity (p>0.05). NaOCl and QMix significantly reduced the mechanical properties of dentine (flexural strength and UTS) (p<0.05) and no statistical difference was found among CHX, GSE and DW (p>0.05). CONCLUSION CHX and GSE were more effective than NaOCl and QMix against E. faecalis. Furthermore, they did not harm dentine mechanical properties as observed for NaOCl and QMix. CLINICAL SIGNIFICANCE The use of GSE can be recommended for endodontic procedures since it has good antimicrobial activity and does not interfere in the mechanical properties of dentine; similarly to CHX.

Effect of root-canal sealer on the bond strength of fiberglass post to root dentin.

Abstract Objective. To evaluate the effects of different root-canal sealers on the bond strength of a fiberglass post cemented with self-adhesive resin cements. Material and methods. Forty extracted maxillary single-rooted canines were prepared with the crown-down technique and randomly divided into four groups according to the tested sealer: Group 1: control group, gutta-percha cone only (no sealer); Group 2: EndoREZ; Group 3: Sealapex; Group 4: Endofill. The roots were obturated with the gutta-percha cone using the cold lateral compaction technique. Fiberglass posts were cemented into the prepared post spaces with the self-adhesive cement RelyX Unicem. Bonded specimens were sectioned into 1-mm thick slabs and a push-out test was performed in a universal machine. Results. Data were subjected to ANOVA and Tukey tests (α = 0.05). No significant difference was detected between Groups 1–3 (P > 0.05). Group 4 showed a lower bond strength than the other sealers (P < 0.05). Conclusions. Endofill negatively interfered with the bond to root dentine; however, EndoRez and Sealapex did not affect the bond strength of the fiberglass post cemented with self-adhesive resin cements.

Effectiveness of final decontamination protocols against Enterococcus faecalis and its influence on bond strength of filling material to root canal dentin

AIM The aim of this study was to evaluate the effectiveness of final decontamination protocols against Enterococcus faecalis and their influence on bond strength of filling material to root canal dentin. MATERIAL AND METHODS Ninety root canals were enlarged with ProTaper system and inoculated with E. faecalis for 15days. Sixty samples were randomly divided into six groups (n=10) and subjected to following protocols: G1-distilled water(control), G2-2% chlorhexidine, G3-QMix, G4-6.5% grape seed extract, G5-photodynamic therapy with optical fiber and G6-photodynamic therapy without optical fiber. The percentage of bacterial reduction was checked by counting of CFUs. The remaining 30 samples were subjected to the same decontamination protocols (n=5) and filled with gutta-percha and AH Plus sealer in order to perform the push-out test. Data from both tests were subjected to one-way ANOVA followed by Tukeys post hoc procedure (α=0.05). RESULTS The greatest bacterial reduction was observed for 2% chlorhexidine, QMix and 6.5% grape seed extract, with no statistically significant difference between them. Photodynamic therapy, with and without optical fiber, demonstrated a significantly higher reduction than distilled water, with no statistically significant difference between them (p<0.05). For the push-out test, final decontamination protocols showed similar bond strength values (p<0.05), with the highest incidence of cohesive failure in all groups. CONCLUSIONS The tested final decontamination protocols showed effectiveness against E. faecalis and did not interfere with the bond strength of filling material to root canal dentin.

Effects of an endodontic auxiliary chemical substance on the bond strength of two methacrylate-based endodontic sealers to dentin

To evaluate the influence of irrigation protocols and drying procedures on the bond strength of two methacrylate‐based sealers to dentin and the associated failure pattern using scanning electron microscopy (SEM).

Influence of ultrasonic activation over final irrigants in the removal of photosensitizer from root canal walls after photodynamic therapy

INTRODUCTION The aim of the present study was to evaluate the influence of ultrasonic activation (US) of the final irrigant in the removal of the photosensitizer from root canal walls after photodynamic therapy. METHODS The root canals of 60 single-rooted bovine extracted teeth were filled with 0.01% methylene blue and submitted to photodynamic therapy for 90s. After that, the roots were divided into six groups (n=10) according to the final irrigation protocol: distilled water (DW), DW+US, 17% EDTA, QMix, EDTA+US, and QMix+US. Then, the samples were submitted to scanning electron microscopy where a scoring system was used to evaluate the images and effectiveness of proposed treatments in the cervical, middle and apical regions of the root canals. The data were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests for intergroup comparisons as well as the Wilcoxon and Friedman tests for intragroup comparisons at 5% of significance. RESULTS The 17% EDTA+US and QMix+US treatments were most effective in the removal of the photosensitizer in all regions of the root canal; the difference was statistically significant when compared to all other groups (p<0.05). There were no significant differences in the intragroup analysis comparing the effectiveness in the different regions of the same group (p<0.05). CONCLUSIONS US can aid 17% EDTA and QMix in removing the photosensitizer after photodynamic therapy and contributes to cleaning root canal walls.

Effect of synthetic and natural-derived novel endodontic irrigant solutions on mechanical properties of human dentin

This study aimed to evaluate the effects of different synthetic and natural-derived root canal irrigants (6% sodium hypochlorite [NaOCl], 6% calcium hypochlorite [Ca(OCl)2] and 6.5% grape seed extract [GSE]) on dentin mechanical properties (flexural strength, ultimate tensile strength [UTS] and fracture resistance). Rectangular-shaped beams and hourglass-shaped sections obtained from mid-coronal and root dentin were treated with 6% NaOCl, 6% Ca(OCl)2 or 6.5% GSE for 30 min. The irrigant solutions were replaced every 5 min. Then, the dentin specimens were rinsed with distilled water (DW) followed by incubation with 17% EDTA for 1 min, and thoroughly rinsed with DW again. Specimens from the control group were tested without prior irrigation. After treatment with the irrigants, dentin beams were used to assess the flexural strength (n = 10) while UTS was evaluated using the root dentin hourglass-shaped sections (n = 10). Similarly, roots with 1 mm of dentinal wall thickness were obtained from human teeth and treated with the same irrigant solutions (n = 10). A compressive loading was applied to the coronal surfaces of roots until fracture. The values of each mechanical test were statistically analyzed individually by one-way ANOVA followed by Tukey HSD test (P < 0.05). NaOCl significantly reduced the mechanical properties of dentin in all mechanical tests (P < 0.05) and no statistical difference was found among Ca(OCl)2, GSE and control group (P > 0.05). It can be concluded that Ca(OCl)2 and GSE may be alternative irrigant solutions, since they do not negatively affect the dentin mechanical properties.Graphical abstract