Sandra Rivera Fidel

Suboptimal Debridement Quality Produced by the Single-file F2 Protaper Technique in Oval-shaped Canals

INTRODUCTION The aim of this study was to determine whether the debridement quality of the single-file F2 ProTaper instrumentation technique is comparable to a full conventional ProTaper sequence in both round and oval-shaped root canals. METHODS Fifty-four recently extracted vital lower incisors were instrumented with either a full range of ProTaper Universal instruments in rotary motion (group 1) or with the single-file F2 ProTaper technique in reciprocating motion (group 2). Teeth were previously classified as round or oval-shaped by means of bidirectional radiographs, resulting in 24 round canals, 24 oval canals, and 12 controls. After instrumentation, the roots were demineralized, and the apical 3 mm was multi-sliced and processed for histologic examination. The percentage of residual pulp tissue (PRPT) was calculated with the aid of image analysis software. Univariate analysis of variance was used to verify the variables influencing PRPT. RESULTS Both canal shape and technique significantly influenced PRPT (P < .05). Oval-shaped canals displayed much more PRPT than round canals in both techniques (P < .05). The difference in PRPT between the techniques depended on the root canal shape, since a significant interaction between canal shape and technique was observed (P < .05). Group 1 displayed considerably less PRPT in oval canals than group 2 (P < .05), whereas in round canals no significant difference was found between the 2 techniques (P > .05). CONCLUSIONS The single-file F2 ProTaper technique displayed similar PRPT to the full range of ProTaper instruments in round canals. However, the debridement quality of the single-file F2 ProTaper technique was suboptimal in oval canals.

Push-out Bond Strength of Resilon/Epiphany and Resilon/Epiphany Self-Etch to Root Dentin

INTRODUCTION The present study was designed to investigate the bond strength produced by Epiphany and Epiphany SE to root canal dentin. METHODS A sample of 36 human upper canines was prepared and assigned to experimental groups (n = 12), designated as group 1, Resilon/Epiphany; group 2, Resilon/Epiphany SE; and group 3, AH Plus/gutta-percha. After the filling procedures, each tooth was prepared for push-out assessment by using root slices of 1-mm thickness. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey test for multiple comparisons were used to compare the results among the experimental groups. RESULTS AH Plus/gutta-percha root fillings showed significantly higher push-out bond strength than both Resilon/Epiphany and Resilon/Epiphany SE (P < .05). There was no significant difference between Epiphany/Resilon and Epiphany SE/Resilon (P > .05). CONCLUSIONS Under the present in vitro conditions, the adhesiveness quality to root dentin promoted by both Epiphany sealers is compromised even when teeth with simple anatomic features were obturated under well-monitored laboratory conditions.

Negligible Expression of Arsenic in Some Commercially Available Brands of Portland Cement and Mineral Trioxide Aggregate

INTRODUCTION This study was designed aiming to determine and compare the amount of arsenic in some brands of mineral trioxide aggregate (MTA) and Portland cement. METHODS In the present study, arsenic species (As[III], As[V], and dimethylarsinic acid) were separated by high-performance liquid chromatography (HPLC) using a strong anion exchange column and converted into arsines by online HG. The instrumental coupling, HPLC-HG-AFS, was applied to 0.2 g of each cement that was prior digested in a solution of HCl, HNO(3), and HBF(4). Data were expressed as a part per million, and the preliminary analysis of the raw pooled data revealed a bell-shaped distribution. Statistical analysis was performed using one-way analysis of variance for multiple comparisons. RESULTS In all chromatograms obtained, only type III arsenic could be detected. The minimum amount of arsenic was detected in samples of white MTA ProRoot (3.3 x 10-4) and the maximum in the samples MTA Bio Angelus (Angelus, Londrina, PR, Brazil) (8.6 x 10-4). In the Gray MTA (Angelus), gray ProRoot MTA (Tulsa/Dentsply, Tulsa, OK) and CP Juntalider (Brasilatex Ltda, Diadema, SP, Brazil) did not detect any trace of arsenic. The values of arsenic found in CP Irajazinho (Votorantim Cimentos, Rio Branco, SP, Brazil) and white MTA Angelus were intermediaries to minimum and maximum values. The nonparametric test Kruskal-Wallis showed statistically similar results among all cements tested (p > 0.5). CONCLUSIONS Overall, the present study showed that all cements showed insignificant amounts of type III arsenic as well as no trace of arsenic DMA and type V could be detected.

A Microbiological Profile of Symptomatic Teeth with Primary Endodontic Infections

The aim of this study was to evaluate the composition of the microbiota of primary endodontic infections associated with symptomatic teeth. Samples were collected by means of a #15 H-type file and 2 sterile paper points from 60 symptomatic (n = 30) or asymptomatic (n = 30) single-rooted teeth with necrotic pulp. The presence of 40 bacterial species was determined by the checkerboard DNA-DNA hybridization method. The species found in higher counts (x10(5)) in symptomatic cases were Fusobacterium nucleatum ssp. vincentii, Veillonella parvula, Treponema socranskii, Enterococcus faecalis, and Campylobacter gracilis and in asymptomatic cases were F. nucleatum ssp. vincentii, Fusobacterium nucleatum ssp. nucleatum, E. faecalis, Eubacterium saburreum, and Neisseria mucosa. Total bacterial counts and counts of Tannerella forsythia were significant higher in symptomatic cases (p < 0.05), whereas levels of Propionibacterium acnes were reduced in this group of teeth. The data of the present investigation suggested an association between higher total bacterial counts and levels of T. forsythia and the presence of pain.

Antimicrobial activity of sodium hypochlorite and chlorhexidine by two different tests

The aim of this study was to evaluate the antimicrobial capacity of sodium hypochlorite (1% and 5%) and chlorhexidine (0.12%, 0.5% and 1%) with or without the addition of organic material (bovine serum albumin, BSA) against some bacterial samples (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis and Fusobacterium nucleatum) using two activity tests (contact and diffusion agar tests). In the contact test (first model), bacterial samples were kept in contact with each irrigating solution for different time intervals: immediately (t(0)), 5 min (t(5)), 15 min (t(15)) and 30 min (t(30)). The agar diffusion test was the second model used. In half the specimens, 0.5% BSA was added to simulate organic tissue present in the root canal. Bacterial growth was evaluated for each microorganism and activity test. Each test was repeated 10 times. In the contact test, 0.12% chlorhexidine solution (CHX) did not eliminate E. faecalis at any tested time. CHX at 0.5% eliminated all strains except E. faecalis after immediate contact. All strains were eliminated by 1% CHX, 1% NaOCl and 5% NaOCl. BSA did not interfere with the antimicrobial activity of the irrigating solutions. In the agar diffusion test, all solutions exhibited zones of antimicrobial activity; however, BSA interfered with the antimicrobial activity of NaOCl and CHX. Under the condition of the contact test, the 0.12% CHX was ineffective in eliminating E. faecalis, while 0.5% CHX, 1% CHX, 1% NaOCl and 5% NaOCl showed antibacterial effectiveness against all the tested bacterial strains. The addition of an organic load interfered with the accuracy of the agar diffusion test.

Lack of correlation between sealer penetration into dentinal tubules and sealability in nonbonded root fillings

AIM To determine the correlation between leakage and sealer penetration into dentinal tubule. METHODOLOGY The root canal of 60 mandibular central incisor teeth were prepared and filled under standardized conditions. Teeth were placed into a device to assess glucose penetration using 15 psi pressure application. After 1 h, glucose concentrations in the lower chamber were measured using an enzymatic reaction. Each specimen was then sectioned horizontally at 3, 6 and 8 mm from the apex, and a standard metallographic preparation was performed. The coronally facing surface of each slice was examined in a high-resolution stereomicroscope and under Confocal Laser Scanning Microscope. For each slice, the external outline of the root canal, the internal circumference of the root canal walls and the areas along the canal walls where the sealer had penetrated into the dentinal tubules (sealer tags) were outlined and measured. Afterwards, the percentage of the sealer penetration in each section was calculated. The Spearman correlation test was used to verify the correlation between the variables studied (glucose leakage and sealer penetration into dentinal tubules). RESULTS The means and standard deviations of glucose leakage were 0.744 g L(-1) (±0.5), and the percentage of the dentinal tubule sealer penetration varied between teeth from 5.6% to 42.21%, with an average of 13.7 ± 17.2%. The Spearman correlation test revealed no significant correlation between the two factors analysed (P = 0.082). The r(2) value was equal to 0.12. CONCLUSIONS There was no significant correlation between sealability sealer penetration into dentinal tubules. The lack of correlation reported is of relevance as sealer penetration into dentinal tubules has been used as an advantageous property during the launch of new root filling materials and techniques.

Antimicrobial activity of different concentrations of NaOCl and chlorhexidine using a contact test

The purpose of this study was to analyze the in vitro antimicrobial activity of sodium hypochlorite (1% and 5%) and chlorhexidine (0.12%, 0.5% and 1%). Bacterial samples (ATCC) of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis and Fusobacterium nucleatum were submitted to a contact test. Solutions were evaluated at different time intervals: immediately, 5 min, 15 min, and 30 min after contact and repeated 10 times. The results of the contact test showed that 0.12% chlorhexidine did not eliminate E. faecalis at any time interval, while 0.5% and 1% chlorhexidine and 1% and 5% sodium hypochlorite did. These results permit us to conclude that to obtain better antimicrobial activity, chlorhexidine in a concentration greater than 0.12% should be used.

Comparison of the root-end seal provided by bioceramic repair cements and White MTA

AIM To compare the ability of Ceramicrete, BioAggregate and white ProRoot MTA (mineral trioxide aggregate) to prevent glucose leakage through root-end fillings. METHODOLOGY After root canal instrumentation, the apical 3 mm of maxillary incisors were resected and retropreparations, 3 mm in depth, were created with ultrasound. Root-end cavities were filled with the tested materials (15 roots per group). All roots were mounted in a double-chamber system to assess glucose penetration using 15 psi pressure application. After 1 h, glucose concentrations in the lower chamber were measured following an enzymatic reaction. Four roots were used as controls. One-way anova verified differences in glucose leakage between groups and Tukey test performed multiple comparisons. Significance was set at α = 5%. RESULTS There was a significant difference between the three materials (anova, P < 0.05). Ceramicrete had significantly lower glucose penetration than BioAggregate (Tukey, P < 0.05). There was no difference between the two bioceramic cements and white MTA (P > 0.05). CONCLUSIONS Both endodontic bioceramic repair cements displayed similar leakage results to white MTA when used as root-end fillings materials. Ceramicrete had significantly lower glucose penetration.

Microbiological evaluation of primary endodontic infections in teeth with and without sinus tract

AIM To examine the microbiological status of primary endodontic infections in teeth with and without a sinus tract. METHODOLOGY Samples were collected by means of a size 15 H-type file and two sterile paper points from 30 cases of primary endodontic infections with (n = 15) or without (n = 15) a sinus tract. The presence of 40 bacterial species was determined by the checkerboard DNA-DNA hybridization method. RESULTS The species found at the highest levels and prevalence were Fusobacterium nucleatum sp. vincentii, Porphyromonas gingivalis, Veillonella parvula, Enterococcus faecalis, Campylobacter gracilis and Neisseria mucosa. Total bacterial counts were similar between teeth with (44 x 10(5)) and without (50 x 10(5)) a sinus tract (t-test: P > 0.05). E. faecalis, Streptococcus anginosus, Capnocytophaga sputigena and Capnocytophaga gingivalis had significantly higher counts in the absence of sinus tract (Mann-Whitney test, P < 0.05). Higher levels of P. gingivalis and Fusobacterium nucleatum sp. nucleatum were observed in cases with a sinus tract. Leptotrichia buccalis (OR = 1.83; CI 95%) and Porphyromonas endodontalis (OR = 2.15; CI 95%) were associated with an increased chance of subjects having a sinus tract. CONCLUSIONS Primary endodontic infections were associated with a large variety of bacterial species. Specific differences between the composition of the microbiota of primary root canal infections were observed in cases with or without a sinus tract.

Assessing accumulated hard-tissue debris using micro-computed tomography and free software for image processing and analysis.

INTRODUCTION The accumulation of debris occurs after root canal preparation procedures specifically in fins, isthmus, irregularities, and ramifications. The aim of this study was to present a step-by-step description of a new method used to longitudinally identify, measure, and 3-dimensionally map the accumulation of hard-tissue debris inside the root canal after biomechanical preparation using free software for image processing and analysis. METHODS Three mandibular molars presenting the mesial root with a large isthmus width and a type II Vertuccis canal configuration were selected and scanned. The specimens were assigned to 1 of 3 experimental approaches: (1) 5.25% sodium hypochlorite + 17% EDTA, (2) bidistilled water, and (3) no irrigation. After root canal preparation, high-resolution scans of the teeth were accomplished, and free software packages were used to register and quantify the amount of accumulated hard-tissue debris in either canal space or isthmus areas. RESULTS Canal preparation without irrigation resulted in 34.6% of its volume filled with hard-tissue debris, whereas the use of bidistilled water or NaOCl followed by EDTA showed a reduction in the percentage volume of debris to 16% and 11.3%, respectively. The closer the distance to the isthmus area was the larger the amount of accumulated debris regardless of the irrigating protocol used. CONCLUSIONS Through the present method, it was possible to calculate the volume of hard-tissue debris in the isthmuses and in the root canal space. Free-software packages used for image reconstruction, registering, and analysis have shown to be promising for end-user application.