Removal of Water Binding Proteins from Dentin Increases the Adhesion Strength of Low-Hydrophilicity Dental Resins

Objectives To investigate the role of proteoglycans (PGs) on the physical properties of the dentin matrix and the bond strength of methacrylate resins with varying hydrophilicities. Methods Dentin were obtained from crowns of human molars. Enzymatic removal of PGs followed a standard protocol using 1 mg/mL trypsin (Try) for 24 h. Controls were incubated in ammonium bicarbonate buffer. Removal of PGs was assessed by visualization of glycosaminoglycan chains (GAGs) in dentin under transmission electron microscopy (TEM). The dentin matrix swelling ratio was estimated using fully demineralized dentin. Dentin wettability was assessed on wet, dry and re-wetted dentin surfaces through water contact angle measurements. Microtensile bond strength test (TBS) was performed with experimental adhesives containing 6% HEMA (H6) and 18% HEMA (H18) and a commercial dental adhesive. Data were statistically analyzed using ANOVA and post-hoc tests (α = 0.05). Results The enzymatic removal of PGs was confirmed by the absence and fragmentation of GAGs. There was statistically significant difference between the swelling ratio of Try-treated and control dentin (p \u3c 0.001). Significantly lower contact angle was found for Try-treated on wet and dry dentin (p \u3c 0.002). The contact angle on re-wet dentin was not recovered in Try-treated group (p = 0.9). Removal of PGs significantly improved the TBS of H6 (109% higher, p \u3c 0.001) and H18 (29% higher, p = 0.002) when compared to control. The TBS of commercial adhesive was not affected by trypsin treatment (p = 0.9). Significance Changing the surface energy of dentin by PGs removal improved resin adhesion, likely due to more efficient water displacement, aiding to improved resin infiltration and polymerization

Morphological analysis of glass, carbon and glass/carbon fiber posts and bonding to self or dual-cured resin luting agents

OBJECTIVE: The aim of this study was to evaluate the morphology of glass (GF), carbon (CF) and glass/carbon (G/CF) fiber posts and their bond strength to self or dual-cured resin luting agents. MATERIAL AND METHODS: Morphological analysis of each post type was conducted under scanning electron microscopy (SEM). Bond strength was evaluated by microtensile test after bisecting the posts and re-bonding the two halves with the luting agents. Data were subjected to two-way ANOVA and Tukey's test (&#945;=0.05). Failure modes were evaluated under optical microscopy and SEM. RESULTS: GF presented wider fibers and higher amount of matrix than CF, and G/CF presented carbon fibers surrounded by glass fibers, and both involved by matrix. For CF and GF, the dual-cured material presented significantly higher (p<0.05) bond strength than the self-cured agent. For the dual agent, CF presented similar bond strength to GF (p>0.05), but higher than that of G/CF (p<0.05). For the self-cured agent, no significant differences (p>0.05) were detected, irrespective of the post type. For GF and G/CF, all failures were considered mixed, while a predominance of adhesive failures was detected for CF. CONCLUSION: The bonding between fiber posts and luting agents was affected by the type of fibers and polymerization mode of the cement. When no surface treatment of the post is performed, the bonding between glass fiber post and dual-cured agent seems to be more reliable

Influência do preparo cervical na determinação da lima anatômica inicial de raízes palatinas de molares superiores

PURPOSE: The aim of this study was to investigate the influence of cervical preflaring in determining the initial apical file (IAF) in the palatal roots of maxillary molars, and to determine the morphologic shape of the canal 1 mm short of the apex. METHODS: After preparing standard access cavities the group 1 received the IAF without cervical preflaring (WCP). In groups 2 to 5, preflaring was performed with Gates-Glidden (GG), Anatomic Endodontics Technology (AET), GT Rotary Files (GT) and LA Axxes (LA), respectively. Each canal was sized using manual K-files, starting with size 08 files, and making passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL. The IAF area and the area of the root canal were measured to verify the percentage occupied by the IAF inside the canal in each sample by SEM. The morphologic shape of the root canal was classified as circular, oval or flattened. Statistical analysis was performed by ANOVA/Tukey test (P < 0.05). RESULTS: The decreasing percentages occupied by the IAF inside the canal were: LA&gt;GT=AET&gt;GG&gt;WCP. The morphologic shape was predominantly oval. CONCLUSION: The type of cervical preflaring used interferes in the determination of IAF

Influência do preparo cervical na determinação da lima anatômica inicial de raízes palatinas de molares superiores

PURPOSE: The aim of this study was to investigate the influence of cervical preflaring in determining the initial apical file (IAF) in the palatal roots of maxillary molars, and to determine the morphologic shape of the canal 1 mm short of the apex. METHODS: After preparing standard access cavities the group 1 received the IAF without cervical preflaring (WCP). In groups 2 to 5, preflaring was performed with Gates-Glidden (GG), Anatomic Endodontics Technology (AET), GT Rotary Files (GT) and LA Axxes (LA), respectively. Each canal was sized using manual K-files, starting with size 08 files, and making passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL. The IAF area and the area of the root canal were measured to verify the percentage occupied by the IAF inside the canal in each sample by SEM. The morphologic shape of the root canal was classified as circular, oval or flattened. Statistical analysis was performed by ANOVA/Tukey test (P < 0.05). RESULTS: The decreasing percentages occupied by the IAF inside the canal were: LA&gt;GT=AET&gt;GG&gt;WCP. The morphologic shape was predominantly oval. CONCLUSION: The type of cervical preflaring used interferes in the determination of IAF

Effect of intracanal medication on the bond strength of root canal sealer to dentin

Objetivo: Este estudo teve como objetivo avaliar a influência da medicação intracanal na resistência de união de um cimento obturador endodôntico à dentina radicular. Métodos: Foram utilizadas 24 raízes bovinas unirradiculares que foram submetidas ao preparo químico-cirúrgico e divididas aleatoriamente em 4 grupos da seguinte forma: G1, (controle), sem medicação; G2, Hidróxido de Cálcio (Ca(OH)2) + Clorexidina (CHX); G3, bolinha de algodão embebida em Formocresol; e, G4, bolinha de algodão embebida em Paramonoclorofenol Canforado. As amostras ficaram armazenadas em temperatura ambiente e 100% de umidade por 1 semana. Logo após, foram obturadas com cimento endodôntico AH Plus e cones de guta-percha. Os dentes foram então fatiados transversalmente e o teste de push-out foi realizado. Os dados foram tabulados e submetidos à Análise de Variância. Resultados: As médias e seus respectivos desvios-padrão foram: G1, 2,42 (±1,45) ; G2, 1,81 (±1,04); G3, 2,21 (±1,14); e, G4, 2.63 (±1.32). Os resultados mostraram que não houve diferença estatisticamente significante entre os grupos em estudo. Conclusão: Pode-se concluir que as medicações intracanal utilizadas neste estudo não influenciaram na resistência de união do cimento obturador AH Plus à dentina radicular. Objective: The aim of this study was to investigate the influence of intracanal medication on the bond strength of root canal sealer to dentin. Methods: The root canals of 24 bovine incisor were prepared and randomly divided into 4 groups as follows: G1, (control group) no intracanal medication; G2, calcium hydroxide (Ca(OH)2) + chlorhexidine; G3, cotton with Formocresol; and, G4, cotton with camphorated paramonochlorophenol. The samples were stored at temperature of 37 degrees and 100% humidity for 1 week. After, they were sealed with AH Plus sealer and gutta-percha. All roots were sectioned transversely, and the push-out test was performed. The bond strength means were analyzed by analysis of variance. Results: The mean values for the bond strength test and standard deviations were: G1, 2.42 (±1.45); G2, 1.81 (±1.04); G3, 2.21 (±1.14); e, G4, 2.63 (±1.32). The results showed no statistically significant difference between the groups. Conclusion: It can be concluded that intracanal medications used in this study did not influence on the bond strength of AH Plus root canal sealer to dentin

Influence of glass fiber posts and class III direct restorations on the resistance of anterior teeth

This study objectives to evaluate the fracture strength of upper central incisors (UCI) restored with composite resin (CR) in Class III cavities and endodontically treated teeth with or without glass fiber post (GFP), analyzing their failure mode. Sixty human UCI were randomly divided into four experimental groups: endodontically treated teeth without GFP (G1), endodontically treated teeth with GFP (G2), teeth with mesial/distal Class III cavities restored with CR without GFP (G3), and teeth with mesial/distal Class III cavities restored with CR with GFP (G4). The samples were submitted to the fracture strength test in a universal testing machine with a compression shear load applied at speed of 1.0 mm/min until fracture occurred. The data were submitted to one-way ANOVA (α=0.05) and the samples were analyzed for failure mode. The analysis did not show a significant statistical difference in fracture strength between the groups (p>0.05). The results showed that only endodontically treated teeth (G1) (753.4N) presented behavior similar to teeth with GFP (G2) (702.1N). The same occurred when comparing teeth with Class III cavities without GFP (G3) (670.2 N) and with GFP (G4) (746.1N). It can be concluded that glass fiber posts do not change the fracture strength of incisors with endodontic treatment and Class III cavities

Effect of reciprocating instrumentation on chlorhexidine substantivity on human dentin: chemical analysis followed by confocal laser microscopy

The present research analyzed the reciprocating instrumentation associated to chlorhexidine (CHX) substantivity as its correlation with E. faecalis viabilityin ex vivoroot canals. Eighty extracted single-rooted human teeth were used, being 40 to high-performance liquid chromatography (HPLC) and 40 to confocal laser scanning microscopy (CLSM). In both, teeth were decoronated and the cervical third was prepared. In the CLSM analysis, the root canals were inoculated with E. faecalisfor 14 days. Samples were divided into 4 groups (n=10) according to instrumentation technique: no instrumentation and irrigation with distilled water (control); manual instrumentation (K-File); rotary instrumentation (ProTaper Next); and reciprocating instrumentation (Reciproc R25). Two percent chlorhexidine was applied as irrigating substance in experimental groups. Longitudinal grooves resulted in 2 halves root and 20 proof bodies in each group. Samples were divided by chance in two groups (n=10) and theoutcomes were evaluated after two days and one week. The retained chlorhexidine and live cells after instrumentation techniques in each evaluation time was measured by HPLC and CLSM, respectively. Specific analysis was applied for experimental tests (p≤0.05). Both rotary as well as reciprocating techniques significantly reduced the amount of chlorhexidine on dentin in all observation periods (p0.05). Reciprocating instrumentation does not interfere on chlorhexidine substantivity

Influence of gel chlorexidine, ethanol and sodium hypoclorite on the bond strenght to root dentin and adhesive durability of the fiber post relined with resin composite

Orientador: Caio Cezar Randi FerrazTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: A resistência de união de pinos à dentina radicular pode ser comprometida ao longo do tempo pela degradação da interface adesiva. Por isso, o objetivo deste estudo foi avaliar o efeito do pré-tratamento da dentina radicular com clorexidina 2% (CHX), etanol 100% (EtOH) e hipoclorito de sódio 5,25% (NaOCl) e a associação dessas substâncias, na resistência de união e durabilidade adesiva de pinos de fibra de vidro reembasados com resina composta à dentina radicular. Também foram avaliadas a técnica úmida (TU) e seca (TS) (secagem com jatos de ar por 5 segundos). No capítulo 1 que compõe este trabalho, os prétratamentos foram: G1(controle)- irrigação com soro fisiológico; G2- TS; G3- CHX por 5 minutos; G4- EtOH por 1 minuto; e G5- CHX por 5 minutos seguido de EtOH por 1 minuto. Logo após, os canais foram secos com cones de papel absorvente (TU) e a dentina hibridizada com Scotch Bond. No G2, após a TU foi realizada TS. Pinos fibra de vidro reembasados com resina composta foram cimentados com Rely X ARC. Cada grupo foi dividido em 3 subgrupos: 24 horas de armazenamento em água; 12 meses em água; 12 meses em óleo. Todos as raízes foram seccionadas, o teste de push-out realizado e os valores de resistência de união analisados estatisticamente pelos testes ANOVA/Tukey's (a=0,05). Os grupos imediatos apresentaram valores similares (P>0,05), com exceção da TS que resultou em menores valores de resistência de união (P<0,05). A CHX preservou os valores nos grupos estocados por 12 meses (P>0,05), e os demais grupos estocados apresentaram redução nos valores de resistência de união (P<0,05). Pode-se concluir que apenas a CHX foi capaz de preservar os valores de resistência por 12 meses. No capítulo 2, foi realizado o pré-tratamento da dentina radicular com NaOCl isolado e em associação com CHX e/ou EtOH, além da realização da TU e TS. O sistema adesivo, os demais procedimentos e análise estatística foram similares ao capítulo 1. Os resultados mostraram maiores valores de resistência de união nos grupos onde apenas o NaOCl foi utilizado ou associado à CHX, com a TU ou TS, nos grupos imediatos e armazenados por 12 meses (P>0.05). Nos grupos onde EtOH foi utilizado, os valores de resistência de união foram menores (P0,05). Houve diminuição significante nos grupos controles após 12 meses de armazenamento (P0,05). Pode-se concluir que o pré-tratamento da dentina com CHX e/ou EtOH foi capaz de preservar a resistência de união por 12 meses.Abstract: The bond strength of posts to root dentin can be compromised over time by adhesive interface degradation. Therefore, the aim of this study was to investigate the effects of pre-treatment of root dentin with 2% chlorhexidine (CHX), 100% ethanol (EtOH) and 5.25% sodium hypochlorite (NaOCl), as well as the association of these substances, on the bond strength and adhesive durability of fiber posts relined with resin composite to root dentin. The wet (WT) and dry (ST) (air-drying for five seconds) techniques were also evaluated. The first chapter of this work, the pre-treatments were: G1-control, irrigation with physiologic solution; G2, ST; G3, 5 minutes with CHX; G4, 1 minute with EtOH; and G5, 5 minutes with CHX followed by 1 minute EtOH. Afterwards, the root canals were dried with absorbent paper cones (WT) and the dentin hybridized with Scotch Bond. In G2, after WT was realized ST. Fiber post relining with resin composite was cemented with RelyX ARC. Each group was randomly divided into three subgroups: 24 h of water storage, 12 months of water storage, and 12 months of oil storage. All roots were sectioned transversely, the push-out test was performed and bond strength values were analyzed by ANOVA/Tukey's test (a=0.05). Immediate groups showed similars bond strengths (P>0.05), except that the ST significantly decreased bond strength (P<0.05). The use of CHX preserved bond strength in the groups stored in water and oil for 12 months (P>0.05). The other groups stored for 12 months showed a significant decrease in bond strength (P<0.05). It may be concluded that CHX preserved the bond strength for 12 months. In the second chapter, pretreatment of root dentin was performed with NaOCl alone, and associated with CHX and/or EtOH. In addition ST and WT were performed. The adhesive system, the sample preparation and statistical analysis were similar to those used in the first chapter. The results showed that the groups in which NaOCl was used alone or associated with CHX showed the highest bond strength values with ST or WT in the immediate and groups stored for 12 months (P>0.05). The groups that used EtOH showed lower bond strength and there was a statistical similarity between them (P<0.05). It may be concluded that the use of NaOCl or NaOCl associated with CHX preserved the bond strength to root dentin for 12 months. In the third chapter, the treatments were the same as those in the first chapter. However, the ST was not studied and the adhesive used was Clearil SE Bond. The sample preparation and statistical analysis were similar to those used in the first chapter. Immediate groups showed similar bond strength values with or without CHX and/or EtOH pre-treatment (P>0.05). A significant decrease in the bond strength was observed in the control groups after 12 months of storage in water and oil (P<0.05). It may be concluded that the use of CHX and/or EtOH preserved bond strength in the groups stored in water and oil for 12 months (P<0.05).DoutoradoEndodontiaDoutor em Clínica Odontológic

Influence of cervical preflaring on determination of apical file size using to instrumentation in root of first maxillary molars: SEM analysis

O objetivo deste estudo foi avaliar ex vivo a influência do alargamento cervical na determinação do instrumento apical inicial (IAI), no comprimento de trabalho (CT), dos canais radiculares de primeiros molares superiores, e determinar a forma do canal a 1 mm do ápice. Cinqüenta dentes foram divididos aleatoriamente em 5 grupos (n=10) de acordo com o preparo dos terços cervical e médio do canal: GI- sem alargamento; GII- brocas Gates- Glidden (#2, #3) (GG); GIII- AET (S1, SC, S2 e S3); GIV- GT Rotary File (20/06, 20/08, 20/10 e 20/10) (GT); GV- LA Axxess (20.06, 35.06) (LA). Os canais foram explorados com lima tipo K inserindo-se passivamente a lima 08 no CT, e limas de diâmetros sucessivamente maiores até obter a sensação de travamento. Foram feitas secções transversais no CT, analisadas em MEV e a área do IAI e a área do canal radicular foram medidas para verificar a porcentagem que o IAI ocupou no interior do canal em cada amostra. A forma do canal radicular foi classificada em circular, oval e achatada. A análise de variância indicou diferença estatisticamente significante entre a área ocupada pelo IAI entre os grupos experimentais (p GT (44,16 ± 9,35) = AET (44,10 ± 8,88) > GG (33,17 ± 6,68) = sem alargamento (23,85 ± 6,86); para o canal disto-vestibular: LA Axxess (75,12 ± 8,56) > GT (58,68 ± 7,70) = AET (54,66 ± 7,12) > GG (39,76 ± 7,52) > sem preparo (26,90 ± 6,10); e para o canal palatino: LA Axxess (66,55 ± 11,40) > AET (51,98 ± 10,67) = GT (49,50 ± 10,05) > GG (35,70 ± 7,62) > sem preparo (21,43 ± 2,79). A forma do canal foi predominantemente achatada para o canal mésio-vestibular, circular para o canal distovestibular e oval para o canal palatino. Pode-se concluir que o preparo dos terços cervical e médio do canal radicular permite melhor determinação do IAI, e que o preparo cervical com brocas LA Axxess apresentou a melhor adaptação do IAI no CT.The aim of this study was to investigate ex vivo the influence of cervical preflaring on determination the initial apical file (IAI), in the working length (WL), of the root canals of the maxillary first molars and to determine the shape of the canal at 1 mm from the apex. Fifty teeth were randomly divided into 5 groups (n=10) in accordance with the preflaring of the cervical and middle thirds of the canal: GI - without preflaring; GII - Gates-Glidden burs (#2, #3) (GG); GIII - AET (S1, SC, S2 and S3); GIV - GT Rotary File (20/06, 20/08, 20/10 and 20/10) (GT); GV - LA Axxess burs (20.06, 35.06) (LA). The canals were sized with the type K-file, passively inserting the file 08 in the WL and files with successively greater diameters until a binding sensation was felt. Cross sections were made in the WL, analyzed by SEM and the IAI area and the area of the root canal were measured to verify the percentage that the IAI occupied inside the canal in each sample. The shape of the root canal was classified as circular, oval and flattened. The analysis of variance indicated a statistically significant difference between the area occupied by the IAI and the experimental groups (p GT (44.16 ± 9.35) = AET (44.10 ± 8.88) > GG (33.17 ± 6.68) = without preflaring (23.85 ± 6.86); for the distobuccal canal: LA Axxess (75.12 ± 8.56) > GT (58.68 ± 7.70) = AET (54.66 ± 7.12) > GG (39.76 ± 7.52) > without preflaring (26.90 ± 6.10); and for the palatal canal: LA Axxess (66.55 ± 11.40) > AET (51.98 ± 10.67) = GT (49.50 ± 10.05) > GG (35.70 ± 7.62) > without preflaring (21.43 ± 2.79). The shape of the canal was predominantly flattened for the mesiobuccal canal, circular for the distobuccal canal and oval for the palatal canal. It may be concluded that the preflaring of the cervical and middle thirds of the root canal allows better determination of the IAI and that the cervical preflaring with LA Axxess burs presented better adaptation of the IAI in the WL