Physicochemical properties of calcium silicate-based formulations MTA Repair HP and MTA Vitalcem

Objective: This study aimed to analyze the following physicochemical properties: radiopacity, final setting time, calcium release, pH change, solubility, water sorption, porosity, surface morphology, and apatite-forming ability of two calcium silicate-based materials. Material and methods: We tested MTA Repair HP and MTA Vitalcem in comparison with conventional MTA, analyzing radiopacity and final setting time. Water absorption, interconnected pores and apparent porosity were measured after 24-h immersion in deionized water at 37°C. Calcium and pH were tested up to 28 d in deionized water. We analyzed data using two-way ANOVA with Student-Newman-Keuls tests (p<0.05). We performed morphological and chemical analyses of the material surfaces using ESEM/EDX after 28 d in HBSS. Results: MTA Repair HP showed similar radiopacity to that of conventional MTA. All materials showed a marked alkalinizing activity within 3 h, which continued for 28 d. MTA Repair HP showed the highest calcium release at 28 d (p<0.05). MTA Vitalcem showed statistically higher water sorption and solubility values (p<0.05). All materials showed the ability to nucleate calcium phosphate on their surface after 28 d in HBSS. Conclusions: MTA Repair HP and MTA Vitalcem had extended alkalinizing activity and calcium release that favored calcium phosphate nucleation. The presence of the plasticizer in MTA HP might increase its solubility and porosity. The radiopacifier calcium tungstate can be used to replace bismuth oxide

Evaluation of the Cyclic and Torsional Fatigue Resistance of Thermally Treated Hyflex CM versus Aurum Blue Nickel-titanium Rotary Instruments

Introduction: We aim to evaluate the cyclic and torsional fatigue resistance of two rotary instruments, Hyflex CM 25/0.06 (HCM) (Coletene-Whaledent, Allstetten, Switzerland) and Aurum Blue (AB) 25/0.06 (Meta-Biomed, Republic of Korea). Methods and Materials: Forty rotary instruments, HCM 25/0.06 and AB 25/0.06 (n=20 each) were used. The instruments were rotated in an artificial stainless steel canal with a 60° angle and a 5-mm radius of curvature (n=10) at body temperature (35°±1°C). The torsional test evaluated the torque and angle of rotation at failure of new instruments (n=10) in the portion 3 mm from the tip according to ISO 3630-1. The fractured surface of each fragment was observed by scanning electron microscopy. The data were analyzed using unpaired student’s t- test, and the level of significance was set at 5%. Results: AB 25/0.06 had significantly greater number of cycles to failure than HCM 25/0.06 (P<0.05). The torsional test showed there were no significant differences in the torsional strength and angular rotation to fracture between the groups (P>0.05). Conclusion: Based on this in vitro study, AB 25/0.06 instrument was more resistant to cyclic fatigue than the HCM 25/0.06 instrument, suggested that these instruments are safer than HCM 25/0.06 for the preparation of severely curved canals. However; there was no significant difference in the torsional properties of the two instruments then appear to have similar performance during constricted canal preparation

Final irrigation protocols can be used to promote stable long-term bond strength of AH Plus to dentin

Irrigation solutions might affect dentin surface characteristics and, consequently, endodontic sealers adhesion. Objective: This study analyzed the effect of different final irrigation protocols on push-out bond strength (BS) of AH Plus to dentin seven days and 20 months after obturation. Scanning electron micrographs were obtained from the dentin surface of one sample/group after final irrigation. Methodology: Canals of bovine incisors were instrumented and received final irrigation with (n=21): G1 – 2.5% sodium hypochlorite (NaOCl) + distilled water; G2 – 2.5% NaOCl + 17% EDTA; G3 – 2.5% NaOCl + 17% EDTA + 2.5% NaOCl; G4 – 2.5% NaOCl + 17% EDTA + 2% chlorhexidine (CHX); G5 – mixture 5% NaOCl + 18% etidronate (HEDP); and G6 – mixture 5% NaOCl + 10% tetrasodium EDTA (Na4EDTA). After irrigation, one root/group was split and images were obtained by scanning electron microscopy (SEM). The other 20 roots/group were filled with only AH Plus sealer. Three slices/root were used for push-out assessment seven days and 20 months after obturation. One-way analysis of variance and Tukey (α<0.05) were used to compare the results among experimental groups, and unpaired t-test (α<0.05) was used to compare the results of the same group over time. Results: The photomicrographs showed that, excepting G1, all groups completely removed the smear layer from the samples. In G2 and G4, the opening of the dentin tubules enlarged. In G3, erosion was observed in the peritubular and intertubular dentin. Values of the BS in the seven days were G2=G3=G4=G5>G6=G1 and in the 20 months were G3=G5>G6=G4>G1=G2. G3, G5, and G6 presented values of BS in 20 months similar to the values of seven days (P>0.05). Conclusions: The final irrigation protocols tested produced dentin surfaces with different characteristics. Only G3 and G5 presented high BS values that were stable over time

Evaluation of single root canals filled using the lateral compaction, tagger's hybrid, microseal and guttaflow techniques

The aim of this study was to determine the percentage of voids, gutta-percha and root canal sealer using 4 different filling techniques. Fifty-two extracted maxillary lateral incisors were prepared using the crown-down pressureless technique. The teeth were randomly divided in 4 groups (n=13): Lateral compaction (LC), Tagger's hybrid (TH), MicroSeal (MS) and GuttaFlow (GF) techniques. Horizontal cross-sections were made at the 2, 10 and 15 mm levels from the apex. Digital images of the root canal areas were acquired using a stereomicroscope and examined using the Image Tool 3.0 software. Statistical analysis was performed using the Kruskal-Wallis test (&#945;=0.05). In general, a significant decrease in the gutta-percha filled area and increase of sealer area were observed at the apical level for all the evaluated techniques (p<0.05). With regard to the presence of voids, no significant difference was found. MS and TH techniques showed a larger gutta-percha filled area than LC and GF techniques at the coronal and middle third level (p<0.05). From the results of the present study, it may be concluded that the gutta-percha filled area of fillings decrease at the apical level, regardless of the filling technique used.O objetivo do estudo foi determinar a porcentagem de espaços vazios, guta-percha e cimento após a obturação por 4 diferentes técnicas. Cinquenta e dois incisivos laterais superiores humanos extraídos foram instrumentados pela técnica coroa-ápice sem pressão. Os dentes foram randomicamente divididos em 4 grupos (n=13): Condensação lateral (LC), Técnica híbrida de Tagger (TH), MicroSeal (MS) e GuttaFlow (GF). Foram feitas secções horizontais a 2, 10 e 15 mm do ápice. Imagens digitais foram obtidas dos canais por meio de estereomicroscópio e analisadas no programa Image Tool 3.0. A análise estatística foi feita utilizando o teste de Kruskal-Wallis (&#945;=0,05). Em geral foi observado um significante decréscimo na área de guta-percha e um aumento na área de cimento para todas as técnicas analisadas (p<0,05). Com relação à presença de espaços vazios, não houve diferença estatística entre as técnicas (p&gt;0,05). As técnicas MS e TH apresentaram área de guta-percha maior que as técnicas LC e GF nos terços médio e cervical (p<0,05). Após análise dos resultados foi possível concluir que a área de guta-percha nas obturações diminui em sentido apical, independente da técnica utilizada

Effectiveness of rotary or manual techniques for removing a 6-year-old filling material

The aim of this study was to evaluate the effectiveness of manual and rotary instrumentation techniques for removing root fillings after different storage times. Twenty-four canals from palatal roots of human maxillary molars were instrumented and filled with gutta-percha and zinc-oxide eugenol-based sealer (Endofill) , and were stored in saline for 6 years. Non-aged control specimens were treated in the same manner and stored for 1 week. All canals were retreated using hand files or ProTaper Universal NiTi rotary system. Radiographs were taken to determine the amount of remaining material in the canals. The roots were vertically split, the halves were examined with a clinical microscope and the obtained images were digitized. The images were evaluated with AutoCAD software and the percentage of residual material was calculated. Data were analyzed with two-way ANOVA and Tukey's test at 5% significance level. There was no statistically significant differences (p&gt;0.05) between the manual and rotary techniques for filling material removal regardless the ageing effect on endodontic sealers. When only the age of the filling material was analyzed microscopically, non-aged fillings that remained on the middle third of the canals presented a higher percentage of material remaining (p<0.05) compared to the aged sealers and to the other thirds of the roots. The apical third showed a higher percentage of residual filling material in both radiographic and microscopic analysis when compared to the other root thirds. In conclusion, all canals presented residual filling material after endodontic retreatment procedures. Microscopic analysis was more effective than radiographs for detection of residual filling material.O objetivo deste estudo foi avaliar a efetividade da instrumentação manual e rotatória na remoção de material obturador de canais radiculares de raízes palatinas de molares superiores humanos, em dois períodos de tempo. Vinte e quatro raízes foram instrumentadas e obturadas com guta-percha, cimento de óxido de zinco e eugenol e armazenadas em solução salina durante 6 anos. Outras 24 raízes foram tratadas da mesma maneira e armazenadas por uma semana. Os canais radiculares foram retratados usando limas manuais ou instrumentos rotatórios do Sistema ProTaper Universal. Radiografias periapicais foram feitas para mensurar a quantidade de material remanescente. Posteriormente as raízes foram clivadas e imagens microscópicas obtidas a partir de um microscópio clínico operatório foram digitalizadas. As imagens foram avaliadas através do software Autocad 2004 e área de material obturador remanescente foi mensurada. A Análise da Variância (Two-way) e o Teste T demonstraram não haver diferenças estatisticamente significantes entre a técnica manual e rotatória na remoção de material obturador. O terço apical mostrou a maior percentagem de remanescentes de material obturador, na análise radiográfica e microscópica quando comparado com os outros terços radiculares. Todos os canais revelaram resíduos de material obturador após o retratamento endodôntico. A análise microscópica foi mais efetiva do que a radiográfica na detecção de remanescente de obturação do canal radicular

Evaluation of the surface of root canal walls after utilization of endodontic rotary systems: SEM study

The objective of the present study was to determine, by scanning electron microscopy, the aspect of root canal walls after utilization of different rotary instrumentation systems for root canal preparation. Forty-two single-rooted and straight teeth were divided into six groups, whose root canals were prepared using the following rotary systems: groups 1 and 2 - Quantec; groups 3 and 4 - Pow-R; groups 5 and 6 - Profile. Irrigation was performed with 2.5% sodium hypochlorite solution in all groups, while only groups 2, 4 and 6 received a final flush with EDTA. Data were analyzed by non-parametric Kruskal-Wallis and Miller tests. Removal of the smear layer and other debris was more effective in the groups receiving EDTA as final irrigant. The Profile system showed the best cleaning, generating only a minimum smear layer, with a significant difference being observed compared to the Pow-R system (pO objetivo do presente estudo foi avaliar por meio de microscopia eletrônica de varredura, o aspecto superficial de paredes de canais radiculares apos uso de sistemas rotatórios de instrumentação endodôntica. Quarenta e dois dentes unirradiculados e com canais retilíneos foram divididos em seis grupos experimentais. Foram preparados utilizando-se os seguintes sistemas: Grupos 1 e 2 - Sistema Quantec; grupos 3 e 4 - Sistema Pow-R; grupos 5 e 6 - Sistema Profile. A irrigação foi realizada com solução de hipoclorito de sódio a 2.5% em todos os grupos durante a instrumentação. Apenas nos grupos 2, 4 e 6 foi realizada toalete final dos canais com solução de EDTA. O dados foram analisados pelos testes não paramétricos de Kruskal-Wallis e Miller. Foi observada maior remoção de smear layer e outros resíduos nos grupos onde foi realizada a toalete final com solução de EDTA. O sistema Profile mostrou melhor resultado, gerando menor quantidade de resíduos, com diferença significante quando comparado com o sistema Pow-R(

Effects of calcium hydroxide addition on the physical and chemical properties of a calcium silicate-based sealer

Recently, various calcium silicate-based sealers have been introduced for use in root canal filling. The MTA Fillapex is one of these sealers, but some of its physicochemical properties are not in accordance with the ISO requirements. Objective: The aim of this study was to evaluate the flowability, pH level and calcium release of pure MTA Fillapex (MTAF) or containing 5% (MTAF5) or 10% (MTAF10) calcium hydroxide (CH), in weight, in comparison with AH Plus sealer. Material and Methods: The flowability test was performed according to the ISO 6876:2001 requirements. For the pH level and calcium ion release analyses, the sealers were placed individually (n=10) in plastic tubes and immersed in deionized water. After 24 hours, 7 and 14 days, the water in which each specimen had been immersed was evaluated to determine the pH level changes and calcium released. Flowability, pH level and calcium release data were analyzed statistically by the ANOVA test (α=5%). Results: In relation to flowability: MTAF>;AH Plus>;MTAF5>;MTAF10. In relation to the pH level, for 24 h: MTAF5=MTAF10=MTAF>;AH Plus; for 7 and 14 days: MTAF5=MTAF10>;MTAF>;AH Plus. For the calcium release, for all periods: MTAF>;MTAF5=MTAF10>;AH Plus. Conclusions: The addition of 5% CH to the MTA Fillapex (in weight) is an alternative to reduce the high flowability presented by the sealer, without interfering in its alkalization potential

The response of dual-species bacterial biofilm to 2% and 5% NaOCl mixed with etidronic acid:A laboratory real-time evaluation using optical coherence tomography

Aim: The addition of etidronic acid (HEDP) to sodium hypochlorite (NaOCl) could increase the antibiofilm potency of the irrigant, whilst maintaining the benefits of continuous chelation. Studies conducted so far have shown that mixing HEDP with NaOCl solutions of relatively low concentration does not compromise the antibiofilm efficacy of the irrigant. However, the working lifespan of NaOCl may decrease resulting in a reduction of its antibiofilm efficacy over time (efficiency). In this regard, continuous irrigant replenishment needs to be examined. This study investigated the response of a dual-species biofilm when challenged with 2% and 5% NaOCl mixed with HEDP for a prolonged timespan and under steady laminar flow. Methodology: Dual-species biofilms comprised of Streptococcus oralis J22 and Actinomyces naeslundii T14V-J1 were grown on human dentine discs in a constant depth film fermenter (CDFF) for 96 h. Biofilms were treated with 2% and 5% NaOCl, alone or mixed with HEDP. Irrigants were applied under steady laminar flow for 8 min. Biofilm response was evaluated by means of optical coherence tomography (OCT). Biofilm removal, biofilm disruption, rate of biofilm loss and disruption as well as bubble formation were assessed. One-way anova, Wilcoxon's signed-rank test and Kruskal–Wallis H test were performed for statistical analysis of the data. The level of significance was set at a ≤.05. Results: Increasing NaOCl concentration resulted in increased biofilm removal and disruption, higher rate of biofilm loss and disruption and increased bubble formation. Mixing HEDP with NaOCl caused a delay in the antibiofilm action of the latter, without compromising its antibiofilm efficacy. Conclusions: NaOCl concentration dictates the biofilm response irrespective of the presence of HEDP. The addition of HEDP resulted in a delay in the antibiofilm action of NaOCl. This delay affects the efficiency, but not the efficacy of the irrigant over time

Rat subcutaneous tissue response to MTA Fillapex® and Portland cement

The aim of this study was to evaluate the response of rat subcutaneous tissue to MTA Fillapex® (Angelus), an experimental root canal filling material based on Portland cement and propylene glycol (PCPG), and a zinc oxide, eugenol and iodoform (ZOEI) paste. These materials were placed in polyethylene tubes and implanted into the dorsal connective tissue of Wistar rats for 7 and 15 days. The specimens were stained with hematoxylin and eosin, and evaluated regarding inflammatory reaction parameters by optical microscopy. The intensity of inflammatory response against the sealers was analyzed by two blinded and previously calibrated examiners for all experimental periods (kappa=0.96). The histological evaluation showed that all materials caused a moderate inflammatory reaction at 7 days, which subsided with time. A greater inflammatory reaction was observed at 7 days in the tubes filled with ZOEI paste. Tubes filled with MTA Fillapex presented some giant cells, macrophages and lymphocytes after 7 days. At 15 days, the presence of fibroblasts and collagen fibers was observed indicating normal tissue healing. The tubes filled with PCPG showed similar results to those observed in MTA Fillapex. At 15 days, the inflammatory reaction was almost absent at the tissue, with several collagen fibers indicating normal tissue healing. Data were analyzed by the nonparametric Kruskal-Wallis test (?=0.05). Statistically significant difference (p<0.05) was found only between PCPG at 15 days and ZOEI at 7 days groups. No significant differences were observed among the other groups/periods (p>0.05). MTA Fillapex and Portland cement added with propylene glycol had greater tissue compatibility than the PCPG paste.O objetivo deste estudo foi avaliar a resposta do tecido subcutâneo de rato ao MTA Fillapex® (Angelus), a um cimento endodôntico experimental à base de cimento Portland e propilenoglicol, e à pasta de óxido de zinco e eugenol com iodofórmio. Estes materiais foram colocados em tubos de polietileno e implantados no tecido conjuntivo do dorso de ratos Wistar, por 7 e 15 dias. Os espécimes foram corados com hematoxilina e eosina e os parâmetros de reação inflamatória foram avaliados em microscópio óptico. A intensidade da resposta inflamatória provocada pelos cimentos foi analisada em todos os períodos por dois observadores previamente calibrados (kappa 0,96) e sem conhecimento dos grupos experimentais. O exame histológico mostrou que todos os materiais provocaram reação inflamatória moderada aos 7 dias que regrediu com o tempo. A maior resposta inflamatória do tecido foi observada aos 7 dias, nos tubos preenchidos com pasta de Óxido de Zinco e Eugenol com Iodofórmio. Os tubos com MTA Fillapex apresentaram algumas células gigantes, macrófagos e linfócitos após 7 dias. Aos 15 dias, a presença de fibroblastos e fibras de colágenas foi observada, indicando processo de cicatrização do tecido. Os tubos com o cimento Portland mostraram resultados semelhantes aos observados no grupo MTA Fillapex. Aos 15 dias, a reação inflamatória apresentada foi praticamente ausente, com muitas fibras colágenas, indicando cicatrização normal do tecido. A análise estatística mostrou diferença estatisticamente significante entre o grupo de cimento Portland (15 dias) e óxido de zinco eugenol com Iodofórmio (7 dias) (p<0,05). Nos outros grupos não houve diferença estatística significante. MTA Fillapex e cimento Portland são mais biocompatíveis do que os outros cimentos testados

19th World Conference on Open Learning and Distance Education

Todos os trabalhos se desenvolveram no Austria Center Vienna, o mais moderno centro de congressos da capital austríaca, adjacente ao complexo das Nações Unidas, na margem esquerda do Danúbio, a menos de quinze minutos de metro do centro da cidade. Com mais de mil e trezentos participantes, na Conferência estiveram representados setenta e nove países, sendo trinta europeus, dezasseis asiáticos, quinze americanos, catorze africanos e quatro da zona do Pacífico. Em termos de representação individual, a Europa, com mais de 57% de presenças, foi a zona do globo mais visível. De salientar, contudo, a presença significativa de um elevado número de representantes de países em busca de desenvolvimento, de todos os continentes, da Letónia à Eslováquia, da Mongólia ao Vietname, da República Dominicana ao Equador, do Botswana à Tunísia, passando pelo Chade e pelo Togo