Effect of ultrasonic streaming on intra-dentinal disinfection and penetration of calcium hydroxide paste in endodontic treatment

Objective The antimicrobial effect of ultrasonic agitation of calcium hydroxide (CH) pastes in infected bovine dentin and their penetrability were evaluated using confocal laser scanning microscopy (CLSM) and microbiological culture. Material and Methods Fifty-two bovine teeth were infected with Enterococcus faecalis using a new contamination protocol; then they received CH paste and were divided into groups with or without ultrasound. Ultrasonic agitation was conducted for 1 min with a plain point insert. After 15 d, the CLSM analyzed the viable and dead bacteria with Live and Dead assay. The dentinal wall debris was collected by burs, and the colony forming units (CFU/mL) were counted. The penetrability of the paste inside dentinal tubules was tested using the B-rodamine dye. Results The calcium hydroxide paste showed better results with the use of ultrasonic agitation (

A new improved protocol for in vitro intratubular dentinal bacterial contamination for antimicrobial endodontic tests: standardization and validation by confocal laser scanning microscopy

Objectives To compare three methods of intratubular contamination that simulate endodontic infections using confocal laser scanning microscopy (CLSM). Material and Methods Two pre-existing models of dentinal contamination were used to induce intratubular infection (groups A and B). These methods were modified in an attempt to improve the model (group C). Among the modifications it may be included: specimen contamination for five days, ultrasonic bath with BHI broth after specimen sterilization, use of E. faecalisduring the exponential growth phase, greater concentration of inoculum, and two cycles of centrifugation on alternate days with changes of culture media. All specimens were longitudinally sectioned and stained with of LIVE/DEAD® for 20 min. Specimens were assessed using CLSM, which provided images of the depth of viable bacterial proliferation inside the dentinal tubules. Additionally, three examiners used scores to classify the CLSM images according to the following parameters: homogeneity, density, and depth of the bacterial contamination inside the dentinal tubules. Kruskal-Wallis and Dunn’s tests were used to evaluate the live and dead cells rates, and the scores obtained. Results The contamination scores revealed higher contamination levels in group C when compared with groups A and B (p;0.05). The volume of live cells in group C was higher than in groups A and B (

composition by different sodium hypochlorite concentrations

S odium hypochlorite (NaOCl) remains the most used irrigation solution during root canal preparation because of characteristics such as wide-spectrum antimicrobial activity and organic tissue dissolution capacity. However, these solutions can alter dentin composition and there is no consensus on the optimal concentration of NaOCl to be used. Objectives: To determine the organic matter dissolution and changes in dentin chemical composition promoted by different concentrations of NaOCl over time. Material and Methods: Fragments of bovine muscle tissue were weighed before and after 5, 10, and 15 min of immersion in the groups (n=10): G1-0.9% saline solution; G2-1% NaOCl; G3-2.5% NaOCl; and G4-5% NaOCl. Bovine dentin fragments were subjected to the same irrigants and absorption Spectroscopy (ATR-FTIR) before and after 0,5, 1, 2, 3, 5, 8, and 10 min of immersion in the solutions. The ratios of the amide III/phosphate and carbonate/phosphate absorption bands were determined. The tissue dissolution and carbonate/phosphate ratios were submitted to the two-way analysis of variance (ANOVA) with Tukey's multiple-comparison test ( <0.05) and to the one-way analysis of variance with Tukey's ( <0.05). The amide III/phosphate ratio was analyzed by Friedman test ( <0.05) and the Kruskal-Wallis test with Dunn's post-hoc ( <0.05). Results: The increase in NaOCl concentration and contact observed in the dissolution of organic matter at 10 min and in the amide III/phosphate ratio between the saline solution and 5% NaOCl at 5 min. The carbonate/phosphate ratio alterations did not occur in the subsequent periods (p>0.05). Intergroup differences were not observed in this ratio (p>0.05). Conclusions: The increase in the exposure time and in the concentration of NaOCl solution lead to an increase in the tissue dissolution and dentin collagen deproteination. Furthermore, some carbonate ions are removed from the dentin inorganic phase by the NaOCl

Análise dos sistemas rotatório e reciprocante com diferentes ligas na desobturação em retratamentos endodônticos

The aim of this study was to evaluate the effects of preparation, filling removal material, reinstrumentation and reobturation of root canals with different Ni-Ti alloys in endodontic retreatment. Firstly, the selection and pairing of mesial root canals of mandibular molars (n = 45) were performed by computerized micro-tomography (micro-CT). After pairing, the specimens were divided into three groups (n = 15), instrumented with the Mtwo® (up to file 25.06), ProDesign Logic (25.06) and ProDesign R (25.06) systems. After this, the specimens were scanned again for root canal deviation analysis at 2, 4, 6, 8 and 10 mm from the apex and the volume increase of these root canals was evaluated through CTan Then, the root canals were filled with Endofill® with 0.1% rhodamine B and scanned in micro-CT once again. For the retreatment of the specimens, 3 groups were established according to the system used (Reciproc®, Hyflex® and ProDesign Duo Hybrid®). During the retreatment, the specimens were scanned in micro-CT in two more phases, after removal of filling material and after reinstrumentation of the root canals. All the images obtained previous and post-retreatment were compared to evaluate the capacity of removal filling material of each system through the volume of material remaining at 3mm in the apical third. Possible deviation of the root canal was assessed at 2, 4, 6, 8 and 10 mm from the apex. In addition, the times of preparation, removal filling material and reinstrumentation of these files were also evaluated. After the removal filling material and reinstrumentation of the root canals, they were refilled with AH Plus with 0.1% fluorescein. The specimens were sectioned crosswise into 2 mm slices to be analyzed by a confocal laser scanning microscope (CLSM) at 1, 3 and 5 mm from the apex, where the volume of material was evaluated through LAS X 3D and 2D software. The time of preparation, removal filling material and reinstrumentation of the root canals between the different systems was measured by a digital timer. The evaluation of canal volumetric increase and preparation time between Mtwo and ProDesign Logic systems were conducted using Student t-test analysis. Non-parametric Wilcoxon test was used to the intragroup comparison at the 2, 4, 6, 8 and 10 mm levels and non-parametric Mann-Whitney test was used to the comparison between groups in the root canal transportation in all sections of the root canal. The intra-group comparison regarding the presence or absence of root canal deviation after removal of root canal filling material and re-instrumentation was submitted to the parametric T-paired statistical test, since it had a normal distribution. The working time with the different alloys used to removal filling material an reinstrumentation was analyzed through parametric ANOVA e Tukey statistical test. The analysis of the remaining material present in the root canals was performed with nonparametric Kruskal-Wallis and Dunn tests. For the intra-group comparison between the different slices (1, 3 and 5 mm), the data were submitted to nonparametric Friedman and Dunn tests. The level of significance was established at 5% in all analysis. After the initial preparation of the root canals, the ProDesign Logic system proved to be faster than Mtwo system, with statistical difference between them (P 0.05). In addition, the groups did not present a significant statistical difference to the volume increase of the root canals after the initial preparation or to the volume of filling material remaining after the retreatment (P> 0.05). The Reciproc system proved to be the fastest system for the removal filling material and reinstrumentation of the root canals (P 0.05). Além disso, os grupos também não apresentaram diferença estatística significante quanto ao aumento do volume dos canais após o preparo inicial, nem em relação ao volume de remanescente de material obturador após o retratamento (P > 0.05). O sistema Reciproc demonstrou ser o mais rápido dentre os sistemas quanto à desobturação e reinstrumentação dos canais (P < 0.05). O presente trabalho demonstrou que os sistemas Prodesign Logic and Mtwo apresentaram capacidade similar de preparo dos canais mesiais de molares inferiores. Os sistemas Reciproc, Hyflex e ProDesign Duo Híbrido são parecidos quanto à remoção de material obturador, preservando o formato original do canal em casos de retratamentos entodônticos. Entretanto, Reciproc foi o mais rápido comparado aos outros grupos

Intratubular decontamination of bovine teeth by acidified sodium hypochlorite solutions

A total descontaminação do sistema de canais radiculares e da massa dentinária é uma constante preocupação clínica. Diante disso, esta pesquisa teve o objetivo de avaliar o nível de descontaminação dentinária alcançada após irrigação com soluções de hipoclorito de sódio em diferentes concentrações valores de pH. Oitenta dentes bovinos unirradiculados foram divididos em 9 grupos experimentais diferentes. As coroas foram seccionadas e despregadas das raízes. Foram obtidos segmentos de 12mm e os canais instrumentados até a lima K120, preenchidos com EDTA 17%, durante 10 minutos. As raízes foram impermeabilizadas externamente com duas camadas de esmalte. Suspensões de Enterococcus faecalis (ATCC 29212) foram padronizadas em espectrofotômetro (3x108 UFC/mL) e depositadas em microtubos com caldo BHI e um espécime. O protocolo de contaminação seguiu a metodologia de MA et al. (2011) com adaptações. Após 5 dias, os espécimes foram fixados em um dispositivo de apoio esterilizado e irrigados durante 5 minutos com as soluções-teste estabilizadas com tampões: (G1) NaOCl 1% - pH5; (G2) NaOCl 1% - pH7; (G3) NaOCl 1% - pH10; (G4) NaOCl 2,5% - pH5; (G5) NaOCl 2,5% - pH 7; (G6) NaOCl 2,5% - pH10; (G7) NaOCl 5% - pH5; (G8) NaOCl 5% - pH7; (G9) NaOCl 5% - pH10, contendo 8 espécimes cada, além dos grupos controles. Após o tratamento com as soluções irrigadoras, metade dos espécimes é avaliada por cultura microbiológica (contagem de unidades formadoras de colônias UFC/mL das raspas de dentina retiradas das paredes dos canais) e a outra metade do mesmo grupo avaliada por microscopia confocal de varredura a laser (MCVL) e corante Live & Dead. Houve diferença estatística entre diversos grupos, analisados pelos testes de Kruskal-Wallis e Dunn. (p<0,05) Concluiu-se que a solução de hipoclorito de sódio acidificada provocou uma redução significante no número de bactérias. Essa redução foi ainda maior quando a concentração da solução era elevada.The complete decontamination of root canal system and dentinal mass is a constant clinical concern. Therefore, this study aimed to evaluate the level of dentin decontamination achieved after irrigation with sodium hypochlorite solutions at different concentrations and pH values. Eighty single rooted bovine teeth were divided into 9 different groups. The crowns were sectioned and separated from the roots. Then, there was obtained segments of 12mm and the root canals were instrumented until size #120 K-file and filled with 17% EDTA during 10 minutes. The roots were externally sealed with two layers of nail polish. Suspensions of Enteroccus faecalis (ATCC 29212) were standardized using a spectrophotometer (3x108 CFU/mL) and placed in microtubes containing BHI broth and one sample. The protocol of contamination followed the methodology of MA et al. (2011) with some adjustments. After five days, the samples were fixed in a sterilized device and irrigated during 5 minutes with the tested solutions stabilized by buffers substances: (G1) 1% NaOCl - pH5; (G2) 1% NaOCl - pH7; (G3) NaOCl 1% - pH10; (G4) 2.5% NaOCl - pH5, (G5) 2.5% NaOCl - pH 7, (G6) 2.5% NaOCl - pH10; (G7) 5% NaOCl - pH5; (G8 ) NaOCl 5% - pH 7 (G9) 5% NaOCl - pH10, containing 8 specimens each, and the control groups. After the treatment with the irrigating solutions, half of the specimens were evaluated by microbiological cultures (counting colony forming units CFU/mL of dentine chips removed from the wall of root canals) and the other half of the same group were evaluated by confocal laser scanning microscopy (CLSM) with fluorescent Live & Dead stain. There was statistical difference among various groups (p<0.05) by Kruskal-Wallis and Dunns test. It was concluded that the acidified sodium hypochlorite solution resulted in a significant reduction in the number of bacteria

Tissue dissolution and modifications in dentin composition by different sodium hypochlorite concentrations

Sodium hypochlorite (NaOCl) remains the most used irrigation solution during root canal preparation because of characteristics such as wide-spectrum antimicrobial activity and organic tissue dissolution capacity. However, these solutions can alter dentin composition and there is no consensus on the optimal concentration of NaOCl to be used. Objectives To determine the organic matter dissolution and changes in dentin chemical composition promoted by different concentrations of NaOCl over time. Material and Methods: Fragments of bovine muscle tissue were weighed before and after 5, 10, and 15 min of immersion in the groups (n=10): G1- 0.9% saline solution; G2- 1% NaOCl; G3- 2.5% NaOCl; and G4- 5% NaOCl. Bovine dentin fragments were subjected to the same irrigants and absorption spectra were collected by Attenuated Total Reflectance of Fourier Transform Infrared Spectroscopy (ATR-FTIR) before and after 0,5, 1, 2, 3, 5, 8, and 10 min of immersion in the solutions. The ratios of the amide III/phosphate and carbonate/phosphate absorption bands were determined. The tissue dissolution and carbonate/phosphate ratios were submitted to the two-way analysis of variance (ANOVA) with Tukey’s multiple-comparison test (

Tissue dissolution and modifications in dentin composition by different sodium hypochlorite concentrations

ABSTRACT Sodium hypochlorite (NaOCl) remains the most used irrigation solution during root canal preparation because of characteristics such as wide-spectrum antimicrobial activity and organic tissue dissolution capacity. However, these solutions can alter dentin composition and there is no consensus on the optimal concentration of NaOCl to be used. Objectives To determine the organic matter dissolution and changes in dentin chemical composition promoted by different concentrations of NaOCl over time. Material and Methods: Fragments of bovine muscle tissue were weighed before and after 5, 10, and 15 min of immersion in the groups (n=10): G1- 0.9% saline solution; G2- 1% NaOCl; G3- 2.5% NaOCl; and G4- 5% NaOCl. Bovine dentin fragments were subjected to the same irrigants and absorption spectra were collected by Attenuated Total Reflectance of Fourier Transform Infrared Spectroscopy (ATR-FTIR) before and after 0,5, 1, 2, 3, 5, 8, and 10 min of immersion in the solutions. The ratios of the amide III/phosphate and carbonate/phosphate absorption bands were determined. The tissue dissolution and carbonate/phosphate ratios were submitted to the two-way analysis of variance (ANOVA) with Tukey’s multiple-comparison test (α0.05). Intergroup differences were not observed in this ratio (p>0.05). Conclusions The increase in the exposure time and in the concentration of NaOCl solution lead to an increase in the tissue dissolution and dentin collagen deproteination. Furthermore, some carbonate ions are removed from the dentin inorganic phase by the NaOCl

Effect of ultrasonic streaming on intra-dentinal disinfection and penetration of calcium hydroxide paste in endodontic treatment

ABSTRACT Objective The antimicrobial effect of ultrasonic agitation of calcium hydroxide (CH) pastes in infected bovine dentin and their penetrability were evaluated using confocal laser scanning microscopy (CLSM) and microbiological culture. Material and Methods Fifty-two bovine teeth were infected with Enterococcus faecalis using a new contamination protocol; then they received CH paste and were divided into groups with or without ultrasound. Ultrasonic agitation was conducted for 1 min with a plain point insert. After 15 d, the CLSM analyzed the viable and dead bacteria with Live and Dead assay. The dentinal wall debris was collected by burs, and the colony forming units (CFU/mL) were counted. The penetrability of the paste inside dentinal tubules was tested using the B-rodamine dye. Results The calcium hydroxide paste showed better results with the use of ultrasonic agitation (p<0.05). Conclusion The ultrasonic agitation of CH paste increased its antimicrobial action and was responsible for intradentinal penetration with the fulfilment of the tubules