Biocompatibilidade de alguns tipos de cimento endodôntico à base de hidróxido de cálcio e cimentos de ionômero de vidro

The purpose of this work was to evaluate the biological compatibility of the Sealapex, Apexit, Sealer 26 and Ketac Endo endodontic cements. Polyethylene tubes containing these cements were implanted in the subcutaneous tissue of 40 (forty) rats. The animals were sacrificed after 14 and 90 days. A descriptive analysis of the reactions found in the connective tissue by contact with the cements was performed. The magnitude of inflammatory infiltrate, the presence and predominance of cell types and their distribution as to the filling material and reparative phenomena, such as fibroblastic and angioblastic proliferation and formation of fibrous capsules, were subjectively measured. After 90 days, all cements presented statistically significant reduction of the inflammatory reaction, presence of a fibrous tissue capsule in contact with the opening of the tubes containing the filling materials, and reduction of fibroblastic proliferation. Angioblastic proliferation decreased only for the Sealer 26 and Ketac Endo groups. All cements tested were either partially or totally phagocyted, and the mildest inflammatory response was found for the Sealer 26 group at both evaluation periods.O objetivo deste trabalho foi avaliar a biocompatibilidade dos cimentos endodônticos Sealapex, Apexit, Sealer 26 e Ketac Endo. Para isto, tubos de polietileno preenchidos com os quatros tipos de cimentos endodônticos foram implantados no tecido conjuntivo subcutâneo de 40 ratos. Os animais foram sacrificados após 14 e 90 dias. Primeiramente foi realizada a análise descritiva das reações encontradas no tecido conjuntivo em contato com os cimentos. A magnitude do infiltrado inflamatório, a presença e predominância de tipos celulares e sua distribuição com relação ao cimento empregado, os fenômenos reparativos, tais como proliferação angioblástica e fibroblástica e formação de cápsula fibrosa também foram subjetivamente quantificados. A análise dos resultados mostraram estatisticamente que todos os cimentos apresentaram após 90 dias redução de reação inflamatória, formação de cápsula fibrosa em contato com a abertura do tubo que continha o material de preenchimento e redução na proliferação fibroblástica. A proliferação angioblástica estava reduzida somente no grupo dos cimentos Sealer 26 e Ketac Endo. Todos os cimentos foram parcialmente ou totalmente fagocitados e a menor resposta inflamatória foi encontrada no grupo do cimento Sealer 26 em ambos períodos de avaliação

In vitro antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis in root canals

Objective: The aim of this study was to evaluate the antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis inoculated in root canals. Material and Methods: Seventy-two human tooth roots were contaminated with C. albicans and E. faecalis for 21 days. The groups were divided according to the auxiliary chemical substance into: G1) 2.5% sodium hypochlorite (NaOCl), G2) 2% chlorhexidine gel (CHX), G3) castor oil, G4) glycolic Aloe vera extract, G5) glycolic ginger extract, and G6) sterile saline (control). The samples of the root canal were collected at different intervals: confirmation collection, at 21 days after contamination; 1st collection, after instrumentation; and 2nd collection, seven days after instrumentation. Microbiological samples were grown in culture medium and incubated at 37°C for 48 hours. Results: The results were submitted to the Kruskal-Wallis and Dunn (5%) statistical tests. NaOCl and CHX completely eliminated the microorganisms of the root canals. Castor oil and ginger significantly reduced the number of CFU of the tested bacteria. Reduction of CFU/mL at the 1st and 2nd collections for groups G1, G2, G3 and G4 was greater in comparison to groups G5 and G6. Conclusion: It was concluded that 2.5% sodium hypochlorite and 2% chlorhexidine gel were more effective in eliminating C. albicans and E. faecalis, followed by the castor oil and glycolic ginger extract. The Aloe vera extract showed no antimicrobial activity

Sealing ability of castor oil polymer as a root-end filling material

OBJECTIVE: The purpose of this study was to evaluate the sealing ability of castor oil polymer (COP), mineral trioxide aggregate (MTA) and glass ionomer cement (GIC) as root-end filling materials. Forty-five single-rooted human teeth were cleaned and prepared using a step-back technique. The apical third of each root was resected perpendicularly to the long axis direction. All teeth were obturated with gutta-percha and an endodontic sealer. After, a root-end cavity with 1.25-mm depth was prepared using a diamond bur. The specimens were randomly divided into three experimental groups (n=15), according to the root-end filling material used: G1) COP; G2) MTA; G3) GIC. The external surfaces of the specimens were covered with epoxy adhesive, except the root-end filling. The teeth were immersed in rhodamine B dye for 24 hours. Then, the roots were sectioned longitudinally and the linear dye penetration at the dentin/material interface was determined using a stereomicroscope. ANOVA and Tukey's tests were used to compare the three groups. The G1 group (COP) presented smaller dye penetration, statistically different than the G2 (MTA) and G3 (GIC) groups (p;0.05). The results of this study indicate that the COP presented efficient sealing ability when used as a root-end filling material showing results significantly better than MTA and GIC

In vitro evaluation of the action of irrigating solutions associated with intracanal medications on Escherichia coli and its endotoxin in root canals

OBJECTIVE: The purpose of this study was to evaluate the effcacy of auxiliary chemical substances and intracanal medications on Escherichia coli and its endotoxin in root canals. MATERIAL AND METHODS: Teeth were contaminated with a suspension of E. coli for 14 days and divided into 3 groups according to the auxiliary chemical substance used: G1) 2.5% sodium hypochlorite (NaOCl); G2) 2% chlorhexidine gel (CLX); G3) pyrogenfree solution. After, these groups were subdivided according to the intracanal medication (ICM): A) Calcium hydroxide paste (Calen®), B) polymyxin B, and C) Calcium hydroxide paste+2% CLX gel. For the control group (G4), pyrogen-free saline solution was used without application of intracanal medication. Samples of the root canal content were collected immediately after biomechanical preparation (BMP), at 7 days after BMP, after 14 days of intracanal medication activity, and 7 days after removal of intracanal medication. The following aspects were evaluated for all collections: a) antimicrobial activity; b) quantifcation of endotoxin by the Limulus Amebocyte Lysate test (LAL). Results were analyzed by the Kruskal-Wallis and Dunn's tests at 5% signifcance level. RESULTS: The 2.5% NaOCl and CLX were able to eliminate E. coli from root canal lumen and reduced the amount of endotoxin compared to saline. CONCLUSIONS: It was concluded that 2.5% NaOCl and CLX were effective in eliminating E. coli. Only the studied intracanal medications were to reduce the amount of endotoxin present in the root canals, regardless of the irrigant used

Effectiveness of carbamide peroxide and sodium perborate in non-vital discolored teeth

OBJECTIVE: To evaluate the efficacy of 16% carbamide peroxide gel (CP16%), tetrahydrate sodium perborate (SP) and mixture (CP16% + SP), in walking bleaching of non-vital discolored teeth. MATERIALS AND METHODS: Sixty single-rooted human premolars with intact crowns were used and initial color was assessed using Vita shade guide and standardized photos. The teeth were stained using rabbit fresh blood for 18 days and photos of discolored teeth and color evaluation were performed. The teeth were divided into 4 groups (n= 15), according to bleaching agent used: G1) CP16% gel; G2) CP16% gel + SP; G3) SP + distilled water; G4: control. The bleaching agents were replaced twice at 7-day intervals for 21 days. All teeth were evaluated by two endodontists at days 0, 7, 14 and 21 and the color changes were assessed using Vita shade guide and standardized photos. The results were analyzed by Kruskal-Wallis and Dunn's tests (p=0.05). RESULTS: The experimental groups presented statistically similar bleaching results (p>;0.05) at the end of 7, 14 and 21 days. These groups presented significantly higher bleaching efficacy than control group (G4) (

Effect of passive ultrasonic activation on microorganisms in primary root canal infection: a randomized clinical trial

Objective: This clinical study sought to evaluate the effectiveness of passive ultrasonic activation (PUA) in eliminating microorganisms in primary endodontic infection (PEI) after instrumentation of root canals using microbiological culture and checkerboard DNA-DNA hybridization. Methodology: Twenty root canals with PEI and apical periodontitis were selected. The root canals were instrumented and then randomly divided into 2 groups, according to the irrigation method: PUA and conventional needle irrigation (CNI). Microbiological samples were collected before instrumentation (S1), after instrumentation (S2) and after irrigation with 17% EDTA (S3). The samples were subjected to anaerobic culture technique and checkerboard DNA-DNA hybridization analysis. Results: A statistically significant difference was found between CNI (23.56%) and PUA (98.37%) regarding the median percentage values for culturable bacteria reduction (p<0.05). In the initial samples, the most frequently detected species was S. constellatus (50%), and after root canal treatment was E. faecalis (50%). Conclusion: Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, no statistical difference in the total microbial load between PUA and CNI groups was detected. The number of cultivable anaerobic bacteria reduced significantly using PUA, and the bacterial composition and number of bacterial species after using either CNI or PUA was similar

Endodontic cements: morphological analysis carried out immediately and after a six-month storage, using atomic force microscopy

The aim of this study was to analyze the high resolution morphological characteristics of Sealapex, Apexit, Sealer 26 (calcium hydroxide cements) and Ketac Endo (glass ionomer cement), using atomic force microscopy (AFM), immediately after root canal obturation and six months after it, keeping the roots stored in human blood plasma. The AFM evaluation used 16 single-rooted human teeth embedded in resin blocks after biomechanical preparation. The samples were divided into four groups (four roots each) and the passive lateral condensation filling technique was used in the obturation of the canals with the mentioned sealers. Apexit suffered the highest degree of disintegration after the six-month storage in human blood plasma, followed by Ketac Endo and Sealapex. Sealer 26 was the most uniform cement and suffered the least disintegration.O objetivo deste trabalho foi analisar a morfologia dos cimentos Sealapex, Apexit, Sealer 26 (cimentos a base de hidróxido de cálcio) e Ketac Endo (cimento de ionômero de vidro), através da microscopia de força atômica, verificando-se as características de suas partículas após a obturação dos canais radiculares e após um período de seis meses de contato com o plasma sanguíneo humano. Utilizaram-se 16 dentes unirradiculares humanos extraídos e incluídos em blocos de resina após o preparo biomecânico. As raízes foram divididas em quatro grupos de quatro raízes cada e os canais radiculares obturados pela técnica de condensação lateral passiva com os cimentos em estudo. Verificou-se que o cimento Apexit foi o que mais sofreu desintegração após seis meses de imersão em plasma sanguíneo humano, seguido pelo Ketac Endo e Sealapex. Dentre todos os cimentos estudados, o Sealer 26 mostrou-se o mais uniforme e com a menor desintegração.19920

Cimentos endodônticos: análise morfológica imediata e após seis meses utilizando microscopia de força atômica

The aim of this study was to analyze the high resolution morphological characteristics of Sealapex, Apexit, Sealer 26 (calcium hydroxide cements) and Ketac Endo (glass ionomer cement), using atomic force microscopy (AFM), immediately after root canal obturation and six months after it, keeping the roots stored in human blood plasma. The AFM evaluation used 16 single-rooted human teeth embedded in resin blocks after biomechanical preparation. The samples were divided into four groups (four roots each) and the passive lateral condensation filling technique was used in the obturation of the canals with the mentioned sealers. Apexit suffered the highest degree of disintegration after the six-month storage in human blood plasma, followed by Ketac Endo and Sealapex. Sealer 26 was the most uniform cement and suffered the least disintegration.O objetivo deste trabalho foi analisar a morfologia dos cimentos Sealapex, Apexit, Sealer 26 (cimentos a base de hidróxido de cálcio) e Ketac Endo (cimento de ionômero de vidro), através da microscopia de força atômica, verificando-se as características de suas partículas após a obturação dos canais radiculares e após um período de seis meses de contato com o plasma sanguíneo humano. Utilizaram-se 16 dentes unirradiculares humanos extraídos e incluídos em blocos de resina após o preparo biomecânico. As raízes foram divididas em quatro grupos de quatro raízes cada e os canais radiculares obturados pela técnica de condensação lateral passiva com os cimentos em estudo. Verificou-se que o cimento Apexit foi o que mais sofreu desintegração após seis meses de imersão em plasma sanguíneo humano, seguido pelo Ketac Endo e Sealapex. Dentre todos os cimentos estudados, o Sealer 26 mostrou-se o mais uniforme e com a menor desintegração

Odontogenic Keratocyst: A Case Report Emphasizing on Root Canal Treatment after Surgical Intervention

This article presents a case of odontogenic Keratocyst (OKC) located in the mandible, involving teeth 36 to 45, with significant loss of alveolar bone and aseptic pulp necrosis, emphasizing on root canal treatment after surgical intervention. Orthopantomogram and computed tomography examinations revealed an extensive, well-defined, and multilocular radiolucent lesion. Histopathological examination after incisional biopsy confirmed OKC, which was removed completely with enucleation and curettage, followed by the endodontic treatments of teeth 36 to 45 using reciprocating nickel-titanium files (Reciproc) in a single session. Afterwards, teeth 33 to 36 underwent apical surgery to create an appropriate bone development. Panoramic radiographic images showed bone formation and no sign of recurrence after one-year follow-up. In conclusion, this surgical approach, combined with the endodontic treatments of the teeth involved in the lesion, was effective for the management of OKC, promoting injury regression and preservation of the natural teeth.Keywords: Dental Pulp Necrosis; Enucleation; Odontogenic Cysts; Odontogenic Keratocyst; Root Canal Therap

The impact of restorative material and ceramic thickness on CAD\CAM endocrowns

Endocrown restorations as a conservative approach to restore endodontically treated teeth still need in vitro investigation under fatigue and made in different materials. This study evaluated the effect of restorative material and restoration thickness on the maximum fracture load of endocrowns subjected to cyclic loading. Sixty (60) third molar teeth received an endocrown preparation with three different heights of remaining dental tissue (1.5, 3.0 or 4.5 mm). A leucite-based ceramic (LEU) and a lithium disilicate (LD) based ceramic were selected to manufacture the CAD/CAM endocrown restorations, totaling 6 groups (n=10). The specimens were subjected to fatigue loading (200N, 2 x 106 cycles, water) and then to the single load to failure test (1 mm/min crosshead speed). Data were analyzed by using two-way ANOVA and Tukey tests (p< 0.05). All endocrowns survived the fatigue test. The thickness did not influence the restoration?s fracture load (p=0.548) instead the restorative material (p=0.003). LD showed higher mean values (1714.43 N)A than LEU (1313.47 N)B. Endocrowns manufactured with CAD/CAM lithium disilicate blocks showed superior fracture load than the leucite-based blocks after mechanical fatigue. Nevertheless, both materials presented acceptable survival and fracture load as long as the material?s minimum thickness and the enamel adhesion are respected