Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning

OBJECTIVES: The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning. MATERIAL AND METHODS: A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained. RESULTS: Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples. CONCLUSION: Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning

Influence of concentration, time and method of application of citric acid and sodium citrate in root conditioning

OBJECTIVES: The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning. MATERIAL AND METHODS: A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained. RESULTS: Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples. CONCLUSION: Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning

Avaliação in vitro de diferentes concentrações, tempos e modos de aplicação do ácido cítrico na biomodificação radicular: análise por meio de microscopia eletrônica de varredura

A raspagem cria “smear layer” que pode obliterar os túbulos dentinários e recobrir a raiz dental, podendo acarretar atraso no reparo de feridas periodontais. Diversas substâncias são utilizadas para biomodificação radicular com objetivo de remover tecido mineralizado e expor as fibras colágenas da matriz dentinária, favorecendo a quimiotaxia e migração de células do ligamento periodontal. Este estudo avaliou diferentes concentrações, modos e tempos de aplicação de ácido cítrico na biomodificação radicular. Dentes humanos tiveram duas áreas de 3x2 mm delimitadas apicalmente a junção cemento-esmalte com a utilização de fresa cilíndrica, instrumentadas com 50 movimentos de raspagem utilizando curetas de Gracey 5/6 e em seguida, espécimes foram obtidos e divididos em 6 grupos (45 amostras/grupo): soro fisiológico (controle), ácido cítrico (0.5%, 1%, 2%, 15% e 25%), com tempos de 1, 2 ou 3 minutos para cada grupo, nos modos de aplicação: a) aplicação passiva (bolinha de algodão); b) fricção suave (pincel); c) fricção vigorosa (bolinha de algodão), com renovação da solução a cada 30 segundos. As amostras foram submetidas à desidratação em concentrações crescentes de álcool etílico e HMDS, sendo em seguidas metalizadas e levadas para observação em microscopia eletrônica de varredura. Um examinador treinado, calibrado e cego avaliou as fotomicrografias obtidas utilizando o Índice de Remoção de Smear Layer proposto por Sampaio em 1999, atribuindo escores de 1 a 8. A análise estatística foi realizada comparando-se as proporções dos escores obtidos, e mostrou que a concentração de 25 % aplicada por fricção suave no tempo de 3 minutos é recomendada para utilização do ácido cítrico na biomodificação radicular.The root scaling produces a smear layer which contains microorganisms and toxins that obliterates the dentinal tubules and covers the root surface, affecting the periodontal healing process. Different substances have been used to promote root biomodification with the purpose of creating the demineralization of the root surface and the collagen fibrils´ exposure. The aim of this study was to evaluate different concentrations, modes and application times of citric acid in the root biomodification. Human teeth had an area of 3x2mm delimited from the apical to the cement-enamel junction. This area was scaled, with 50 strokes by hand instruments, to produce smear layer. The specimens were divided in 6 groups. (45 samples/group): physiologic solution (control) and citric acid (0.5%, 1%, 2%, 15% and 25%). The application time was 1´, 2´and 3´ to each group. The application modes were: a) topic application, with cotton pellets; b) brushing, with a soft brush; c) burnishing, with cotton pellets. In all modes, the solution was renewed every 30”. The samples were submitted to ethylic alcohol and HMDS dehydration and then they were evaluated using the scanning electron microscopy. A blind and trained examiner evaluated photomicrographs based on Sampaio´s index (1999). Data were statistically analyzed by means of a binomial test (p≤0.05). The statistical analysis showed that the best results were achieved with the 25% concentration applicated by brushing for 3 minutes. Thus, theses parameters are the recommended for root biomodification with the citric acid.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Adesão de células sanguineas em raízes biomodificadas de pacientes fumantes

The periodontal treatment begins with scaling and root planning and patient motivation, aiming at an increase in oral health. Scaling and root planning produce smear layer which impairs periodontal regeneration. Chemical substances are used to remove this layer exposing a sound root surface and collagens fibers. Some substances are proposed to it: tetracycline, EDTA, citric acid and lasers. Several researches were conducted in order to determine the best way to apply those substances. These researches determined the adequate concentration, period and method of application to promote root demineralization. The aim of this study was to evaluate blood cell adhesion to collagen of demineralized dental surfaces in association of plasma rich platelet application. 24% EDTA, 25% citric acid (pH 1.5) and distilled water (control) were used in the teeth of the smoking patients. After the samples were photographed in a scanning electron microscope, non-parametrical analysis was performed to evaluate the formation and interlacing of network fibrinolytic and adhesion of blood cells to the root surface. It can be concluded that the use of EDTA and citric acid did not affect the adhesion of blood cells. The application of PRP before the deposition of tissue blood seems to have influenced the adhesion of cells to the root surface. The use of EDTA and citric acid in combination to PRP favored the adhesion of blood cells. EDTA and citric acid removed smear layer and exposed dentinal tubules; but were not effective in the exposure of collagen fibers.O tratamento periodontal inicia-se com raspagem e aplainamento radicular e a motivação do paciente, visando melhoria na higienização e na saúde bucal do indivíduo. A raspagem e o aplainamento radicular formam smear layer, dificultando a reparação periodontal. Substâncias químicas são utilizadas para remoção desta camada, promovendo a exposição de superfície radicular sadia e fibras colágenas. Vários agentes condicionantes são propostos: tetraciclina, EDTA, ácido cítrico e laser. Para determinar a melhor maneira de utilizar essas substâncias, foram realizados estudos que determinaram quais as concentrações, tempos e modos de aplicação em relação à biomodificação radicular. O objetivo deste estudo foi avaliar a adesão das células sanguíneas ao colágeno da superfície dental, exposto por condicionadores associados ao plasma rico em plaquetas. Assim, utilizou-se o EDTA 24%, o ácido cítrico 25% (pH 1,5) e a água destilada (controle) em dentes de pacientes fumantes. Após, as amostras foram fotografadas em microscópio eletrônico de varredura, realizada análise estatística não paramétrica quanto ao grau de formação e entrelaçamento da rede fibrinolítica e a adesão das células sanguíneas à superfície radicular. Pôde-se concluir: a utilização de EDTA e ácido cítrico não influenciaram na adesão de células sanguíneas; a aplicação de PRP antes da deposição do tecido sanguíneo parece ter influenciado a adesão de células à superfície radicular; a utilização de EDTA e ácido cítrico em associação ao PRP favoreceram a adesão de células sanguíneas; o EDTA e o ácido cítrico removeram smear layer e expuseram túbulos dentinários, mas não foram eficazes na exposição de fibras colágenas.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Análise dos troncos radiculares, abertura da raízes e projeções cervicais de esmalte de furcas de molares superiores e inferiores: Estudo in vitro

Periodontal treatment of teeth with furcation lesions often have unpredictable results due to several factors that may hinder therapy or influence the progress of periodontal disease. Of these, the length of the root trunk may contribute to the early injury of the furcations or even cause complications for the application of the treatment; the opening of the roots can guide the type of treatment to be instituted and cervical enamel projections may hinder the instrumentation of the region or even act as a retention plate niche. Thus, the purpose of this study was measured using a digital caliper, root logs database 400 molar both the 1st and the 2nd and both upper and lower as well as analyze using appropriate index type projection cervical enamel and through appropriate classification the opening of the roots in order to guide the diagnosis and treatment plan. We conclude that there is variation in measures of root trunk between the faces of the teeth examined and that greater cervical enamel projection (ECP) correlates with a decrease in the length of the root trunk in the sample evaluated as the first molars have higher occurrence of roots with a degree of opening larger than the second molars.O tratamento periodontal de dentes que apresentam lesão de furca, muitas vezes, tem resultados imprevisíveis devido a diversos fatores que podem dificultar a terapia ou influenciar no progresso da doença periodontal. Destes, o comprimento do tronco radicular pode contribuir para a lesão precoce das furcas ou mesmo trazer complicações para a aplicação do tratamento. A abertura das raízes pode orientar o tipo de tratamento a ser instituído e as projeções cervicais de esmalte podem dificultar a instrumentação da região, ou mesmo atuar como nicho de retenção de placa. Assim, o propósito deste estudo foi medir, por meio de um paquímetro digital, os troncos radiculares de 400 molares de banco, tanto os primeiros como os segundos, e tanto os superiores como os inferiores, assim como analisar, por meio de índice apropriado, o tipo da projeção cervical de esmalte e, por meio de classificação apropriada, a abertura das raízes, com o objetivo de orientar no diagnóstico e no plano de tratamento. Concluiu-se que há variação das medidas de tronco radicular entre as faces dos dentes avaliados e que uma maior projeção cervical de esmalte (PCE) correlaciona-se com uma diminuição do comprimento de tronco radicular na amostra avaliada, assim como os primeiros molares apresentam maior ocorrência de raízes com grau de abertura maior do que os segundos molares

In vitro evaluation of Biosilicate® dissolution on dentin surface: a SEM analysis

INTRODUCTION: Biomaterials such as bioactive glasses and glass-ceramics have been proposed for the treatment of dentinal hypersensitivity. OBJECTIVE: to evaluate by scanning electron microscopy (SEM), the dissolution of a novel bioactive glass-ceramic (Biosilicate® 1-20 µm particles) on dentin surface samples, with different application methods and different dilution medium used for applying Biosilicate®. MATERIAL AND METHOD: 280 dentin samples were randomly divided into four groups: (1) Biosilicate® plus fluoride gel applied with Robinson brush; (2) Biosilicate® plus fluoride gel applied with microbrush; (3) Biosilicate® plus distilled water applied with Robinson brush; (4) Biosilicate® plus distilled water applied with microbrush. After treatment, the samples were immersed in saliva at different periods (0, 15 and 30 minutes, 1, 2, 12 and 24 hours). Two photomicrographs were obtained from each sample and were further analyzed by a blind calibrated examiner according to a Particle Dissolution Index created for this study. RESULT: The data were analyzed using the Mann-Whitney, Kruskal-Wallis and Dunn's tests. There was no statistical difference among the degrees of dissolution between the 4 groups in any period. CONCLUSION: Biosilicate® can be incorporated in both substances without differences in the degree of dissolution of the particles in any of the evaluated periods and the application of dentine can be performed with both methods evaluated.INTRODUÇÃO: Biomateriais, tais como vidros bioativos e vidros cerâmicos têm sido propostos para o tratamento da hipersensibilidade dentinária. OBJETIVO: Avaliar por microscopia eletrônica de varredura (SEM), a dissolução de uma nova vitrocerâmica bioativa (Biosilicato®, partículas de 1-20 µm) na superfície de amostras de dentina, com diferentes métodos de aplicação e de meio de diluição diferente, usado para aplicação de Biosilicato®. MATERIAL E MÉtODO: 280 amostras de dentina foram divididas aleatoriamente em quatro grupos: (1) Biosilicato® mais flúor gel aplicado com escova de Robinson, (2) Biosilicato® mais flúor gel aplicado com microbrush, (3) Biosilicato® mais água destilada aplicado com escova de Robinson; (4) Biosilicato® mais água destilada aplicado com microbrush. Após o tratamento, as amostras foram imersas em saliva, em diferentes períodos (0, 30 e 15 minutos, 1, 2, 12 e 24 horas). Duas fotomicrografias foram obtidas a partir de cada amostra e foram analisadas por um examinador calibrado cego de acordo com um Índice de Dissolução de Partículas, criado para este estudo. RESULTADO: Os dados foram analisados usando o teste de Mann-Whitney, Kruskal-Wallis e Dunn. Não houve diferença estatística entre os graus de dissolução entre os quatro grupos em qualquer período. CONCLUSÃO: Biosilicato® pode ser incorporado em ambas às substâncias, sem diferenças no grau de dissolução das partículas em qualquer dos períodos de avaliação e a aplicação sobre da dentina pode ser realizada com os dois métodos avaliados.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

In vitro evaluation of Biosilicate® dissolution on dentin surface: a SEM analysis

INTRODUCTION: Biomaterials such as bioactive glasses and glass-ceramics have been proposed for the treatment of dentinal hypersensitivity. OBJECTIVE: to evaluate by scanning electron microscopy (SEM), the dissolution of a novel bioactive glass-ceramic (Biosilicate® 1-20 µm particles) on dentin surface samples, with different application methods and different dilution medium used for applying Biosilicate®. MATERIAL AND METHOD: 280 dentin samples were randomly divided into four groups: (1) Biosilicate® plus fluoride gel applied with Robinson brush; (2) Biosilicate® plus fluoride gel applied with microbrush; (3) Biosilicate® plus distilled water applied with Robinson brush; (4) Biosilicate® plus distilled water applied with microbrush. After treatment, the samples were immersed in saliva at different periods (0, 15 and 30 minutes, 1, 2, 12 and 24 hours). Two photomicrographs were obtained from each sample and were further analyzed by a blind calibrated examiner according to a "Particle Dissolution Index" created for this study. RESULT: The data were analyzed using the Mann-Whitney, Kruskal-Wallis and Dunn's tests. There was no statistical difference among the degrees of dissolution between the 4 groups in any period. CONCLUSION: Biosilicate® can be incorporated in both substances without differences in the degree of dissolution of the particles in any of the evaluated periods and the application of dentine can be performed with both methods evaluated

Efeito do fumo sobre os tecidos periodontais: uma revisão de literatura

Smoking is one of the most important risk factors for periodontal disease. Increased destruction of periodontal tissues has been observed in smokers. Studies show changes caused by different cigarette components, morphological, microbiological and immunological alterations which could lead to clinical changes. However, the pathophysiology of smoking on periodontal tissues are not completely understood. Therefore, this article aims to present a review of the literature addressing the changes on the periodontal tissues caused by the main components of the smoke observed in recent studies.O fumo é um dos mais importantes fatores de risco para a doença periodontal. Maior destruição dos tecidos periodontais vem sendo observada em indivíduos fumantes. Estudos mostram diferentes alterações provocadas pelos componentes do cigarro, alterações morfológicas, microbiológicas e imunológicas que poderão levar a alterações clínicas. Porém, os mecanismos etiopatogênicos do fumo sobre os tecidos periodontais não estão completamente esclarecidos. Portanto, o presente artigo teve como objetivo apresentar uma revisão da literatura abordando as alterações sobre os tecidos periodontais, provocadas pelos principais componentes do fumo, observadas em estudos recentes

Relationship between quality of root canal obturation and periapical lesion in elderly patients: a systematic review

ObjectiveThe aim of this study was to investigate the relationship between quality of root canal obturations and the presence/absence of periapical lesion in elderly patients. MethodologyThis was a systematic conducted by means analysing studies on the quality of root canal obturations and their relationship with periapical health in elderly patients. The methodological procedures were based on Cochrane. The inclusion criteria for selection of the titles were the following: (i) studies in humans; (ii) sample consisting of individuals aged 60years or older; (iii) intending criteria defined for the evaluation of quality of root canal obturations; (iv) intending criteria defined for the evaluation of periapical health; (v) determination of the relationship between quality of endodontic treatment and presence of periapical lesions; and (vi) articles published between 1st March 2003 and 1st March 2013. ResultsA total of 3161 potentially relevant studies were found in three databases chosen for the literature review, with 1669 being repeated and 395 duplicated. Therefore, the abstracts of 1097 studies were read. A total of 1022 studies were excluded, resulting in 75 articles for full analysis. However, no study could be included in the present literature review. ConclusionThere is no consensus on the relationship between the quality of root canal obturations and periapical health in older patients333290298sem informaçã

Influence of dental exposure to oral environment on smear layer removal and collagen exhibition after using different conditioning agents

Although in vitro studies have shown encouraging results for root surface conditioning with demineralizing agents, in vivo studies have failed to show its benefits in periodontal healing. This can be attributed to several factors, among which, the hypermineralization of dental surface. Therefore, this in vitro study compared, using scanning electron microscopy (SEM), the effect of root surface conditioning with different conditioners (1% and 25% citric acid, 24% EDTA and 50 mg/mL tetracycline hydrochloride) in impacted teeth and in teeth that had their roots exposed to the oral environment. One trained examiner assessed the SEM micrographs using a root surface modification index. There was a tendency of more root surface modification in the group of impacted teeth, suggesting that the degree of root mineralization influences its chemical demineralization