Search

This study evaluated the feasibility of an automated method to delimit the required area to quantitatively analyze root filling voids and gaps from cross-sectional confocal laser scanning microscopy (CLSM) images. Root canals of maxillary canines were prepared with rotary instruments and filled by lateral compaction technique using gutta-percha and AH Plus sealer. The roots were stored (100% humidity, 37 °C) for a period of 24 h and then transversally sectioned to obtain 2-mm-thick slices from the apical and middle thirds. The areas corresponding to filling materials, gaps, and voids were manually delimited or automatically demarked by ImageJ software after converting the images to the RGB color system. Based on manual and automatic delimitations, the percentages of voids and gaps were calculated. Data of voids and gaps between middle and apical thirds were individually compared by paired t-test. Pearson's correlation test was used to assess the correlation of data between the methods. Irrespective of the method of area delimitation, no difference was observed between the root thirds for both voids and gaps, while the p-values calculated for each method were similar. Almost perfect correlations between the methods were observed for both outcomes. The proposed method to automatically delimit the areas corresponding to filling material, voids, and gaps appears to be a valid method to facilitate the quantitative analysis of defects in root canal fillings using topographic CSLM images. [ABSTRACT FROM AUTHOR]

The aim of this study was to perform an integrative review to identify the most effective supplementary protocols used after filling material (FM) removal and root canal reinstrumentation, during endodontic reintervention. The literature search was performed on the electronic databases PubMed and Latin American and Caribbean Health Sciences Literature (LILACS), using a combination of specific scientific descriptors. Selection criteria accepted articles published in English, Spanish and Portuguese languages, up to August 2021, involving in vitro and ex vivo studies. After applying the eligibility criteria, 46 articles were included for qualitative analysis. The tool for qualitative analysis of quasi-experimental studies of the Joanna Briggs Institute was used to determine the risk of bias of the included articles. The selected articles provided important data regarding the following supplementary protocols: sonic and ultrasonic activation of the irrigating solution; the use of ultrasonic inserts, XP-endo system instruments, and photon-induced photoacoustic streaming for mechanical debridement; and new devices as GentleWave system, and the self-adjusting file. Overall, all supplementary protocols demonstrated efficacy in removing the remaining FM. The implementation of various supplementary protocols can effectively remove the remaining FM from the root canal walls, although complete removal is not always achieved. However, it was not possible to determine the most effective protocol. Conversely, their association can enhance remaining FM removal. Remaining FM attached to root canal walls hinders proper chemical–mechanical preparation during endodontic reintervention. Supplementary protocols optimize the remaining FM removal, enhancing cleaning and disinfection of root canal. [ABSTRACT FROM AUTHOR]

Background: The recent classification of odontogenic keratocysts (OKSs) recognized them as benign neoplasms, although previous findings have revealed their aggressive nature. Immunohistochemical and molecular analyses have investigated OKSs, but the role of epidermal growth factor receptor (EGFR) has not been fully investigated, despite the importance of this oncogene in the process of carcinogenesis in tumors of epithelial origin. The EGFR protein is usually overexpressed, and the EGFR gene is mutated or amplified. Aims of study: This brief review aims to emphasize the importance of EGFR detection in these types of cysts. Methods and results: It was revealed that the majority of the studies examined EGFR protein expression using immunohistochemical methods; however, considering EGFR gene variants, mutations were less explored in the previous period from 1992 to 2023. Although EGFR gene polymorphisms are clinically important, they were not identified in the present study. Conclusions: In light of the current significance of EGFR variants, it would be beneficial to examine them in odontogenic lesions. This would enable resolving of discrepancies about their nature, and potentially enhance classifications OKCs in the future. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the influence of preparation size on the efficacy of shock wave–enhanced emission photoacoustic streaming (SWEEPS) and conventional irrigation (CI) on removal of accumulated hard tissue debris (AHTD) from isthmus-containing mandibular molars using micro-computed tomographic analysis. Materials and methods: Sixty extracted mandibular molars with two mesial canals connected by an isthmus were selected. Canals were shaped with Mtwo instruments (VDW, Munich, Germany) up to sizes 25/.06, 40/.04 or 40/.06 (n = 20), and specimens were distributed into 2 final irrigation groups (n = 10): SWEEPS and CI. Roots were scanned at a resolution of 10.5 µm before and after preparation and final irrigation. Data sets were co-registered, and the percentage reduction of AHTD calculated for each specimen was statistically compared using analysis of variance with a of 5% significance level. Results: The preparation size did not significantly influence the percentage reduction of AHTD (p < 0.05), whereas the final irrigation technique had a significant effect on debris removal (p < 0.05). A significant reduction of AHTD was achieved after final irrigation in all groups (p < 0.05); however, SWEEPS was associated with a significantly greater percentage reduction of debris than CI (p < 0.05). None of the specimens presented a completely clean isthmus. Conclusions: Removal of AHTD was not significantly affected by the preparation size. SWEEPS was associated with significantly less debris than CI. Clinical relevance: SWEEPS performed significantly better than CI regarding the removal of AHTD from isthmus-containing mandibular molars irrespective of the preparation size. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the effect of the supplementary use of the XP-endo Finisher on postoperative endodontic pain. Methods: This study was a randomized clinical trial with a parallel design. Ninety-two posterior teeth with necrotic pulps and apical periodontitis were instrumented with a single file (Reciproc) in a reciprocating movement followed or not (control) by additional instrumentation with XP-endo Finisher. Postoperative pain was assessed 24 h, 48 h, 72 h, and 7 days after the endodontic treatment (single session) using a universal pain assessment tool. The pain level was scored as absent, mild, moderate, or severe. The occurrence of sealer extrusion and flare-up was also recorded. Data on postoperative pain were analyzed through chi-square analysis, and the odds ratio was adjusted using a logistic regression model (α = 0.05). Results: Similar levels and risks of postoperative pain were observed for both interventions, regardless of the assessment time. Approximately half of the participants presented any postoperative pain in the first 24 h after the endodontic treatment, and this occurrence reduced by less than 20% after 72 h. The extrusion of root filling material was observed in 36% of cases, and no participant presented flared-up. Conclusions: The supplementary use of the XP-endo Finisher file did not affect the incidence or level of postoperative pain reported after the endodontic treatment of posterior teeth with periapical lesions. Clinical relevance: The supplementary use of the XP-endo Finisher did not affect postoperative pain following the endodontic treatment of posterior teeth using a single-file reciprocating system. Clinical trial registration: The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018). [ABSTRACT FROM AUTHOR]

Objective: The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI). Methods: A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the "META" package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence. Results: A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23] p < 0.0001, I2 = 80%; and OR 3.86 [1.98; 7.53] p< 0.0001, I2 = 28.7%. Conclusion: Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI. Clinical Relevance: UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study is to assess the laser effect in root canal disinfection and periapical healing of endodontically treated teeth from patients with asymptomatic apical periodontitis. This study was performed as a randomized clinical trial. Thirty patients were selected according to the inclusion/exclusion criteria. Fifteen patients received the root canal retreatment (RCR) combined with 980-nm diode laser irradiation (LI). The canals were irrigated with saline solution and gently dried with paper points, keeping the dentin partially moist. The irradiation was performed using a 320-µm-diameter fiber in helicoidal movements (pulsed mode, power output of 1.5 W, 100 Hz for 20 s). The other 15 patients received the RCR with placebo irradiation (PI). Microbiological samples were taken in three periods: S1, after the filling material removal (baseline); S2, after laser or placebo irradiation (LI or PI); and S3, after the RCR followed by laser or placebo. The samples were submitted to the total microbial and E. faecalis counting. The periapical radiographic healing was analyzed after 3, 6, 9, and 12 months. Microbiological data (CFU/mg) were analyzed by ANOVA and Tukey’s test (P < 0.05), and the repair by Mann–Whitney test (P < 0.05). In S2, the laser provided 42.44% microbial reduction and 53.14% of E. faecalis, different from the placebo that had no reduction, and 4.85% for Enterococcus (P < 0.05). In S3, the bacterial counts decreased without differences between groups. No differences in healing were found at 3 months. However, diode laser facilitated the repair from 3- to 12-month follow-up (P < 0.05) and had 45% more healed cases than placebo. Diode laser provided an antimicrobial effect before the biomechanical preparation but was not synergistic in RCR. It improved the periapical healing during follow-up. [ABSTRACT FROM AUTHOR]

Pharyngeal lipoma of the upper aero-digestive system is extremely rare. It is typically benign, slow growing and symptoms would depend on its size and location. Surgical intervention is often needed especially for large tumour with impending airway obstruction. Here we present a case of potentially life threatening presentation of pharyngeal lipoma. [ABSTRACT FROM AUTHOR]

Objective: Confocal laser scanning microscopy (CLSM) was used to investigate the penetration of endodontic sealers into the dentinal tubules after retreatment using two different obturation techniques. Materials and methods: Thirty mandibular premolars were prepared up to instrument F3 (ProTaper Universal, Dentsply) and filled with Endofill using the single cone technique. The canals were retreated using Mtwo instruments. Reobturation was performed with the Bio-C sealer mixed with a fluorophore dye (Fluo-3) using either the lateral condensation technique (group LC) or the single cone technique (group SC) (n = 15). Teeth were sectioned 2, 4, and 6 mm from the apex and analyzed with CLSM to assess the penetration of the sealer into the canal perimeter and the maximum depth of penetration of the sealer into the dentinal tubules. Data were analyzed using ANOVA and the Student-t and Holm-Sidak tests. Results: In the apical segment, the penetrated perimeter was significantly higher in the LC group than in the SC group (p < 0.05); no significant difference was found in the middle and cervical segments (p > 0.05). In terms of penetration depth, no significant differences were found for any of the segments studied (p > 0.05). Conclusion: The LC technique promoted a higher percentage of canal circumference penetrated by the sealer than the SC technique in the apical segment after endodontic retreatment. Clinical relevance: CLSM demonstrated that the LC technique promoted a higher percentage of canal perimeter penetrated by the Bio-C sealer than the SC technique in the apical segment of mandibular premolars after retreatment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the bond strength of four types of posts (pre-fabricated fiberglass post, fiberglass post anatomized with composite resin, milled fiberglass post, and milled polyetheretherketone (PEEK) post), and two types of resin cements (conventional and self-adhesive) by assessing immediate bond strength and post-mechanical aging at each root third. Materials and methods: Bovine endodontically treated roots (16 groups, n = 8) were prepared and the posts were produced and luted; the specimens of aging groups were cycled (300,000 cycles under 50 N load at 1.2 Hz frequency); six slices of each root were obtained; push-out test was performed by using a universal testing machine (500 N load at 1 mm/min cross speed); fracture pattern was classified into five levels. The statistical analyses used were three-way ANOVA, Tukey's test (for bond strength), and Fisher's test (for fracture pattern) (α < 0.05). Results: Differences were found between the cements for posts (conventional: p < 0.001; self-adhesive: p = 0.002), whereas no difference was found for root region (p = 0.941; p = 0.056, respectively); analysis of each root showed significant differences for cements (p < 0.001), posts (p < 0.001), and mechanical cycling (p = 0.001); in terms of double interaction, differences were found for posts and mechanical cycling (p = 0.005); no other interactions were observed (double or triple); the fracture pattern showed difference between the groups for both cements. Conclusions: Milled PEEK posts seem to be a good clinical option, but they require improvement of CAD-CAM technology and advances towards their adhesion. Clinical relevance: Milled posts are promising and can reduce clinical time for rehabilitation of extensively destroyed teeth. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of passive ultrasonic irrigation (PUI) and super short pulse (SSP) and shock wave–enhanced emission photoacoustic streaming (SWEEPS) modes of Er:YAG laser–activated irrigation (LAI) with two different laser tips, in removing filling remnants after conventional retreatment in severely curved root canals. Materials and methods: The study sample consisted of 40 extracted molars with curved mesiobuccal root canals. The canals were instrumented with ProTaper Next and filled with an epoxy resin–based sealer and gutta-percha using continuous wave vertical compaction and warm injection back-filling. After retreatment with ProTaper Universal Retreatment system and sodium hypochlorite (NaOCl), all samples were randomly divided into four groups (n = 10) according to the final irrigation technique: PUI, LAI/SSP, SWEEPS/flat-tip, and SWEEPS/radial-tip, using 6 mL of 3% NaOCl for an activation time of 3 × 30 s. The samples were subjected to micro-CT scans after root canal filling, retreatment, and final irrigation. The filling material volume and percentage reduction were calculated. Results: All tested irrigation techniques were successful in the elimination of the filling remnants after the retreatment (p < 0.001). The LAI/SSP group showed a higher reduction rate than the SWEEPS/flat-tip group (p = 0.032). No significant differences were found between the other groups (p > 0.05). Conclusion: All tested techniques improved the removal of filling material during retreatment in curved canals. LAI/SSP showed slightly better results than other techniques. Clinical relevance: The study highlights the need for additional activated irrigation after the retreatment of curved root canals. The choice between PUI and LAI is not decisive for success. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate by means of microcomputed tomography (micro-CT), the efficacy of four final irrigation protocols in the removal of hard-tissue debris (HTD) in mesial roots of mandibular molars containing isthmus. Materials and methods: Forty standardized mesial roots of extracted mandibular molars presenting isthmus were selected. The root canals were prepared and randomly divided into 4 groups (n = 10): EA, EndoActivator (Dentsply Sirona); EC, Easy Clean (Easy Dental Equipment, Belo Horizonte, Brazil); XPF, XP-Endo Finisher (FKG Dentaire, La Chaus-de Fonds, Switzerland); and PUI, passive ultrasonic irrigation using Irrisafe tip (Satelec Acteon, Merignac, France). Each final irrigation protocol was performed in two cycles (60 s), using, respectively, 2.5% sodium hypochlorite and 17% EDTA. Micro-CT scans were obtained pre-operatory, post-preparation, and post-irrigation. The percentage of HTD reduction was calculated. Data was analyzed statistically (ANOVA and Kruskal–Wallis, significance set at 5%). Results: The percentage of HTD reduction was greatest for the XPF group (77.92%), followed by EA (62.92%), PUI (47.48%), and EC (32.65%). Statistical differences (p <.05) were found between XPF and EC only. A significant difference (p <.05) was found between XPF and EC in all thirds and between PUI and EC in the middle third. Conclusions: XPF, EA, and PUI were similarly effective in HTD reduction. However, none of the evaluated protocols was able to completely remove all the debris. Clinical relevance: Final irrigation protocols aim to clean the canal complexities that are not addressed by the shaping procedures. Micro-CT allowed to assess the removal of hard-tissue debris in the isthmus and canals of mandibular molars. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate a digital multi-piece zirconia post-crown to restore a mandibular second molar with extensive coronal loss and limited restoration space, and to compare the stress distribution between endocrowns made of zirconia or alloy and CAD/CAM multi-piece zirconia post-crowns. Material and methods: Four three-dimensional finite element analysis models of a mandibular second molar with extensive coronal loss and limited restoration space were created as follows: (A) intact molar; (B) zirconia endocrown restored molar; (C) multi-piece post-crown restored-molar with tapered nail; (D) multi-piece post-crown restored molar with T-shaped nail. Models C and D were divided into two subgroups according to the material type: C1/D1, zirconia; C2/D2, NiCr alloy. The maximum modified von Mises failure criterion (mvM) stresses were calculated, and the stress distribution was recorded to analyze the effects of the restoration and material types on the biomechanical properties of dentin and prosthesis. Results: The maximum mvM stress of dentin in model B (33.80 MPa) was lower compared with models C (C1, 37.81 MPa; C2, 36.36 MPa) and D (D1, 36.34 MPa; D2, 34.97 MPa) under vertical load, but the opposite was observed under oblique load. The highest mvM stress was concentrated in the nail region located in the root canal, and the T-shaped nail values were greater than the tapered nail, whereas model D with T-shaped nail showed a lower mvM stress level in dentin compared with Model C with tapered nail. Conclusions: The digital multi-piece zirconia post-crown is a potential approach to restore mandibular second molars with extensive coronal loss and limited restoration space. Clinical relevance: The digital multi-piece zirconia post-crown has potential to restore mandibular second molars with extensive coronal loss and limited restoration space using an innovative approach. [ABSTRACT FROM AUTHOR]

Objective: The present study evaluated the efficacy of three different supplementary cleaning protocols on the removal of bioceramic-based root canal filling materials from oval-shaped canals. Materials and methods: A total of 36 human mandibular premolars were instrumented and obturated with gutta-percha and iRoot SP using the single-cone technique. Retreatment was performed with ProTaper Universal retreatment files. The samples were randomly divided into the following supplementary cleaning protocols: conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher R (XPR). The samples underwent micro-CT scanning to quantify the amount of residual filling materials after retreatment and after performing the cleaning protocols. The volume of filling material removal was analyzed by one-way analysis of variance and post hoc Bonferroni and Games–Howell tests (P < 0.05). Results: There were significant differences in the amount of root canal filling material removal in every comparison group (P < 0.05). The XPR removed significantly more residual filling materials (P < 0.01) followed by PUI and CSI (P < 0.05). Similar efficacy was found in the total root canal and all root thirds. Conclusions: The additional use of XP-endo Finisher R and passive ultrasonic irrigation effectively removed the bioceramic-obturated root filling materials from the oval-shaped canals. However, none of the techniques completely removed the filling materials. Clinical relevance: The XP-endo Finisher R and passive ultrasonic irrigation exhibited greater efficacy compared with syringe irrigation in the reduction of residual filling materials after retreatment in root-filled teeth with a bioceramic sealer. [ABSTRACT FROM AUTHOR]

Objectives: This study using contralateral teeth from human cadavers assessed the amount of unprepared wall surface areas (USA), accumulated hard tissue debris (AHTD), and dentinal crack formation after root canal preparation using either reciprocating or rotary instruments. Materials and methods: Incisors with a single root canal from 11 human mandibles had their root canals prepared with Reciproc or Mtwo. Each contralateral tooth was treated with one of the test instruments in order to create matched pairs. Micro-CT scans were taken before and after preparation to instrument sizes 40 and 50 in both groups. USA and AHTD were evaluated in the full canal length or the apical portion only. Crack formation was also evaluated in the full root length. Results: After size 40, no significant differences in USA and AHTD were observed in the full canal length (P >.05). Separate analysis of the apical 4-mm canal revealed no difference in AHTD, but significantly more USA with Mtwo than Reciproc (P <.05). After size 50, the amount of USA was similar between groups both in the full canal and in the apical canal (P >.05). More AHTD were observed in the full canal after using Mtwo size 50 (P <.05), but no difference occurred in the apical canal only (P >.05). Intragroup analyses showed a significant decrease of USA and a significant increase of AHTD when preparation size increased from 40 to 50 (P <.05). In teeth without any pre-existing detectable dentinal defect (n = 38), crack formation occurred in 4 teeth, 2 from each preparation system. Clinical relevance: Reciproc instrument size 40 resulted in more prepared areas in the apical canal than Mtwo instrument of the same size. However, the amount of AHTD did not differ between them at this file size. Canal enlargement to size 50 prepared more walls but created more debris. Dentinal defects were produced after preparation with both systems. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate if the ultrasonic activation of sealer hinders the root canal retreatment. Materials and methods: Thirty mandibular premolars were prepared using the ProTaper Universal system (Dentsply) until the instrument F3 (0.30/0.09). The canals were distributed into 2 groups (n = 15), according to the filling technique: NUact group - sealer without ultrasonic activation + gutta-percha cones and Uact group - sealer with ultrasonic activation + gutta-percha cones. The canals were re-instrumented with Largo burs, followed by the instrument R50 (0.50/0.05) of the Reciproc system. The time required to perform re-instrumentation was recorded (s). The roots were longitudinally cleaved, and the total area of root canal and remaining filling material were quantified (%). The ANOVA test was applied to the data and complemented by Student's t test (P < 0.05). Results: Uact group had higher percentage of remaining filling material than NUact group (P < 0.05). When the root thirds were considered, there was statistically significant difference only for Uact group at the apical third (P < 0.05). There was no difference between groups regarding the time required to perform re-instrumentation (P > 0.05). Conclusions: Ultrasonic activation of sealer leads to a higher percentage of remaining filling material attached to the root canal walls. However, it did not affect the retreatment time. Clinical significance: Ultrasonic activation increases sealer penetration into dentinal tubules, improving its resistance to dislodgement. However, there is no scientific evidence to prove if ultrasonic activation of sealer hinders its removal when root canal retreatment is necessary. [ABSTRACT FROM AUTHOR]

Objectives: To assess the influence of different sealers used in root canal filling, in terms of bond strength (BS) to dentin, after restoration of weakened roots using resin composite (RC) and fiber posts. Material and methods: Roots of 39 maxillary incisors were used. After root canal preparation, root dentin was flared to produce a space between fiber post and root canal walls. The root canals were randomly distributed into three groups (n = 13), according to the sealer used: Endofill, AH Plus, and Acroseal. After removing the filling material to a depth of 12 mm, the flared roots were adhesively restored using RC. Posts were cemented and, after 24 h, roots were sectioned transversely producing 1-mm-thick slices. The slices from 30 roots were used for push-out test, and failure modes were noted. The remaining slices were analyzed by scanning electron microscopy (SEM). Results: Statistical analysis by 2-way ANOVA showed a significant difference among sealers (p = 0.001) and among root regions (p < 0.001). The BS mean of Endofill was lower and significantly different from the others. Overall, the coronal region presented higher BS mean values, followed by the middle and apical regions of the reinforced roots. The most frequent failure type was the adhesive failure between RC and dentin. SEM analysis showed the formation of a hybrid layer and many tags in the coronal and middle regions, while the apical region exhibited remnants of the endodontic sealers in all groups. Conclusions: AH Plus and Acroseal sealer groups presented similar results, and the Endofill sealer negatively affected the BS of fiber post to restored root dentin. Clinical relevance: Weakened dentin walls are often found in teeth undergoing endodontic treatment, so the sealer used must allow or at least not interfere the bonding between restorative materials and root dentin. [ABSTRACT FROM AUTHOR]

Objectives: To present and explore the potential of an animal-based experimental model developed to determine the set of root canal sealers in vivo. The setting of AH Plus, BioC Sealer, TotalFill BC Sealer, and Sealapex was determined using either ISO 6876 or the novel in vivo method proposed in this study. Material and methods: The in vitro setting time of the sealers tested was determined in accordance with ISO 6876:2012. In determining the in vivo set, 24 adult Wistar rats were followed up for two evaluation periods: 1 and 4 weeks. Their upper-right incisor was extracted, and its pulp tissue was removed. The root canal was then filled from retrograde with one of the 4 sealers, and the tooth was re-implanted and fixed with a layer of a flowable composite resin. After 1 or 4 weeks of the surgical procedures, the animals were euthanized, and their incisors were extracted. Two-mm-thick slices of the middle third of the tooth root were obtained and assessed with a Gillmore device, to determine whether or not the sealer had set. Results: The following in vitro results were obtained by using ISO 6876 methodology: AH Plus set after a mean time of 423 ± 20 min and 476 ± 35 min, in metal and plaster molds, respectively. BioC Sealer set after 7 days (in dental plaster molds), whereas TotalFill BC Sealer and Sealapex did not set even after 25 days in both tested conditions (metal or dental plaster molds). Using the novel in vivo methodology, AH Plus, BioC Sealer, and TotalFill BC Sealer set after both 7 and 30 days. In contrast, Sealapex did not set at either time point. Conclusions: AH Plus and BioC Sealer set under both in vitro and in vivo test conditions. TotalFill BC Sealer did not set under in vitro conditions but did after 1 week under in vivo conditions. Sealapex did not set under either in vitro or in vivo conditions. Clinical relevance: The influence of the testing conditions on the setting results is a clear indication that new in vivo experimental models should be useful in future studies on Bioceramics root canal sealers. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficacy of supplementary techniques (ultrasonic tip/XP-endo Finisher R) in removing remaining filling materials (gutta-percha/AHPlus/BCSealer) from oval-shaped root canals during non-surgical endodontic retreatment. Material and methods: Twenty-eight distal roots of human mandibular molars with single and oval-shaped canals were initially shaped with a R40 instrument and filled with gutta-percha points and AH Plus (n = 14) or BC Sealer (n = 14) followed by an initial micro-CT scanning. Initial filling material removal was performed in all 28 samples with an R50 instrument, and all samples submitted to a second micro-CT. Supplementary techniques with ultrasonic tips or XP-endo Finisher R instruments were performed in each sealer group, and all samples submitted to a third micro-CT. The volume of remaining filling material was calculated for the entire canal as well as for the coronal, middle, and apical thirds. Statistical analyses were performed using T, ANOVA 3-way, and Tukey tests. Results: Lower values of remnant filling material were found for BC Sealer (16.06 ± 14.34) compared to AH Plus (28.30 ± 10.54) (P < 0.001), and considering the supplementary technique, lower values of remnant filling material were found for the ultrasonic tip (18.95 ± 11.05) compared to XP-endo Finisher R (25.41 ± 15.81) (P = 0.025). Ultrasonic instruments significantly reduced the percentage of remaining filling material for both AH Plus (P = 0.04) and BC Sealer (P = 0.02) while XP-endo Finisher R was effective for AHPlus only (P = 0.04). The remaining filling material was observed in all samples regardless the filling material or the supplementary technique employed. Conclusions: Supplementary techniques increased filling material removal; however, none of them was able to render root canals completely free from root fillings. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for bioceramic cases. Clinical relevance: Supplementary instrumentation techniques are effective tools to reduce the amount of filling materials during root canal retreatment. [ABSTRACT FROM AUTHOR]

PEEK has been used in many dental applications except intra-radicular post. The aim of this study is to test polyetheretherketone (PEEK) as a dental post material through tensile bond strength (TBS) and surface roughness (SR), and to compare it with glass-fiber and cast-metal posts. Thus, 60 human maxillary central incisors with a single root were endodontically treated and divided into three groups (n = 20) according to the type of post (Group P: PEEK, Group F: Glass-fiber, Group M: Cast-metal). Appropriate surface treatment was employed for each group and SR was determined by a three-dimensional non-contact profilometer before cementation. All posts were luted to the canal dentin using self-etch resin cement (Panavia F2.0). Pull-out test was performed on a universal testing machine at a speed of 0.5 mm/min crosshead speed until failure, and TBS were calculated. One-way ANOVA, Tukey's HSD, and Pearson chi-squared tests were performed for statistical analyses (α = 0.05). According to the results, group F demonstrated the highest SR (2.93 ± 0.18 µm) and lowest TBS values (10.05 ± 0.53 MPa), while group P exhibited lowest SR (1.37 ± 0.11 µm) and highest TBS values (14.33 ± 0.58 MPa) (p < 0.001). No significant differences in failure modes were identified among groups, mostly adhesive (p = 0.243). As conclusion, PEEK may be a reliable and contemporary option for dental post systems when used with appropriate surface treatment and luting agent. This high-performance polymer may be a novel candidate as a contemporary dental post system due to its superior mechanical, chemical, thermal, and esthetical properties with low risk of fracture. [ABSTRACT FROM AUTHOR]

Autophagy is a catabolic process that degrades dysfunctional proteins and organelles and plays critical roles in cancer development. Our preliminary screening identified that extracts of the fruits of Arctium lappa and the fruits of Forsythia suspensa notably suppressed the proliferation of hepatocellular carcinoma HepG2 cells and downregulated the autophagy. In this study, we explored the effect of arctigenin (ARG), a bioactive lignan in both extracts, on cell proliferation and autophagy-related proteins in HepG2 cells. ARG inhibited the proliferation of HepG2 cells. Analysis of autophagy-related proteins demonstrated that ARG might block the autophagy that leads to sequestosome 1/p62 (p62) accumulation. The stage of inhibition in autophagy by ARG differed from those by the autophagy inhibitors 3-methyladenine (3-MA) or chloroquine (CQ). ARG could also inhibit starvation-induced autophagy. Further analysis of apoptosis-related proteins indicated that ARG did not affect caspase-3 activation and PARP cleavage, suggesting that the antiproliferative effect of ARG can occur independently of apoptosis. In summary, our study showed that ARG suppresses cell proliferation and inhibits autophagy, and might lead to the development of agents for autophagy research and cancer chemoprevention. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate and compare irrigant distribution throughout the root canal system of mesial roots of mandibular molars after application of distinct adjunctive irrigant activation procedures. Materials and methods: Fifteen extracted mandibular molars presenting Fan's type II, III, or IV isthmus configurations were selected. The canals were initially enlarged and cleaned. The same specimens were subjected to conventional positive pressure irrigation (PPI) followed by adjunctive irrigation approaches: passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher instrument, and a control group in which the irrigant remained in the canal with no activation. Retention time for the irrigant was the same for all groups. Sodium hypochlorite mixed with a contrast medium (Omnipaque 300) was used as the irrigant. Before and immediately after the adjunctive irrigation, micro-computed tomographic (micro-CT) scans were taken to evaluate the volume of the entire root canal system that was filled by the irrigant. An exclusive analysis was also done for the isthmus area. Results: Analysis of the entire root canal system showed that the XP-endo Finisher instrument promoted better distribution of the irrigant than PUI and the control group (p < 0.01). PUI was not significantly different from the control group (p > 0.05). A separate analysis of the isthmus area showed no significant difference between the adjunctive irrigation methods and the control (p > 0.05). Conclusions: The XP-endo Finisher instrument promoted better distribution of irrigant throughout the root canal system, especially in the apical canal segment, when compared to PUI. However, the tested approaches did not differ as to the ability to drive irrigants into the isthmus area. Clinical relevance: This study highlighted that the XP-endo Finisher instrument presented a better performance to distribute irrigant throughout the root canal system, especially in the apical canal segment compared to positive pressure irrigation and PUI. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the mineral deposition, push-out bond strength, radiopacity, the degree of conversion, film thickness, flow, calcium ion release, and pH of experimental endodontic sealers containing hydroxyapatite (HAp), aflfa-ticalcium phosphate (α-TCP), or octacalcium phosphate (OCP) particles. Materials and methods: Fifty single straight root human premolars were instrumented and divided into five groups (n = 10). Experimental endodontic sealers were formulated by 70 wt% urethane dimethacrylate (UDMA), 15 wt% of glycerol-1,3-dimethacrylate (GDMA), 15 wt% of ethoxylated bisphenol A glycol dimethacrylate (BISEMA), camphorquinone (CQ), N,N-dihydroxyethyl-para-toluidine (DHEPT), and benzoyl-peroxide. 10 wt% of each HAp, α-TCP, or OCP were added to the resin and its properties were assessed. Results: After 7 days, the degree of conversion ranged from 44.69% (GOCP) to 50.74% (Gcontrol) and no statistical difference were observed (p < 0.05). GAHplus showed the highest push-out bond strength 4.91 (± 2.38) MPa at 28 days of analysis (p < 0.05). Film thickness and pH were not statistically different (p > 0.05). Statically lower values of flow were found for GHAp, GOCP, and Gα-TCP (p < 0.05). Calcium deposition values were higher for GHAp at 28 days. Conclusions: Bond strength, degree of conversion, and film thickness of endodontic sealers with phosphates showed similar results compared with AHplus, but displayed higher amounts of Ca2+ release. Clinical relevance: Phosphate fillers improve the performance of endodontic sealers after 28 days of simulated body fluid. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present vitro study was to examine the question whether devitalized Enterococcus faecalis (E. faecalis) cells can migrate into dentinal tubules and if that process takes place in a time-dependent manner. Design: Sixty bovine root canals were incubated with devitalized and vital streptomycin-resistant E. faecalis strains after root canal enlargement (size 80, taper.02) with 3% NaOCl solution. Incubation times 7, 14, 21, 28, 35, and 42 days. Samples were processed for analysis by scanning electron microscopy (SEM) and DAPI (4′,6-diamidino-2-phenylindole) staining. The penetration depth was calculated with the measurement tool of the Axio Vision program (Zeiss, Jena, Germany). Statistical analysis was performed by Kruskal-Wallis (α = 0.05) and Mann-Whitney U test (p < 0.05). Results: Devitalized E. faecalis strains were able to migrate into dentinal tubules. The total number and penetration depth of devitalized E. faecalis cells was lower compared to the vital suspension of E. faecalis. It was noted, that bacterial penetration was not common to all of the dentinal tubules in the vital E. faecalis control and especially in the devitalized control. The migration took place in a time-dependent migration characteristic. Conclusions: Devitalized E. faecalis cells are still able to migrate into the dentinal tubules due to possible electrokinetic and osmotic processes. Thereby, increased exposure times lead to a time-dependent penetration characteristic. Clinical relevance: Since devitalized bacteria can migrate as well into dentinal tubules, the presence of bacteria within dentinal tubules cannot be interpreted as a failure of tested preparation regimens. [ABSTRACT FROM AUTHOR]

Objectives: The effect of ultrasonic agitation (UA) on bond strength and adaptation of cervical plugs prepared with MTA Angelus (MTA), MTA Repair HP (MTAHP), and Biodentine (BIO) was evaluated. Dentin discoloration caused by the materials/treatment was also assessed. Materials and methods: Seventy-two single rooted teeth were divided into six groups depending on the materials/treatment. After cervical plug preparation, dentin discs were excised for the push-out test; additional discs were analyzed under the confocal microscope to determine adaptation (gaps occurrence). For dentin discoloration analysis (ΔE), blocks of bovine incisors had cavities prepared and filled with the materials/treatment (from 7 to 180 days). Results: Both bond strength and adaptation were positively influenced by UA (P < 0.05). Comparison between materials showed an advantage for BIO when compared to MTAHP (P < 0.05). The best and worst results were provided by BIO/UA (12.66 MPa and 1.87%) and MTAHP (2.54 MPa and 28.58%), respectively. For ΔE, significant differences were observed throughout the periods. Just the MTA without UA exhibited noticeable discoloration at 180 days (P < 0.05). Conclusions: UA favored a better adaptation of the materials to the dentin root, resulting in higher bond strength and adaptation of the materials to the root canal walls. Moreover, UA reduced MTA discoloration, keeping it imperceptible over the period evaluated. Clinical relevance: The better adaptation and higher bond strength provided by UA can be considered clinically relevant due to the importance of maintaining blood clot integrity and the possible esthetic compromise provided by reparative materials when used as coronary barrier in regenerative procedures. [ABSTRACT FROM AUTHOR]

This study assessed the antibacterial activity of BioRoot RCS in comparison with that of the Totalfill BC and AH Plus sealers against Enterococcus faecalis biofilms in dentinal tubules using confocal laser-scanning microscopy. Sixty-six root dentin halves were prepared and sterilized. Three sections were used to ensure sterilization. The remaining were inoculated with E. faecalis. Three specimens were examined to verify the viability of biofilms. The sixty specimens were randomly divided into four groups: AH Plus, BioRoot RCS, Totalfill BC sealer, and no sealer. The specimens were incubated for 1, 7, and 30 days. The specimens were stained and four corners of each disc were scanned. Statistical analysis was performed using two-way ANOVA and Tukey's post hoc test. Almost half of the bacteria were dead in BioRoot RCS group on day 1 and in Totalfill BC group on day 7. All sealers killed significantly more bacteria than the control after 30 days (P <.05). On day 7, Totalfill BC showed a significantly higher percentage of dead bacteria than BioRoot RCS (P <.05). On day 30, the BioRoot RCS group registered the highest percentage of dead cells (61.75%), which was significantly higher than the percentages of the AH Plus and Totalfill BC groups (P <.05). Calcium silicate-based root canal sealers exerted antimicrobial effects against E. faecalis biofilms. The antibacterial activity of BioRoot RCS was significantly higher than that of the Totalfill BC and AH Plus sealers after 30 days of exposure. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of the XP-endo Finisher instrument and passive ultrasonic irrigation (PUI) as final irrigation protocols on the removal of accumulated hard-tissue debris (AHTD) from oval-shaped canals using micro-computed tomographic (micro-CT) analysis. Methods: Twenty mandibular incisors were anatomically pair-matched based on similar morphological dimensions (length, volume, aspect ratio, and configuration) through micro-CT analysis, prepared with Reciproc R25 instrument, scanned again, and assigned to one of the two experimental groups (n = 10), according to the final irrigation protocol: XP-endo Finisher and PUI. After the final irrigation protocols, the specimens were rescanned and the registered datasets were examined to quantify the amount of AHTD. Data were statistically analyzed using Student's t test with a significance level of 5%. Results: The final irrigation protocols were highly similar in terms of volumetric percentage reduction of AHTD (P = 1.000). Conclusions: XP-endo Finisher and PUI showed the same effectiveness on the removal of AHTD. None of the tested final irrigation protocols completely removed the AHTD from oval-shaped root canals. Clinical relevance: AHTD may be considered clinically relevant because it could harbor bacterial contents away from the disinfection procedures. Both final irrigation protocols were effective on the removal of AHTD. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the influence of different irrigation solutions on the push-out bond strength (POBS) of three different sealers (AH Plus, BioRoot RCS, GuttaFlow2). Root canals of 180 single-rooted human teeth were instrumented with F360 up to size 45.04. All canals were irrigated with 5 ml NaOCl 3% and 5 ml EDTA 17%. The canals were finally irrigated with either 5 ml NaOCl 3%, CHX 2%, EDTA 17%, citric acid 20% or NaCl 0.9% (n = 36) with a contact time of 5 min and obturated using matching gutta-percha cones according to the single-cone technique in combination with one of the sealers (n = 12). After 8 weeks of incubation, the roots were embedded in resin. Two slices of 1 mm thickness were obtained representing the middle third of the root. Dislodgement resistance was measured and POBS was calculated. Specimens were examined under 4× magnification to determine the mode of bond failure. Statistical analysis was performed using two-way ANOVA and Student–Newman–Keuls test for POBS and Chi-square test for the mode of failure. POBS was significantly affected by the factor "sealer" (P < 0.001) and by the interaction "sealer/irrigation solution" (P < 0.01). AH Plus revealed significantly higher POBS than BioRoot RCS and GuttaFlow2 (P < 0.05). The POBS of GutttaFlow2 was not affected by the irrigation protocol (P > 0.05). The POBS of AH Plus was positively influenced by EDTA and NaOCl. EDTA had a negative effect on the POBS of BioRoot RCS. The POBS of GuttaFlow2 was not influenced by the irrigation solutions. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effects of diode and Er:YAG laser irradiation of root dentin on push-out bond strength of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cements. An in vitro experimental study was conducted on 90 dentin discs, cut out of freshly extracted human teeth. The discs were instrumented to obtain 1.3-mm lumen diameter. Then, they were randomly divided into six groups (n = 15). Groups 1 and 4 subjected to diode laser (Wiser, Doctor Smile, Italy) (980 nm, 1 W, continuous mode) for 10 s and filled with MTA and CEM cements. Groups 2 and 5 subjected to Er:YAG laser (Deka, Italy) (2940 nm, 1 W, 10 Hz, 230 μs) for 10 s and filled with MTA and CEM cements. Groups 3 and 6 (control groups) were filled with MTA and CEM cements without laser irradiation. After 7 days, push-out bond strength test was performed using a universal testing machine in order to evaluate the adhesion of the biomaterials to dentin. The samples were evaluated under a light microscope at × 40 magnification to determine the mode of fracture. Data were analyzed using two-way ANOVA. The highest push-out bond strength (8.76 ± 3.62 MPa) was noted in group 1 (diode/MTA), which was significantly higher than the other groups (P < 0.001). The lowest bond strength (2.61 ± 0.81) was noted in group 6 (control/CEM). Diode laser significantly increased the bond strength of both cements (P < 0.05), but Er:YAG laser irradiation only increased the bond strength of CEM and had no significant effect on MTA (P = 0.603). The bond strength of MTA control group was higher than that of CEM control group (P = 0.001). Push-out bond strength of endodontic cements can be affected by dentin conditioning with diode 980 nm and Er:YAG laser. Nine hundred eighty-nanometer diode laser irradiation is recommended to increase the bond strength of endodontic cements particularly the CEM cement to dentin. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare four final irrigation protocols (passive ultrasonic irrigation [PUI], EndoVac, Self-Adjusting File [SAF] and EasyClean) on the removal of accumulated hard-tissue debris (AHTD) from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis.Materials and methods: Forty mesial roots of mandibular molars presenting isthmuses type I or III were scanned in a micro-CT device and instrumented up to Reciproc R40 instrument. After the completion of canal preparations, root canals of each group were submitted to a final rinse using 20 mL of solution (16 mL of 5.25% NaOCl and 4 mL of 17% EDTA) in a total time of 5 min according to one of the four final irrigation protocols (n = 10): PUI, EndoVac, SAF and EasyClean operated at reciprocating motion. The sample was scanned again after canal preparation and after the use of the final irrigation protocols, and the registered data sets were examined to evaluate the percentage of AHTD. Data were statistically compared using the Tukey test with a significance level set at 5%.Results: All groups presented a decrease on the accumulation of hard-tissue debris after the use of the final irrigation protocols (P < 0.05). No significant differences in the removal of AHTD were observed among the final irrigation protocols (P > 0.05).Conclusions: All final irrigation protocols showed the same effectiveness in the removal of AHTD. None of them was able to render mesial canals of mandibular molars completely free from packed debris.Clinical relevance: This study highlighted that all final irrigation protocols (PUI, EndoVac, SAF, and EasyClean) promoted a similar removal of AHTD. However, none of the final irrigation protocols was able to render mesial canals of mandibular molars completely free from packed debris. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to systematically review and critically analyze the published data of in vitro studies testing the effect of root canal sealers on the fracture resistance of endodontically treated teeth.Methods: A comprehensive literature search was performed by using the Medline, Scopus, Web of Science, Cochrane, and Open Grey databases. A hand search of the reference lists of identified articles was also performed. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and performed data extraction. Evaluation of the risk of bias of the studies was performed.Results: A total of 48 studies were assessed for eligibility. Of these, 20 met the inclusion criteria and were included in the systematic review. All studies had a medium or high risk of bias. Although the majority of the studies reported that the use of root canal sealers increased the fracture resistance of endodontically treated teeth, conflicting evidence was found for the reinforcing effect of resin, glass ionomer, and calcium silicate-based sealers while there was moderate evidence for zinc oxide eugenol-based sealers in favor of no reinforcing effect.Conclusion: On the basis of available evidence, the use of root canal sealer increases the fracture resistance of endodontically treated teeth. However, included studies presented considerable risk of bias. Regarding the comparisons among the sealers, no conclusions could be drawn for the superiority of one sealer type to another.Clinical relevance: A considerable heterogeneity was found in the methodologies of included studies. Therefore, this review strongly suggests the development of standardized methods to test the reinforcement effect of root canal filling materials in in vitro studies. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare ex vivo the toxic effects of six root canal sealers immediately after mixing or setting on human periodontal ligament fibroblasts (HPdLF). Freshly mixed (I group) or set (allowed to dry for 24 h) (II group) specimens of AH Plus Jet (AH), Apexit Plus (AP), MTA Fillapex (FL), GuttaFlow (GF), MetaSEAL Soft (META), and Tubli-Seal (TS) were prepared. HPdLF were exposed for 24 h to the specimens. 3-(4,5-dimethylthiazolo-2-yl)-2,5-diphenyltetrazolium bromide assay was used to examine the effect of the root canal sealers on mitochondrial metabolic activity. Fluorescein isothiocyanate (FITC)-annexin V (AnV) and propidium iodide staining followed by flow cytometry was used to identify the effects of the materials on cell apoptosis/necrosis. Statistical analyses were performed by one-way ANOVA followed by post hoc tests, and significance was determined at P < 0.05. Most materials from the two groups reduced the viability of the cultured cells compared with the control group (P < 0.05). Statistical analysis showed significant differences in HPdLF viability between the individual materials in each group (P < 0.001). AH and AP induced a significant increase in the percentage of apoptotic cells, while TS, FL, and META elevated the proportion of necrotic cells compared with other materials and the controls (p < 0.05). The cytotoxic effects of the tested root canal sealers (both fresh and set) on HPdLF varied. Both forms of sealers were able to cause toxic effects by inducing apoptosis and necrosis in HPdLF. The cytotoxicity of FL, META, TS was mainly associated with necrosis, while AH and AP with apoptosis. [ABSTRACT FROM AUTHOR]

Objectives: To compare the accuracy of confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM) during the analysis of the adhesive interface integrity and intratubular penetration of root canal sealers to radicular dentine.Materials and methods: Twenty roots of human maxillary incisors were prepared and distributed into two groups (n = 10), followed by filling with gutta-percha and Endofill (G1) or AH Plus (G2). After 7 days, roots were sectioned and analyzed under CLSM and SEM. Score systems were used to evaluate the adhesive interface integrity (0-4) and sealer intratubular penetration (0-3). Data were submitted to Wilcoxon-Mann-Whitney and Kendall correlation statistical tests (α = 5%).Results: In the adhesive interface analysis, CLSM was similar (P = 0.157) to SEM for Endofill; however, the results were different for AH Plus (P = 0.029). Intratubular penetration had significant difference between observational methods for both sealers (P < 0.0001). Correlation analysis between SEM and CLSM for adhesive interface was moderate for Endofill and low for AH Plus. Intratubular penetration was low for both sealers.Conclusion: SEM and CLSM analysis had similar results when sealers were compared, with a more homogeneous adhesive interface, and greater intratubular penetration for AH Plus. Comparison between observational methods demonstrated low positive correlation for adhesive interface and intratubular penetration analysis.Clinical relevance: A proper interface formed between sealer and dentine is very important for final quality of root canal filling. Observational methods which allow an accurate analysis of this interface must be selected to assess such features. [ABSTRACT FROM AUTHOR]

Background: Arctium lappa L., popularly known as burdock, is a medicinal plant used worldwide. The antiulcer and gastric-acid antisecretory effects of ethanolic extract from roots of Arctium lappa (EET) were already demonstrated. However, the mechanism by which the extract reduces the gastric acid secretion remains unclear. Therefore, this study was designed to evaluate the antisecretory mode of action of EET.Materials and methods: The effects of EET on H+, K+-ATPase activity were verified in vitro, whereas the effects of the extract on cholinergic-, histaminergic- or gastrinergic-acid gastric stimulation were assessed in vivo on stimulated pylorus ligated rats. Moreover, ex vivo contractility studies on gastric muscle strips from rats were also employed.Results: The incubation with EET (1000 µg/ml) partially inhibited H+, K+-ATPase activity, and the intraduodenal administration of EET (10 mg/kg) decreased the volume and acidity of gastric secretion stimulated by bethanechol, histamine, and pentagastrin. EET (100-1000 µg/ml) did not alter the gastric relaxation induced by histamine but decreased acetylcholine-induced contraction in gastric fundus strips. Interestingly, EET also reduced the increase in the gastric muscle tone induced by 40 mM KCl depolarizing solution, as well as the maximum contractile responses evoked by CaCl2 in Ca2+-free depolarizing solution, without impairing the effect of acetylcholine on fundus strips maintained in Ca2+ -free nutritive solution.Conclusion: Our results reinforce the gastric antisecretory properties of preparations obtained from Arctium lappa, and indicate that the mechanisms involved in EET antisecretory effects include a moderate reduction of the H+, K+-ATPase activity associated with inhibitory effects on calcium influx and of cholinergic pathways in the stomach muscle. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the bond strength of three calcium silicate-based root-end filling materials.Materials and methods: The root canals of 30 single-rooted teeth were endodontically treated; their root ends were resected and root-end cavities were prepared using ultrasonic tip. The teeth were randomly divided into three groups according to the material: (1) Micro-Mega mineral trioxide aggregate (MM-MTA), (2) Biodentine, and (3) TotalFill root repair material (RRM). Push-out test was performed using universal testing machine, and failure mode was analyzed by stereomicroscope. The data were statistically analyzed using Kruskal-Wallis and Man-Whitney post hoc tests. All p values < 0.05 were considered significant.Results: TotalFill RRM exhibited significantly higher bond strength (12.69 MPa) than Biodentine (9.34 MPa, p = 0.023) and MM-MTA (7.89 MPa, p = 0.002). The difference between Biodentine and MM-MTA was not significant (p = 0.447). Mixed failures were the most noted in all three groups. MM-MTA had more adhesive failures than Biodentine and TotalFill, and no cohesive failures, but without statistical significance (p = 0.591).Conclusion: The bond strength was the highest for TotalFill RRM.Clinical relevance: In order to provide a persistent apical seal, root-end filling materials should resist dislodgement under static conditions, during function and operative procedures. TotalFill RRM exhibited higher bond strength to dentin than MM-MTA and Biodentine. [ABSTRACT FROM AUTHOR]

Objectives: The study aims to correlate the depth of bacterial penetration into filled root canals with the time of exposure to the oral environment and different pressures.Materials and methods: One-hundred and twenty-two root canals of male Beagle dog teeth were prepared and filled. The root canals were distributed into three groups, according to the pressure applied: (A) no pressure, (B) 30 kPa, and (C) 60 kPa. Then, the root canals were exposed to the oral environment, establishing sub-groups considering the time intervals of exposure: (1) 45 days and (2) 120 days (n = 17). Sub-groups had positive and negative controls (n = 5). The animals were sacrificed, and the specimens were prepared for histological analysis.Results: There was no significant difference in the bacterial penetration among groups A, B, and C at 45 days (P = 0.903) and 120 days (P = 0.211). No statistically significant difference was found (P = 0.608) between the exposure time intervals. Most of the specimens from experimental groups exposed for 120 days presented moderate inflammatory infiltrate.Conclusions: Pressures of 30 and 60 kPa did not affect sealing ability of root canal filling. The time of exposure did not influence bacterial penetration, which was limited to the first 4 mm of the root canals exposed for 120 days.Clinical relevance: This animal study demonstrated that disinfection of the first millimeters of root canals could be considered before retreatment of their entire length. However, clinical studies in humans should be conducted before validation of this protocol. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to assess the amount of apically extruded debris during the preparation of oval canals with either a rotary file system supplemented by the XP-endo Finisher file or a full-sequence self-adjusting file (SAF) system.Materials and methods: Sixty mandibular incisors were randomly assigned to two groups: group A: stage 1—glide path preparation with Pre-SAF instruments. Stage 2—cleaning and shaping with SAF. Group B: stage 1—glide path preparation with ProGlider file. Stage 2—cleaning and shaping with ProTaper Next system. Stage 3—Final cleaning with XP-endo Finisher file. The debris extruded during each of the stages was collected, and the debris weights were compared between the groups and between the stages within the groups using t tests with a significance level set at P < 0.05.Results: The complete procedure for group B resulted in significantly more extruded debris compared to group A. There was no significant difference between the stages in group A, while there was a significant difference between stage 2 and stages 1 and 3 in group B, but no significant difference between stages 1 and 3.Conclusions: Both instrumentation protocols resulted in extruded debris. Rotary file followed by XP-endo Finisher file extruded significantly more debris than a full-sequence SAF system. Each stage, in either procedure, had its own contribution to the extrusion of debris.Clinical relevance: Final preparation with XP-endo Finisher file contributes to the total amount of extruded debris, but the clinical relevance of the relative difference in the amount of apically extruded debris remains unclear. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the influence of tip design on patterns of laser energy dispersion through the dentine of tooth roots when using near-infrared diode lasers. Diode laser emissions of 810 or 940 nm were used in combination with optical fiber tips with either conventional plain ends or conical ends, to irradiate tooth roots of oval or round cross-sectional shapes. The lasers were operated in continuous wave mode at 0.5 W for 5 s with the distal end of the fiber tip placed in the apical or coronal third of the root canal at preset positions. Laser light exiting through the roots and apical foramen was imaged, and the extent of lateral spread calculated. There was a significant difference in infrared light exiting the root canal apex between plain and conical fiber tips for both laser wavelengths, with more forward transmission of laser energy through the apex for plain tips. For both laser wavelengths, there were no significant differences in emission patterns when the variable of canal shape was used and all other variables were kept the same (plain vs conical tip, tip position). To ensure optimal treatment effect and to prevent the risks of inadvertent laser effects on the adjacent periapical tissues, it is important to have a good understanding of laser transmission characteristics of the root canal and root dentine. Importantly, it is also essential to understand transmission characteristics of plain and conical fibers tips. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate in vitro the influence of high-power lasers (Nd:YAG and diode 980 nm) associated with mineral coal as fotopotencializer on bond strength of an epoxy resin-based root canal sealer to root dentin, using the pushout test, and on the dentin/filling material interface, using confocal laser microscopy. For this purposes, 50 canines were instrumented with Mtwo rotary system up to #50.04 instrument and randomly assigned to five groups (n = 10): group I-control EDTAC; group II-EDTAC and Nd:YAG laser; group III-EDTAC and diode laser 980 nm; group IV-EDTAC, Nd:YAG laser and mineral coal 5 g/100 mL; and group V-EDTAC, diode laser 980 nm and mineral coal 5 g/100 mL. All data were analyzed by ANOVA (at 5% significance level) following the Kruskal-Wallis, Dunn and Tukey tests. The group I increased more bond strength of the sealer to root dentin that treated with only EDTAC 17% (17.21 ± 21.75 MPa), similar to the group II (12.21 ± 18.20 MPa) and group IV (14.92 ± 28.06 MPa), both treated with Nd:YAG laser, with the exception of group IV, which was added to mineral coal. The group V (8.75 ± 13.42 MPa) had similar results to the groups II and IV, but the same similarity were found when compared with group III (7.11 + 11.28 MPa), with lower results. Regarding the root thirds, the apical third (23.27 ± 29.21 MPa) presented a statistically higher value on bond strength than the cervical third (5.92 ± 5.33 MPa) and middle third (6.93 ± 7, 11 MPa) (p > 0.05). Group II (86.27 μm) showed the highest tags penetration values, with a statistically difference to the group III (51.57 μm), IV (36.77 μm) and V (32.37 μm) (p < 0.05). Group I (71.63 μm) was statistically similar to groups II and III (p > 0.05). Group IV had the lowest values and was statistically similarity to groups III and V (p > 0.05). It was concluded that the treatment with Nd:YAG laser provides better results than the diode 980 nm laser, except when was added mineral coal. The control and diode 980 nm laser groups presented less adhesive failures and more mists failures than the other groups. Both lasers did not interfere negatively compared to the control group. [ABSTRACT FROM AUTHOR]