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The aim of this study was to evaluate in vitro the effect of sputter-coating for SEM analysis on the formation of cracks on root-end surfaces after retrograde cavity preparation with ultrasonic tips. Root-end cavities were prepared with either Satelec S12/90 degrees D diamond-coated or S12/90 degrees non-coated stainless steel retrotips. Impressions were taken before and after retrograde cavity preparation. The resected root apices and their respective impressions were examined using a scanning electron microscope, and the presence, extension and numbers of cracks were recorded after each procedure. The number of cracks observed directly on the ultrasonically prepared root-end surfaces was larger than that observed in their respective impressions taken after root-end cavity preparation, which suggests that cracking was mostly produced by the sputter-coating process required for SEM analysis. Impressions of the root-end cavities prepared with non-coated ultrasonic stainless steel retrotips showed a greater incidence of cracks (3/10 impressions) than those that replicated cavities prepared with diamond-coated retrotips (1/10 impressions). No statistical difference was found between the diamond and stainless steel retrotips.

Objective: The aim of this study was to evaluate the percentage of sealer penetration in root canals filled with the Thermafil or RealSeal-1 systems analyzed by confocal laser scanning microscopy (CLSM)., Study Design: Twenty canals in 10 mesial roots of mandibular molars were cleaned and shaped using ProTaper and ProFile instruments to a size 35 and .04 taper at the apex and filled using RealSeal-1 or Thermafil systems in the mesial canal of each root. Horizontal sections were made at the 3 and 5 mm levels from the apex, and the percentage of sealer penetration in the root canal walls was analyzed using CLSM., Results: Thin layers of sealer (2-30 microm) and sealer tags into dentinal tubules were found in the root canal walls in a high percentage using both techniques at both evaluated levels, with no statistical differences between the techniques (Student t test: P > .05)., Conclusion: The percentage of sealer penetration in the root canal walls was similar using both thermoplastic carriers based systems.

Objective: The aim of this study was to compare Profile .04 taper series 29 instruments and hand files for gutta-percha removal., Study Design: Twenty maxillary central incisors with a single straight canal were instrumented and filled. The teeth were divided into 2 groups of 10 specimens each, according to gutta-percha removal techniques: Group 1- Profile series 29 and Group 2- hand files and solvent. The amount of time for gutta-percha removal and the number of fractured instruments were evaluated. Radiographs were taken and the teeth were grooved longitudinally and split. The area of residual debris was measured using computer software., Results: The time for filling material removal was significantly shorter when Profile series 29 was used (P = .00). Regarding cleanliness, there were no statistical differences in the teeth halves evaluations (P > .05). Hand instruments cleaned the canals significantly better than Profiles, in the radiographic analysis considering the whole canal. Overall, the radiographic analysis showed a smaller percentage of residual debris than the teeth halves analysis., Conclusion: The Profile series 29 instruments proved to be faster than hand instruments in removing root filling materials; however, hand instruments yielded better root canal cleanliness. Some residual debris was not visualized by radiographs.

Introduction: The aim of this study was to compare the influence of preflaring on the accuracy of 4 electronic apex locators (EALs): Root ZX, Elements Diagnostic Unit and Apex Locator, Mini Apex Locator, and Apex DSP., Methods: Forty extracted teeth were preflared by using S1 and SX ProTaper instruments. The working length was established by reducing 1mm from the total length (TL). The ability of the EALs to detect precise (-1mm from TL) and acceptable (-1+/-0.5 mm from TL) measurements in unflared and preflared canals was determined., Results: The precise and acceptable (P/A) readings in unflared canals for Root ZX, Elements Diagnostic Unit and Apex Locator, Mini Apex, and Apex DSP were 50%/97.5%, 47.5%/95%, 50%/97.5%, and 45%/ 67.5%, respectively. For preflared canals, the readings were 75%/97.5%, 55%/95%, 75%/97.5%, and 60%/87.5%, respectively. For precise criteria, the preflared procedure increased the percentage of accurate electronic readings for the Root ZX and the Mini Apex Locator (P < .05). For acceptable criteria, no differences were found among Root ZX, Elements Diagnostic Unit and Apex Locator, and Mini Apex Locator (P > .05). Fisher test indicated the lower accuracy for Apex DSP (P < .05)., Conclusions: The Root ZX and the Mini Apex Locator devices increased significantly the precision to determine the real working length after the preflaring procedure. All the EALs showed an acceptable determination of the working length between the ranges of+/-0.5mm except for the Apex DSP device, which had the lowest accuracy.

Objective: The aim was to compare the percentage and depth of sealer penetration into dentinal tubules during obturation using Sealer 26, GuttaFlow, or Sealapex in root canals filled with the lateral compaction technique., Study Design: Thirty root canals filled with the lateral compaction technique using GuttaFlow (n = 10), Sealapex (n = 10), or Sealer 26 (n = 10) were analyzed using confocal microscopy. The teeth were sectioned at 3 and 5 mm from the apex, and statistical analyses was performed using analysis of variance-Tukey test (P < .05)., Results: Sealapex showed the deepest sealer penetration at both levels evaluated (P < .05). No statistically significance was found between Sealer 26 and GuttaFlow at the 3 mm and 5 mm levels. No statistical significance was found in the percentage of penetration around the root canal wall among the 3 sealers evaluated at both levels., Conclusions: Although Sealapex displayed deeper penetration into the dentinal tubules there was no difference in the percentage of adaptation to the root canal walls among the 3 sealers evaluated.

Objective: The purpose of this study was to evaluate the pH and calcium ion release of 6 materials used for root-end filling and perforation repair., Study Design: Gray ProRoot MTA, gray MTA-Angelus, white MTA-Angelus, and CPM were compared to 2 experimental ones: MTA-exp, also based in Portland cement with a modified mixing liquid, and MBPc, an epoxy-resin based cement containing calcium hydroxide. After 3, 24, 72, and 168 hours the water in which each sample had been immersed was tested to determine the ph and calcium ion release., Results: All the analyzed materials showed alkaline pH and capacity to release calcium ions; however, a tendency of reduction of these characteristics was noted for all the analyzed materials, except for the MBPc, which showed a slight increase of pH among the 3 initial periods., Conclusion: The results suggest that all materials investigated presented alkaline pH and ability of release of calcium ions.

Objective: The objective of this study was to determine the expression of matrix metalloproteinase-9 (MMP-9) in apical periodontitis lesions., Study Design: Nineteen epithelialized and 18 nonepithelialized apical periodontitis lesions were collected after periapical surgery. After histological processing, serial sectioning, H&E staining, and microscopic analysis, 10 epithelialized and 10 nonepithelialized lesions were selected for immunohistochemical analysis for MMP-9 and CD 68. At least one third of each specimen collected was frozen at -70 degrees C for further mRNA isolation and reverse transcription into cDNA for real-time-PCR procedures. Geometric averaging of multiple housekeeping genes normalized MMP-9 mRNA expression level., Results: Polymorphonuclear neutrophils, macrophages and lymphocytes presented MMP-9 positive immunostaining in both types of lesions. When present, epithelial cells were also stained. The number and the ratio of MMP-9(+)/total cells were greater in nonepithelialized than epithelialized lesions (P = .0001) presenting a positive correlation to CD68(+)/total cells (P = .045). Both types of lesions presented increased MMP-9 expression (P < .0001) when compared to healthy periapical ligaments. However, no significant differences were observed for MMP-9 mRNA expression between ephithelized and nonephithelized lesions., Conclusion: The present data suggest the participation of several inflammatory cells, mainly CD68(+) cells, in the MMP-9 expression in apical periodontitis lesions. MMP-9 could be actively enrolled in the extracellular matrix degradation in apical periodontitis lesions.

Objective: The presence of arsenic in various types of mineral trioxide aggregate (MTA) and Portland cements were evaluated to verify if they comply with the ISO-recommended limit for water-based cements of 2 mg arsenic/kg material., Study Design: An amount of 5 mL of hydrochloric acid was added to 2 g each of MTA and Portland cement to be analyzed. After 15 minutes, the material was filtered and the volume of supernatant was diluted with reagent-grade water up to 40 mL. Atomic absorption spectrophotometry readings were performed in triplicate., Results: The following mean values were obtained: CPM (Egeo, Buenos Aires, Argentina) 11.06 mg/kg; CPM sealer (Egeo) 10.30 mg/kg; MTA-Obtura (Angelus, Londrina, PR, Brazil) 0.39 mg/kg; Experimental MTA: 10.30 mg/kg; White MTA-Angelus (Angelus) 1.03 mg/kg; Gray MTA-Angelus (Angelus) 5.91 mg/kg; ProRoot-MTA (Dentsply/Tulsa Dental Specialties, Tulsa, OK) 5.25 mg/kg; Gray Portland cement (Votorantim Cimentos, Cubatão, SP, Brazil): 34.27 mg/kg; and White Portland cement (Cimento Rio Branco, Rio de Janeiro, RJ, Brazil) 0.52 mg/kg., Conclusion: All tested materials presented arsenic in their composition. The form of arsenic was not analyzed nor the toxicity of the arsenic found. Only MTA-Obtura, White MTA-Angelus, and White Portland cement presented arsenic levels below the limit set in the ISO 9917-1 standard.

The purpose of this study was to explore the potential of confocal laser scanning microscopy (CLSM) for in situ identification of live and dead Enterococcus faecalis in infected dentin. Eight cylindrical dentin specimens were infected with Enterococcus faecalis in BHI for 21 days. After the experimental period, the specimens were stained with fluorescein diacetate (FDA) and propidium iodide (PI) or acridine orange (0.01%) and analyzed by CLSM. Two noninfected dentin specimens were used as negative controls. CLSM analysis shows that the discrimination between viable (green) and dead (red) bacteria in infected dentinal tubules could be observed after staining with FDA/PI. Acridine orange was able to show metabolic activity of the E. faecalis cells inside the dentinal tubules showed by its red fluorescence. The viability of bacteria in infected dentin can be determined in situ by CLSM. FDA/PI and acridine orange are useful for this technique.

The aim of this study was to evaluate the reaction of the pulp tissue against mineral trioxide aggregate (MTA) with or without 10% calcium chloride (CaCl(2)). Pulpotomies were performed in 4 canines and 8 premolars of two 8-month-old dogs. MTA with or without CaCl(2) was applied on the pulp tissue. The animals were killed after 90 days, and the specimens were processed for the microscopic analysis. Pulp tissue response was similar for MTA with and without CaCl(2). Pulp vitality was present in all specimens, along with pulp repair with formation of mineralized tissue bridging. The addition of CaCl(2) to MTA did not change its biologic properties in formation of mineralized barrier after pulpotomy.

Objective: This study compared the coronal bacterial leakage of root canals obturated by different techniques and with different lengths of obturation., Study Design: The canals of palatal roots of 160 maxillary molars were instrumented and divided into different groups according to the obturation technique used (lateral condensation, Microseal system, Touch 'n Heat + Ultrafil system, or Tagger's hybrid technique) and the length of obturation (5 mm or 10 mm). The roots were impermeabilized, sterilized in ethylene oxide, and mounted on a device for evaluation of the bacterial leakage., Results: Tagger's hybrid technique produced a statistically greater number of specimens with coronal leakage than the other techniques. There was no statistically significant difference between the lateral condensation, Touch 'n Heat + Ultrafil, and Microseal groups. Root canals with 10 mm of obturation produced a statistically significantly smaller number of specimens with leakage than root canals with 5 mm of obturation., Conclusion: Tagger's hybrid technique produced a greater number of specimens with coronal leakage than the other techniques, and a greater number of root canals with 5 mm of obturation leaked than root canals with 10 mm of obturation.

The use of substances that inhibit root resorption may be an alternative for cases of unsuccessful reimplants. Hence, the purpose of this study was to test a solution of alendronate, a resorption inhibitor, as an intracanal therapeutic agent for teeth submitted to late reimplantation. Thirty rat maxillary right central incisors were avulsed and kept dry for 30 min. The teeth were instrumented, and the root surfaces treated with 1% hypochlorite solution followed by application of 2% sodium fluoride. Thereafter, the teeth were divided in two groups according to the intracanal dressing: (i) group I, solution of alendronate and (ii) group II, calcium hydroxide paste. Teeth were then reimplanted in their respective sockets. The animals were killed at 15, 30 and 60 days after reimplantation and the samples processed for morphometric and microscopic analysis. The results demonstrated that the solution of alendronate and the calcium hydroxide paste limited the root resorption, yet did not impair its occurrence. It may be concluded that alendronate and calcium hydroxide paste demonstrated similar behavior.

The aim of this study was to evaluate the influence of calcium chloride (CaCl(2)) on the sealing ability of three Mineral Trioxide Aggregate (MTA) cements, ProRoot MTA, MTA-Angelus, and radiopaque White Portland cement (WPC), for retrograde root filling. Seventy roots of extracted single-rooted teeth were instrumented and obturated. After sectioning the samples at 2 mm from the apex, they received one layer of Araldite and two coats of nail enamel, except for the apical dentinal surface submitted to apicectomy. Standardized retrograde cavities were prepared, filled with one of the materials, and immersed in 0.2% Rhodamine B solution for 72 hours. Dye leakage was analyzed on a light microscope with ocular micrometer. Kruskal-Wallis and Miller tests were used to compare groups arranged in increasing order of leakage, according to mean rank of scores: WPC+CaCl(2), MTA-Angelus+CaCl(2), ProRoot MTA+CaCl(2), MTA-Angelus, ProRoot MTA, and WPC. CaCl(2) improved the sealing ability of all three MTA cements.

The aim of this study was to evaluate and compare the quantitative and qualitative inflammatory responses and bone formation potential after implantation of polyethylene tubes filled with a new calcium hydroxide containing sealer (MBPc) and ProRoot mineral trioxide aggregate (MTA). There were 48 Wistar rats divided in three groups: Group I (control group) empty polyethylene tubes were implanted in the extraction site; group II and III, polyethylene tubes were implanted filled with ProRoot mineral trioxide aggregate (MTA) and MBPc, respectively. At 7, 15, and 30 days after tube implantation, the animals were killed, the hemi-maxillas were removed and prepared to light microscopic analyses. The scores obtained were submitted to Kruskal-Wallis statistical test (p < 0.05). Significant differences between the materials were not observed. The results showed that both materials had similar biological response.

The bone tissue has a great regenerative potential, with ability to completely restore its structure and original functions. In some situations, though, bone defects cannot be self-repaired, thus requiring the use of grafts for a correct treatment and good prognosis. This work aimed at microscopically analyzing the effect of the particle size of demineralized bovine cancellous bone matrix in micro and macrogranular forms on the repair of bone defects in femurs of rabbits, with blood clot used as control. At 1, 3 and 6 months after implantation of the materials, the animals were killed and the anatomic specimens were removed. A foreign body-type granulomatous reaction containing macrophages and multinucleated giant cells in contact with the implanted particles was observed. These results suggest a failure in demineralization and/or interruption of the antigenic potential during production of the biomaterial. It is concluded that the size of the particles did not influence the evolution of the repair process of bone defects, acting only as bone-filler substances, and that the material implanted should be improved by quality control during production, since it may represent a good alternative for bone graft.

Objective: The purpose of this study was to investigate the pulpal response of dogs' teeth after pulpotomy and direct pulp protection with MTA Angelus, ProRoot, Portland cement and white Portland cement., Study Design: Seventy-six teeth were treated with these materials. One hundred twenty days after treatment, the animals were sacrificed and the specimens removed and prepared for histological analysis., Results: All the materials demonstrated similar results when used as pulp-capping materials. Pulp vitality was maintained in all specimens and the pulp had healed with a hard tissue bridge., Conclusion: The materials used in this study were equally effective as pulp protection materials following pulpotomy.