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This study aims to report a root perforating internal replacement resorption treated and followed up for ten years. A 19-years female showed in periapical tomography enlargement of the entire length of the root canal of tooth 11. The cone-beam computed tomography (CBCT) showed a hypodense area with jagged edges involving the pulp cavity space and communication with the periodontium. After being accessed and prepared, the canal and its resorption defect were obturated with mineral trioxide aggregate. The cervical third was sealed with glass ionomer, and the tooth was restored with composite resin. Ten years later, the tomography showed intact root canal filling and periapical and periodontal injury absence. The use of repair cement for root canal obturation with perforating internal replacement resorption is an alternative for these cases, being fundamental to have a clinical, radiographic and tomographic follow-up to evaluate the treatment success.

This study aimed to evaluate if 2.5% sodium hypochlorite compromises the adhesion of bonding materials. The factors in the study were the irrigation solutions in two levels: 2.5% sodium hypochlorite and saline solution; and the adhesive systems used in three levels: three-step adhesive, universal adhesive, and two-step self-etch adhesive systems. The answer variable used was the microshear bond strength obtained through a universal testing machine and fracture mode. Six groups were obtained (n=10) : Etch-and-rinse/Saline (saline solution + 3-step adhesive system - Scotchbond Multipurpose, 3M ESPE); Universal/saline (saline solution + universal adhesive system – Prime&Bond,); Self-etch/saline (saline solution + 2-step self-etch adhesive systems - Clearfil SE Bond); Etch-and-rinse/Hypo (sodium hypochlorite 2,5% + 3-step adhesive system - Scotchbond Multiuso); Universal/Hypo (sodium hypochlorite 2,5% + universal adhesive system – Prime&Bond); Self-etch/Hypo (sodium hypochlorite 2,5% + 2-step self-etch adhesive system - Clearfil Se Bond). The specimens were obtained from 60 healthy bovine incisors. The crowns were separated from the roots, and the regularization of the buccal surface was performed. The groups received saline solution and 2.5% sodium hypochlorite for 30 minutes, respectively. A matrix of 1mm and 3mm oh height was stabilized by Scotch tape to obtain the resin sticks. Afterward, the bond strength test was performed in a universal testing machine at 1mm/min speed. The data were analyzed with normality Shapiro-Wilk, two-way ANOVA, and Tukey’s tests (p

Introduction: This study aimed to evaluate the dentinal tubule penetration of an endodontic bioceramic sealer, Sealer Plus BC, after three final irrigation protocols. Methods: Thirty distobuccal roots of maxillary molars were selected. Root canal preparation was performed up to an #40.06 instrument (X1 Blue) under 2.5% sodium hypochlorite irrigation. Specimens were randomly divided into three groups (n=10), according to the final irrigation protocol: G-NaOCl (2.5% sodium hypochlorite + PUI), G-SS (0.9% saline solution + PUI) and G-H20 (Deionized water + PUI). After final irrigation protocols, all specimens were irrigated with phosphate buffer solution. Root canal obturation was performed using the single cone technique and Sealer Plus BC, stained with a specific fluorophore. Specimens were transversely sectioned and each root third was evaluated in a confocal scanning laser microscopy. Images obtained were analyzed for sealer penetration in the dentinal tubules. Results: Dentinal tubule penetration of Sealer Plus BC was not observed in any root third, regardless of the final irrigation protocol investigated. Conclusions: Sealer Plus BC dentinal tubule penetration was not observed after none of the protocols tested. Dentinal tubule penetrability of Sealer Plus BC may be related to other factors rather than the final irrigation protocol.

Whether ultrasonic activation of the adhesive system improves dentin tubule penetration and the bond strength of fiber posts to root dentin is unclear.The purpose of this in vitro study was to evaluate the effect of ultrasonic activation of 2 adhesive systems (etch-and-rinse and self-etch) and 1 glass ionomer cement on the dentin tubule penetration and pushout bond strength of fiber posts to root dentin.Sixty maxillary central incisors were endodontically treated and divided into 6 groups (n=10) as per the post cementation strategy: etch-and-rinse, etch-and-rinse and ultrasonic, self-etch, self-etch and ultrasonic, glass ionomer cement, and glass ionomer cement and ultrasonic. The primers, the adhesives, and the glass ionomer cement were activated for 20 seconds each, and the fiber posts were cemented with a resin cement. Dentin tubule penetration was evaluated by confocal laser scanning microscopy and the pushout bond strength measured at 3 post locations: cervical, middle, and apical. The failure patterns were also described after pushout testing.Self-etch and ultrasonic showed higher dentin tubule penetration than the other cementation strategies (P.05) and improved the bond strength values (P.05), which were higher than etch-and-rinse and ultrasonic and glass ionomer cement and ultrasonic (P.05). Adhesive failures at the cement and dentin interface were predominant in the etch-and-rinse, self-etch, and self-etch and ultrasonic groups.Ultrasonic activation improved the dentin tubule penetration of a self-etch adhesive system. The bond strength of fiber posts cemented with a self-etch adhesive system and a resin cement was improved after ultrasonic activation.

Introdução: O conceito de Odontologia baseada em evidências requer a produção e publicação de pesquisas de alta qualidade em periódicos internacionais criteriosos. Objetivo: O presente estudo teve como objetivo avaliar as taxas de publicação de resumos endodônticos apresentados na reunião da SBPqO nos anos de 2013, 2014, 2015 e 2016. Material e Métodos: O fator de impacto e a classificação Qualis dos periódicos, e o tempo decorrido entre o congresso e a publicação completa também foram avaliados. Em seguida, foram classificados em seis categorias: pesquisa básica endodôntica, revisão de temas endodônticos, estudos clínicos, ensaios clínicos randomizados, pesquisa básica tecnológica ou relatos de caso. Uma pesquisa em bancos de dados eletrônicos usando o mecanismo Medline (PubMed) foi realizada de janeiro de 2018 a julho de 2018, para identificar publicações escritas em inglês com texto completo dos resumos endodônticos previamente selecionados. A identificação da publicação em texto completo dos resumos foi inicialmente realizada utilizando o sobre- nome do primeiro autor e as principais palavras-chave do título do resumo. Após a verificação do artigo em texto completo, informações adicionais foram registradas, tais como: tempo decorrido até a publicação; nome, fator de impacto e classificação Qualis da revista; e o tipo de estudo. Resultados: Após a leitura do conteúdo da reunião, 1.238 resumos (10,2%) foram considerados de interesse endodôn- tico e, em seguida, foi realizada uma busca eletrônica no banco de dados. Conclusão: Um grande número de resu- mos endodônticos não foi publicado como um manuscrito completo. Estudos clínicos e ensaios clínicos randomizados representaram uma pequena parte das publicações.

Background Orthodontic tooth movements are performed by applying forces on teeth, which may cause alterations within the dental pulp. Previously published systematic reviews on the subject only included a small number of studies that assessed pulp status through reliable diagnostic methods. Since then, new evidence has been published, and a further systematic review on the subject is necessary. Objectives To evaluate whether there is scientific evidence to support the possibility that orthodontic tooth movements could induce pulp necrosis. Methods A systematic search of articles published until June 2020 was performed using MeSH and free terms in the PubMed, Cochrane Library, LILACS, SciELO, Web of Science, EMBASE, Open Grey and Grey Literature databases. Randomized clinical trials (RCTs), nonrandomized clinical trials (nRCTs) and longitudinal (prospective or retrospective) studies that evaluated the pulp status of teeth subjected to orthodontic movements using laser Doppler flowmetry or pulse oximetry were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized interventions (ROBINS-I) were used to assess the quality of the included studies. Relevant findings were summarized and evaluated. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Results Initial screening of databases resulted in 353 studies. In total, 285 studies were excluded because they were duplicates. Of 68 eligible papers, fourteen met the inclusion criteria and were selected for full-text reading. Two studies were excluded due to the methods used to evaluate pulp status. Twelve studies (five RCTs, one nRCT and six prospective) were included. Four RCTs were classified as having an unclear risk of bias and one as having a high risk of bias. The nRCT was classified as having a low risk of bias. Two prospective studies were classified as having a moderate risk of bias and four as having a serious risk of bias. The GRADE analysis demonstrated a low to very low quality of evidence. Discussion Significant limitations regarding the randomization processes within the included RCTs and a lack of control of confounders on most nonrandomized and longitudinal studies were verified. Conclusions This systematic review indicates that orthodontic movements do not induce loss of pulp vitality with low to very low certainty of evidence.

This study aimed to evaluate the influence of ultrasonic activation (UA) on the physicochemical properties of hydraulic calcium silicate-based sealers. Nine experimental conditions were created based on the hydraulic calcium silicate-based sealers (Bio-C Sealer, Sealer Plus BC and Bio Root RCS) and the ultrasonic activation (no activation [NA], 10 seconds, and 20 seconds). Then the experimental groups were BC-NA, BC-10, BC-20, SPBC-NA, SPBC-10, SPBC-20, BR-NA, BR-10, and BR-20. Activation was performed with an ultrasonic insert 20/.01. The mold for the physicochemical analysis was filled and evaluated according to the ANSI/ADA specification nº. 57: initial and final setting time, flow, radiopacity and solubility. Tests were also performed to evaluate pH and calcium ion release with experimental periods of 1, 24, 72, and 168 hours with a pH meter and colorimetric spectrophotometer. Data were analyzed by one-way analysis of variance and post-hoc Tukey tests. The significance level was set at 5%. The time of UA progressively delayed the initial setting time for all hydraulic calcium silicate-based sealers (p < 0.05). Twenty seconds of UA increased the mean flow values of Sealer Plus BC and Bio-C Sealer compared to NA (p < 0.05). UA did not influence the radiopacity and solubility of the tested sealers (p > 0.05). UA for 20 seconds enhanced the pH levels and the calcium ion release of Sealer Plus BC and Bio-C Sealer at 168h (p < 0.05). UA for twenty seconds interferes with some physicochemical properties of hydraulic calcium silicate-based sealers. Resumo Este estudo teve como objetivo avaliar a influência da ativação ultrassônica (AU) nas propriedades físico-químicas de cimentos de silicato de cálcio. Nove condições experimentais foram criadas com base nos cimentos de silicato de cálcio (Bio-C Sealer, Sealer Plus BC e Bio Root RCS) e na ativação ultrassônica (sem ativação [SA], 10 segundos e 20 segundos). Os grupos experimentais foram BC-SA, BC-10, BC-20, SPBC-SA, SPBC-10, SPBC-20, BR-SA, BR-10 e BR-20. A ativação foi realizada com um inserto ultrassônico 20/.01. O molde para a análise físico-química foi preenchido e avaliado de acordo com a especificação ANSI/ADA nº. 57: tempo de presa inicial e final, escoamento, radiopacidade e solubilidade. Também foram realizados testes para avaliação de pH e liberação de íons cálcio com períodos experimentais de 1, 24, 72 e 168 horas com pHmetro e espectrofotômetro colorimétrico. Os dados foram analisados por análise de variância one-way e testes post-hoc de Tukey. O nível de significância foi estabelecido em 5%. O tempo de AU aumentou progressivamente o tempo de presa inicial para todos os cimentos de silicato de cálcio (p < 0,05). Vinte segundos de AU aumentaram os valores médios de escoamento de Sealer Plus BC e Bio-C Sealer em comparação com SA (P < 0,05). A AU não influenciou a radiopacidade e a solubilidade dos cimentos testados (P > 0,05). AU por 20 segundos aumentou os níveis de pH e a liberação de íons cálcio de Sealer Plus BC e Bio-C Sealer em 168h (P < 0,05). AU por vinte segundos interfere em algumas propriedades físico-químicas dos cimentos de silicato de cálcio.

This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments.Systematic searches were performed for studies published up to May 17Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence.This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

This study is aimed at answering the following question: "Does the timing of periodontal intervention influence the periapical/periodontal repair in endodontic-periodontal lesions?".Six electronic databases were systematically searched for studies published up to April 2022, without restriction of language or year of publication, following the PIOS strategy: (P) adult patients with a diagnosis of endodontic-periodontal lesions, (I) endodontic and periodontal treatment, (O) periapical and periodontal healing, and (S) clinical studies. Risk of bias assessment was performed with the revised Cochrane risk of bias tools for randomized trials (RoB 2) and non-randomized interventions (ROBINS-I). The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.Three studies (one prospective, one retrospective, and one randomized clinical trial) were included in the present review. Non-randomized studies had a critical and serious risk of bias. The randomized clinical trial had some concerns risk of bias. Non-randomized studies reported that the endodontic intervention should be performed previous to the periodontal intervention. Randomized clinical trial reported improvements when endodontic and periodontal interventions were performed simultaneously. GRADE analysis showed a very low quality of evidence for both randomized and nonrandomized studies.Based on the evidence from the included studies, although it is suggested that the endodontic treatment should be performed prior to periodontal treatment, it is not possible to assure the best treatment sequence for endodontic-periodontal lesions.Evidences suggests that although the endodontic intervention should be the first therapy of choice, it was not possible to specify the best time to perform the periodontal intervention.

This study aimed to evaluate the influence of calcium silicate-based sealers on the bond strength of fiber posts using conventional and self-adhesive resin cement. Sixty single-rooted teeth were selected. The canals were prepared with a reciprocating instrument 40.06. The roots were randomly distributed in six groups (n = 10) according to the strategies for root canal filling and fiber posts cementation: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; and Sealer Plus BC/RelyX U200. The roots were transversally sectioned, and one slice per post-third was obtained. The push-out test was performed at a crosshead speed of 1mm/min. The failure patterns were described after assessment with a stereomicroscope with a 10× magnification. Bond strength was calculated and analyzed using the ANOVA and Tukey test. AH Plus did not influence the bond strength of fiber posts cemented with conventional (RelyX ARC) or with self-adhesive resin cement (RelyX U200). The lowest bond strength values were obtained when calcium silicate-based sealers were associated with conventional resin cement (Bio C Sealer/RelyX ARC and Sealer Plus BC/RelyX ARC). Except for Sealer Plus BC/RelyX ARC, all groups presented lower bond strength at the apical portion compared to the cervical portion of the post. Adhesive failures between cement and post and cement and dentin were predominant (55.3%). Calcium silicate-based sealers decreased the bond strength of fiber posts cemented with conventional resin cement. Resumo Este estudo teve como objetivo avaliar a influência de cimentos à base de silicato de cálcio na resistência de união de pinos de fibra utilizando cimentos resinosos convencionais e autoadesivos. Sessenta dentes humanos monorradiculares foram selecionados. Os canais foram preparados um instrumento reciprocante 40.06. As raízes foram distribuídas aleatoriamente em seis grupos (n = 10) de acordo com as estratégias de obturação do canal e cimentação dos pinos de fibra: AH Plus/RelyX ARC; AH Plus/RelyX U200; Bio C Sealer/RelyX ARC; Bio C Sealer/RealyX U200; Sealer Plus BC/RelyX ARC; e Sealer Plus BC/RelyX U200. As raízes foram seccionadas transversalmente e foi obtido um espécime por terço. O teste de push-out foi realizado em uma velocidade de 1mm/min. Os padrões de falha foram descritos após avaliação em estereomicroscópio com aumento de 10×. A resistência de união foi calculada e analisada por ANOVA e teste de Tukey. AH Plus não influenciou na resistência de união dos pinos de fibra cimentados com cimento resinoso convencional (RelyX ARC) ou autoadesivo (RelyX U200) (p > 0,05). Os menores valores de resistência de união foram obtidos quando os cimentos à base de silicato de cálcio foram associados ao cimento resinoso convencional (Bio C Sealer/RelyX ARC e Sealer Plus BC/RelyX ARC) (p < 0,05). Com exceção do Sealer Plus BC/RelyX ARC, todos os grupos apresentaram menor resistência de união na porção apical em comparação com a porção cervical do pino (p < 0,05). Falhas adesivas entre cimento e pino e cimento e dentina foram predominantes (55,3%). Cimentos a base de silicato de cálcio diminuíram a resistência de união de pinos de fibra cimentados com cimento resinoso convencional.

Objetivos: Avaliar três protocolos de irrigação final para remoção de detritos e material obturador de istmos simulados. Métodos: Setenta e oito pré-molares foram preparados com o sistema WaveOne Gold 45.05. Os dentes foram seccionados longitudinalmente e um istmo padronizado foi confeccionado no terço apical. Seis raízes foram utilizadas como controle negativo. Os espécimes foram randomizados em dois grupos principais (n=36). Trinta e seis raízes tiveram o istmo preenchido com detritos e as outras trinta e seis raízes foram obturadas com guta-percha e cimento endodôntico, por meio da técnica híbrida de Tagger. Cada grupo foi dividido em três subgrupos (n=12), de acordo com o protocolo de irrigação final: Easy Clean; irrigação ultrassônica passiva (PUI); e XP Clean. A ativação do NaOCl 2,5% pelo Easy Clean foi realizada em três ciclos de vinte se- gundos; e pelo XP Clean, por um minuto em movimento reciprocante e contínuo, respectivamente. No grupo PUI, o irrigante foi ativado em três períodos de vinte segundos. Resultados: Não foi encontrada associação entre os escores de remoção de detritos e os protocolos de irrigação (p=0,165). Foi observada associação entre os escores de remoção do material obturador e os protocolos de irrigação final (p

Root canal filling aims at eliminating empty spaces into the root canal system using biologically compatible materials. Three-dimensional root canal obturation must prevent or minimize the reinfection caused by microorganisms' leakage. This study aimed at evaluating whether fluorophore (Rhodamine or Fluo-3) influences the CLSM images of intratubular penetration of four endodontic sealers. Eighty bovine teeth were prepared using K files up to a size #70 and irrigated with 2.5% sodium hypochlorite. All roots were divided into eight groups (n = 10) according to the sealer and fluorophore used: AH Plus/Rhodamine, AH Plus/Fluo-3, Sealer Plus/Rhodamine, Sealer Plus/Fluo-3, Sealer Plus BC/Rhodamine, Sealer Plus BC/Fluo-3, Endosequence/Rhodamine, and Endosequence/Fluo-3. All roots were filled using cold lateral compaction technique. After 7 days, the roots were transversely sectioned, and three slices, one of each canal third, were obtained. Intratubular penetration was evaluated using CLSM. Sealer Plus BC/Rhodamine and Endosequence BC/Rhodamine presented higher intratubular penetration than AH Plus/Fluo-3 and Sealer Plus/Fluo-3 (p ˂ .05). The intragroup analysis showed similar intratubular penetration, regardless of the root third, except for the apical third in AH Plus/Fluo-3 and Sealer Plus BC/Fluo-3 groups. The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones using CLSM. Bioceramic sealers should not be used associated with Rhodamine for CLSM evaluation. RESEARCH HIGHLIGHTS: The type of fluorophore influences the calcium silicate sealers' tubular penetration but not of epoxy resin-based ones when CLSM is used for assessment. Bioceramic sealers should not be used associated with Rhodamine.

This study aimed to evaluate the effect of ultrasonic activation (UA) of endodontic sealers on dentin tubule penetration and the bond strength to root dentin.One hundred single-rooted teeth were prepared with 40.06 nickel-titanium instruments and divided into 2 groups: with or without UA. Three resin-based sealers (MTA Fillapex [Angelus Dental Solutions, Londrina, PR, Brazil], Sealer Plus [MK Life Medical and Dental Products, Porto Alegre, RS, Brazil], and AH Plus [Dentsply, DeTrey GmbH, Konstanz, Germany]; n = 20) and 2 calcium silicate-based sealers (Sealer Plus BC [MK Life Medical and Dental Products] and EndoSequence BC [Brasseler, Savannah, GA], n = 20) were used and subdivided (n = 10) according to the protocols. Fluo-3 (Thermo Fisher Scientific, Waltham, MA) and rhodamine B dyes were added to the calcium silicate- and resin-based sealers, respectively. In the UA groups, the activation was performed for 40 seconds followed by lateral compaction. Samples were transversely sectioned to evaluate the dentin tubule penetration and the bond strength to root dentin. The penetration data were analyzed with the Student t test, 1-factor analysis of variance, and Bonferroni tests. Bond strength was evaluated using the Student t test, Kruskal-Wallis, and Dunn post hoc test.Resin-based sealers showed the highest tubule penetration without UA (P.05). UA significantly enhanced MTA Fillapex and Endosequence BC dentin tubule penetration (P.05). AH Plus and Sealer Plus BC improved their bond strength to root dentin after UA (P.05). AH Plus/UA, Sealer Plus/UA, and Sealer Plus BC/UA presented the highest bond strength values (P.05). Adhesive failures were predominant in all groups regardless of the use of ultrasound.UA interferes with tubule penetration and the bond strength to root dentin of resin- and calcium silicate-based sealers.

The study aimed to compare the acetaminophen administration efficacy or its combination with codeine for pain control in acute apical abscesses cases.Thirty-nine patients who sought emergency treatment in the Faculty of Dentistry of the Federal University of Rio Grande do Sul were included, all of them with acute apical abscess diagnosis. These patients were divided into two groups: acetaminophen group-prescription of acetaminophen (1000 mg) and acetaminophen-codeine group-prescription of acetaminophen (1000 mg) + codeine (30 mg), both with oral intake every 6 h for 3 days. The pain scores were recorded by the patients on their own at 6, 12, 24, 48, and 72 h after finishing clinical assistance, by filling a pain evolution journal, containing a visual analogue scale (VAS). Student t test was conducted to investigate different mean ages between groups 1 and 2. A comparison of weight and means of initial pain scores between groups was carried out using the Mann-Whitney U test. Chi-square test was performed to compare gender, affected tooth, education, initial swelling, and frequency of adverse effect between test and control groups. Mann-Whitney U test was applied to compare groups in the same period. Friedman's test was used to compare results from the same group over time.Both groups showed score reduction over time (P 0.05). Paracetamol-codeine group showed significant pain score reduction at 48 h registers when compared to baseline and at 6 h scores (P 0.05). Further, pain scores at 72 h were significantly lower, when compared to the baseline, at 6 h, and at 12 h scores (P 0.05). Acetaminophen group showed significant pain score reduction observed at 72 h, when compared to the baseline and at 6 h scores (P 0.05). There were no significant differences in pain score reduction over time between groups (P 0.05). There was no difference between the groups regarding the frequency of adverse reactions (P 0.05).Both medications were effective for pain control in acute apical abscess cases. The findings might have inferred in pain control of acute apical abscess associated pain in patients who used an antibiotic drug. External validity of the findings for acute apical abscess cases with no need for an antibiotic prescription is uncertain.This paper suggests acetaminophen 1000 mg can be used for pain control in the treatment of acute apical abscess associated with systemic manifestation.

Made available in DSpace on 2022-04-28T19:28:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-11-01 Introduction: The aim of this study was to evaluate the bleaching effect after aging simulation in teeth submitted to bonding and debonding of orthodontic brackets. Materials and methods: For this study, 90 human premolars were selected, and randomly divided into 6 groups: control, bleaching, and other 4 groups submitted to bleaching after bonding and debonding brackets using different methods. Color measurement of sample through the CIE L*a*b* system was performed in three moments: T1 – after brackets debonding, T2 – after staining cycling, and T3 – after bleaching. For evaluation of results among the components L*, a* and b*, the two criteria analysis of variance and the multiple comparison Tukey test (p < 0.05) were used. Results: Statistically significant difference was observed among the groups submitted to brackets bonding and debonding through self-conditioning adhesive system and tungsten drill, also the control and bleaching groups between the moments T1 e T2. Conclusion: Bonding and debonding brackets methods tested in this study showed influence on the sample color change, and after the tooth bleaching process, only the group without brackets previous bonding achieved the color value presented before the staining and aging of samples in the brackets absence. Postgraduate Program in Health Sciences University of Southern Santa Catarina, José Acácio Moreira, 787 Department of Social Dentistry School of Dentistry São Paulo State University, Humaitá, 1680 Department of Orthodontics and Public Health School of Dentistry University of São Paulo, Alameda Doutor Octávio Pinheiro Brisolla, 975 Postgraduate Program in Oral Science School of Dentistry Santa Maria Federal University, Roraima Av., 1000 Department of Conservative Dentistry School of Dentistry Federal University of Rio Grande do Sul, Paulo Gama Av., 110 Postgraduate Program in Health Sciences University of Southern Santa Catarina, José Acácio Moreira Tubarão, 787 Department of Social Dentistry School of Dentistry São Paulo State University, Humaitá, 1680

This study aimed to investigate the effect of ultrasonic activation (UA) of three endodontic sealers on the bond strength to root dentin and root canal filling quality. Ninety six bovine incisors were instrumented and root canal filling was carried out using AH Plus (AP), Sealer Plus (SP), or Sealer Plus BC (BC), with or without UA (n=16/group). Two 1.5-mm slices were obtained from each root third. The first slice was subjected to push-out testing and failure mode analysis, while the second was observed under a stereomicroscope for filling quality assessment. Data were analyzed by Kruskal-Wallis, Mann-Whitney and Friedman tests (α=0.05). SP showed higher bond strength and fewer voids than BC in the apical third and when root thirds data were pooled. SP also had higher bond strength compared with AH Plus in the apical third. UA improved the bond strength when BC was used but did not affect the filling quality of any sealer. There were no significant differences between the ultrasonically activated sealers regarding bond strength and filling quality. When root thirds were compared, the bond strength was similar along the root, but there was a tendency to worsen filling quality, with more voids, in the apical segment. In conclusion, UA was effective in increasing the bond strength of the calcium silicate-based sealer but did not improve its filling quality. For the epoxy resin-based sealers, these properties were not affected by UA.

Background. This cross-sectional study aimed to evaluate the impact of pain from dental urgencies on the oral health-related quality of life (OHRQoL).Methods. A sample of sixty-eight patients seeking urgent attention to a primary health unit were included. Clinical diagnosis and sociodemographic data were assessed, dental pain measured by visual analog scale (VAS) and numerical pain rating scale (NPRS). The Oral Health Impact Profile-14 (OHIP-14) instrument was used to measure the OHRQoL. Associations were analyzed using the Student t-test, except for types of urgencies, that were evaluated with one-way analysis of variance (ANOVA) test.Results. The most prevalent urgency type was of endodontic origin (81%). There was no difference between pain and other variables. The type of tooth showed significant differences in OHIP-14 scores.Conclusion. Dental urgencies were associated with a high level of pain and impacted negatively on the patients’ OHRQoL. The type of tooth had a positive association the OHRQoL measures.

This study aimed to compare the main root canal configurations of mandibular incisors (MI) in a Brazilian population using Vertucci and Ahmed et al. classifications. One hundred and sixty-five human permanent MI were scanned using a micro-CT. Two examiners classified the samples according to Vertucci and Ahmed et al. classification. Kappa coefficient was employed. The majority of MI had a single root canal (52.1%). Type III Vertucci and 1 MI1-2-1 Ahmed et al. was the most common 2-canal MI (20%). In the apical third, the presence of one, two and three canals was found in 81.8%, 15.2% and 3% respectively. In the cervical and middle thirds, one, two and three canals were found in 86%, 12.2% and 1.8% respectively. Ahmed et al. classification was able to classify the entire sample studied, whereas 11 teeth (6.66%) did not fit Vertucci's classification.

Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments . Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25–0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98–0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies) . Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth.

This study evaluated the efficacy of 3 reciprocating systems and the effects of 2 instruments for irrigant activation on filling material removal.Forty mesiobuccal roots of maxillary molars were prepared up to size 25.06 and obturated. Micro-computed tomography (micro-CT) examination #1 was performed. Teeth were then divided into 4 groups (WaveOne Gold removed a significantly greater amount of filling material than the manual group (None of the tested instruments completely removed the filling material. X1 Blue size 25.06 reached the working length in the shortest time. XP Clean and Flatsonic improved the filling material removal.

This study aimed to evaluate the influence of endodontic sealer inside dentinal tubules on the retention of fibreglass posts. One hundred eighty extracted teeth were instrumented with rotary instruments and divided into two groups (n = 90) according to their filling technique: (LC) lateral condensation and (CT) controlled technique, and subdivided into three subgroups according to the endodontic sealer used: (A) epoxy resin sealer, (B) zinc-oxide and eugenol sealer, and (C) bioceramic endodontic sealer. After root preparation, each subgroup received a fibreglass posts cemented with (1) adhesive resin cement, (2) self-adhesive resin cement, and (3) glass ionomer cement. After stored for 15 days at 37 °C and 100% humidity, the teeth were sectioned transversely into 1-mm thick slices and subjected to laser confocal scanning microscopy and push-out test. The failure mode was analyzed by stereo microscope, and scanning electron microscopy images of representative fractures were made. Although there were no significant differences in the dislocation resistance among the filling techniques (p > 0.05), the type of sealer used affected bond strengths on the cervical and middle thirds. Fibreglass posts cemented with glass ionomer cement presented higher values for the push-out test than those cemented with resin cements (p

This study investigated the cyclic fatigue, bending, torsional resistance and angular deflection of Pro-R 25.08, Logic RT 25.08, MK Retreatment 25.08 (MK RT) and ProTaper Retreatment D2 instruments. Cyclic fatigue test was performed until fracture in a custom stainless-steel device with water bath equipment to simulate body temperature. Fracture time was recorded. A number of cycles were calculated. Resistance to bending at 45°, torsional resistance and angular deflection were evaluated. The fracture surfaces were examined by scanning electron microscopy. Statistical analysis was performed with one-way ANOVA and Tukey and Kruskal-Wallis and Dunn tests. Pro-R and Logic RT presented the highest cyclic fatigue (P 0.05). D2 had higher strength to bend than Pro-R and Logic RT (P 0.05). Logic RT showed the highest torque and angular deflection (P 0.05), without differences when compared to D2 (P 0.05). Instrument performances were dependent on their geometrical features and heat treatments.

Background: Infection control is mandatory for revascularization procedures, enabling to eliminate patient's clinical symptoms and signs. Despite presenting a complex morphology when compared to anterior teeth, if a strict disinfection protocol is adopted and the revascularization procedure's biological principles are followed, the therapy can be successful in molar teeth. Methods: This case report aims to present a clinical case of successful revascularization in an immature permanent necrotic second lower molar. Clinical decisions and explanations regarding possible mechanisms related to the treatment's success in a tooth with complex morphology are discussed. Results: Revascularization procedures were performed on a 12-year-old male patient diagnosed with symptomatic periapical periodontitis in a tooth 37. The case highlights the need for infection control and biological principles that surrounds the success of this therapy. Follow-up times presented in this case were six months, 1, 2, 4 and 4.5-years, respectively. Continued root development was observed, and the tooth remains intact and without symptoms. Conclusion: The association of infection control and the biological principles of revascularization procedures allow the maintenance and continuation of tooth development, even when these present complex morphologies.

Introdução: A dor ocorre por um processo inflamatório e apresenta diferentes intensidades em função de fatores como o tipo e a duração do procedimento odontológico. O controle da dor pós-operatória dá-se por meio do uso de medicamentos, escolhidos por causa dos seus sítios de ação, do tipo de efeito esperado, da duração do efeito e de características individuais do paciente. Outro método é a realizaçãode analgesia preventiva, utilizando medicamentos previamente aos procedimentos para prevenir ou diminuir a sensibilização nervosa no pós-operatório. Objetivos: Revisar e discutir as diferentes classes de medicamentos disponíveis e suas associações para controle da dor pós-operatória. Revisão da literatura: Os medicamentos analisados foram os corticosteroides e anti-inflamatórios não esteroides (Aines), os analgésicos opioides e não opioides, a associação desses medicamentos e aqueles utilizados para analgesia preemptiva. Resultados: Para dor leve e moderada, recomenda-se o uso de um Aine, associado ou não, a um analgésico não opioide. Para dor intensa, pode ser indicada a associação de um Aine a um analgésico opioide. Para analgesia preemptiva, sugere-se o uso de corticosteroide cerca de 1 hora antes do procedimento. Conclusão: A combinação de dois medicamentos parece alcançar melhores resultados em comparação ao uso de um individualmente, mesmo que seja uma associação ou um opioide. A analgesia preemptiva, pelo uso de corticosteroide em dose única previamente aos procedimentos, contribui para o controle efetivo da dor, bem como o uso de anestésico local a longo prazo. Introduction: Pain occurs through an inflammatory process with different intensities due to factors such as the type and duration of the dental procedure. The control of postoperative pain occurs through the use of drugs, chosen due to their sites of action, type of effect expected, effect duration, and the individual characteristics of the patient. Another method is to perform preemptive analgesia, using drugs before the procedures to prevent or decrease postoperative nerve sensitization. Objectives: To report and discuss the different classes of medication available and which associations are the most recommended for use in the dental office. Literature review: The drugs analyzed were the corticosteroids and non-steroidal anti-inflammatory drugs (NSAID), opioid and non-opioid analgesics, the association of these drugs, and those used for preemptive analgesia. Results: For mild and moderate pain, the use of an NSAID associated or not with a non-opioid analgesic is recommended, and, when facing severe pain, the association of an NSAID with an opioid analgesic may be recommended. For preemptive analgesia, it is recommended the use of a corticosteroid about 1 hour before the procedure. Conclusion: The combination of two drugs seems to achieve better results compared to the use of one individually, even if this is an association or an opioid. Preemptive analgesia, through the use of a corticosteroid in a single dose, previously to the procedures contributes in the effective control of pain, as well as the use of a long-term local anesthetic.

The aims of this study were to evaluate the physical and chemical properties, cytotoxicity and dentinal tubule penetration of a new calcium silicate-based root canal dressing. For pH and calcium ion release evaluation (1, 24, 72 and 168 h) were used a pH meter and colorimetric spectrophotometer, respectively. Radiopacity evaluation followed the ISO 6876:2012. Cytotoxicity was evaluated by the percentage of cell viability using MTT assay. Illustrative images of dentinal tubule penetration were obtained using confocal laser scanning microscopy (CLSM). Data from pH and calcium ion release were statistically analyzed by two-way analysis of variance and Tukey test. Radiopacity was analyzed using the Student t-test. The statistical tests for cytotoxicity results were the one-way analysis of variance and Tukey test. Both materials showed alkaline pH in all experimental times. The pH values for calcium hydroxide paste were higher than bioceramic paste at 1, 24, and 72 h (p

Background: The aim of this study was to evaluate the bending and torsional resistance of the following instruments: Mtwo 25.07, Navigator W-XN, ProTaper SX, MK Orifice Shapper and MK Sequence 17.12. Methods: One hundred instruments were used (n=20). Resistance to bending (n=10), torque and angular deflection (n=10) at the failure of new instruments were measured according to ISO 3630-1. The fractured surface of each fragment was examined by scanning electron microscopy (SEM). Data were analyzed using 1-way analysis of variance and Tukey tests. Results: Torsional resistance values of MK Sequence were higher than the other groups (P.05) and ProTaper SX, which presented the lowest values (P.05). ProTaper SX and MK Orifice Shapper also showed no significant differences (P>.05). MK Sequence 17.12 instruments had the lowest angular deflection values (PConclusions: In conclusion MK Sequence 17.12 had the highest torsional fracture resistance. Mtwo 25.07 showed higher angular deflection capacity, and ProTaper SX the lower bending stiffness.

Background Evaluate the fracture resistance of endodontically treated teeth after cervical preflaring and root canal preparation and to assess the volume of the root canal and the amount of remaining root dentin before and after cervical preflaring. Methods Forty-four mandibular incisors were selected using micro-CT scanning and distributed into 4 groups (n = 11) according to the instrument used for cervical preflaring: control group - no cervical preflaring; Gates Glidden – burs size #2 and #3; WXN – 25.07 Navigator instrument; and Easy – 25.08 ProDesign S instrument. Coronal opening was performed, and the canals were prepared with Wave One Gold Primary and filled with an epoxy-resin based sealer and gutta-percha cones. Micro-CT scans were performed before and after root canal instrumentation. All images were reconstructed and assessed for the thickness of mesial and distal root dentin at 3 mm and 5 mm from the cement -enamel junction and for the volume of cervical portion of the canal after preparation. Fracture resistance test was performed applying compressive loads at a crosshead speed of 0.5 mm/min, applied on the palatal aspect of specimens at 135° along the long axis of the tooth. The data were analyzed using ANOVA and Tukey’s test (P = .05). Results Cervical preflaring and canal preparation reduced the dentin thickness (P P P Conclusions All instruments reduced the dentin thickness and increased the canal volume in the cervical at 3 mm and 5 mm. Gates Glidden reduced fracture resistance of mandibular incisors submitted to cervical preflaring, whereas NiTi instruments did not. Clinical relevance Cervical preflaring assumes particular importance previously to the root canal preparation because it minimizes the occurrence of operative accidents, and permits more accurate determination of working length and the apical diameter.

This study aimed to evaluate penetrability on dentinal tubule of a new bioceramic sealer through confocal laser scanning microscopy (CLSM). A specific fluorophore (Fluo-3) was mixed with the sealer. Forty distobuccal roots from maxillary molars were selected, and root canal preparation was carried out with Wave One Gold # 35.06 instruments. Roots were randomly assigned to 4 groups according to the filling procedures: Bioceramic/Lentulo (Sealer Plus BC); Bioceramic/EasyClean group, three activation of the sealer (3x20 s) with Easy Clean instrument; Bioceramic/Irrisonic: ultrasonic activation for 30 s; and AHplus/Lentulo: epoxy resin based sealer (AH Plus) was utilized with the same protocol as the BC/LE group. After 72 h, specimens were transversally sectioned at 2 and 7 mm from root apex and then analyzed through CLSM. Sealer penetration area on dentinal tubule was measured by Adobe Photoshop CC2018. Kruskal Wallis and Wilcoxon T tests were carried out. Penetrability results were similar for both sealers regardless of which technique was performed to activate them inside the root canal (p>0.05). It is reasonable to conclude that penetration of bioceramic and epoxy resin based sealers occurred unimpressively. The type of instrument used to activate bioceramic sealer did not affect penetrability. Fluo 3 should be recommended as the fluorophore to evaluate dentinal tubule penetration of bioceramic sealers. Resumo Este estudo objetivou avaliar a penetração nos túbulos dentinários de um novo cimento biocerâmico utilizando microscopia confocal de varredura a laser (MCVL). Um fluoróforo específico (Fluo-3) foi misturado com o cimento. Quarenta raízes distovestibulares de molares superiores foram selecionados e o preparo do canal radicular foi realizado com instrumentos Wave One Gold #35.06. As raízes foram divididas randomicamente em quatro grupos de acordo com os procedimentos obturadores: Bioceramic/Lentulo: cimento biocerâmico (Sealer Plus BC); Bioceramic/EasyClean: três ativações do cimento com instrumento Easy Clean (3 x 20 s); Bioceramic/Irrisonic: ativação ultrassônica do cimento por 30 s e AHplus/Lentulo: cimento à base de resina epóxica (AH Plus) foi utilizado com o mesmo protocolo que o grupo Bioceramic/Lentulo. Após 72h, os espécimes foram seccionados transversalmente em 2 e 7 mm do ápice radicular e analisados com MCVL. A área de penetração nos túbulos dentinários foi mensurada com Adobe Photoshop CC2018. O teste de Kruskal Wallis e T de Wilcoxon foram realizados. Os resultados de penetração foram similares para ambos os cimentos independentemente de qual técnica foi utilizada para ativá-los no interior do canal radicular (p>0,05). É razoável concluir que a penetração de cimentos biocerâmicos e à base de resina epóxica ocorreram de forma pouco expressiva. O tipo de ativação do cimento biocerâmcio não afeta sua penetrabilidade nos túbulos dentinários. Fluo 3 deve ser recomendado como o fluoróforo para avaliar a penetração intratubular de cimentos biocerâmicos.

The aim of this study was to evaluate the effect of 95% ethanol irrigation, with 5 or 10 min of action, on the antibacterial properties of 2% chlorhexidine (CHX), on oral biofilm, evaluated with confocal laser scanning microscopy (CLSM). Oral biofilm development was induced in 80 sterilized bovine dentin blocks, distributed in two groups (5 or 10 min) and 4 subgroups, according to time and the solution used: Saline (SALINE5, SALINE10); Saline followed by CHX (SALINE/CHX5, SALINE/CHX10); Ethanol (ETHANOL5, ETHANOL10), Ethanol followed by CHX (ETHANOL/CHX5, ETHANOL/CHX10). The surface of the block was dyed with Live/Dead® BacLight. Images from different areas were analyzed by BioImage L program. The total biovolum (µm³), biovolum of live cells (green), percentage of live cells of the thickness of the biofilm visualized in CLSM and on surface biofilm were evaluated. Total biovolum and biovolum of living cells showed similar results among the different groups (p > .05). The percentage of living cells in total thickness of the biofilm also was similar among the groups (p > .05), except ETHANOL5, SALINE/CHX10, ETHANOL10, and ETHANOL/CHX10 that showed lower percentage than SALINE5 (p < .05). The ETHANOL10 and ETHANOL/CHX10 also showed lower percentage of living cells than ETHANOL/CHX5 and SALINE10 (p < .05). In relation to biofilm surface, SALINE/CHX5, SALINE/CHX10, ETHANOL5, ETHANOL10, ETHANOL/CHX5, and ETHANOL/CHX10 showed a lower percentage of living cells percentage than SALINE5 and SALINE10 groups (p < .05). Therefore, ethanol has no effect on antimicrobial properties of 2% chlorhexidine, prior when used as endodontic irrigating solution.

SUMMARY Objective: The aim of this study was to evaluate the effect of five intracanal irrigants on bond strength of fiber posts cemented with newer self-adhesive resin cement. Methods: A total of 60 extracted, single-rooted human premolars, sectioned at 14 mm, were prepared with the ProTaper Universal system with a size F3 instrument and filled with an F3 master cone and AH Plus. The root canal filling was partially removed, leaving 4 mm of apical gutta-percha. Specimens were randomly assigned to five groups (n=12), according to the solution used for dentin surface treatment before fiber post cementation, as follows: EDTA 17% (EDTA); QMix (QM); SmearClear (SC); 2.5% sodium hypochlorite (NaOCl), and 0.9% saline solution (SS). Ultrasonic activation was performed (three times, 20 seconds each), and root canals were dried with paper points. Fiber posts were cemented with RelyX U200. In one specimen per group, rhodamine B dye was mixed with RelyX U200 to provide adequate fluorescence for confocal laser scanning microscopy (CLSM) assessment. Specimens were transversally sectioned and three slices were obtained, one for each root third. Next, a push-out test was performed. A stereomicroscope and CLSM were used to analyze the failure modes and to illustrate the pattern of infiltration of RelyX U200 into dentinal tubules, respectively. Bond strength means were calculated, and analysis of variance and Bonferroni tests were used for statistical analysis. Results: SS showed the highest mean bond strength values (11.5±5.3), superior to QM (5.1±3.1) and SC (5.1±3.3). NaOCl presented intermediary bond strength values (9.7±5.0), similar to EDTA (7.7±2.9) and SS. QM and SC showed the lowest mean bond strength (p Conclusion: SS and NaOCl associated with ultrasonic activation seem to be adequate solutions for root canal cleaning before fiber post cementation with self-adhesive resin cement, whereas chelating solutions, such as EDTA, QM, and SC, cause a decrease in bond strength.

The aim of this study was to quantify the residual filling material after filling removal, re-preparation with rotary or reciprocating files and passive ultrasonic irrigation (PUI). Twenty maxillary molars were prepared using ProTaper instruments up to F1. The teeth were filled with AH Plus and ProTaper gutta-percha points using the single-cone technique. Thereafter, the specimens were scanned using a micro-computed tomography system (Micro-CT #1). Then, the root canal filling was removed using ProTaper Retreatment files, and a new scan was performed (Micro-CT #2). The specimens were divided into two groups according to the instrument used for re-preparation: ProTaper rotary or WaveOne reciprocating files (Micro-CT #3). Finally, PUI was performed, and a new micro-CT scan was performed (Micro-CT #4). Intragroup and intergroup analyses were performed using Friedman and Dunn's post hoc test and the Kruskal-Wallis and Dunn post hoc tests, respectively. Palatal canal presented the highest volume of residual filling material in all stages of endodontic retreatment (p0.05). Rotary and reciprocating files achieved similar removal of the root canal filling (p>0.05). The greatest reduction in filling material was achieved after using ProTaper Retreatment files. Rotary and reciprocating instruments and PUI did not improve the removal of root canal filling materials. Resumo O objetivo dente estudo foi quantificar o material obturador residual após remoção da obturação, repreparo do canal com instrumentos de rotação contínua e reciprocantes e após irrigação ultrassônica passiva (IUP). Vinte molares superiores foram preparados usando instrumentos ProTaper sequencialmente até F1. Os dentes foram obturados com AH Plus e cones de guta percha ProTaper utilizando a técnica de cone único. Em seguida, os espécimes foram submetidos à microtomografia computadorizada (Micro-CT #1). Então, o material obturador foi removido utilizando instrumentos ProTaper Retratamento e novo escaneamento foi realizado (Micro-CT #2). Os espécimes foram divididos em dois grupos de acordo com o instrumento usado para o repreparo: de rotação contínua (ProTaper) ou reciprocante (WaveOne) (Micro-CT #3). Finalmente, IUP foi realizada e nova micro-CT foi conduzida (Micro-CT #4). As análises intra-grupo e inter-grupos foram realizadas utilizando os testes de Friedman e de Dunn e o teste de Kruskal-Wallis e Dunn, respectivamente. O canal palatino apresentou o maior volume de material obturador remanescente em todos os estágios do tratamento endodôntico (p0,05). Instrumentos de rotação contínua e reciprocantes proporcionaram similar remoção de material obturador (p>0,05). A maior redução do volume de material obturador foi obtida após utilizar os instrumentos ProTaper Retratamento. Instrumentos de rotação contínua e reciprocantes, assim como a IUP, não reduzíram o volume de material obturador remanescente.

The aim of this study was to evaluate the effect of post-space irrigation with NaOCl and CaOCl at different concentrations on the bond strength of posts cemented with a self-adhesive resin cement. Eighty premolars were sectioned 14 mm from the apex, and endodontically treated. The root canal filling was partially removed. Specimens were randomly assigned into 8 groups (n=10), according to the irrigant for post-space irrigation: SS - 0.9% saline solution (control group); CHX - 2% chlorhexidine; 1% NaOCl - 1% sodium hypochlorite; 2.5% NaOCl - 2.5% sodium hypochlorite; 5% NaOCl - 5% sodium hypochlorite; 1% CaOCl - 1% calcium hypochlorite; 2.5% CaOCl - 2.5% calcium hypochlorite; and 5% CaOCl - 5% calcium hypochlorite. For each group, irrigation was performed continuously with 2 ml of solution. The post-spaces were dried with paper points (#80), and glass fiber posts were cemented using a self-adhesive resin cement. The specimens were sectioned perpendicularly and the push-out test was performed. Optical microscopy was used to analyze the failure mode. ANOVA and Bonferroni tests analyzed the bond strength data. NaOCl and CaOCl presented similar bond strength regardless the concentration used to irrigate the post-space (p>0.05). SS showed the highest bond strength (11.47 MPa) (p

The purpose of this study was to quantify the presence of nickel (Ni) and titanium (Ti) on dentin walls of prepared root canals using Endosequence (ES) and Wave One (WO) systems, the deformation, and fracture of these instruments. Thirty extracted human premolar teeth were selected and prepared with WO, ES, and manually (control group-CG). Each instrument was used in four root canals. The root canals were irrigated with 2.5% sodium hypochlorite solution. After preparation, roots were sectioned longitudinally and the apical third was analyzed by scanning electron microscopy with X-ray microanalysis (SEM-EDS). The percentage of Ni and Ti found on dentin walls was compared using Kruskal-Wallis test and post hoc Dunn. The instruments deformation and fracture was evaluate by SEM before and after use. Spiral distortion, fractures, and surface wear were compared using Mann-Whitney test. The level of significance was set at 5%. Ni and Ti were found on the dentin walls of the apical root canal for ES and WO systems (p > .05). No distortion in the spirals and no instrument fracture were observed. Regarding to surface wear, most of the instruments scored as moderate wear (p > .05). This study concluded the WO and ES presented Ni and Ti loss. In addition, the preparation of four root canals did not caused irreversible deformation in WO and ES instruments.

This study compared the cyclic fatigue and the canal transportation promoted by Twisted File (TF) Adaptive and Navigator EVO systems when used with 2 different motions.Forty mesiobuccal roots of maxillary molars were scanned by using micro-computed tomography imaging before and after root canal preparation with the 2 instrument systems used with 2 motions (adaptive and continuous rotation). Samples were divided into 4 groups: TFA, TF Adaptive instruments under adaptive motion; TFC, TF Adaptive instruments under continuous motion; NA, Navigator instruments under adaptive motion; and NC, Navigator instruments under continuous motion. Root canals were prepared until 35.04 instruments. Apical transportation was analyzed by using micro-computed tomography at 3 levels: 3, 6, and 9 mm from the apex. The cyclic fatigue tests were performed by using a custom-made device. Ten instruments of each brand were activated by using a 6:1 reduction handpiece powered by a torque-controlled motor using the preset programs "custom mode" and "TF Adaptive" to activate 25.06 and 35.04 instruments. Kruskal-Wallis and Dunn tests were used to assess canal transportation, centering ability, and canal volume. The Student t test was used to evaluate cyclic fatigue (P = .05).At 3 and 9 mm, the canal transportation and centering ability were similar in all groups (P .05). At 6 mm, TFC presented higher canal transportation toward furcal region than NA and NC (P .05). After canal preparation, TFA promoted great dentinal excision, presenting higher canal volume than NA and NC (P .05). Higher cyclic fatigue resistance was observed under continuous than adaptive motion regardless of system or tip/diameter of the instrument (P .05).Both systems can be used under adaptive or continuous rotation. However, the life span of the instruments was higher when used under continuous rotation. Small canal transportation occurred when mesiobuccal root canals from maxillary molars were prepared until 35.04 instruments.

This study aimed to evaluate the penetration of a new endodontic sealer into the dentinal tubules. Twenty single-rooted teeth were selected. The crown was sectioned, and the canals were instrumented with a reciprocating system. Irrigation was performed with 2 mL of 2.5% sodium hypochlorite between each file change. After instrumentation, the root canals were irrigated with 2 mL of17% EDTA for 3 min followed by saline solution. The specimens were randomized into two groups (n =10) according to the endodontic sealer: AH Plus (AP) or Sealer Plus (SP). All specimens were filled using the lateral compaction technique. Rhodamine B dye (red) was incorporated to the sealers to provide the fluorescence which will enable confocal laser scanning microscopy (CLSM) assessment. The roots were sectioned 2, 4, and 6 mm from the apex and assessed by CLSM. The root canal level affected the penetration of the sealer, but no statistical significant differences were found between the two experimental groups (p > .05). SP presented similar dentinal penetration and perimeter integrity to the gold standard (AP). RESEARCH HIGHLIGHTS: Sealer Plus presents dentinal penetrability and perimeter integrity similar to the gold standard sealer (AH Plus), demonstrating excellent ability of filling areas of difficult access.

This study aimed to evaluate the physicochemical properties of a calcium silicate-based sealer (Sealer Plus BC; MK Life, Porto Alegre, Brazil) compared with an epoxy-resin sealer (AH Plus; Dentsply DeTrey GmbH, Konstanz, Germany). Initial and final setting time was assessed based on ISO 6876:2012 and ASTM C266:03. Calcium ion release and pH were evaluated by filling polyethylene tubes with sealers and then immersing them in 10 mL of deionized water. Following experimental periods of 1, 24, 72 and 168 hours, the samples were measured regarding pH and calcium ion release with a pH meter and a colorimetric spectrophotometer, respectively. The flow was examined based on ISO 6876:2012. Rings of 10 mm in diameter with 1 mm thickness were prepared to analyze the radiopacity (ISO 6876:2012 and ADA n.57) and solubility (ISO 6876:2012). The data were analyzed by variance analysis, Student-T and Tukey tests (p

Introduction: The aim of this study was to evaluate the incidence of dentinal defects and vertical root fractures (VRFs) after endodontic retreatment and mechanical cycling (MC). Methods and Materials: Two hundred mandibular premolars were selected. Forty teeth were left unprepared (control group). The remaining 160 root canals were prepared with ProTaper instruments and filled by using two different techniques [eighty with lateral compaction (LC) and eighty with single-cone (SC)]. Forty canals from each group (LC and SC) received no further treatment. The remaining eighty teeth were divided into two groups (LCR and SCR) (n=40) in order to undergo the removal of the root filling, re-preparation and refilling with lateral compaction and single-cone, respectively. All of the teeth were subjected to MC (1000000 cycles, 130 N, 2.2 Hz and 37°C). The roots were sectioned at 3, 6 and 9 mm from the apex and observed under 20× magnification. The defects were classified as: no defect, VRF and other defects. Statistical analysis was performed using the Fisher’s Exact test and the Chi-Squared tests (α=0.05). Results: MC alone did not promote any other defects or VRFs. Experimental groups presented higher dentinal defects than the control group (P=0.021). Retreatment groups did not present a higher amount of dentinal defects than the groups that were subjected to the first treatment (P>0.05). Conclusion: Endodontic treatment and retreatment, regardless of the filling technique and MC, did not influence the occurrence of dentinal defects or VRFs in the human premolars.