Abstract This study compared the pH and calcium ion release of calcium silicate- (Bio-C Temp) and calcium hydroxide-based (Ultracal XS) medications. Intracanal remnants of both medications were also evaluated using SEM-EDS after the removal protocol. Thirty-five bovine teeth were prepared. Fifteen were filled with Bio-C Temp and 15 with Ultracal XS. Five remained without intracanal medication (control group). Five samples from each experimental time (i.e.. 24, 72, and 168 hours) were used to measure pH and calcium ions release using a digital pH meter and microplate reader, respectively. Afterward, the peaks of the chemical elements composing both medications were analyzed in SEM-EDS. One-way ANOVA and Tukey's post hoc test analyzed the pH and calcium ion release data. Student's t-test compared the medications in each experimental time. SEM-EDS described the percentage of chemical elements in the samples. Bio-C Temp and Ultracal XS showed a significant pH increase from 24 to 168 hours (p<0.05). Ultracal XS showed a higher pH value at 24 hours than Bio-C Temp (p<0.05) but were similar at 72 and 168h (p > 0.05). Calcium ion release did not depend on the experimental period (p > 0.05). Bio-C Temp showed lower calcium ions release than Ultracal XS at 24 hours (p<0.05). SEM-EDS analyses showed the remains of both medications, but the concentration of Si, Al, and W ions was present only in the calcium silicate-based medication. Bio-C Temp presented alkaline pH and a satisfactory calcium ion release over the time. The remaining of both medications were present after the protocols for paste removal.

Resumo Este estudo comparou o pH e a liberação de íons cálcio de medicações intracanais a à base de silicato de cálcio (Bio-C Temp) e à base de hidróxido de cálcio (Ultracal XS). Remanescentes de ambas as medicações também foram avaliados usando microscopia eletrônica de varredura e espectroscopia de dispersão de energia após o protocolo de remoção. Trinta e cinco dentes bovinos foram preparados. Quinze dentes foram preenchidos com Bio-C Temp e 15 com Ultracal XS. Cinco permaneceram sem medicação intracanal (grupo controle). Cinco amostras de cada tempo experimental (ou seja, 24, 72 e 168 horas) foram usadas para medir o pH e a liberação de íons de cálcio usando um medidor de pH digital e um leitor de microplacas, respectivamente. Em seguida, os picos dos elementos químicos que compõem os dois medicamentos foram analisados em microscopia eletrônica de varredura e por espectroscopia de dispersão de energia. Os testes One-way ANOVA e post hoc de Tukey analisaram os dados de pH e liberação de íons cálcio. O teste t de Student comparou as medicações em cada tempo experimental. A microscopia eletrônica de varredura e a espectroscopia de dispersão de energia descreveu a porcentagem de elementos químicos nas amostras. O Bio-C Temp e o Ultracal XS mostraram um aumento significativo de pH de 24 a 168 horas (p<0,05). O Ultracal XS apresentou um valor de pH mais alto em 24 horas do que o Bio-C Temp (p<0,05), mas foi semelhante em 72 e 168h (p > 0,05). A liberação de íons cálcio não dependeu do período experimental (p> 0,05). O Bio-C Temp apresentou menor liberação de íons de cálcio do que Ultracal XS em 24 horas (p<0,05). As análises de microscopia eletrônica de varredura e espectroscopia de dispersão de energia mostraram remanescentes de ambas as medicações, mas a concentração de íons Si, Al e W estavam presentes apenas na medicação à base de silicato de cálcio. O Bio-C Temp apresentou pH alcalino e maior liberação de íons cálcio. Remanescentes de ambas as medicações estiveram presentes após os protocolos de remoção da pasta.

Abstract The aim of this study was to evaluate the quality of curved root canal preparation, torsional fatigue, and cyclic fatigue of rotary systems manufactured with different NiTi alloys. Ninety single-rooted canals with curvatures of 15° to 30o were scanned and divided into three groups according to the rotary system used: BT-Race (BTR) – 10.06, 35.00, 35.04; SequenceRotaryFile (SRF) – 15.04, 25.06, 35.04; and ProDesignLogic (PDL) – 25.01, 25.06, 35.05. Each system was used on three specimens. The teeth were prepared, scanned, and analyzed to assess increase in volume, transportation, and centering ability of the root canal. Torsional fatigue of glide path instruments (BTR 10.06, SRF 15.04 and PDL 25.01) and cyclic fatigue of the finishing instrument (BTR 35.04, SRF 35.04 and PDL 35.05) were obtained by analyzing completely new instruments (n = 10) and instruments after they had been used three times (n = 10). After the torsional and cyclic fatigue tests, the fractured surface of the new and used instruments were examined by scanning electron microscopy. Increase in volume, canal transportation, and centering ability showed no significant differences among the groups (p > 0.05). The torsional test showed that SRF 15.04 produced the highest torque values for both new and used instruments, followed by PDL 25.01 and BTR 10.06 (p < 0.05). PDL 25.01, both new and used, exhibited higher values of angular deflection followed by SRF 15.04 and BTR 10.06 (p < 0.05). As regards cyclic fatigue, use of PDL 35.05, both new and used, required a longer time and larger number of cycles than did SRF 35.04 and BTR 35.04 (p < 0.05). Clinical use affected the torsional fatigue of BTR; however, cyclic fatigue was not significantly affected (p < 0.05). All rotary systems were able to prepare the curved canals satisfactorily and were used safely on the three specimens. Relative to torsional fatigue, SRF 15.04 exhibited a higher torque, and PDL 25.01, higher angular deflection. BTR 10.06 was the most affected by clinical use. PDL 35.05 showed greater resistance to cyclic fatigue.

Abstract To evaluate the influence of novel ultrasonic tips as an auxiliary method for the rotary preparation of flattened/oval-shaped canals. Forty-five mandibular incisors were selected and divided into one of three experimental groups (n = 15): Group PFCP – ProDesign Logic 25/.05 + Flatsonic + Clearsonic + Prodesign Logic 40/.01; Group FCP – Flatsonic + Clearsonic + ProDesign Logic 40/.01; and Group PP – Prodesign Logic 25/.05 + Prodesign Logic 40/.05. The teeth were scanned preoperatively and postoperatively using microcomputed tomography. The percentage values for increase in volume, non-instrumented surface area, dentin removal, degree of canal transportation, and centering ratio between the experimental groups were examined. Data were analyzed using the non-parametric Kruskal-Wallis and Dunn’s tests (p < 0.05). Group PFCP showed the greatest volume increase in the total portion of the root canal and the lowest percentage of non-instrumented surface area. Regarding the degree of transportation in the buccolingual direction, statistically significant differences between groups PFCP and PP were observed at the coronal third of the canal. In the mesiodistal direction, no statistically significant differences were observed at the coronal, middle, and apical thirds. As for the centering ratio, statistically significant differences were found in the buccolingual direction. In the mesiodistal direction, no statistically significant differences were observed at the coronal, middle, and apical thirds. The use of novel ultrasonic tips combined with rotary instruments in group PFCP provided a significant increase in volume and reduced the percentage of non-instrumented areas during the preparation of flattened/oval-shaped canals.

Resumo O objetivo deste estudo foi avaliar a influência de diferentes protocolos de irrigação ultrassônica passiva na remoção de detritos em sulcos artificialmente criados nos terços radiculares cervical, médio e apical. Quarenta raízes de incisivos bovinos extraídos foram instrumentadas a 1 mm do ápice radicular com um instrumento R50 Reciproc e irrigadas com hipoclorito de sódio a 2,5%. As raízes foram então inseridas numa mufla e clivadas em duas hemisecções. Sulcos (3 mm de comprimento) foram feitos a 2, 7 e 12 mm do ápice radicular em uma hemisecção e preenchidos com detritos dentinários. As hemisecções foram reagrupadas na mufla e divididas em 4 grupos (n = 10) de acordo com o protocolo de irrigação final: Grupo controle: 3x20 s usando agulha de calibre #30 sem agitação da solução irrigadora; Grupo PUI-s (static passive ultrasonic irrigation): 3x20 s de irrigação ultra-sônica passiva com a ponta do inserto mantida estática no terço apical; Grupo PUI-t (Irrigação ultrassônica passiva por terço): 20 s de PUI em cada terço; Grupo PUI-d (Irrigação ultrassônica dinâmica): 3x20 s de PUI movendo dinamicamente o inserto em toda extensão do canal radicular. Em todos os grupos, foi utilizado um total de 6 mL de hipoclorito de sódio a 2,5% como irrigante. Após estes procedimentos, os sulcos foram analisadas com um estereomicroscópio e pontuações foram atribuídas quanto à remoção dos detritos. Os dados foram analisados estatisticamente (a=0.05). Os resultados mostraram uma melhor limpeza em todos os grupos onde a solução de irrigação foi agitada com dispositivo ultrassônico do que no grupo controle (p<0,05). No terço apical, o PUI-d e o PUI-s apresentaram performance semelhantes (p>0,05) e melhor limpeza do que o PUI-t (p<0,05). Os métodos dinâmico e estático de agitação da solução de irrigação proporcionaram uma limpeza mais eficaz. O PUID promoveu os sulcos mais completamente limpos sugerindo que seu uso é o mais adequado em casos de dentes com anatomia de canal complexa.

Abstract The aim of this study was to evaluate the influence of different passive ultrasonic irrigation protocols on the removal of debris in artificially created grooves in the cervical, middle and apical root thirds. Forty extracted bovine incisor roots were instrumented to 1 mm of the root apex with a R50 Reciproc instrument and irrigated with 2.5% sodium hypochlorite. The roots were then inserted in a muffle and cleaved into two hemisections. Grooves (3-mm long) were done at 2, 7 and 12 mm from the root apex in one hemisection and filled with dentinal debris. The hemisections were regrouped into the muffle and divided into 4 groups (n=10) according to the final irrigation protocol: Control group: 3x20 s using a #30 gauge needle without agitation of the irrigating solution; Group PUI-s (static passive ultrasonic irrigation): 3x20 s of passive ultrasonic irrigation with the tip of the insert maintained static on the apical third; Group PUI-t (passive ultrasonic irrigation per third): 20 s of PUI in each third; Group PUI-d (passive dynamic ultrasonic irrigation): 3x20 s of PUI dynamically moving the insert in the whole extent of the root canal. In all groups, was used a total of 6 mL of 2.5% sodium hypochlorite as irrigant. After these procedures, the grooves were analyzed with a stereomicroscope and assigned scores as regards removal of the debris. The data were analyzed statistically (a=0.05). The results showed a better cleaning in all the groups where the irrigating solution was agitated with ultrasonic device than in the control group (p<0.05). In the apical third, the PUI-d and PUI-s showed similar performance (p>0.05) and a better cleanness than PUI-t (p<0.05). The dynamic and static methods of agitation of the irrigating solution provided more effective cleaning. PUI-d provided the most completely clean grooves suggesting that its use is the most adequate in cases of teeth with complex canal anatomy.

Abstract This study aimed to compare apical transportation, centering ratio, and working time during root canal preparation with Wizard Navigator (WN), WaveOne (WO), or ProTaper Universal (PT) and to describe deformation and fracture of these instruments. Thirty-six mesiobuccal roots from maxillary molars were micro-computed tomography (micro-CT) scanned and then sorted into three groups (n = 12): Wizard Navigator (WN), WaveOne (WO), and ProTaper Universal (PT). The root canals were prepared using WN, WO, or PT; the time of each canal preparation was timed; and the specimens were micro-CT re-scanned. The instruments were submitted to scanning electron microscopy (SEM) before and after their use. The data on canal transportation at 1, 2, 3, 4 and 5 mm and preparation time were analyzed by the Kruskal-Wallis test, followed by the Mann-Whitney U test. The centering ratio was analyzed by ANOVA, followed by Tukey’s test. Both instrument deformation and fracture were described. Apical transportation was similar among groups at 1, 2, 3 and 4 mm. The WO group showed higher canal transportation at 5mm than the other groups (p = 0.03). There was no significant difference in centering ratio among the groups. Preparation time in the WO group was significantly lower than in the other groups (p = 0.004). Small differences were observed in the surface area of all instruments. The WN, WO, and PT groups had a similar centering ratio without procedural errors or significant structural changes. At 5 mm from the apex, the WO group showed the largest canal transportation toward the furcation and root canal preparation was faster than in the WN and PT groups.

This study aimed to determine the presence of Prevotella strains and genes associated with resistance to lactamics in different oral niches from patients with/without primary endodontic infections. Saliva (S) and supragingival biofilm (SB) were collected from three patient groups: Group I – no endodontic infection (n = 15); Group II – acute endodontic infection (n = 12); and Group III – chronic endodontic infection (n = 15). Root canal (RC) samples were collected from Groups II and III. The presence of P. intermedia, P nigrescens, P. tannerae and cfxA/cfxA2 gene was assessed by PCR. The cfxA/cfxA2 gene was not detected in all environments within the same patient. The cfxA/cfxA2 gene was present in 23.81% of S samples, 28.57% of SB samples, and 7.41% of RC samples. Prevotella species were detected in 53.97%, 47.62% and 34.56% of the S, SB, and RC samples, respectively. P. intermedia had a high frequency in saliva samples from Group 3. Saliva samples from Group 1 had higher detection rates of P. nigrescens than did Groups 2 and 3. Patients without endodontic disease had high frequencies of P. nigrescens in the SB samples. The presence or absence of spontaneous symptoms was not related to the detection rates for resistance genes in the RC samples. Saliva, supragingival biofilm and root canals can harbor resistant bacteria. The presence of symptomatology did not increase the presence of the cfxA/cfxA2 gene in the supragingival biofilm and inside root canals.

OBJETIVO: O estudo avaliou, em diversos períodos de análise, o pH e liberação de cálcio e a atividade antibacteriana proporcionada pelo MTA Fillapex, em relação ao Sealapex e AH Plus. MATERIAL E MÉTODO: Tubos de polietilenos foram preenchidos com um dos cimentos e imersos em água destilada. Após de 24 horas, 14 e 28 dias, o valor do pH e o cálcio liberado pelos cimentos foram avaliados diretamente na água destilada em que os espécimes permaneceram imersos. A atividade antibacteriana dos cimentos foi avaliada em culturas de Enterococcus faecalis ou Staphylococcus aureus, por meio do teste de difusão em ágar. Os dados obtidos foram submetidos aos testes de ANOVA e Tukey (α=0.05). RESULTADO: Em todos os períodos analizados, o Sealapex proporcionou os maiores valores de pH (p<0,05) em relação aos demais cimentos e o MTA Fillapex proporcionou maiores valores que o dos AH Plus (p<0,05). Em 14 dias, o MTA Fillapex promoveu maior liberação de cálcio que o proporcionado pelo Sealapex (p<0,05). Em 28 dias, o Sealapex proporcionou maior liberação de cálcio que o MTA Fillapex (p<0,05). Em todos os períodos, o AH Plus apresentou a menor liberação de cálcio em relação aos outros cimentos (p<0,05). Em relação ao E. faecalis, não foram observadas diferenças (p>0,05) entre as zonas de inibição de crescimento bacteriano produzidas pelos diveros cimentos. Em relação ao S. aureus, o Sealapex apresentou maior atividade antibacteriana que o MTA Fillapex e o AH Plus (p<0,05), que por sua vez foram semelhantes entre si (p>0,05). CONCLUSÃO: Após o período final de avaliação, o pH e a liberação de cálcio proporcionado pelo MTA Fillapex foram menores que os do Sealapex e maiores que os do AH Plus. A atividade antimicrobiana do MTA Fillapex não diferiu dos demais cimentos endodônticos.

OBJECTIVE: This study evaluated, in several analysis periods, pH and calcium release and antibacterial activity provided by MTA Fillapex sealer compared to Sealapex and AH Plus sealers. MATERIAL AND METHOD: Polyethylene tubes were filled with a sealer and immersed in distilled water. After 24 hours, 14 and 28 days, pH and calcium release by endodontic sealers were evaluated directly in water which the tubes were stored. Sealers antibacterial activity was evaluated against Enterococcus faecalis and Staphylococcus aureus by means of agar diffusion test. All data were submitted to ANOVA and Tukey tests (α=0.05). RESULT: In all periods evaluated, Sealapex had the highest pH value (p<0.05) in comparison to other sealers and MTA Fillapex provided higher pH values than AH Plus (p<0.05). In 14-days period, MTA Fillapex had greater calcium release value than Sealapex (p<0.05). In 28-days period, Sealapex provided higher calcium release than MTA Fillapex (p<0.05). In all periods, AH Plus provided lower calcium release than other sealers (p<0.05). In relation to E. faecalis, there were no differences among the sealers, in relation to antibacterial activity (p>0.05). In relation to S. aureus, Sealapex presented better antibacterial effectiveness than the MTA Fillapex and AH Plus (p<0.05), which were similar each other (p>0.05). CONCLUSION: In final evaluation period, pH values and calcium release provided by MTA Fillapex were lower than provided by Sealapex and higher than provided by AH Plus. The MTA Fillapex antimicrobial action was similar to other endodontic sealers.

The aim of this study was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File) in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000). The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05).

O objetivo deste estudo foi avaliar a eficácia de dois tipos de instrumentos rotatórios em associação à irrigação com hipoclorito de sódio (NaOCl) ou EDTA na remoção de resíduos de hidróxido de cálcio (HC) das paredes do canal radicular. Quarenta e dois incisivos inferiores de humanos foram instrumentados com o sistema ProTaper até o instrumento F2, irrigados com NaOCl a 2,5%, seguido de EDTA a 17% e preenchidos com medicação intracanal à base de HC. Após 7 dias, o HC foi removido utilizando 4 técnicas: instrumento 25/0.06 (K3 Endo) e irrigação com EDTA a 17% (Grupo 1), instrumento F1 (ProTaper) e irrigação com EDTA a 17% (Grupo 2), instrumento 25/0.06 e irrigação com NaOCl a 2,5% (Grupo 3) e instrumento F1 e irrigação com NaOCl a 2,5% (Grupo 4). Duas raízes que não receberam medicação intracanal foram utilizadas como controles negativo. Foram avaliados os terços cervical e apical dos canais radiculares por meio de microscopia eletrônica de varredura. Nenhuma das técnicas removeu completamente a medicação à base HC. Nos terços apical e cervical, o instrumento F1 foi melhor do que o instrumento 25/0.06 na remoção dos resíduos de HC (p<0,05), independentemente da solução irrigadora final. Não houve diferença entre as soluções irrigadoras nos grupos do instrumento F1 e do instrumento 25/0.06 (p>0,05). Os controles negativos não apresentaram resíduos de HC nas paredes dentinárias. Concluiu-se que o instrumento F1 do ProTaper foi melhor que o instrumento 25/0.06 do K3 Endo na remoção da medicação intracanal à base de HC, independentemente da solução irrigadora utilizada.

This study evaluated the efficacy of 2 types of rotary instruments employed in association with sodium hypochlorite (NaOCl) or EDTA in removing calcium hydroxide (CH) residues from root canals dentin walls. Forty-two mandibular human incisors were instrumented with the ProTaper System up to F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA and filled with a CH intracanal dressing. After 7 days, the CH dressing was removed using 4 techniques: NiTi rotary instrument size 25, 0.06 taper (K3 Endo) and irrigation with 17% EDTA (Group 1), NiTi rotary F1 instrument (ProTaper) and irrigation with 17% EDTA (Group 2), NiTi rotary instrument size 25, 0.06 taper and irrigation with 2.5% NaOCl (Group 3) and NiTi rotary F1 instrument and irrigation with 2.5% NaOCl (Group 4). Two roots without intracanal dressing were used as negative controls. Teeth were evaluated by scanning electron microscopy, in the cervical and apical canal thirds. None of the techniques removed the CH dressing completely. In the apical and cervical thirds, F1 instrument was better than instrument size 25, 0.06 taper in removing CH residues (p<0.05), regardless of the final irrigating solution. No difference was found between the irrigating solutions in the groups of F1 instrument and of instrument size 25, 0.06 taper (p>0.05). The negative controls had no CH residues on the dentin walls. In conclusion, the ProTaper F1 instrument was better than K3 Endo instrument size 25, 0.06 taper in the removal of CH intracanal medication, regardless of irrigating solution used.