Resumo O objetivo neste estudo foi avaliar a influência de diferentes instrumentos e mecanismos de agitação da solução irrigadora na penetração e resistência de união (RU) do AH Plus à dentina. Pré molares humanos foram distribuídos em dois grupos experimentais (n=30), de acordo com o sistema de instrumentação: ProTaper Next (PN) ou XP-endo Shaper (XS) e de acordo com três protocolos de irrigação (n=10): NaviTip (Nv), XP-endo Finisher (XF), passive ultrasonic irrigation/ XP-endo Finisher (PUIXF). A irrigação do canal radicular foi realizada com NaOCl 2,5% e EDTA 17%. A obturação foi realizada por meio da técnica da condensação lateral, com AH Plus acrescido de rodhamina B 0,1%. As raízes foram seccionadas, obtendo-se 2 slices de 2,0 mm para cada terço radicular. O primeiro slice foi submetido a análise da penetração do cimento e ao teste de push-out e o segundo slice submetido a MEV para análise da interface de união. Para penetração (%) Tukey evidenciou que PNXF (82,38±13,48), PNPUIXF (82,48±12,02), XSXF (82,24±11,28) e XSPUIXF (86,23±10,45) apresentaram os maiores valores, diferentes (p<0,05) de PNC (68,29±15,12) e XPSC (71,41±16,50). Na RU (MPa) foi evidenciado que PNPF (4,92±1,04) e XPSPF (5,03±0,70), no terço cervical, obtiveram os maiores valores diferentes dos demais (p<0,05). MCVL e MEV evidenciaram maior penetração do cimento em toda extensão da parede do canal radicular inclusive nas regiões polares, quando foi realizada a agitação da solução irrigadora. Concluiu-se que a associação PUI e XP-endo Finisher favoreceu a penetração e resistência de união do material obturador à dentina radicular.

Abstract The aim of this study was to evaluate the influence of different instruments and mechanisms of agitation of the irrigating solution on the penetration by confocal laser scanning microscopy (CLSM), and the bond strength (BS) of the filling material to the dentin by push-out test. Human premolars were distributed in two experimental groups (n=30), according to the instrumentation system: ProTaper Next (PN) or XP-endo Shaper (XS) and three irrigation protocol (n=10): NaviTip (Nv), XP-endo Finisher (XF), passive ultrasonic irrigation/ XP-endo Finisher (PUIXF). The 2.5% NaOCl and 17% EDTA were the irrigating solutions used. The filling was performed using a lateral condensation technique, with AH Plus added to 0.1% rodhamine B. The roots were sectioned, obtaining 2 slices for each third of the root. The first slice was submitted to the sealer penetration analysis and the push-out test. The second slice was submitted to qualitative analysis (SEM) of the union interface. For the penetration (%) Tukey showed that PNXF (82.38±13.48), PNPUIXF (82.48± 12.02), XSXF (82.24±11.28) and XSPUIXP (86.23±10.45) presented the highest values, different (p<0.05) from PNNv (68.29±15.12) and XSNv (71.41±16.50). The BS (MPa) test evidenced that in the cervical third, PNPF (4.92±1.04) and XPSPF (5.03±0.70) obtained the highest values differing from the others groups (p<0.05). CSLM and SEM showed greater penetration of the sealer on the entire length of the root canal when the irrigation solution was stirred. In conclusion that the association PUI and XP-endo Finisher favored the penetration and bond strength of the filling material to the root dentin.

Abstract This study evaluated by the efficacy of rotary and reciprocating systems to remove filling material by micro-CT. Sixty human canines were instrumented up to F3 by ProTaper Universal system and filled with AH Plus/ gutta-percha. Specimens were submitted to 1,200 thermal cycles, scanned by microCT SkyScan 1176 and randomly distributed in groups according to the filling material removal protocol (n = 10): ProTaper Universal, ProTaper Universal/xylol, ProTaper Next, ProTaper Next/xylol, Reciproc and Reciproc/xylol. After filling removal, specimens were analyzed by microCT to separately verify the presence of gutta-percha and sealer remnants. The data (mm3) were analyzed by two way ANOVA and Tukey´s test (5%). For the remaining gutta-percha, the use of xylol provided the highest values for Reciproc (7.60 ± 0.73), which was statistically different from the other groups (p < 0.05) that presented lower values and were statistically similar to each other (p > 0.05). For the remaining sealer, xylol provided the highest values (21.25 ± 6.94) different (p < 0.05) from the use of instruments alone (11.47 ± 9.45). ProTaper Next presented the lowest values (8.16 ± 1.37) for the remaining sealer, different (p < 0.05) from that of Reciproc (24.67 ± 6.32). The qualitative analysis revealed that all groups presented some remaining root filling material, with the highest volumes presented by Reciproc and Reciproc/xylol. In conclusion the rotary systems provided greater removal of filling material regardless of the use of xylol. The use of xylol negatively interfered with the action of the reciprocating system in the removal of the gutta-percha and sealer.

Abstract This study evaluates the influence of root dentin treatment with NaOCl alone and combined with EDTA, with and without ultrasound activation, on the push-out bond strength (BS) of fiber-reinforced posts in weakened roots, cemented with RelyX or Panavia. The root canals of 42 maxillary canines were instrumented with Reciproc and 2.5% NaOCl. In the coronal 12mm of all canals, experimental weakening of the roots was produced by reducing dentin thickness with 2.44mm diameter diamond burs. The roots were assigned to 3 groups (n = 14) according to root dentin treatment: 2.5% NaOCl; 2.5% NaOCl + 17% EDTA; and 2.5% NaOCl + 17% EDTA, with solutions agitated using passive ultrasonic irrigation. After cementation of the fiber-reinforced posts the roots were divided in thirds. The first slice of each third was used for the push-out BS test, the second slice for confocal laser scanning microscopy and dentin microhardness (Knoop) analysis. Data were analysed by a two-way ANOVA and Tukey test (a = 0.05). NaOCl + EDTA provided highest BS values than NaOCl (p < 0.0001). Specimens cemented with Panavia presented significantly higher BS than those with RelyX in the three root thirds (p < 0.0001). The highest BS values occurred in the cervical third (p < 0.001). Ultrasound-activated NaOCl + EDTA promoted the greatest reduction in dentin microhardness, followed by NaOCl/EDTA and NaOCl. Ultrasonic activation of NaOCl and EDTA reduced root dentin microhardness, but did not improve the push-out BS of resin-based cements. Panavia presented higher BS than RelyX. RelyX was not influenced by the root dentin treatment protocols.

Abstract This study evaluated the removal of filling material with ProTaper Universal Rotary Retreatment system (PTR) combined with solvents and the influence of solvents on the bond strength (PBS) of sealer to intraradicular dentin after canal reobturation. Roots were endodontically treated and distributed to five groups (n = 12). The control group was not retreated. In the four experimental groups, canals were retreated with PTR alone or in combination with xylol, orange oil, and eucalyptol. After filling material removal, two specimens of each group were analysed by SEM and µCT to verify the presence of filling remnants on root canal walls. The other roots were reobturated and sectioned in 1-mm-thick dentin slices that were subjected to the push-out test. Data were analysed by two-way ANOVA and Tukey’s test (α = 0.05). SEM and µCT analysis revealed that all retreatment techniques left filling remnants on canal walls. The control group (3.47 ± 1.21) presented significantly higher (p < 0.05) PBS than the experimental groups. The groups retreated with PTR alone (2.59 ± 0.99) or combined with xylol (2.54 ± 0.77) and orange oil (2.32 ± 0.93) presented similar bond strength (p > 0.05), and differed significantly from the group with eucalyptol (1.89 ± 0.63). The solvents reduced the PBS of the sealer to dentin and no retreatment technique promoted complete removal of filling material.

Resumo O objetivo neste estudo foi avaliar a influência do cimento endodôntico e da fonte de luz fotoativadora na resistência de união (RU) regional da resina composta às raízes fragilizadas. Noventa raízes de incisivos foram experimentalmente fragilizados, submetidos ao preparo biomecânico e obturadas com Endofill, AH Plus ou MTA Fillapex. Os canais foram desobturados e reforçados com pinos de fibra de vidro e resina composta fotoativada com uma das fontes de luz: halógena a 600 mW/cm2 (QTH-600), diodo emissor de luz a 800 mW/cm2 (LED-800) e LED a 1500 mW/cm2 (LED-1500). As raízes foram seccionadas em slices provenientes dos terços cervical, médio e apical das regiões da raiz reforçada e analisadas por meio do teste de push out, microscopia eletrônica de varredura (MEV) e microscopia confocal de varredura a laser (MCVL). Os dados de resistência de união foram analisados por ANOVA a três critérios e teste de Tukey (α=0,05). Os espécimes obturados com AH Plus apresentaram maior resistência de união, seguido do MTA Fillapex e do Endofill (p<0,05). Para fonte de luz fotoativadora, LED-1500 apresentou resistência de união superior ao LED-800 que foi maior que QTH-600 (p<0,05). A região cervical obteve as maiores médias (p<0,05), enquanto que a região apical apresentou a menor resistência de união (p<0,05). MCVL revelou remanescente de material endodôntico nos túbulos dentinários para todos os grupos. O cimento contendo eugenol (Endofill) comprometeu a resistência de união da resina composta à dentina radicular. A resistência de união foi favorecida na região cervical, e quando o LED-1500 foi empregado.

Abstract The aim of this study was to assess the influence of sealer and light-curing unit on regional bond strength of resin composite to the weakened roots. Ninety roots of incisors were experimentally weakened, subjected to biomechanical preparation and filled with either Endofill, AH Plus or MTA Fillapex The roots were desobturated e reinforced with resin composite and fiber post light-activated with one of the light sources: halogen at 600 mW/ cm2 (QTH-600), LED at 800 mW/ cm2 (LED-800) and LED at 1500 mW/ cm2 (LED-1500). The roots were sectioned in slices from cervical, middle and apical root-reinforcement regions and analyzed by push out test, scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Bond strength data were analyzed using three-way ANOVA and Tukey´s test (α=0.05). Specimens filled with AH Plus had higher bond strength, followed by MTA Fillapex and Endofill (p<0.05). For light-curing unit, LED-1500 presented superior bond strength than LED-800, which was higher than QTH-600 (p<0.05). The cervical region had the greatest mean values (p<0.05) while apical part showed the lowest bond strength (p<0.05). CLMS revealed remaining filling material in the dentinal tubules for all groups. The eugenol-containing sealer (Endofill) compromised the push-out bond strength of composite resin to the root dentin. Bond strength was favored in the cervical region, and when LED-1500 was used.

This study evaluates the effect of two thermoplastic obturation systems (MicroSeal and Obtura II) on bond strength of different sealers to intraradicular dentin. Sixty root canals of human canines were prepared using ProTaper rotary files (crown-down technique) and irrigated with 2.5% sodium hypochlorite and 17% EDTA. The root canals were filled by MicroSeal, Obtura II, or lateral compaction techniques using AH Plus and Epiphany SE. 1.5 mm thick root slices were subjected to the push-out test. ANOVA and Tukey's test showed that the bond strength values (MPa) observed in the groups obturated with MicroSeal (2.96 ± 2.72) and Obtura II (2.68 ± 2.18) did not significantly differ from each other (p > 0.05) but were significantly higher than that observed in the group obturated with lateral condensation (2.01 ± 1.48; p < 0.05). There were no statistically significant differences in strength (p > 0.05) among the root canal thirds (cervical: 2.44 ± 2.03; middle: 2.50 ± 2.27; and apical: 2.70 ± 2.34). Adhesive failures were predominant (60%) in all groups. In conclusion, MicroSeal and Obtura II techniques, using AH plus sealer, increased the resistance to displacement of the filling material, when compared with lateral compaction. Moreover, when used with Epiphany SE, these obturation systems did not affect the bond strength of the material to root dentin.

This study aimed to evaluate, by means of scanning electron microscopy (SEM), the cleaning of flattened root canals, varying irrigation/aspiration protocols during biomechanical preparation. Thirdy human mandibular incisors were distributed into three groups (n = 10) according to the aspiration/irrigation protocols: conventional, conventional + brush, and apical negative pressure irrigation. Irrigation procedure was performed with 5 mL of 1% NaOCl at each change of instrument; final irrigation was conducted with 17% EDTA for 5 min. After biomechanical preparation, the roots were sectioned and prepared for SEM analysis. The images obtained were evaluated under 35× and 1,000× magnification by three calibrated examiners, following a double-blind design. All data were analyzed using Kruskal–Wallis and Dunn’s post hoctests (α = 0.05). Canals wherein the conventional method and apical negative pressure irrigation were employed revealed less debris, statistically different from the conventional + brush group (p < 0.05). Regarding the presence of smears, apical negative pressure irrigation was more effective in cleaning, showing lowest scores (p < 0.05), compared with the other tested protocols. Comparing each root canal third revealed that the apical portion was difficult to clean as all the tested protocols showed similar high scores (p > 0.05), both for the presence of debris and smear layer. In conclusion, although none of the studied irrigation/aspiration protocols have completely cleaned flattened root canals, apical negative pressure irrigation was more effective in smear layer removal, whereas the conventional + brush protocol was the least effective in removing the debris and smear layer.

Soluções químicas são fundamentais para o tratamento endodôntico; entretanto, promovem alterações ultraestruturais na superfície dentinária. O objetivo deste estudo foi quantificar a rugosidade da dentina radicular com diferentes concentrações de hipoclorito de cálcio (Ca(OCl)2) e hipoclorito de sódio (NaOCl) utilizando microscopia confocal à laser (CLSM). Foram utilizados 52 premolares humanos inferiores e aleatoriamente divididos em treze grupos (n=8): Soro fisiológico (controle); NaOCl a 1%, 2,5% and 5%; Ca(OCl)2 a 1%, 2,5% and 5%; os grupos de hipoclorito foram subdivididos pela associação ou não ao ácido etilenodiaminotetracético (EDTA). A concentração de cloro ativo foi avaliada para diferentes soluções utilizando titulação iodométrica (%). A rugosidade superficial (Sa) foi quantificada por CLSM. Ca(OCl)2 apresentou perda substancial de cloro ativo e que foi distinta da condição descrita pelo fabricante, sem entretanto comprometer as alterações no substrato dentinário. Não houve diferenças significantes na rugosidade dentinária produzida pelos Ca(OCl)2 e NaOCl em todas as concentrações estudadas e associação com EDTA. A associação ao EDTA produziu rugosidade semelhante entre as soluções (p>0.05). O Ca(OCl)2 e NaOCl na concentração de 5% aumentaram significativamente a rugosidade dentinária e não apresentaram diferenças dos valores obtidos com a associação de EDTA (p>0.05). O Ca(OCl)2 alterou a rugosidade da dentina radicular de forma semelhante ao NaOCl, nas concentrações e associações utilizadas neste estudo. Como a concentração de 5% de Ca(OCl)2 e NaOCl, apresentou maior rugosidade dentinária, independente da associação ao EDTA, pode-se concluir que Ca(OCl)2 nas concentrações de 1% e 2,5% pode ser considerado uma solução adequada para a irrigação de canais radiculares.

Chemical solutions play important roles in endodontic treatment and promote ultrastructural changes in dentin surface. The aim of this study was to quantify root canal roughness at different concentrations of calcium hypochlorite (Ca(OCl)2) and sodium hypochlorite (NaOCl) by confocal laser scanning microscopy (CLSM). Fifty-two human mandibular premolars were sectioned and randomly organized into thirteen groups (n=8): saline (control); 1%, 2.5% and 5% NaOCl; 1%, 2.5% and 5% Ca(OCl)2; the hypochlorite groups were further divided into with or without EDTA. The chlorine concentrations of the different solutions were measured by iodine titration (%). The superficial roughness (Sa) was quantified by CLSM. Ca(OCl)2 presented substantial decrease in chlorine concentration that differed from the package indication, but without compromising the dentin ultrastructure changes. There were no significant differences in dentin roughness between Ca(OCl)2 or NaOCl at all studied concentrations. The combination with EDTA provided similar roughness values among the solutions (p>0.05). The 5% Ca(OCl)2 and NaOCl solutions significantly increased dentin roughness and did not differ from the EDTA association (p>0.05). Ca(OCl)2 promoted similar dentin roughness as the NaOCl at the same concentrations and combined with EDTA. It may be concluded that Ca(OCl)2 modified the root canal dentin roughness similarly to NaOCl, at the same concentrations and EDTA combinations used in this study. Ca(OCl)2 and NaOCl, both at 5%, significantly altered dentin roughness, overcoming EDTA association, thus Ca(OCl)2 concentrations ranging from 1% to 2.5% may be suitable solutions for root canal irrigation protocols.

O objetivo deste estudo foi avaliar a resistência de união à dentina de uma resina utilizada para reforço de raiz, ativada com diferentes fontes de luz. De acordo com a fonte de luz utilizada as raízes foram divididas em 4 grupos (n = 15): GI, raízes não fragilizadas (controle); GII, luz halógena (H) 600 mW/cm2; GIII, LED 800 mW/cm2 e GIV, LED 1500 mW/cm2. O reforço foi feito com adesivo, resina composta e pino de fibra de vidro. Após 24 h, os espécimes foram seccionados e o primeiro slice de cada região utilizado para o teste de união push out, na máquina de ensaios universais com 0,5 mm/min, e o tipo da falha avaliada. Os dados obtidos (MPa) foram analisados utilizando os testes de ANOVA e Holm-Sidak (=0.05). O segundo slice de cada região foi analisado por microscopia eletrônica de varredura (MEV). O LED-1500 (4.69 ± 1.74) proporcionou resistência a união similar ao controle (5.05 ± 2.63) e estatisticamente diferente do H-600 (1.96 ± 0.94) e LED-800 (2.75 ± 1.90), que são similares entre si (p<0.05). As regiões cervical (4.16 ± 2.32) e média (4.43 ± 2.32) apresentaram alta resistência à união quando comparadas à região apical (2.25 ± 1.50) (p<0.05). Houve uma predominância de falhas adesivas com as fontes de luzes H-600 e LED-800 e coesivas com o LED-1500. A análise em MEV demonstrou a formação de longos tags resinosos. Desta forma, pode-se concluir que o LED-1500 proporcionou maior resistência à resina utilizada para o reforço da dentina radicular.

The aim of this study was to evaluate the bond strength to the dentin of an adhesive material used for root reinforcement light activated with different sources. Roots were divided into 4 groups (n=15) according to the light source used to activate the resin reinforcement: GI, non-weakened roots (control); GII, halogen light (H) 600 mW/cm2; GIII, LED 800 mW/cm2 and GIV, LED 1500 mW/cm2. The reinforcement was done with adhesive, composite resin and fiberglass posts. After 24 h, the specimens were sectioned and the first slice of each post region was used in the push out test in a universal testing machine with a crosshead speed of 0.5 mm/min. Failure modes of the debonded specimens were examined. Data (MPa) were analyzed by ANOVA and Holm-Sidak test (=0.05). The second slice from each region was analyzed by scanning electron microscopy (SEM). LED-1500 (4.69 ± 1.74) provided bond strength similar to the control group (5.05 ± 2.63) and statistically different from H-600 (1.96 ± 0.94) and LED-800 (2.75 ± 1.90), which were similar to each other (p<0.05). Cervical (4.16 ± 2.32) and middle (4.43 ± 2.32) regions showed higher bond strength than the apical (2.25 ± 1.50) (p<0.05). There was a prevalence of adhesive failures in H-600 and LED-800 and cohesive failures in LED-1500. SEM showed the formation of long, numerous and fine tags. It was concluded that LED-1500 provided higher bond strength of resin reinforcement to the dentin.

OBJECTIVE: To assess the setting time (ST), flow (FL), radiopacity (RD), solubility (SB) and dimensional change following setting (DC) of different sealers (AH Plus®, Polifil, Apexit Plus®, Sealapex®, Endométhasone® and Endofill®) according to American National Standards Institute/American Dental Association (ANSI/ADA) Specification 57. MATERIAL AND METHODS: Five samples of each material were used for each test. For ST, cast rings were filled with sealers and tested with a Gilmore needle. For FL, the sealer was placed on a glass plate. After 180 s, another plate with 20 g and a load of 100 g were applied on the material, and the diameters of the discs formed were measured. In RD, circular molds were filled with the sealers, radiographed and analyzed using Digora software. For SB, circular molds were filled with the sealers, a nylon thread was placed inside the material and another glass plate was positioned on the set, pressed and stored at 37°C. Samples were weighed, placed in water, dried and reweighed. The water used for SB was analyzed by atomic absorption spectrometry. For DC, circular molds were filled with the sealers, covered by glass plates and stored at 37°C. Samples were measured and stored in water for 30 days. After this period, they were dryed and measured again. RESULTS: Regarding ST, AH Plus®, Apexit® and Endofil® sealers are in accordance with ANSI/ADA standards. Endométhasone's manufacturer did not mention the ST; Polifil is an experimental sealer and Sealapex® did not set. Considering RD, SB and DC, all sealers were in accordance with ANSI/ADA. The spectrometric analysis showed that a significant amount of K+ and Zn2+ ions was released from Apexit Plus® and Endofill®, respectively. CONCLUSION: Except for DC, all other physicochemical properties of the tested sealers conformed to ANSI/ADA requirements.

O objetivo deste estudo foi avaliar a influência do pré-tratamento de superfície dos pinos de fibra de vidro na resistência à flexão (RF), módulo de elasticidade (ME) e morfologia, bem como a resistência de união (RU) entre os pinos e o núcleo de preenchimento. Cinqüenta e dois pinos de fibra de vidro (lisos e serrilhados) foram divididos em 4 grupos (n=13): sem tratamento (controle), peróxido de hidrogênio a 10% por 10 min (HP-10), peróxido de hidrogênio 24% por 1 min (HP-24) e jato de óxido de alumínio (Al2O3). Para avaliar a RF e ME, o ensaio de flexão de 3 pontos foi realizado. Três pinos de cada grupo foram examinados em MEV. Resina composta foi utilizada como núcleo de preenchimento e as amostras foram seccionadas para obter palitos de microtração. Os dados foram analisados por ANOVA e teste de Tukey (α=0,05). Na RF, observou-se diferença estatisticamente significante entre os pinos e tipo de pré-tratamento de superfície (p<0,05), com as maiores médias para os pinos lisos. Al2O3 proporcionou maior RF que HP-24. Al2O3 promoveu maior ME que HP-24 e grupo controle. MEV revelou dissolução parcial da matriz de resina em todos os grupos tratados. Os pinos lisos tiveram a maior RU (p<0,05). Os pinos lisos apresentaram RF e RU superior aos pinos serrilhados (p<0,05). As propriedades mecânicas dos pinos de fibra de vidro e a resistência de união entre os pinos e o material resinoso não foram alterados pelos tratamentos de superfície, com exceção do jato de óxido de alumínio que aumentou o módulo de elasticidade dos pinos.

The aim of this study was to assess the influence of surface pretreatments of fiber-reinforced posts on flexural strength (FS), modulus of elasticity (ME) and morphology of these posts, as well as the bond strength (BS) between posts and core material. Fifty-two fiber posts (smooth and serrated) were assigned to 4 groups (n=13): no treatment (control), 10% hydrogen peroxide (HP) for 10 min (HP-10), 24% HP for 1 min (HP-24) and airborne-particle abrasion (Al2O3). To evaluate FS and ME, a 3-point bending test was performed. Three posts of each group were examined by scanning electron microscopy. Composite resin was used as the core build-up and samples were sectioned to obtain microtensile sticks. Data were analyzed by ANOVA and Tukey's test (α=0.05). For FS, significant differences were observed between posts type and surface pretreatment (p<0.05), with the highest means for the smooth posts. Al2O3 provided higher FS than HP-24. Al2O3 promoted higher ME than HP-24 and control. SEM images revealed partial dissolution of the resin matrix in all treated groups. The smooth posts had higher BS and FS than serrated posts (p<0.05). Mechanical properties of the glass fiber posts and the bond strength between posts and composite material were not altered by the surface treatments, except for airborne-particle abrasion that increased the post elastic modulus.