Resumo Este estudo avaliou o impacto do pré-alargamento do canal usando uma lima K de tamanho #25 na incidência de fraturas de três instrumentos reciprocantes após múltiplos usos. Após um glide path realizado com uma lima K de tamanho #15, os instrumentos (Reciproc R25, Reciproc Blue R25, e WaveOne Gold Primary) foram inicialmente usados em 936 canais radiculares. Depois, para o segundo e terceiros usos (933 e 927 canais, respectivamente), um pré-alargamento usando uma lima K de tamanho #25 no comprimento de trabalho foi realizado. Radiografias periapicais avaliaram a localização e o comprimento dos fragmentos, e os testes qui-quadrado compararam as frequências observadas e esperadas (α = 5%). A incidência de fraturas durante o reuso variou de 0% a 0,64%. Reciproc não fraturou durante o reuso (P = 0,99), mas sofreu duas fraturas no terceiro uso (P = 0,000). Reciproc Blue e WaveOne Gold tiveram, cada um, uma fratura durante o segundo (P = 0,000) e terceiro (P = 0,000) usos. Após o pré-alargamento do canal usando uma lima K de tamanho #25 em 1.860 canais, apenas 6 instrumentos fraturaram (0,32%), sugerindo que esta abordagem pode prolongar a vida útil desses instrumentos e servir como uma alternativa para sua reutilização com risco reduzido de fratura. préalargamento pré alargamento 25 #2 15 #15 R25 R Primary 93 radiculares Depois 933 (93 92 respectivamente, respectivamente , respectivamente) fragmentos quiquadrado qui quadrado α 5%. 5 5% . 5%) 0 064 64 0,64% P 0,99, 099 0,99 99 0,99) 0,000. 0000 0,000 000 tiveram 1860 1 860 1.86 0,32%, 032 0,32% 32 (0,32%) 2 # #1 R2 9 (9 06 0,64 09 0,9 0,00 00 186 86 1.8 03 0,32 3 (0,32% ( 0,6 0, 0,0 18 8 1. 0,3 (0,32 (0,3 (0, (0

Abstract This study assessed the impact of pre-enlarging the root canal using a size 25 K-file on the fracture incidence of three reciprocating instruments after multiple uses. After a glide path performed with a size 15 K-file, the instruments (Reciproc R25, Reciproc Blue R25, and WaveOne Gold Primary) were initially used in 936 root canals. Then, for the second and third uses (933 and 927, respectively), a pre-enlargement using a size 25 K-file at the working length was done. Periapical radiographs assessed fragment location and length, and chi-square tests compared observed and expected frequencies (α = 5%). The fracture incidence during reuse ranged from 0% to 0.64%. Reciproc did not fracture during reuse (P = 0.99), but experienced two fractures in the third use (P = 0.000). Reciproc Blue and WaveOne Gold each had one fracture during the second (P = 0.000) and third (P = 0.000) uses. Following a pre-enlargement using a size 25 K-file for the second and third uses in 1,860 canals, only 6 instruments fractured (0.32%), suggesting that this approach may prolong the lifespan of these instruments and serve as an alternative for their reuse with a reduced risk of fracture. preenlarging pre enlarging 2 Kfile K file 1 Kfile, file, R25 R Primary 93 canals Then 933 (93 927 respectively, respectively , respectively) preenlargement enlargement done chisquare chi square α 5%. 5 5% . 5%) 0 064 64 0.64% P 0.99, 099 0.99 99 0.99) 0.000. 0000 0.000 000 1860 860 1,86 0.32%, 032 0.32% 32 (0.32%) R2 9 (9 92 06 0.64 09 0.9 0.00 00 186 86 1,8 03 0.32 3 (0.32% ( 0.6 0. 0.0 18 8 1, 0.3 (0.32 (0.3 (0. (0

Abstract To investigate the influence of the remaining volume of a new intracanal medication based on bioceramic compounds on the bond strength (BS) and formation of an adhesive interface between calcium silicate-based and epoxy resin-based root canal sealers. For this purpose, the specimens were distributed according to the intracanal medication (n = 26): Bio-C Temp (BCT) and Ultracal XS (UXS). The roots were scanned in microCT, and after 7 days, the medication was removed. Then a new scan was performed to evaluate the volume of medication remaining. Subsequently, 40 specimens were redistributed into 2 subgroups (n = 10) and filled according to the sealer used: AH Plus (AHP) and Bio-C Sealer (BCS), to assess the bond strength by using the push-out test, and the adhesive interface by confocal laser fluorescence microscopy (CLSM) and scanning electron microscopy (SEM). The t test showed a smaller remainder of BCT (1.77 ± 0.86) compared with UXS (10.47 ± 5.78), irrespective of the root third evaluated. The BS showed that teeth with BCT + BCS had higher bond strength values (3.70 ± 1.22) when compared to the other groups: BCT + AHP (2.15 ± 1.07), UXS + BCS (3.18 ± 1.09) and UXS + AHP (2.11 ± 1.02) (p<0.001). The cervical third had higher BS when compared with the middle and apical thirds (p < 0.001), and higher number of adhesive failures. The adhesive interface in SEM and CLSM images showed better adaptation for the association between BCT + BCS. Intracanal medication and silicate-based endodontic sealer appeared to interact chemically by forming a biomineralizing layer, allowing for an increase in the bond strength and forming an adhesive interface between the materials, with no or less gap formation. (BS silicatebased silicate resinbased resin sealers purpose n 26 26) BioC Bio C (BCT UXS. . (UXS) microCT days removed Subsequently 4 10 used (AHP BCS, , (BCS) pushout push out (CLSM SEM. (SEM) 1.77 177 1 77 (1.7 0.86 086 0 86 10.47 1047 47 (10.4 5.78, 578 5.78 5 78 5.78) evaluated 3.70 370 3 70 (3.7 1.22 122 22 groups 2.15 215 15 (2.1 1.07, 107 1.07 07 1.07) 3.18 318 18 (3.1 1.09 109 09 2.11 211 11 1.02 102 02 p<0.001. p0001 p p<0.001 001 (p<0.001) 0.001, 0001 0.001 0.001) failures layer materials (UXS (BCS (SEM 1.7 17 (1. 0.8 08 8 10.4 104 (10. 57 5.7 3.7 37 (3. 1.2 12 2.1 21 (2. 1.0 3.1 31 p000 p<0.00 00 (p<0.001 000 0.00 1. (1 0. 10. (10 5. 3. (3 2. (2 p00 p<0.0 (p<0.00 0.0 ( p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p<

Resumo O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

Abstract The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

Abstrac The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey’s test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.

Resumo O objetivo desse estudo foi o de avaliar se o aumento de volume e/ou tempo de contato do NaOCl afeta a resistência à fratura de dentes bovinos tratados endodonticamente. Quatro incisivos bovinos de 10 animais foram alocados em 4 grupos usando um desenho experimental de boca dividida. Os canais radiculares foram instrumentados usando uma sequência de 4 limas manuais de aço inoxidável e irrigados com uma solução de NaOCl alcalinizada a 5,25%. O volume total e o tempo de irrigação, por amostra, variaram entre os grupos da seguinte forma: volume e tempo de contato padrão (grupo controle) - 15 mL/11,5 min; aumento de volume - 30 mL/11,5 min; aumento no tempo de contato - 15 mL/19 min; e aumento no volume e no tempo de contato - 30 mL/19 min. As amostras foram submetidas a um ensaio de resistência à fratura. Com p=0.05, o teste two-way ANOVA analisou estatisticamente os resultados. O tamanho do efeito do tempo de contato e volume de NaOCl também foi calculado (h2). A variação no tempo (p=0,000), no volume de irrigação (p=0,000) e a interação entre ambos (p=0.038) influenciaram negativamente a resistência à fratura. O volume e o tempo padrão de irrigação apresentaram a maior resistência à fratura, enquanto o aumento isolado no volume ou no tempo de contato reduziram 25% e 37%, respectivamente, a resistência à fratura; o aumento simultâneo do volume e tempo de irrigação promoveu uma redução de 47%. O tamanho do efeito do tempo de contato com o NaOCl foi superior (0,746) ao volume (0,564). Aumentando o volume e/ou o tempo de uma solução de NaOCl alcalinizada a 5,25% reduz a resistência à fratura de dentes bovinos tratados endodonticamente.

Abstract The aim of this study was to evaluate whether amplifying the volume and/or time of contact of NaOCl affects the fracture strength of endodontically treated bovine teeth. Four bovine incisors from 10 animals were allocated into 4 groups using a split-mouth design. Root canals were instrumented using a sequence of 4 manual stainless steel files and irrigated with a 5.25% alkalized NaOCl solution. The total volume and time of irrigation, per sample, varied among the groups as following: standard volume and time of contact - 15 mL/11.5 min; volume raise - 30 mL/11.5 min; time of contact raise - 15 mL/19 min; and volume and time of contact raise - 30 mL/19 min. Samples were subjected to a fracture resistance assay. At p=0.05, two-way ANOVA statistically scrutinized the results. Effect size of NaOCl time of contact and volume were also calculated (η2). The variation in time (p=0.000), volume of irrigation (p=0.000) and the combination of both (p=0.038) negatively influenced the fracture resistance. Standard volume and time of irrigation showed the highest fracture strength while isolated increase in volume or time reduced in 25% and 37%, respectively, the fracture resistance; the simultaneous increase in volume and time of irrigation promoted a reduction of 47%. Effect size of NaOCl time of contact was superior (0.746) than the volume (0.564). Raising the volume and/or time of a 5.25% alkalized NaOCl solution reduces the fracture resistance of endodontically treated bovine teeth.

Resumo Este estudo avaliou a quantidade de debris extruídos apicalmente após o preparo químico-mecânico (PQM) utilizando sistemas de irrigação com pressão positiva e negativa [irrigação convencional (IC) e EndoVac (EV)] em associação com diferentes irrigantes [hipoclorito de sódio 6% (NaOCl), clorexidina gel + solução salina (CLXg + SS), solução de clorexidina 2% (CLXs) ou solução salina (SS)]. Oitenta pré-molares inferiores com único canal radicular foram selecionados e aleatoriamente alocados em 8 grupos (n=10) de acordo com o sistema de irrigação e irrigante utilizado durante o PQM: G1 (EV + NaOCl), G2 (EV + CLXg + SS), G3 (EV + CLXs), G4 (EV + SS), G5 (IC + NaOCl), G6 (IC + CLXg + SS), G7 (IC + CLXs) e G8 (IC + SS). Limas Reciproc® R25 foram utilizadas durante o PQM e os debris extruídos de cada dente foi coletado em tubos pré-pesados e secos. O peso médio de debris foi avaliado por meio de microbalança, e os dados foram analisados estatisticamente utilizando ANOVA e teste de Tukey (a = 0.05). Todos os grupos foram associados com extrusão de debris. EV foi o sistema de irrigação com menos debris extruídos (p<0.05). Não foram observadas diferenças entre os irrigantes quando o EV foi utilizado. Quando foi utilizada IC, CLXg + SS foram associados a menor extrusão de debris (p<0.05). Concluiu-se que nenhum protocolo de irrigação conseguiu prevenir extrusão de debris. EV resultou em menores níveis de extrusão de debris que a IC. A utilização da CLXg + SS resultou em menor extrusão de debris.

Abstract This study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) using positive and negative pressure irrigation systems [Conventional irrigation (CI) and EndoVac (EV)] in association with different irrigants [6% Sodium Hypochlorite (NaOCl), 2% Chlorhexidine gel + saline solution (CHXg + SS), 2% Chlorhexidine solution (CHXs) or Saline solution (SS)]. Eighty mandibular premolars with single root canals were selected and randomly assigned into 8 groups (n = 10) according to the irrigation system and the irrigant used during CMP: G1 (EV + NaOCl), G2 (EV + CHXg + SS), G3 (EV + CHXs), G4 (EV + SS), G5 (CI + NaOCl), G6 (CI + CHXg + SS), G7 (CI + CHXs) and G8 (CI + SS). Reciproc® R25 files (25/.08) were used during the CMP and the extruded debris from each tooth was collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed using a microbalance, and the data were statistically analyzed using ANOVA and the post hoc Tukey’s test (a = 0.05). All groups were associated with debris extrusion. EV was the irrigation system with less extruded debris (p < 0.05). No differences were observed regarding the irrigant when EV was used. When CI was used, CHXg + SS were associated with lower debris extrusion (p < 0.05). It was concluded that no irrigation protocol succeeded in preventing debris extrusion. EV resulted in lower levels of debris extrusion than CI. The use of CHXg + SS resulted in lower debris extrusion.

Resumo O presente estudo comparou o efeito da utilização de uma irrigação intermediária com água destilada usando a irrigação convencional, a microcânula EndoVac ou o sistema Self-Adjusting File (SAF) na prevenção de formação da smear-layer química (SLQ). Trinta pré-molares humanos foram utilizados. Os canais foram preparados com sistema Reciproc e irrigados com NaOCl a 5,25%. Após o preparo químico mecânico, as amostras foram divididas em 3 grupos (n=10) de acordo com o protocolo de irrigação intermediária com água destilada utilizado: irrigação convencional, a microcânula EndoVac ou SAF. Utilizou-se uma lavagem final com solução de clorexidina a 2% e a microscopia electrónica de varredura foi utilizada para avaliar a eficácia dos protocolos. Dois avaliadores calibrados atribuíram escores de acordo com a presença ou ausência de SLQ nas paredes do canal radicular nos terços coronal, médio e apical, como a seguir: (1) sem SLQ; (2) pequenas quantidades de SLQ; (3) SLQ moderada e (4) muita SLQ. As diferenças entre protocolos foram analisadas com testes de Kruskal-Wallis e Mann-Whitney U. Os testes Friedman e Wilcoxon foram utilizados para comparação entre cada terço do canal radicular. SAF resultou em menor formação de SLQ quando comparado com a irrigação convencional e a microcânula EndoVac (p<0,05). Quando os terços dos canais radiculares foram analisados, os grupos irrigação convencional e microcânula EndoVac apresentaram menor formação de SLQ nos terços coronal e médio em relação ao terço apical (p<0,05). No grupo SAF, não houve diferença entre os terços (p>0,05). Dentro dos resultados do presente estudo, pode-se concluir que um fluxo intermediário de água destilada, administrado pelo sistema SAF resultou em melhor redução da formação de SLQ durante o preparo químico mecânico.

Abstract This study compared the effect of intermediate flush with distilled water delivered by conventional irrigation, EndoVac microcannula or Self-Adjusting File (SAF) system in the prevention of chemical smear layer (CSL) formation. Thirty human premolars were used. Canals were prepared with Reciproc system and 5.25% NaOCl. After chemomechanical preparation, samples were divided in 3 groups (n=10) according to the intermediate irrigation protocol with distilled water using: conventional irrigation, EndoVac microcannula or SAF. A final flush with 2% chlorhexidine solution was used and scanning electron microscopy was performed to assess protocol effectiveness. Two calibrated evaluators attributed scores according the presence or absence of CSL on the surface of the root canal walls at the coronal, middle and apical thirds, as follows: (1) no CSL; (2) small amounts of CSL; (3) moderate CSL; and (4) heavy CSL. Differences between protocols were analyzed with Kruskal-Wallis and Mann-Whitney U tests. Friedman and Wilcoxon signed rank tests were used for comparison between each root canal third. SAF resulted in less formation of CSL when compared with the conventional irrigation and EndoVac microcannula (p<0.05). When root canal thirds were analyzed, conventional irrigation and EndoVac groups showed less CSL formation at coronal and middle thirds in comparison to the apical third (p<0.05). In SAF group, there was no difference among the thirds (p>0.05). It may be concluded that an intermediate flush of distilled water, delivered by the SAF system resulted in a better reduction of CSL formation during chemomechanical preparation.

Abstract Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a “dentin replacement” material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.

Resumo O objetivo do presente estudo foi avaliar os efeitos citotóxicos de cinco cimentos endodônticos (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex e Pulp Canal Sealer EWT) utilizando um modelo de cultura celular tridimensional (3D). Utilizou-se um modelo convencional de cultura de células bidimensionais (2D) como técnica de referência para comparação. Os fibroblastos Balb/c 3T3 foram cultivados em culturas de células bidimensionais convencionais e em modelos de cultura de células tridimensionais de colagéno de cauda de rato do tipo I. Em seguida, ambas as culturas de células foram incubadas com eluções dos cimentos endodônticos recém manipulados, durante 24 h. A viabilidade celular foi medida pelo ensaio de MTT. Os dados foram analisados estatisticamente utilizando ANOVA e o teste de Tukey com nível de significância de p<0,05. Todos os cimentos testados exibiram efeitos citotóxicos. Contudo, o efeito citotóxico foi dependente do modelo de cultura e do cimento testado. Os cimentos apresentaram maior citotoxicidade no modelo 2D do que no modelo 3D (p<0,05). Em ambas as condições, a EndoSequence BC apresentou a menor citotoxicidade (p<0,05). MTA Fillapex foi mais citotóxico do que os outros cimentos endodônticos testados (p<0,05), com exceção do AH Plus no modelo de cultura de células 2D (p>0,05). Endomethasone N e EWT mostraram efeitos citotóxicos mais baixos do que AH Plus no modelo de cultura de células 2D (p<0,05); entretanto, não houve diferenças estatísticas entre esses cimentos no modelo de cultura de células 3D. Pode concluir-se que a citotoxicidade foi maior na cultura de células 2D em comparação com a cultura de células 3D. EndoSequence BC selante exibiu a maior citocompatibilidade e MTA Fillapex a menor citocompatibilidade.

Abstract The aim of the present study was to evaluate the cytotoxic effects of five endodontic sealers (AH Plus, Endomethasone N, EndoSequence BC, MTA Fillapex and Pulp Canal Sealer EWT) using a three-dimensional (3D) cell culture model. A conventional bi-dimensional (2D) cell culture model was used as reference technique for comparison. Balb/c 3T3 fibroblasts were cultured in conventional bi-dimensional cell culture and in rat-tail collagen type I three-dimensional cell culture models. Then, both cell cultures were incubated with elutes of freshly mixed endodontic sealers for 24 h. Cell viability was measured by the methyl-thiazol-diphenyltetrazolium assay (MTT). Data were statistically analyzed using ANOVA and the Tukey test at a significance level of p<0.05. All tested sealers exhibited cytotoxic effects; however, cytotoxic effect was culture model- and sealer-dependent. Sealers showed higher cytotoxicity in 2D than in 3D cell culture model (p<0.05). In both conditions, EndoSequence BC showed the lowest cytotoxicity (p<0.05). MTA Fillapex was much more cytotoxic than the other tested endodontic sealers (p<0.05), with the exception of AH Plus in the 2D cell culture model (p>0.05). Endomethasone N and Pulp Canal Sealer EWT showed lower cytotoxic effects than AH Plus in 2D cell culture model (p<0.05); however no statistical differences was observed among these sealers in 3D cell culture model. It may be concluded that cytotoxicity was higher in 2D cell culture compared to 3D cell culture. EndoSequence BC sealer exhibited the highest cytocompatibility and MTA Fillapex the lowest cytocompatibility.

Resumo O objetivo deste estudo foi avaliar a relação de causa-efeito entre o preparo do canal radicular com o sistema ProTaper Universal (PTU) e a formação de defeitos dentinários usando a análise por micro-tomografia computadorizada (micro-CT). Quarenta raízes mesiais de molares inferiores com a configuração tipo II de Vertucci foram escaneadas com resolução isotrópica de 14.16 μm. A amostra foi distribuída em um grupo experimental (n = 30) e um grupo controle (n = 10), e os canais mesiais foram preparados com o sistema PTU até a lima F2. As amostras do grupo experimental foram escaneadas e as imagens de secção transversal das raízes mesiais, antes e após o preparo, foram analisadas para identificar a presença de defeitos dentinários. No grupo controle, os dentes foram seccionados perpendicularmente em relação ao longo eixo da raiz em fatias de 1 mm de espessura (n = 80) e examinados ao microscópio óptico. Uma vez detectado um defeito dentinário, a fatia foi escaneada através da micro-CT. No grupo experimental, defeitos dentinários foram observados em 4.828 secções transversais (24,04%). Em todas as imagens de secção transversal, os defeitos dentinários após os procedimentos experimentais já estavam presentes na secção pré-operatória correspondente. No grupo controle, 13 das 80 fatias (16,25%) apresentaram pelo menos um defeito dentinário visualizado através do microscópio, o qual foi identificado em um escaneamento posterior. A micro-CT mostrou confiabilidade com a microscopia óptica para detecção e visualização dos defeitos dentinários, permitindo acompanhar o tecido dentinário antes e depois do preparo do canal. O preparo do canal radicular com o sistema PTU não induziu a formação de novos defeitos dentinários.

Abstract This study aimed to evaluate the cause-effect relationship between canal preparation with ProTaper Universal (PTU) system and dentinal defects formation using micro-computed tomography (micro-CT) analysis. Forty mesial canals of mandibular molars with a type II Vertucci's canal configuration were scanned at an isotropic resolution of 14.16 µm. The sample was assigned to an experimental (n = 30) and a control (n = 10) groups, and the mesial canals were prepared with PTU system up to F2 instrument. The specimens from the experimental group were scanned and the cross-section images of the mesial roots, before and after preparation, were screened to identify the presence of dentinal defects. In the control group, the specimens were sectioned perpendicularly to the long axis of the root into 1-mm-thick slices (n = 80) and examined under optical microscope. Once a dentinal defect was detected, the slice was scanned through micro-CT. In the experimental group, dentinal micro-cracks were observed in 4,828 slices (24.04%). In all cross-section images, dentinal defects identified in the postoperative images were already present in the corresponding preoperative image. In the control group, 13 out of 80 slices (16.25%) had at least one dentinal defect visualized under stereomicroscopy, which was identified after a further micro-CT scanning. Micro-CT showed reliability as similar as optical microscopy in detecting dentinal defects, adding the possibility of tracking the dentinal tissue, before and after canal preparation, and providing a clear visualization of micro-cracks. Root canal preparation with PTU system did not induce the formation of new dentinal defects.

Resumo A relação do forame principal com o ápice anatômico da raiz tem sido objeto de vários estudos. Embora estejam anatomicamente próximos, eles raramente coincidem, e a sua distância pode variar de acordo com a idade ou o tipo de dente, oscilando entre 0,2 e 3,0 mm. O objetivo deste artigo é relatar que a saída foraminal do canal mediano (MMC), presente na raiz mesial de molares inferiores, pode apresentar variações significativas, atingindo distâncias acima de 3 mm do ápice anatômico. Vinte e cinco primeiros molares inferiores com MMC foram escaneados (resolução de 9,9 mm) e a distância do forame principal ao ápice anatômico avaliada. Em geral, a distância mostrou variações consideráveis; no entanto, em 3 espécimes esta distância ficou acima de 3 mm. Este estudo teve como objetivo relatar que a saída do forame principal de canais medianos de primeiros molares inferiores pode apresentar variações consideráveis, podendo atingir distâncias maiores do que as relatadas previamente na literatura.

Abstract The relationship of the main foramen to the anatomic root apex has been the subject of several studies. Although they are anatomically close, they rarely coincide, and their distance can vary according to age or tooth type, ranging from 0.2 to 3.0 mm. The aim of this short communication was to evaluate the distance between the main foramen of independent middle mesial canals (MMCs) and the anatomical mesial root apex of mandibular first molars using the micro-computed tomography. Twenty-five mandibular first molars with MMCs were scanned (resolution of 9.9 µm), and the distance from its main foramen to the anatomical apex was evaluated. Overall, the distance ranged from 0.2 to 2.4 mm; however, in 3 specimens the distance was greater than 3 mm. This report demonstrates that the exit of the main foramen of the MMC varies considerably and could approach a substantial distance from the anatomical apex greater than previously reported in the literature.

Resumo O objetivo do presente estudo foi avaliar prospectivamente a frequência de dentes em que os instrumentos Reciproc foram capazes de alcançar o comprimento de trabalho (CT) completo. Este estudo com série de casos envolveu 277 dentes consecutivos que necessitavam de tratamento endodôntico primário realizado com o sistema Reciproc (VDW) sem a realização de uma via de penetração inicial (glide path) prévio por 3 endodontistas experientes. Instrumentos R25, R40 ou R50 foram selecionados, respectivamente, para canais estreitos, médios e largos, de acordo com as radiografias pré-operatórias, seguindo a recomendação do fabricante. Os canais foram instrumentados e classificados como atingindo o WL completo (ACTC) e de não atingindo o WL completo (NACTC), de acordo com a capacidade do instrumento Reciproc de alcançar o CT completo determinado eletronicamente, sem a realização de glide path. Finalmente, os canais foram preenchidos usando a técnica de obturação de cone único. O teste de qui-quadrado de Pearson comparou a frequência das distribuições de canais classificados como ACTC e NACTC. A partir de um pool total de 673 canais radiculares, instrumentos Reciproc atingiram o CTC em 96,28% dos casos e 3 fraturas ocorreram. Para canais estreitos, a percentagem de ACTC foi 95,37% com 3 fraturas. Para canais médios e largos, os instrumentos R40 e R50 atingiram o CTC em 98,51% e 97,62% dos casos, respectivamente, sem fratura. Ampliação dos canais radiculares utilizando os instrumentos Reciproc até o CTC sem a realização de glide pathfoi bem sucedida em uma grande porcentagem dos casos. Esta série de casos sugere a possibilidade de utilizar um único instrumento para ampliar o espaço do canal radicular usando uma abordagem mais simples, sem um procedimento prévio deglide path.

Abstract The aim of the present study was to prospectively assess the frequency of teeth in which the Reciproc instruments were able to reach the full working length (WL). This case series study enrolled 277 consecutive teeth requiring primary endodontic treatment performed with the Reciproc system (VDW) without a previous glide path by 3 experienced endodontists. Instruments R25, R40 or R50 were selected, respectively, for narrow, medium and large canals, according to the preoperative radiographs, as per manufacturer recommendation. Canals were instrumented and classified as reaching the full WL (RFWL) and not reaching the full WL (NRFWL), according to the ability of the Reciproc instrument to reach without a glide path the full electronically determined WL. Finally, canals were filled using a single matched cone technique. Pearson's squared-chi test compared the frequency distributions of canals classified as RFWL and NRFWL. From a total pool of 673 root canals, Reciproc instruments reached the FWL in 96.28% of cases and 3 fractures occurred. For narrow canals the percentage of RFWL was 95.37% with 3 fractures. For medium and large canals, the R40 or R50 instruments reached the FWL in 98.51% and 97.62% of the cases respectively, with no fracture. Enlarging of root canals using the Reciproc instruments up to the FWL without a glide path is successful in a great percentage of cases. This case series suggests the possibility of using a single instrument to enlarge the root canal space of teeth by a simpler approach without an a prioriglide path procedure.

Abstract The purpose of this study was to assess the ability of an off-centered rectangular design system [ProTaper Next (PTN)] to maintain the original profile of the root canal anatomy. To this end, ProTaper Universal (PTU), Reciproc (R) and WaveOne (WO) systems were used as reference techniques for comparison. Forty clear resin blocks with simulated curved root canals were randomly assigned to 4 groups (n = 10) according to the instrumentation system used: PTN, PTU, R and WO. Color stereomicroscopic images of each block were taken before and after instrumentation. All image processing and data analysis were performed with an open source program (Fiji v.1.47n). Evaluation of canal transportation was obtained for two independent regions: straight and curved portions. Univariate analysis of variance and Tukey’s Honestly Significant Difference test were performed, and a cut-off for significance was set at α = 5%. Instrumentation systems significantly influenced canal transportation (p = 0.000). Overall, R induced significantly lower canal transportation compared with WO, PTN and PTU (p = 0.000). The curved portion displayed superior canal transportation compared to the straight one (p = 0.000). The significance of the difference among instrumentation systems varied according to the canal level evaluated (p = 0.000). In its straight portion, R and WO exhibited significantly lower transportation than PTN; whereas in the curved portion, R produced the lowest deviation. PTU exhibited the highest canal transportation at both levels. It can be concluded that PTN produced less canal transportation than PTU and WO; however, R exhibited better centering ability than PTN.

Abstract This study was designed to investigate the resistance to dislodgment provided by MTA HP, a new high-plasticity calcium silicate-based cement. Biodentine and White MTA Angelus were used as reference materials for comparison. Three discs 1 ± 0.1 mm thick were obtained from the middle third of the roots of 5 maxillary canines. Three 0.8-mm-wide holes were drilled on the axial surface of each root disc. Standardized irrigation was performed. Then the holes were dried with paper points and filled with one of the three tested cements. The filled dental slices were immersed in a phosphate-buffered saline (PBS) solution (pH 7.2) for 7 days before the push-out assessment. The Kruskal-Wallis test was applied to assess the effect of each endodontic cement on the push-out bond strength. Mann-Whitney with Bonferroni correction was used to isolate the differences. The alpha-type error was set at 0.05. All specimens had measurable push-out values and no premature failure occurred. There were significant differences among the materials (p <0.05). The Biodentine specimens had the highest push-out bond strength values (p < 0.05). MTA HP had significantly higher bond strength than White MTA (p < 0.05). MTA HP showed better push-out bond strength than its predecessor, White MTA; however, Biodentine had higher dislodgment resistance than both MTA formulations.

Resumo O objetivo deste estudo foi comparar a porcentagem de área não-instrumentada de canais radiculares preparados com diferentes ampliações utilizando sistemas reciprocantes de lima única (Reciproc e WaveOne) e um sistema rotatório convencional de múltiplas limas (BioRaCe) usando a análise da micro tomografia computadorizada. Trinta raízes mesiais de molares inferiores com curvatura moderada (10º a 20º) apresentando a configuração classe II de Vertucci e semelhança de volume do canal foram selecionadas e escaneadas em uma resolução isotrópica de 14,16 µm. A amostra foi dividida em 3 grupos (n=10) de acordo com o sistema utilizado para a preparação do canal radicular: grupo Reciproc, grupo WaveOne e grupo BioRaCe. Segundo e terceiro escaneamentos foram realizados após os canais serem preparados com instrumentos tamanhos 25 e 40, respectivamente. As imagens registradas de voxels da área de superfície dos canais, antes e após o preparo, foram examinadas desde o nível da furca até o ápice para quantificar a superfície não instrumentada. Os dados foram comparados estatisticamente através de GLM para medidas repetidas com um nível de significância de 5%. Os sistemas de instrumentação não influenciaram o percentual de superfícies não tocadas dos canais radiculares (p=0,690), enquanto que uma redução significativa no percentual de voxels estáticos foi observada após o alargamento do canal radicular (p=0,010) em todos os grupos (p=0,507). Nenhum dos sistemas foi capaz de preparar toda a área de superfície do canal mesial dos molares inferiores. O aumento do tamanho final apical resultou num efeito positivo significativo sobre a capacidade de modelar dos sistemas testados.

The aim of this study was to compare the percentage of non-instrumented area of root canals prepared with different enlargements using single-file reciprocating systems (Reciproc and WaveOne) and a conventional multi-file rotary (BioRaCe) system by micro-computed tomographic analysis. Thirty mesial roots of mandibular molars with moderate curvature (10° to 20°) presenting a type II Vertucci canal configuration and similar internal volume were chosen and scanned at an isotropic resolution of 14.16 µm. The sample was assigned to 3 groups (n=10) according to the system used for root canal preparation: Reciproc, WaveOne, and BioRaCe groups. Second and third scans were taken after the canals were prepared with instruments sizes 25 and 40, respectively. The recorded images of the surface area voxels of the canals, before and after preparation were examined from the furcation level to the apex to quantify the non-instrumented surface. Statistical data were compared using GLM for repeated-measures with a significance level set at 5%. Instrumentation systems did not influence the percentage of untouched root canal surfaces (p=0.690) whilst a significant reduction in the percentage of static voxels was observed after the enlargement of the root canal (p=0.010) in all groups (p=0.507). None of the systems was able to prepare the entire surface area of the mesial root canal of mandibular molars. The increased final apical size resulted in a significant positive effect on the shaping ability of the tested systems.