Abstract This study assessed the intratubular antibacterial ability of different activated irrigations after chemical mechanical preparation. Seventy-two palatal root canals of upper molars were infected with Enterococcus faecalis for 4 weeks, and then initial bacterial collection from the main root canal was performed. The root canals were prepared by using a WaveOne Gold large (45/.05) and distributed into 6 groups according to the activation of the final irrigation: ultrasonic activation (UA), XP-Endo Finisher (25/.00), XP Clean (25/.02), EasyClean (25/.04) in reciprocating motion and continuous rotary motion (ECRot), and conventional irrigation. After final irrigation, another bacterial collection from the main root canal was performed, and the root was sectioned transversely in three-thirds and stained for analysis by confocal laser microscopy. Intratubular bacteria were collected through dentin powder and plated for bacterial viability analysis. Intergroup and intragroup comparisons were performed by using analysis of variance and repeated measures analysis of variance, respectively, both at 5% significance. ECRot had higher antibacterial ability than UA (p<0.05), and both were superior to the other groups (p<0.05) in both methodologies. It can be concluded that activation of final irrigation enhances the disinfection of the root canal system, and activators have different efficacies preparation Seventytwo Seventy two weeks 45/.05 4505 45 05 (45/.05 UA, , (UA) XPEndo Endo 25/.00, 2500 25/.00 25 00 (25/.00) 25/.02, 2502 25/.02 02 (25/.02) 25/.04 2504 04 (25/.04 ECRot, (ECRot) threethirds three thirds microscopy respectively 5 significance p<0.05, p005 p p<0.05 0 (p<0.05 methodologies system 45/.0 450 (45/.0 (UA 250 25/.0 2 (25/.00 (25/.02 (25/.0 (ECRot p00 p<0.0 (p<0.0 45/. (45/. 25/. (25/. p0 p<0. (p<0. 45/ (45/ 25/ (25/ p<0 (p<0 (45 (25 p< (p< (4 (2 (p (

Resumo Este estudo avaliou a capacidade antibacteriana intratubular de diferentes irrigações ativadas após o preparo químico-mecânico. Setenta e dois canais palatinos de molares superiores foram contaminados com Enterococcus faecalis por 4 semanas, e então a coleta bacteriana inicial do canal principal foi realizada. Os canais foram preparados com WaveOne Gold large (45/.05) e distribuídos em 6 grupos de acordo com a ativação da irrigação final: ativação ultrassônica (UA), XP-Endo Finisher (25/.00), XP Clean (25/.02), EasyClean (25/.04) em movimento reciprocante e em movimento rotatório contínuo (ECRot) e irrigação convencional. Após a irrigação final, outra coleta bacteriana do canal principal foi realizada, e a raiz foi seccionada transversalmente em três terços e corada para análise por microscopia laser confocal. Bactérias intra tubulares foram coletadas através de pó de dentina e cultivadas para análise de viabilidade bacteriana. As comparações entre grupos e intragrupos foram realizadas usando análise de variância e análise de variância de medidas repetidas, respectivamente, ambas com 5% de significância. ECRot apresentou maior capacidade antibacteriana que UA (p<0,05), e ambos foram superiores aos demais grupos (p<0,05) em ambas as metodologias. Pode-se concluir que a ativação da irrigação final melhora a desinfecção do sistema de canais radiculares, e os ativadores têm eficácias diferentes. químicomecânico. químicomecânico químico mecânico. mecânico químico-mecânico semanas realizada 45/.05 4505 45 05 (45/.05 UA, , (UA) XPEndo Endo 25/.00, 2500 25/.00 25 00 (25/.00) 25/.02, 2502 25/.02 02 (25/.02) 25/.04 2504 04 (25/.04 (ECRot convencional confocal repetidas respectivamente 5 significância p<0,05, p005 p p<0,05 0 (p<0,05 metodologias Podese Pode se radiculares 45/.0 450 (45/.0 (UA 250 25/.0 2 (25/.00 (25/.02 (25/.0 p00 p<0,0 (p<0,0 45/. (45/. 25/. (25/. p0 p<0, (p<0, 45/ (45/ 25/ (25/ p<0 (p<0 (45 (25 p< (p< (4 (2 (p (

Abstract This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation. ovalshaped oval shaped XPendo XP endo Twentyfour Twenty four 2 Kfile K file microCT micro CT 17.42 1742 17 42 (17.4 µm assessed p>0.05. p005 p p>0.05 . 0 05 (p>0.05) p<0.05. p<0.05 (p<0.05) 17.4 174 1 4 (17. p00 p>0.0 (p>0.05 p<0.0 (p<0.05 17. (17 p0 p>0. (p>0.0 p<0. (p<0.0 (1 p>0 (p>0. p<0 (p<0. ( p> (p>0 p< (p<0 (p> (p< (p

Resumo Este estudo comparou o preparo de canais radiculares ovais longos usando os sistemas WaveOne Gold e XP-endo Shaper, ambos complementados ou não com instrumentação manual. Vinte e quatro canais longos e ovais de incisivos inferiores foram distribuídos em dois grupos de acordo com a instrumentação: sistemas WaveOne Gold Primary ou XP-endo Shaper. Todos os canais foram instrumentados manualmente com uma lima K tamanho 25 após preparo automatizado. Os espécimes foram escaneados usando um dispositivo de micro-CT (17,42 µm) antes e após o preparo automatizado e instrumentação manual. O aumento de superfície do canal radicular e a porcentagem de áreas intocadas foram avaliadas. Ambos os sistemas WaveOne Gold e XP-endo Shaper aumentaram a superfície do canal radicular e apresentaram áreas intocadas semelhantes (p>0,05). A instrumentação complementar aumentou a superfície do canal radicular e diminuiu o percentual de áreas intocadas (p <0,05). Os sistemas WaveOne Gold e XP-endo Shaper tiveram o preparo de canais ovais longos semelhantes, e a instrumentação manual melhorou o preparo. XPendo XP endo 2 microCT micro CT 17,42 1742 17 42 (17,4 µm avaliadas p>0,05. p005 p p>0,05 . 0 05 (p>0,05) <0,05. 005 <0,05 <0,05) 17,4 174 1 4 (17, p00 p>0,0 (p>0,05 00 <0,0 17, (17 p0 p>0, (p>0,0 <0, (1 p>0 (p>0, <0 ( p> (p>0 < (p>

Abstract The aim of this study was to assess the performance and surface alteration of two single-file systems according to the number of uses. Ten WaveOne Primary files (25/.08) and ten One Shape NG files (25/.06) were used for instrumentation of mesial root canals of mandibular molars. Each instrument was cleaned and sterilized after the preparation of two root canals and then reused. The time spent for instrumentation of each root canal was recorded and analyzed by using t-test. Microphotographs of the surface of the instruments were taken with a scanning electron microscope at different magnifications (i.e. 18x, 160x, 500x and 1000x) and at a distance of 4 mm from the instrument’s tip before being analyzed by four observers. Presence of disruption of cutting edge, crack, craters and unwinding was assessed and submitted to Fisher’s exact test. Both systems showed manufacturing defects and cracks. The presence of disruption of cutting edges was major in WaveOne files from the sixth use, whereas One Shape NG files showed more unwinding. Only preparation time using WaveOne files was influenced by the number of uses. One can conclude that WaveOne files had more disruption of cutting edges and took longer time for root canal preparation from the sixth use onwards, whereas the One Shape NG files showed more unwinding at the tenth use.

Resumo A proposta deste estudo foi avaliar os sistemas WaveOne Gold e One Shape New Generation em relação à remoção bacteriana de canais infectados com Enterococcus faecalis, comparando-os com seus sistemas convencionais WaveOne e One Shape. Quarenta e oito canais disto vestibulares de molares superiores esterilizados em óxido de etileno foram contaminados com E. faecalis por 21 dias, e então acoleta bacteriana inicial foi feita com cone de papel e plaqueadas em M-enterococcus agar. Os espécimes foram aleatoriamente divididos em quarto grupos de acordo com a instrumentação: WaveOne Gold, One Shape New Generation, WaveOne e One Shape. Após instrumentação, amostras foram coletadas utilizando limagem e cones de papel imediatamente e 7 dias após o preparo. A redução bacteriana foi calculada e então feita análise intra grupos com teste de Friedman, e entre grupos utilizando Kruskal-Wallis e teste de Dunn, todos a 5% de significância. Todas as técnicas reduziram significantemente o número de bactérias do canal radicular (p<0.05). WaveOne Gold e One Shape New Generation promoveram maior redução bacteriana que WaveOne e One Shape (p<0.05), mas nenhuma diferença significante foi encontrada entre WaveOne Gold e One Shape New Generation ou entre WaveOne e One Shape (p>0.05). Novos sistemas de lima-única promovem melhor remoção bacteriana que seus sistemas convencionais.

Abstract The aim of this study was to evaluate the WaveOne Gold and One Shape New Generation systems regarding the bacterial removal from root canals infected with Enterococcus faecalis by comparing them to the conventional WaveOne and One Shape systems. Forty-eight distobuccal root canals of maxillary molars sterilized with ethylene oxide were infected with E. faecalis for 21 days, and then root canal initial bacterial sample was collected with paper cones and plated on M-enterococcus agar. The specimens were randomly divided into 4 groups according to the instrumentation: WaveOne Gold, One Shape New Generation, WaveOne and One Shape. After instrumentation, samples were collected with use of scraping and paper cones at immediate and 7 days after instrumentation. The bacterial reduction was calculated and then made intragroup analysis by Friedman test and intergroup analysis by Kruskal-Wallis with Dunn’s post-hoc test, all at 5% significance. All techniques significantly reduced the number of bacteria in the root canal (p<0.05). WaveOne Gold and One Shape New Generation promoted higher bacterial reduction than WaveOne and One Shape systems (p<0.05), but no significant difference was found between WaveOne Gold and One Shape New Generation or between WaveOne and One Shape (p>0.05). Novel single-file systems promote better bacterial removal than the conventional single-file systems.

Abstract Tissue bioengineering has been applied to Endodontics to seek a more biological treatment. The presence of blood vessels is crucial for cell nutrition during tissue formation. Objective This study analysed the application of vascular endothelial growth factor (VEGF) in the angiogenesis of mature root canals. Material and methods Upper first molars of twelve 13-week old Wistar male rats were used. The root pulp of the mesiobuccal canal was removed and the root canal instrumented with K-files up to size #25. Periapical bleeding was induced into the root canal by introducing a #15 K-file beyond the apex. The teeth on the right side of the arch were filled up with blood clot (G1), whereas those on the left side were filled up with blood clot plus 50 ng/ml of VEGF (G2). Teeth were sealed with light-curing glass-ionomer cement and the animals were sacrificed after 60 days. The maxilla was dissected and fixed before obtaining serial sections for histological processing with haematoxylin-eosin (HE) and immunohistochemical factor-VIII. Immunohistochemical labelling was evaluated using scores for statistical analysis. Results Immunohistological analysis demonstrated the presence of angiogenesis in both groups, but with higher angiogenic maturation in G2 during the experimental period (p<0.05). HE staining showed connective tissue with absence of odontoblasts in all specimens. Conclusions It can be concluded that it is possible to obtain angiogenesis in mature root canals with or without the use of VEGF, although the latter tends to accelerate blood vessel formation.

Resumo A proposta deste estudo foi avaliar a redução bacteriana promovida pelos sistemas ProTaper Next e Twisted File comparando-os ao sistema ProTaper Universal e técnica manual. Sessenta raízes disto vestibulares de molares superiores esterilizadas com óxido de etileno foram contaminadas com Enterococcus faecalis. Após incubação por 21 dias, amostras foram coletas e cultivadas em m-Enterococcus agar. Os canais foram divididos em 4 grupos de acordo com o sistema de instrumentação: ProTaper Next, Twisted File, ProTaper Universal, e técnica manual crown-down. Outros 8 canais não contaminados foram utilizados como controle de assepsia. Amostra bacteriana foi coletada imediatamente após o prepare e aos 7 dias. A redução bacteriana foi calculada, e então feita a análise intergrupos utilizando teste t-pareado, e análise entre grupos utilizando os testes ANOVA e Tukey, todos com 5% de significância. Todas as técnicas reduziram significantemente o número de bactérias no canal radicular (p<0.05). ProTaper Next e Twisted File resultaram em maior redução bacteriana que ProTaper Universal e técnica manual (p<0.05). ProTaper Next e Twisted File foram semelhantes (p>0.05). Pode-se concluir que ProTaper Next e Twisted File promovem maior redução bacteriana que Protaper Universal e técnica manual.

Abstract The aim of this study was to evaluate the bacterial reduction promoted by ProTaper Next and Twisted File by comparing to ProTaper Universal and manual technique. Sixty distobuccal root canals of maxillary molars sterilized with ethylene oxide were contaminated with Enterococcus faecalis broth culture. After incubation for 21 days, bacterial samples were collected and cultured on m-Enterococcus agar plates. The root canals were divided into 4 groups, according to the system used for instrumentation: ProTaper Next, Twisted File, ProTaper Universal, and crown down manual technique. Other 8 uncontaminated root canals were control asepsis. Bacterial samples were collected immediately and 7 days after instrumentation. The bacterial reduction was calculated and then made intragroup analysis by paired t-test and intergroup analysis by ANOVA and Tukey tests, all at 5% significance. All techniques significantly reduced the bacterial number in the root canal (p<0.05). ProTaper Next and Twisted File resulted in more bacterial reduction than ProTaper Universal and manual technique (p<0.05). ProTaper Next and Twisted File were similar (p>0.05). It can be concluded that ProTaper Next and Twisted File promote a higher bacterial reduction than Protaper Universal and manual technique.

AIM: To compare bacterial leakage in root canals obturated with the modified single-cone, lateral condensation, and continuous wave of condensation techniques. METHODS: Distobuccal root canals of maxillary molars were shaped up to ProTaper F2 and obturated with modified singlecone, lateral condensation or continuous wave of condensation technique. Two-chamber bacterial model using Enterococcus faecalis was employed for bacterial leakage evaluation for 30 days. The chi-square test was applied to evaluate differences between turbid and non-turbid samples, and the Kruskal-Wallis test was used for evaluating the time necessary for microleakage. A significance level of 5% was set for all analyses. RESULTS: The modified single-cone technique showed leakage in 73.3% of samples, lateral condensation in 66.6%, and continuous wave of condensation in 53.3%, but there were no significant differences among the groups (p>0.05). CONCLUSIONS: It can be concluded that the modified single-cone technique shows similar sealing efficacy to that of lateral condensation and continuous wave of condensation technique.

OBJETIVO: O presente estudo verificou o efeito antibacteriano do hidróxido de cálcio e do iodofórmio em Enterococcus faecalis com diferentes tempos de exposição, avaliando as alterações morfológicas bacteriana. MÉTODOS: A ação antibacteriana foi investigada através de caldo de cultura após zero, sete, 14 e 21 dias, e assim, 5 mL das amostras do sétimo dia foram analisadas morfologicamente por microscopia eletrônica de transmissão. Os dados da ação antibacteriana em caldo foram analisados pelo teste Exato de Fisher. RESULTADOS: Os resultados revelaram que entre o 7º e o 14º dia houve diminuição do crescimento bacteriano com ambos os medicamentos (P=0,098), onde a eliminação bacteriana ocorreu entre o 14º e 21º dia. A microscopia eletrônica de transmissão apresentou alterações na estutura morfolófica bacteriana. CONCLUSÃO: Pode-se concluir que ambos os medicamentos destroem o Enterococcus faecalis com tempo de exposição de 7 a 14 dias, onde a viabilidade celular não é observada após este período devido alterações irreversíveis na morfologia celular bacteriana.

PURPOSE: The aim of this study was to verify the antimicrobial effect of calcium hydroxide and iodoform on Enterococcus faecalis with different exposure times evaluating the bacterial morphologic alterations. METHODS: The antibacterial action was investigated in culture broth after zero, seven, fourteen and twenty-one days. Five mL samples were analyzed morphologically on the seventh day by transmission electron microscopy. The data of the antibacterial test were analyzed by Fisher's exact test. RESULTS: The results revealed that between the seventh and fourteenth day, there was a decrease in bacterial growth with both medicaments (P=0.098), where they were eliminated between the fourteenth and twenty-first day. Transmission electronic microscopy showed alterations in the morphologic structures. CONCLUSION: It concluded that both medicaments kill Enterococcus faecalis, with an exposure time of 7 to 14 days, where no cell viability is seen after this period due to irreversible alterations in bacterial cell morphology.

OBJETIVO: Este estudo avaliou a contaminação de cones de papel absorventes não esterilizados e esterilizados e selados em embalagens, e outros expostos ao ambiente de consultório odontológico. METODOLOGIA: Vinte cones de papel sob diferentes condições foram testados para verificar a contaminação: comercialmente esterilizados, comercialmente não esterilizados, expostos ao ambiente clínico, e intencionalmente contaminados. A contaminação foi determinada qualitativamente e quantativamente por diferentes condições: aerobiose, crescimento capnofílico ou pour plate. As placas Petri cultivadas com o cone foram analizadas através de contagem de colônias, e os resultados expressos em unidade formadora de colônias. Os dados foram analisados por teste de Kruskal-Wallis (α>0,05). RESULTADOS: Não houve diferença estatística significante entre os grupos, sendo que todos cones de papel endodôntico estavam contaminados por bactérias e fungos. CONCLUSÃO: Concluiu-se que a esterilização de cones de papel endodônticos deve ser recomendada antes do uso clínico independente de sua apresentação comercial.

PURPOSE: The aim of this study was to assess the contamination status of endodontic absorbent paper points from sterilized or not sterilized commercial packs, as well as paper points exposed to the dental office environment. METHODS: Twenty absorbent paper points were evaluated for contamination status packed under different conditions: commercial/sterilized pack, commercial/non-sterilized pack, exposed to the clinical environment, and intentionally contaminated (positive control). Contamination was determined qualitatively and quantitatively by aerobiosis, capnophilic growth, and pour plate. The Petri dishes were analyzed with a colony counter, and the results were expressed as colony-forming units. The data were analyzed by Kruskal-Wallis test (α=0.05). RESULTS: No difference in colony-forming units was found among the groups of endodontic absorbent paper points. All groups were contaminated by fungi and bacteria. CONCLUSION: It can be concluded that the sterilization of absorbent endodontic paper points before clinical use should be recommended regardless of commercial presentation

OBJETIVO: O objetivo deste estudo foi avaliar a resposta inflamatória causada pela implantação do iodofórmio ou hidróxido de cálcio em dorso de ratos. Estas drogas podem ser usadas como curativo intracanal para eliminar bactérias residuais do sistema de canal radicular. METODOLOGIA: Foram utilizados 20 ratos albinos (Rattus norvegicus, var Wistar) e divididos em 4 grupos: grupo controle 1 (CG1) representado por tecido normal íntegro; grupo controle 2 (CG2) com ferida e sem medicação; nos grupos 3 e 4, Iodofórmio (IG) e hidróxido de cálcio (CHG) foram, respectivamente, inseridos nas feridas. Após três, cinco e onze dias, cortes microscópicos das áreas implantadas foram observados macroscópica e microscopicamente quanto a seus aspectos qualitativos e quantitativos. RESULTADOS: Na análise macroscópica, o CHG mostrou uma grande área de necrose e edema, o que diminuiu progressivamente, no GI, a presença de iodofórmio rodeada por tecido normal foi observado. A análise qualitativa e quantitativa histológica mostrou que IG promoveu um prazo mais curto na resposta inflamatória do que o CHG. CONCLUSÃO: A reação inflamatória de iodofórmio teve um período de pico de cinco dias após a inserção de drogas. Em comparação, o hidróxido de cálcio mostrou uma grande área de necrose que só poderia ser parcialmente eliminada após onze dias.

PURPOSE: This study evaluated the inflammatory reaction caused by the implantation of iodoform and calcium hydroxide in the back of rats. These drugs may be used as intracanal dressings to eliminate residual bacteria of the root canal system. METHODS: Twenty albinic rats (Rattus norvegicus, var Wistar) were divided into four groups: control group 1 (CG1) had normal skin; control group 2 (CG2) had wounded tissue without drugs; in groups 3 and 4, iodoform (IG) and calcium hydroxide (CHG) were inserted into the wounds, respectively. After 3, 5 and 11 days, slices of the implanted areas were macroscopically and microscopically observed regarding to their qualitative and quantitative aspects. RESULTS: In the macroscopical analysis, the CHG showed a large area of necrosis and swelling, which progressively decreased; in the IG the presence of iodoform surrounded by normal tissue was observed. The qualitative and quantitative histological analysis showed that IG promoted a shorter delay in the inflammatory response than the CHG. CONCLUSION: The inflammatory reaction for iodoform had a peak period five days after the drug insertion. By comparison, calcium hydroxide showed a very large area of necrosis that could only be partially eliminated after eleven days.