RESUMEN
This study evaluated the influence of canal irrigation protocols with 5.25% calcium hypochlorite [Ca(OCl)2 ], 5.25% sodium hypochlorite (NaOCl) and 17% EDTA solution on the inorganic component of root canal dentin. Sixty roots were randomly divided into six groups (n = 10): Saline solution (SS) (control); Saline solution (SSE) +17% EDTA; CH - 5.25% Ca(OCl)2 ; CHE - 5.25% Ca(OCl)2 + 17% EDTA; SH - 5.25% NaOCl; SHE - 5.25% NaOCl +17% EDTA. After canal irrigation, the specimens were longitudinally split and analyzed by scanning electron microscopy (SEM). Dentinal tubules were observed in transverse (middle and apical thirds) direction. The images were classified in scores, according to smear layer removal and peritubular dentin alteration, and data were analyzed by Kruskal-Wallis's test, followed by Dunn's test (α = 0.05). In the middle third, all groups with EDTA presented better removal of the smear layer with higher peritubular dentin alteration (p < .05). In the apical third, this happened only in SHE (p < .05). Ca(OCl)2 and NaOCl exhibit similar performance to remove smear layer and alteration of the inorganic component in the middle third. In the apical third, NaOCl associated with EDTA showed better performance in smear layer removal.
Asunto(s)
Compuestos de Calcio/metabolismo , Cavidad Pulpar/efectos de los fármacos , Dentina/efectos de los fármacos , Ácido Edético/metabolismo , Irrigantes del Conducto Radicular/metabolismo , Capa de Barro Dentinario/ultraestructura , Hipoclorito de Sodio/metabolismo , Diente Premolar/efectos de los fármacos , Diente Premolar/ultraestructura , Cavidad Pulpar/ultraestructura , Dentina/ultraestructura , Humanos , Microscopía Electrónica de RastreoRESUMEN
The purpose of this study was to compare the efficacy of different chelating solutions (17% EDTA and 10% citric acid) on the smear layer removal, and their effect on tubular dentin sealer penetration. Sixty root canals were prepared and distributed into four groups (n = 15) according to the final irrigation protocol: G1, final irrigation with 2.5 mL of distilled water; G2, final irrigation with 2.5 mL of 2.5% sodium hypochlorite solution; G3, final irrigation with 2.5 mL of 17% EDTA; and G4, final irrigation with 2.5 mL of 10% citric acid. Five specimens from each group were not filled to assess smear layer removal by scanning electron microscopy. Ten specimens from each group were filled for analysis of sealer penetration into dentinal tubules by confocal laser scanning microscopy. Smear layer removal (Kruskal-Wallis and Dunn's tests) and sealer penetration (F and Tukey's tests) were statistically analyzed with 95% of significance level. G3 and G4 had greater smear layer removal rates in the cervical and middle thirds, in comparison with G1 and G2 (p < .05). G3 and G4 had the highest percentages of sealer penetration in all thirds, in comparison with G1 and G2 (p < .05). Smear layer removal was effective only at the cervical and middle thirds when the chelating solutions were used. Sealer penetration into the dentinal tubules significantly increased in all root thirds when the specimens were treated with both chelating solutions.
Asunto(s)
Quelantes/análisis , Ácido Cítrico/análisis , Dentina/química , Ácido Edético/análisis , Capa de Barro Dentinario/química , Quelantes/química , Cavidad Pulpar , Dentina/ultraestructura , Humanos , Microscopía Confocal , Microscopía Electrónica de Rastreo , Materiales de Obturación del Conducto Radicular/análisis , Materiales de Obturación del Conducto Radicular/química , Irrigantes del Conducto Radicular/química , Preparación del Conducto Radicular , Capa de Barro Dentinario/ultraestructuraRESUMEN
The present study aimed to evaluate the effects of four endodontic chelating agents, followed by 2.5% sodium hypochlorite (NaOCl), as final irrigation regimens on organic and inorganic components of human root dentin. Sixty mandibular incisors were prepared and randomly divided into six groups (n = 10): QMiX, 1% peracetic acid (PA), 17% EDTA, 10% citric acid (CA), 2.5% NaOCl (solution control) and distilled water (DW-negative control). After irrigation with the chelating agents, a final flush was performed with 2.5% NaOCl. The specimens were split longitudinally in halves; one was designated for organic component analysis by polarized light microscopy (PLM) and the other for inorganic structure analysis by scanning electron microscopy (SEM). Scores data obtained in the PLM analysis were submitted to Kruskal-Wallis' test, followed by Dunn's test (p < .05). SEM findings were presented descriptively. NaOCl and DW groups showed uniformity in the fibrillar network and smear layer obliterating the dentinal tubules, while CA group presented alteration in organic and inorganic components of dentin. EDTA group did not show differences from others in the organic component, but altered the inorganic structure. QMiX and PA groups did not cause a significant morphological alteration in collagen and removed the smear layer without inorganic structure modification. As final irrigation, QMiX and PA solutions, followed by 2.5% NaOCl, showed better behavior than the other chelating agents tested, preserving organic and inorganic components of human root dentin.
Asunto(s)
Dentina/química , Dentina/ultraestructura , Ensayo de Materiales/estadística & datos numéricos , Irrigantes del Conducto Radicular/farmacología , Quelantes , Colágeno/efectos de los fármacos , Colágeno/ultraestructura , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/ultraestructura , Dentina/efectos de los fármacos , Humanos , Ensayo de Materiales/métodos , Microscopía Electrónica de Rastreo/métodos , Microscopía de Polarización/métodos , Preparación del Conducto Radicular/métodos , Capa de Barro Dentinario/ultraestructura , Hipoclorito de Sodio/farmacologíaRESUMEN
The aim of this study was to compare the rotary ProTaper Universal system, the single-file reciprocating WaveOne system and an association of motions assessing shaping ability, cleanliness, preparation time and instrument failures after preparation of curved root canals. Sixty root canals of extracted human molar teeth, with curvatures ranging between 20° and 40°, were divided into three groups, according with preparation system. Canals were prepared until apical size 25 using the ProTaper Universal system (G1), WaveOne (G2), or a hybrid technique (G3) associating reciprocating preparation with rotary glide path and cervical pre-enlargement. Teeth were scanned pre and post-operatively using computed tomography. Direction of transportation and centering ability of canals were measured using a computer image analysis program, and the results were analyzed statistically using one-way ANOVA. Preparation time was analyzed by one-way ANOVA and the Tukey post hoc test. Instrument failures were recorded. The amounts of debris and smear layer were quantified based on a numerical evaluation scale by scanning electron microscopy and were analyzed statistically using the Kruskal-Wallis test. No difference in transportation and centering ratio was found between the systems. Instrumentation with WaveOne was significantly faster than with other instruments (p < 0.05). During preparation, no instruments fractured and three suffered deformations. For debris removal and remaining smear layer, the results for the three groups were similar. The single-file reciprocating instrument was capable of providing faster root canal preparation with similar transporting, centralization and cleaning ability when compared with continuous and an association of motions in curved canals. SCANNING 38:462-468, 2016. © 2016 Wiley Periodicals, Inc.
Asunto(s)
Preparación del Conducto Radicular/métodos , Instrumentos Dentales , Humanos , Microscopía Electrónica de Rastreo , Movimiento (Física) , Níquel , Capa de Barro Dentinario/ultraestructura , TitanioRESUMEN
This study evaluated the effect of different pulse widths in the morphological characteristics of human dentin irradiated with Er:YAG in cavity preparation protocols and dentin pretreatment. Dentin discs with 2 mm thickness were obtained from 18 human molars. The experimental groups were composed from two variables: (1) clinical protocol-cavity preparation (E = 200 mJ/20 Hz)-and pretreatment (E = 80 mJ/2 Hz); and (2) pulse duration-50, 300, and 600 µs. This formed six experimental groups (n = 3): G1 (E = 200 mJ/20 Hz/50 µs); G2 (E = 200 mJ/20 Hz/300 µs); G3 (E = 200 mJ/20 Hz/600 µs); G4 (E = 80 mJ/2 Hz/50 µs); G5 (E = 80 mJ/2 Hz/300 µs); G6 (E = 80 mJ/2 Hz/600 µs). The samples were irradiated with the Er:YAG laser by noncontact mode at a focal distance of 7 mm from the target point under continuous water spray (60% water and 40% air). After the irradiation, they were processed for scanning electron microscopy (SEM). Morphological analysis showed an irregular dentin surface, absence of smear layer with opening of the exposure of dentinal tubules and protruding peritubular dentin-without indications of changes for all protocols used. Regardless of the analyzed experimental group, the dentin surface showed a microretentive morphology characteristic of ablation. The G1 and G4 showed a rougher surface when compared to other groups. Finally, we concluded that the pulse width can influence the morphological characteristics of the irradiated dentin tested in different clinical indications. The larger surface irregularity caused by regulation with less pulse width (50 µs) seems more appropriate to get a microretentive pattern necessary for successful adhesives restoration procedures.
Asunto(s)
Caries Dental/radioterapia , Preparación de la Cavidad Dental/métodos , Dentina/efectos de la radiación , Láseres de Estado Sólido/uso terapéutico , Cementos Dentales/química , Dentina/ultraestructura , Humanos , Microscopía Electrónica de Rastreo , Diente Molar/patología , Diente Molar/efectos de la radiación , Diente Molar/ultraestructura , Capa de Barro Dentinario/ultraestructura , Propiedades de SuperficieRESUMEN
Mechanical instrumentation of the root surface causes the formation of a smear layer, which is a physical barrier that can affect periodontal regeneration. Although different procedures have been proposed to remove the smear layer, there is no information concerning how long the smear layer persists on root surfaces after instrumentation in vivo. This study assessed the presence of the smear layer on root surfaces over a 28-day period after subgingival instrumentation with hand instruments. Fifty human teeth that were referred for extraction because of advanced periodontal disease were scaled and root planed (SRP) by a single experienced operator. Ten teeth were randomly assigned to be extracted 7, 14, 21, and 28 days after SRP. Another 10 teeth were extracted immediately after instrumentation (Day 0, control group). The subgingival area of the instrumented roots was evaluated with scanning electron microscopy. Representative photomicrographs were assessed by a blinded and calibrated examiner according to a scoring system. A rapid and significant (p < 0.05, Z test) initial reduction in the amount of smear layer was observed at 7 days, and a further significant (p < 0.05) decrease was observed 28 days after SRP. Interestingly, even 28 days after SRP, the smear layer was still present on root surfaces. This study showed that the physiological elimination of the smear layer occurred in a biphasic manner: a rapid initial reduction was observed 7 days after instrumentation, which was followed by a slow process leading to a significant decrease 28 days after instrumentation.
Asunto(s)
Instrumentos Dentales , Raspado Dental/efectos adversos , Capa de Barro Dentinario/ultraestructura , Raíz del Diente/fisiología , Adulto , Anciano , Raspado Dental/instrumentación , Dentina/ultraestructura , Femenino , Humanos , Masculino , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Enfermedades Periodontales/terapia , Reproducibilidad de los Resultados , Capa de Barro Dentinario/etiología , Propiedades de Superficie , Factores de Tiempo , Extracción Dental , Raíz del Diente/ultraestructuraRESUMEN
Mechanical instrumentation of the root surface causes the formation of a smear layer, which is a physical barrier that can affect periodontal regeneration. Although different procedures have been proposed to remove the smear layer, there is no information concerning how long the smear layer persists on root surfaces after instrumentation in vivo. This study assessed the presence of the smear layer on root surfaces over a 28-day period after subgingival instrumentation with hand instruments. Fifty human teeth that were referred for extraction because of advanced periodontal disease were scaled and root planed (SRP) by a single experienced operator. Ten teeth were randomly assigned to be extracted 7, 14, 21, and 28 days after SRP. Another 10 teeth were extracted immediately after instrumentation (Day 0, control group). The subgingival area of the instrumented roots was evaluated with scanning electron microscopy. Representative photomicrographs were assessed by a blinded and calibrated examiner according to a scoring system. A rapid and significant (p < 0.05, Z test) initial reduction in the amount of smear layer was observed at 7 days, and a further significant (p < 0.05) decrease was observed 28 days after SRP. Interestingly, even 28 days after SRP, the smear layer was still present on root surfaces. This study showed that the physiological elimination of the smear layer occurred in a biphasic manner: a rapid initial reduction was observed 7 days after instrumentation, which was followed by a slow process leading to a significant decrease 28 days after instrumentation.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Instrumentos Dentales , Raspado Dental/efectos adversos , Capa de Barro Dentinario/ultraestructura , Raíz del Diente/fisiología , Raspado Dental/instrumentación , Dentina/ultraestructura , Microscopía Electrónica de Rastreo , Enfermedades Periodontales/terapia , Reproducibilidad de los Resultados , Propiedades de Superficie , Capa de Barro Dentinario/etiología , Factores de Tiempo , Extracción Dental , Raíz del Diente/ultraestructuraRESUMEN
This study aimed to evaluate, by scanning electron microscopy (SEM), the cleaning of canal walls with moderate curvature subjected to biomechanical preparation with different final diameters using apical negative pressure irrigation. Thirty-two mesiobuccal roots of molars were divided into 4 groups (n=8) according to the instrument's final diameter: GI: 30.02, GII: 35.02, GIII: 40.02 and GIV: 45.02. Irrigating procedure was performed at each change of instrument with 1% NaOCl using the Endovac system. Final irrigation was conducted with 17% EDTA for 5 min. The SEM photomicrographs were evaluated under 35× and 1000× magnification, by three calibrated examiners, in a double-blind design. Data were submitted to Kruskal-Wallis and Dunn's post hoc tests (α=0.05). Canals instrumented with 30.02 and 35.02 final diameters showed more debris, statistically different from the other groups (p<0.05). Comparing each root canal third, for the cervical and apical portions no statistically significant difference (p>0.05) was found among the four groups. Regarding the presence of smear layer, canals with 30.02 final diameter showed the highest scores, statistically different from the 45.02 group (p<0.05) and similar to the 35.02 and the 40.02 groups (p>0.05). Although none of the studied diameters completely removed debris and smear layer, it may be concluded that instrumentation with higher final diameters was more effective in cleaning the root canals with moderate curvature.
Asunto(s)
Cavidad Pulpar/ultraestructura , Preparación del Conducto Radicular/métodos , Capa de Barro Dentinario/ultraestructura , Irrigación Terapéutica/métodos , Ápice del Diente/ultraestructura , Método Doble Ciego , Ácido Edético/administración & dosificación , Humanos , Microscopía Electrónica de Rastreo , Presión , Irrigantes del Conducto Radicular/administración & dosificación , Preparación del Conducto Radicular/instrumentación , Hipoclorito de Sodio/administración & dosificación , Irrigación Terapéutica/instrumentación , Cuello del Diente/ultraestructura , VacioRESUMEN
INTRODUCTION: The aim of this in vitro study was to compare the effectiveness of saline, 2.5% sodium hypochlorite, and 2% chlorhexidine, with or without passive ultrasonic irrigation (PUI), in debris removal from simulated canal irregularities within prepared root canals. METHODS: Ninety bovine lateral incisors were randomly divided into 3 main groups (n = 30) based on the irrigant and prepared with hand files attached to an oscillating handpiece (NSK, Tokyo, Japan) up to a size #80 K-file. Next, the teeth were split longitudinally, and a standardized groove was prepared into the apical third and filled with dentin debris. After the halves were reassembled, they were placed in a muffle. Each main group was randomly subdivided into 2 groups (n = 14) and was treated with different final irrigation protocols. In the sodium hypochlorite/PUI, chlorhexidine/PUI, and saline/PUI groups, the solution was ultrasonically activated 3 times for 20 seconds. In the remaining groups, PUI was not performed. Specimens were scored for debris removal and analyzed under a scanning electron microscope. RESULTS: An association was observed between the score of debris removal and protocols using PUI (P < .05). No association was observed between the scores of debris removal and the irrigants (P = .87). CONCLUSIONS: Final irrigation protocols that used PUI were more effective in removing debris from simulated canal irregularities into the apical third than those that did not use it.