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OBJECTIVE: This study evaluated the influence of melatonin supplementation on tissue's response of endodontic sealers in Wistar rats. METHODOLOGY: Forty-eight rats received subcutaneous implants of four polyethylene tubes: one empty (control) and three filled with endodontic sealers (AH Plus, Endofill and Sealapex). Half of the animals were supplemented with melatonin (ME) and the remaining treated with water (WA) for 15 days before the implantation until euthanasia, forming the groups: control-WA, AH Plus-WA, Endofill-WA, Sealapex-WA, Control-ME, AH Plus-ME, Endofill-ME and Sealapex-ME. After 5, 15 and 30 days, (n = 8) tubes were removed and evaluated in H&E., immunohistochemistry, PSR, VK and POL. The results were statistically analyzed (p < 0.05). RESULTS: In animals treated with water, Endofill-WA evoked more intense inflammatory infiltrate compared to AH Plus-WA and Control-WA in a 30-day period (p < 0.05). In animals supplemented with melatonin, there was any difference among endodontic sealers' response in any period of analysis (p > 0.05). Comparing the individual response of each sealer, over a 30-day period, Endofill-ME and Sealapex-ME showed less inflammatory infiltrate compared to Endofill-WA and Sealapex-WA, respectively (p < 0.05). Immunostaining for IL-6 and TNF-α was less intense for all groups in animals supplemented with melatonin, in most periods, except for the Endofill sealer (p < 0.05). Furthermore, Endofill-ME at 5 days and AH-Plus-ME at 30 days showed a higher percentage of mature collagen fibers compared to the Endofill-WA and AH Plus-WA, respectively (p < 0.05). Positive structures for von Kossa staining and birefringent to polarized light were observed only for Sealapex-WA and Sealapex-ME in all periods. CONCLUSIONS: It can be concluded that melatonin influences the tissue response to endodontic sealers, modulating the inflammatory and reparative process.
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To evaluate the inflammatory tissue response to BioRoot™ RCS (BR) and AH Plus Jet (AHPJ) sealers implanted in mice subcutaneous tissue. It was hypothesized that the inflammatory tissue response to BR would be milder than to AHPJ. An in vivo study was carried out using isogenic mice. The sealers were implanted during standardized surgical procedures. The inflammatory response was evaluated by microscopic analysis and von Kossa reaction in the reactionary tissue around the specimens after 7, 21, and 63 days. For comparisons, a zinc oxide and eugenol sealer (ZOE) was used as a positive control, in addition to a negative control without a sealer (n = 10 per group/period). All statistical analyses considered a significance level of 5%. All endodontic sealers triggered an inflammatory tissue response after 7 days. BR had a higher inflammatory cell count and a thicker fibrous capsule when compared with AHPJ, but both were less inflammatory than ZOE (p < .001). After 21 days, BR continued to trigger an intense inflammatory tissue response, higher in both microscopic parameters compared to AHPJ, and a thicker fibrous capsule than ZOE (p < .001). After 63 days, the inflammatory tissue response decreased in BR, matching the fibrous capsule thickness with AHPJ and ZOE. BR promoted intense calcium precipitation in all study periods. After 63 days, AHPJ and BR sealers were more biocompatible to subcutaneous mice tissue, but AHPJ present better early inflammatory response, as well as BR showed potential bioactivity. RESEARCH HIGHLIGHTS: The inflammatory tissue response triggered by a bioceramic endodontic sealer (BR) was not milder than that triggered by an epoxy-resin based endodontic sealer (AHPJ) during the first 3 weeks, considering the microscopic analysis of the reactionary tissue.
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Resinas Epóxi , Inflamação , Materiais Restauradores do Canal Radicular , Tela Subcutânea , Animais , Materiais Restauradores do Canal Radicular/farmacologia , Camundongos , Tela Subcutânea/efeitos dos fármacos , Tela Subcutânea/patologia , Cerâmica , Materiais BiocompatíveisRESUMO
Introducción: la persistencia de microorganismos en los conductos radiculares es uno de los principales factores del fracaso endodóncico. Por ello la importancia de conocer las propiedades antimicrobianas de los distintos tipos de selladores. Objetivo: realizar una comparación con base en la evidencia disponible sobre la actividad antimicrobiana de los diferentes cementos selladores en endodoncia. Material y métodos: la información fue recopilada de las bases de datos PubMed y Google Académico en el idioma inglés y español, publicados en el periodo 2014-2023. Resultados: un gran número de microorganismos se encuentran presentes en los diferentes tipos de infecciones de origen endodóncico, se han identificado más de 500 especies microbianas, entre ellas bacterias, hongos, arqueas y virus. Los cementos selladores se pueden clasificar según su composición química, en cementos a base de óxido de zinc-eugenol, hidróxido de calcio, a base de ionómero de vidrio, silicona, resina y biocerámicos. Conclusión: los cementos selladores que mostraron mayor actividad antimicrobiana contra los microorganismos persistentes fueron los cementos a base de óxido de zinc-eugenol, resina y biocerámicos. Sin embargo, se identificó que cada autor utilizó diferentes métodos y tiempos, por lo tanto, no es posible lograr definir con exactitud qué cemento sellador posee la mejor capacidad antimicrobiana (AU)
Introduction: the persistence of microorganisms in root canals is one of the main factors of endodontic failure. Therefore, the importance of knowing the antimicrobial properties of the different types of sealants. Objective: to make a comparison based on the available evidence on the antimicrobial activity of the different endodontics sealers. Material and methods: the information was collected from PubMed and Google Academic databases in English and Spanish, published in the period 2014-2023. Results: a large number of microorganisms are present in the different types of infections of endodontic origin, more than 500 microbiological species have been identified, including bacteria, fungi, archaea and viruses. Sealer cements can be classified according to their chemical composition, into cements based on zinc oxide-eugenol, calcium hydroxide, based on glass ionomer, silicone, resin and bioceramics. Conclusion: sealer cements that showed the highest antimicrobial activity against persistent microorganisms were zinc oxide-eugenol, resin, and bioceramic-based cements. However, it was identified that each author used different methods and times, therefore, it is not possible to accurately define which sealer cement has the best antimicrobial capacity (AU)
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Materiais Restauradores do Canal Radicular/química , Cavidade Pulpar/microbiologia , Cimento de Óxido de Zinco e Eugenol/química , Hidróxido de Cálcio/química , Bases de Dados Bibliográficas , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Cimentos de Resina/química , Cerâmicas Modificadas Organicamente/química , Cimentos de Ionômeros de Vidro/química , Antibacterianos/farmacologiaRESUMO
Introduction: This systematic review aimed to help further elucidate the following question: are endodontics sealers able to induce DNA damage in vitro or in vivo? Methods: This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement 2020 criteria. A total of 23 studies were carefully selected by the authors. Results: Regarding the general characteristics, most studies evaluated, on average, 3-5 types of sealers (resin epoxy, salicylate, salicylate + MTA, zinc oxide-eugenol, bioceramic products, calcium hydroxide), performing comparisons between them. Our results demonstrate that endodontic sealers may be a genotoxic agent since most studies demonstrated positive findings, with the resin-based ones being the most potentially genotoxic. Conclusion: The type of genotoxicity assay, material evaluated, and dilution concentration levels influenced the outcome. This study clarifies whether and to what extent endodontic sealers are capable of inducing DNA injury in oral tissues.
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This scoping review aimed to map whether the use of sonic and ultrasonic methods to activate the endodontic sealer improves the sealer filling quality in the root canal, considering the bond strength and intratubular penetration to the root dentin as evaluation criteria. The study protocol was prospectively registered and is available online ( https://osf.io/x5fma/ ). Reporting was based on PRISMA Extension for Scoping Reviews. The search was performed in Embase, PubMed, Scopus, and Web of Science. We selected studies without time and language restrictions that used sonic or ultrasonic methods to activate endodontic sealer, whose outcomes were bond strength and intratubular penetration. Three researchers independently selected the articles and collected data. Of 1422 articles, 19 were read in full and 13 studies were included. The vast majority of studies opted for direct activation of the endodontic sealer. The most investigated sealers were the epoxy resin-based sealers, and the ultrasonic activation method was the most explored. For the bond strength outcome, there was a trend toward higher values when the sealer was activated ultrasonically, but the findings seem to be divergent. The sonic activation was not effective for its intended purpose. For the outcome of intratubular penetration, the vast majority of studies indicate that the use of sonic and ultrasonic methods to activate the endodontic sealer is capable of increasing intratubular penetration. The use of sonic and ultrasonic methods to directly activate the endodontic sealer can increase the intratubular penetration of the sealer, but their benefits on the bond strength are uncertain.
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Materiais Restauradores do Canal Radicular , Materiais Restauradores do Canal Radicular/química , Humanos , Ultrassom , Obturação do Canal Radicular/métodos , Colagem Dentária/métodos , SonicaçãoRESUMO
El retratamiento no quirúrgico es la primera opción ante el fracaso del tratamiento endodóntico, por lo que se vuelve importante asegurar el completo retiro del material de relleno del conducto radicular, para mejorar el pronóstico del procedimiento. Los cementos biocerámicos en base a silicatos cálcicos han aparecido en los últimos años, caracterizados principalmente por su bioactividad, lo que adicionalmente se puede traducir en una mayor dificultad para su retiro del conducto radicular. El objetivo de esta revisión es determinar qué técnica de retratamiento es más efectiva en la eliminación de cementos selladores biocerámicos, en base al volumen de material remanente en el conducto radicular, evaluado a través del análisis de imágenes con micro-CT. Se realizó una revisión sistemática mediante la búsqueda de publicaciones en las bases de datos Pubmed, ScienceDirect y SciELO, de los últimos 10 años, en idioma español e inglés. Se incluyeron sólo estudios in vitro de dientes obturados con cemento biocerámico y diferentes técnicas de retratamiento endodóntico, en los que se evalúe la limpieza del conducto post eliminación del relleno mediante micro-CT. De un total de 174 artículos encontrados, 7 fueron seleccionados, analizados y se incluyeron en esta revisión sistemática. Los resultados de los estudios seleccionados no encuentran diferencias significativas en la eliminación de material entre las diferentes técnicas de retratamiento evaluadas. A pesar de la heterogeneidad presente en las metodologías de los artículos analizados, ninguna técnica de retratamiento ni técnicas complementarias lograron dejar completamente limpios los conductos radiculares, por lo que se sugiere realizar nuevos estudios en el futuro que evalúen nuevas técnicas de desobturación radicular.
Non-surgical retreatment is the first option in the case of endodontic treatment failure, so it becomes important to ensure complete removal of the root canal filling material, to improve the prognosis of the procedure. Bioceramic cements based on calcium silicate have appeared in recent years, characterized mainly for their bioactivity, which can additionally translate into greater difficulty in their removal from the root canal. The aim of this review is to determine which retreatment technique is most effective in the removal of bioceramic sealer cements, evaluated through micro-CT image analysis. A systematic review was performed by searching for publications in Pubmed, ScienceDirect and SciELO databases, of the last 10 years in Spanish and English. Only in vitro studies of teeth filled with bioceramic cement and different endodontic retreatment techniques were included, in which the cleaning of the canal after removal of the filling was evaluated by micro- CT. From a total of 174 articles found, 7 were selected, analyzed and included in this systemic review. The results of the included studies did not find significant differences in the removal of material between the different retreatment techniques evaluated. Despite the heterogeneity in the methodologies of the studies, no retreatment technique or complementary techniques were able to completely clean the root canals, it is therefore suggested that new studies be carried out in the future to evaluate new techniques.
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The use of fluorescent dyes in microscopy studies is frequent. Therefore, it is important to investigate whether these compounds may alter the physicochemical properties of materials in which they are incorporated to avoid methodological biases. This study evaluated the physicochemical properties of two endodontic sealers containing dry or diluted rhodamine B. Six groups were evaluated: AH Plus and MTA Fillapex in their original composition and mixed with 0.1% dry or diluted rhodamine. Push-out test was applied to assess the bond strength to root dentin. ANSI-ADA No. 57 and ISO No. 6876:2012 specifications were followed to evaluate flowability, setting time, and solubility of the sealers. pH changes were assessed after 24 h, 7, and 30 days. Intergroup comparisons were analyzed by ANOVA complemented by Tukey's post-hoc test; comparisons among periods were analyzed by Wilcoxon and Friedman tests. The incorporation of dry rhodamine decreased the bond strength and prolonged the setting time of AH Plus. The incorporation of diluted rhodamine decreased the setting time and increased the flowability of MTA Fillapex. Diluted rhodamine promoted pH reduction of AH Plus after 24 h and dry rhodamine after 7 days. Rhodamine incorporation promoted pH reduction after 30 days for MTA Fillapex. Solubility was not affected. In conclusion, the incorporation of diluted rhodamine changed the properties of MTA Fillapex, and the incorporation of dry rhodamine changed the properties of AH Plus. Previous dilution of rhodamine did not severely compromise the physicochemical properties of AH Plus and may be suggested to assess its penetrability.
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Materiais Restauradores do Canal Radicular , Materiais Restauradores do Canal Radicular/química , Resinas Epóxi/química , Compostos de Cálcio/química , Óxidos/química , Rodaminas , Solubilidade , Combinação de Medicamentos , Silicatos/química , Teste de MateriaisRESUMO
BACKGROUND: The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin. METHODS: This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05). RESULTS: Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome. CONCLUSION: It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
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Anti-Infecciosos , Fotoquimioterapia , Materiais Restauradores do Canal Radicular , Fotoquimioterapia/métodos , Dentina , Fármacos Fotossensibilizantes , Teste de MateriaisRESUMO
Abstract This laboratory study aimed to evaluate the influence of endodontic sealer and cervical limit of root filling on the discoloration of root canal treated teeth. Bovine incisors were randomly distributed into six experimental groups and control (n=21/group), according to the endodontic sealer used [AH Plus (AP); MTA Fillapex (MF) and Sealer Plus BC (SPB)] and the cervical limit of root filling [dental cervix (DC) or 2 mm in apical direction (2mm-AD)]. Tooth discoloration (ΔE) was evaluated by a digital spectrophotometer using the CIED2000 method. Color assessments were performed immediately before (baseline), 1 week, 1, 3, 6 months, and 1 year after obturation. Data were analyzed by ANOVA and Tukey's post-hoc tests (α=5%). Teeth filled with the three sealers showed perceptible tooth discoloration (ΔE≥2.7) in 1 week, maintaining similar values over time. There was a significant difference between MF and SPB sealers in the 2mm-AD groups. In addition, 2mm-AD groups promoted significantly lower discoloration than DC groups for AH (3 months) and SPB (1 and 3 months) sealer,s. Teeth filled with AP, MF, and SPB sealers displayed discoloration from 1 week to one year, with differences between MF and SPB sealers. A cervical limit of filling material at 2 mm from the dental cervix seems more advisable, promoting lower crown discoloration.
Resumo O presente estudo laboratorial teve como objetivo avaliar a influência do cimento endodôntico e do limite cervical da obturação radicular na alteração de cor de dentes tratados endodonticamente. Incisivos bovinos foram distribuídos aleatoriamente em seis grupos experimentais e um controle (n=21/grupo), de acordo com o cimento endodôntico utilizado [AH Plus (AP); MTA Fillapex (MF) e Sealer Plus BC (SPB)] e o limite cervical da obturação [Colo dentário (CD) ou 2mm na direção apical (2mm-DA)]. A alteração de cor (ΔE) foi avaliada por um espectofotômetro digital usando o método CIED2000. As avaliações de cor foram realizadas imediatamente antes (baseline), 1 semana, 1, 3, 6 meses e 1 ano após a obturação. Os dados foram analisados pelos testes ANOVA e post-hoc de Tuckey (α=5%). Dentes obturados com os três cimentos apresentaram alteração de cor perceptível (ΔE≥2.7) em 1 semana, mantendo valores semelhantes ao longo do tempo. Houve uma diferença significativa entre os cimentos MF e SPB nos grupos 2mm-DA. Além disso, os grupos 2mm-DA promoveram uma alteração de cor significativamente menor do que o grupos CD para os cimentos AH (3 meses) e SPB (1 e 3 meses). Os dentes obturados com os cimentos AH, MF e SPB apresentaram alteração de cor entre 1 semana a um ano, com diferenças entre os cimentos MF e SPB. O limite cervical do material obturador a 2mm do colo dentário parece mais aconselhável, promovendo menor alteração de cor da coroa dentária.
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Abstract The aim of this study was to compare the influence of endodontic sealers artifacts on the detection of vertical root fracture in cone beam computed tomography (CBCT). Premolars and central incisors were assigned into five different groups: Control, Pulp Canal Sealer, AH Plus, Sealer 26, and BC Sealer (n= 10, per group). VRFs were mechanically induced and the teeth were inserted into an image phantom. Subsequently, CBCT (Cranex 3Dx, Soredex, Tuusula, Finland) images were obtained and two observers were asked separately to identify root fracture, by visual analysis. For both premolar and central incisors, kappa coefficients of intraobserver agreement varied from good to excellent (K: 80% - 87%), and the values for interobserver agreement varied from fair to moderate (K: 30% - 35%). As follows, the area under the curve (AUC) of receiver operating characteristic (ROC) values for VRFs highlighted that the use of BC sealer reduced the observers' ability to discriminate VRFs relative to other sealers. Moreover, sensitivity values for premolars teeth ranged from 20% to 60%, and specificity ranged from 60% to 100%; while sensitivity values for central incisors ranged from 30% to 70%, and specificity ranged from 70% to 100%. In conclusion, the low sensitivity values, mainly for premolars, demonstrated the difficulty in VRF diagnosis. Furthermore, BC Sealer induced significantly more imaging artifacts than other sealers. These results highlighting that endodontic sealers may interfere with the diagnosis of VRFs.
Resumo O objetivo deste estudo foi comparar a influência dos artefatos de cimentos endodônticos na detecção de fratura radicular vertical (FRV) em tomografia computadorizada de feixe cônico (TCFC). Pré-molares e incisivos centrais foram divididos em cinco grupos diferentes: Controle, Pulp Canal Sealer, AH Plus, Sealer 26 e BC Sealer (n = 10, por grupo). As FRVs foram induzidas mecanicamente e os dentes inseridos em uma réplica da mandibula humana. Posteriormente, imagens de TCFC (Cranex 3Dx, Soredex, Tuusula, Finlândia) foram obtidas e dois observadores foram solicitados a identificar fratura radicular separadamente, o critério utilizado foi a análise visual. Tanto para pré-molares quanto para incisivos centrais, os coeficientes kappa de concordância intraobservador variaram de bom a excelente (K: 80% - 87%), e os valores de concordância interobservador variaram de regular a moderado (K: 30% - 35%). A seguir, a área sob a curva (AUC) dos valores da característica de operação do receptor (ROC) para FRVs destacou que o uso do cimento BC Sealer reduziu a capacidade dos observadores de discriminar FRVs em relação a outros cimentos endodônticos. Além disso, os valores de sensibilidade para pré-molares variaram de 20% a 60%, e a especificidade variou de 60% a 100%; enquanto os valores de sensibilidade para incisivos centrais variaram de 30% a 70%, e a especificidade variou de 70% a 100%. Em conclusão, os baixos valores de sensibilidade, principalmente para pré-molares, demonstraram uma dificuldade no diagnóstico de FRV. Além disso, o BC Sealer induziu significativamente mais artefatos de imagem do que outros cimentos. Esses resultados evidenciam que os cimentos endodônticos podem interferir no diagnóstico das FRVs.
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OBJECTIVE: This study evaluated the influence of adding bioactive glasses particles [Niobophosphate (NbG) or bioglass (45S5)] into endodontic cements in relation to physical, chemical and biological properties. METHODS: The following commercial cements were used as comparison: AH Plus (Dentsply), Endofill (Dentsply), MTA Fillapex (Angelus) and EndoSequence (BC Sealer, Brasseler). Setting time, radiopacity, flow rate, weight loss/variation, alkaline capacity (pH) at different time-intervals (24h/48h/7d/14d/28d), bioactivity (assessed under SEM/EDS, FTIR/ATR and XDR) and cell viability were measured. Data were analyzed by One-way ANOVA/Holm-Sidak post-test (α = 5%) (normal distribution) and Kruskal-Wallis/Students-Newman-Keuls post-test (α = 5%) (non-normal distribution). RESULTS: Bioactive endodontic experimental cements (containing NbG or 45S5) had high alkalinization capacity. The experimental cements presented high weight loss/variation (p < 0.001). 45S5 experimental cement did not present radiopacity (p < 0.001). AH Plus had the lowest cell cytotoxicity when compared to the other tested cements (p < 0.001). Regarding bioactivity, SEM/EDS analyses showed precipitates with high concentrations of Ca/P for 45S5 and NbG, as well as for MTA Fillapex and BC Sealer. AH plus and Endofill did not present bioactive precipitates. FTIR/ATR and XDR analyses found hydroxyapatite precursors for NbG, 45S5, MTA Fillapex and BC Sealer. SIGNIFICANCE: The incorporation of bioactive particles (NbG or 45S5) into endodontic cements had potential to neutralize acidic environments and induced formation of hydroxyapatite precursors. Clinically, these would produce a cement that is bactericidal and have the potential to improve tissue healing. The improved radiopacity and flowability would facilitate the visualization of the material in the radiograph and the filling of anatomical complexities during root canal obturation. As drawbacks, the excessive weight loss and post-setting cytotoxicity could result in clinical degradation of the cement and adjacent tissue irritation for the patient.
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Materiais Restauradores do Canal Radicular , Cimentos Ósseos , Durapatita , Cimentos de Ionômeros de Vidro , HumanosRESUMO
AIM: To evaluate an ultrasonic-based experimental model (US), to assess the setting time of AH Plus® , Bio-C Sealer® and MTA Fillapex® , and compare the results obtained with ANSI/ADA specifications (2012). METHODS: To determine the setting time according to the ANSI/ADA specification, moulds measuring 10 mm (diameter) × 2 mm (thickness) were used, and for the US tests a transducer (1 MHz) and an oscilloscope were used. Fourier-transform infrared spectroscopy (FTIR) was used to evaluate the changes on chemical structure at the different setting times found by the US and ANSI/ADA methods. After checking the normal distribution, setting time data were analysed using unilateral analysis of variance with Tukey-HSD post-test to compare the methods. RESULTS: AH Plus® and Bio-C Sealer® had longer mean setting time values for the US method than for the ANSI/ADA (p < .05), whilst for MTA Fillapex® no significant difference was found between the methods (p < .05). FTIR spectra demonstrated that at the setting time determined by the US method, AH Plus® and Bio-C Sealer® were in a more advanced stage of polymerization than at the ANSI/ADA, whilst there was no significant difference for MTA Fillapex® . CONCLUSIONS: The use of US was effective for setting time determination and measured longer values than ANSI/ADA specification for AH Plus® and Bio-C Sealer® , identifying the entire (and not only superficial) setting of the endodontic sealers.
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Materiais Restauradores do Canal Radicular , Resinas Epóxi , Teste de Materiais , Modelos Teóricos , UltrassomRESUMO
The cytotoxic and genotoxic effects of commercial endodontic sealers (AH Plus, Sealer 26 and Endomethasone N) incorporated with nanostructured silver vanadate decorated with silver nanoparticles (AgVO3 - at concentrations 2.5, 5, and 10%) on human gingival fibroblast (HGF), and the silver (Ag+ ) and vanadium (V4+ /V5+ ) ions release were evaluated. Cytotoxicity, cell death, and genotoxicity tests were carried out with extract samples of 24-hr and 7-days. The release of Ag+ and V4+ /V5+ was evaluated. Cytotoxicity in HGF was caused by AH Plus (AP) with 5 and 10% of AgVO3 (83.84 and 67.49% cell viability, respectively) with 24-hr extract (p < 0.05), as well as all concentrations of AP with 7-days extract (p < 0.05 -AP 0% = 73.17%; AP 2.5% = 75.07%; AP 5% = 70.62%; AP 10% = 68.46% cell viability). The commercial sealers Sealer 26 (S26) and Endomethasone N (EN) were cytotoxic (p < 0.05 - S26 0% = 34.81%; EN 0% = 20.99% cell viability with 7-days extract). AP 10% with 7-days extract induced 32% apoptotic cells in HGF (p < 0.05). Genotoxic effect was not observed. The AP groups released more Ag+ , while S26 and EN released more V4+ /V5+ in 24 hr. The Ag+ can be cytotoxic. In conclusion, the cytotoxicity caused to HGF can be attributed by the commercial sealers and enhanced by incorporation of AgVO3 , was not observed genotoxic effect, and apoptosis was induced only by AH Plus 10% 7-days extract. Ag+ can influence cell viability.
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Antibacterianos/química , Bismuto/química , Hidróxido de Cálcio/química , Fibroblastos/citologia , Gengiva/citologia , Materiais Restauradores do Canal Radicular/química , Prata/química , Vanádio/química , Antibacterianos/farmacologia , Apoptose/efeitos dos fármacos , Materiais Biocompatíveis/química , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Dexametasona/química , Combinação de Medicamentos , Liberação Controlada de Fármacos , Resinas Epóxi/química , Formaldeído/química , Humanos , Hidrocortisona/química , Íons/química , Prata/farmacologia , Relação Estrutura-Atividade , Timol/análogos & derivados , Timol/química , Titânio/químicaRESUMO
OBJECTIVES: To assess the influence of different sealers used in root canal filling, in terms of bond strength (BS) to dentin, after restoration of weakened roots using resin composite (RC) and fiber posts. MATERIAL AND METHODS: Roots of 39 maxillary incisors were used. After root canal preparation, root dentin was flared to produce a space between fiber post and root canal walls. The root canals were randomly distributed into three groups (n = 13), according to the sealer used: Endofill, AH Plus, and Acroseal. After removing the filling material to a depth of 12 mm, the flared roots were adhesively restored using RC. Posts were cemented and, after 24 h, roots were sectioned transversely producing 1-mm-thick slices. The slices from 30 roots were used for push-out test, and failure modes were noted. The remaining slices were analyzed by scanning electron microscopy (SEM). RESULTS: Statistical analysis by 2-way ANOVA showed a significant difference among sealers (p = 0.001) and among root regions (p < 0.001). The BS mean of Endofill was lower and significantly different from the others. Overall, the coronal region presented higher BS mean values, followed by the middle and apical regions of the reinforced roots. The most frequent failure type was the adhesive failure between RC and dentin. SEM analysis showed the formation of a hybrid layer and many tags in the coronal and middle regions, while the apical region exhibited remnants of the endodontic sealers in all groups. CONCLUSIONS: AH Plus and Acroseal sealer groups presented similar results, and the Endofill sealer negatively affected the BS of fiber post to restored root dentin. CLINICAL RELEVANCE: Weakened dentin walls are often found in teeth undergoing endodontic treatment, so the sealer used must allow or at least not interfere the bonding between restorative materials and root dentin.
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Colagem Dentária , Técnica para Retentor Intrarradicular , Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Dentina , Resinas Epóxi , Teste de MateriaisRESUMO
OBJECTIVES: Root canal sealers are widely used worldwide in endodontics to prevent reinfection and growth of surviving microorganisms. Considering the strong correlation between genetic damage and carcinogenesis, evaluation of genotoxicity induced by endodontic sealers is recommended for elucidating the true health risks to patients and professionals. The purpose of this article was to provide a comprehensive review of studies involving genotoxicity analysis of endodontic sealers and the used methodologies. MATERIALS AND METHODS: A literature search was made in PubMed using the following combination of words "genotoxicity," "mutagenicity," "endodontic sealers," and "root canal sealers." A total of 39 articles with genotoxicity studies were selected for the present study. RESULTS: Sealers have been ranked in decreasing order of their genotoxicity as: ZOE sealers > GIC sealers > S sealers > ER sealers > MR sealers > Novel sealers > CH sealers > CS sealers. CONCLUSIONS: All published data showed some evidence of genotoxicity for most of the commercial root canal sealers; however, contradictory results were found, mainly for AH Plus, the most studied sealer. CLINICAL RELEVANCE: The information provided would direct the endodontists to use the less genotoxic materials in endodontic treatment in a way to reduce DNA damage promoting oral healthcare.
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Cavidade Pulpar , Dano ao DNA , Resinas Epóxi , Humanos , Mutagênicos , Materiais Restauradores do Canal RadicularRESUMO
INTRODUCTION: This study aimed to evaluate the effect of ultrasonic activation (UA) of endodontic sealers on dentin tubule penetration and the bond strength to root dentin. METHOD: One hundred single-rooted teeth were prepared with 40.06 nickel-titanium instruments and divided into 2 groups: with or without UA. Three resin-based sealers (MTA Fillapex [Angelus Dental Solutions, Londrina, PR, Brazil], Sealer Plus [MK Life Medical and Dental Products, Porto Alegre, RS, Brazil], and AH Plus [Dentsply, DeTrey GmbH, Konstanz, Germany]; n = 20) and 2 calcium silicate-based sealers (Sealer Plus BC [MK Life Medical and Dental Products] and EndoSequence BC [Brasseler, Savannah, GA], n = 20) were used and subdivided (n = 10) according to the protocols. Fluo-3 (Thermo Fisher Scientific, Waltham, MA) and rhodamine B dyes were added to the calcium silicate- and resin-based sealers, respectively. In the UA groups, the activation was performed for 40 seconds followed by lateral compaction. Samples were transversely sectioned to evaluate the dentin tubule penetration and the bond strength to root dentin. The penetration data were analyzed with the Student t test, 1-factor analysis of variance, and Bonferroni tests. Bond strength was evaluated using the Student t test, Kruskal-Wallis, and Dunn post hoc test. RESULTS: Resin-based sealers showed the highest tubule penetration without UA (P < .05). UA significantly enhanced MTA Fillapex and Endosequence BC dentin tubule penetration (P < .05). AH Plus and Sealer Plus BC improved their bond strength to root dentin after UA (P < .05). AH Plus/UA, Sealer Plus/UA, and Sealer Plus BC/UA presented the highest bond strength values (P < .05). Adhesive failures were predominant in all groups regardless of the use of ultrasound. CONCLUSIONS: UA interferes with tubule penetration and the bond strength to root dentin of resin- and calcium silicate-based sealers.
Assuntos
Colagem Dentária , Materiais Restauradores do Canal Radicular , Brasil , Compostos de Cálcio , Dentina , Resinas Epóxi , Alemanha , Humanos , Teste de Materiais , Silicatos , Raiz DentáriaRESUMO
INTRODUCTION: The aim of the present study was to assess the effects of different silicate-based sealers (ie, BioRoot RCS [Septodont, Saint Maur des Fosses, France], ProRoot ES [Dentsply Sirona, York, PA], and MTA Fillapex [Angelus, Londrina, PR, Brazil]) on cytokine production and viability of human periodontal ligament stem cells (PDLSCs). AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) was used as a reference material. METHODS: PDLSCs were cultured either in 2-dimensional or 3-dimensional conditions (in 0.15%-0.5% PuraMatrix [BD Biosciences, Bedford, MA]) for 24 hours with eluates from set endodontic sealers. Additionally, the toxicity of eluates from endodontic sealers was evaluated using an in vitro root model experimental procedure. PDLSC viability was determined using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. PDLSC culture medium was used for cytokine quantification (interleukin [IL]-6, IL-8, growth-regulated oncogene, IL,-4 and IL-10) using the HCYTMAG-60K-PX41 Milliplex kit (EMD Millipore, Burlington, MA). RESULTS: In 2-dimensional culture conditions, BioRoot RCS revealed a good PDLSC viability rate. ProRoot ES had no effect on PDLSC viability regardless of the dilution. MTA Fillapex was strongly cytotoxic even at the lowest extract dilutions (1:1, 1:2, and 1:4). Encapsulation of PDLSCs in PuraMatrix tended to decrease the cytotoxic effect of the sealers. In the 3-dimensional in vitro root model experimental procedure, BioRoot RCS, ProRoot ES, and MTA Fillapex revealed a cytocompatibility pattern. Different calcium silicate-based sealers exhibited different proinflammatory cytokine production. BioRoot RCS greatly stimulated the release of IL-10 and, to a lesser degree, IL-4 by PDLSCs (P < .05). CONCLUSIONS: BioRoot RCS and ProRoot ES did not induce proinflammatory cytokines and promoted anti-inflammatory cytokine secretion by PDLSCs that may have a positive local impact by attenuating an initial inflammatory response.
Assuntos
Materiais Restauradores do Canal Radicular , Brasil , Compostos de Cálcio , Citocinas , Combinação de Medicamentos , Resinas Epóxi , França , Alemanha , Humanos , Teste de Materiais , Óxidos , SilicatosRESUMO
INTRODUCTION: This cross-sectional study evaluated the influence of endodontic filling material, cervical limit of root filling, and tooth location on the color variation (∆E00 ) from 1 to 60 months of follow-up. MATERIALS AND METHODS: Color records were obtained from 70 participants who received 83 endodontic treatments. CIEL*a*b* color coordinates were measured on the homologous tooth, which was considered as baseline, and on endodontic treated teeth with a spectrophotometer. ∆E00 was calculated by the CIEDE2000 method at three conditions (condition 1: homologous tooth vs endodontically treated tooth after ≤1 month; condition 2: homologous tooth vs endodontically treated tooth after >1-12 months; condition 3: homologous tooth vs endodontically treated tooth after >12 months up to 5 years) for each variable. The zinc oxide and eugenol mineral trioxide aggregate or resin-based filling materials, dental cervix or ≥2 mm in the apical direction cervical limit of root filling and anterior or posterior tooth location were considered in the comparisons. Confidence intervals for the means (95% CI) were calculated, ∆E00 values and CIEL*a*b* individual color coordinates were compared for each pair of variables using the Student t test or Welch test (α = .05). RESULTS: Greater ∆E00 values were generally observed in the condition 3 for cervical limit (∆E00 = 10.7), use of zinc oxide and eugenol and mineral trioxide aggregate-based filling materials (∆E00 = 10.7), and anterior teeth (∆E00 = 12.4). Only in the condition 1, the ∆E00 values of the filling materials did not show statistical differences (P = .198). CONCLUSIONS: Higher ∆E00 values were yielded from zinc oxide and eugenol and mineral trioxide aggregate-based filling materials, anterior teeth, and dental cervix cervical limit of root filling. CLINICAL SIGNIFICANCE: Tooth discoloration yielded by endodontic materials and procedures is a challenge to clinical practice resulting in aesthetic problems and discomfort to both patient and professional, especially when it occurs in anterior teeth.
Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Dente não Vital , Dente , Estudos Transversais , Combinação de Medicamentos , Feminino , HumanosRESUMO
Este estudo avaliou as influências da incorporação de nanopartículas (NPs) de clorexidina-hexametafosfato em diversas propriedades dos cimentos endodônticos: AH Plus, MTA Fillapex e Pulp Canal Sealer (PCS). As NPs foram sintetizadas através de uma suspensão contendo 5 mM de hexametafosfato de sódio (HMP) e 4 mM de digluconato de clorexidina (CHX) a 20%, caracterizadas por microscopia eletrônica de varredura (MEV), espalhamento dinâmico de luz (DLS), potencial zeta, microscopia de força atômica (AFM) e espectroscopia de energia dispersiva de raios-X (EDS). Os cimentos endodônticos sofreram incorporação, em peso, de 2% e 5% das NPs. A ação antimicrobiana das amostras foi avaliada pelo teste de difusão em ágar e contato direto (DCT) frente a Enterococcus faecalis. O DCT foi conduzido em 3 tempos de armazenamento: cimentos frescos (T0), após 7 dias (T7) e após 30 dias (T30), e nos tempos de contato: 10 e 60 min. A citotoxicidade foi avaliada conforme as normas ISO 10993-12 através de extratos preparados em meio de cultura Dulbecco's modified Eagle's medium. As interações dos fibroblastos da linhagem MRC-5 com as diluições seriadas (1:1 a 1:8) dos extratos foram analisadas através do ensaio de quantificação do metabolismo mitocondrial pelo tetrazollium (MTT). O escoamento, radiopacidade, solubilidade e tempo de presa das amostras foi avaliado segundo a norma ISO 6876:2012. A solubilidade foi avaliada após 24 horas e 7 dias de imersão das amostras e o pH aferido após: 3h, 24h, 48h, 72h e 7 dias de armazenamento. Os resultados obtidos foram submetidos à análise estatística por análise de variância one-way e teste de Tukey, com nível de significância de 5%. A análise por MEV demonstrou aglomeração das NPs CHX-HMP, o diâmetro médio efetivo aferido por DLS foi de 169,39 nm e o potencial zeta foi de -10,18 mV. As NPs foram mensuradas por AFM, apresentando: 22,99 a 52,75 nm. Os elementos químicos: C, N, O, Na, P, Cl, identificados por EDS, comprovam a interação entre o digluconato de CHX e HMP. A ação antimicrobiana das NPs confirmou-se preliminarmente no teste de difusão em ágar e o DCT demonstrou o aumento da ação antimicrobiana dos cimentos endodônticos após incorporação das NPs, principalmente no MTA Fillapex, eliminando totalmente as cepas após 30 dias. A citotoxicidade dos cimentos analisados não foi potencializada pelas NPs. Houve redução do escoamento após a incorporação das NPs, no entanto sem infringir a norma ISO 6876:2012. A incorporação de NPs não alterou a radiopacidade das amostras, mas o MTA Fillapex não atingiu a radiopacidade mínima preconizada. As amostras incorporadas apresentaram redução da solubilidade após 24h de imersão, no entanto o MTA Fillapex em todas as amostras excedeu os valores preconizados pela ISO 6876:2012. Quanto ao pH, todas as amostras apresentaram decréscimo do valor com a progressão do tempo de imersão. O tempo de presa do AH Plus aumentou após a incorporação das NPs e o MTA Fillapex não atingiu a presa em nenhuma das condições testadas. Com os resultados obtidos conclui-se que a incorporação das NPs pode beneficiar o desempenho antimicrobiano dos cimentos endodônticos.(AU)
This study evaluated the influence of the incorporation of chlorhexidine hexametaphosphate NPs in various properties of the following endodontic sealers: AH Plus, MTA Fillapex and Pulp Canal Sealer (PCS). The NPs were synthesized using a suspension containing 5 mM sodium hexametaphosphate (HMP) and 4 mM 20% chlorhexidine digluconate (CHX), and characterized by scanning electron microscopy (SEM), dynamic light scattering (DLS), zeta potential, atomic force microscopy (AFM), energy-dispersive X-ray spectroscopy (EDS). Endodontic sealers were incorporated by weight of 2% and 5% of NPs. The antimicrobial activity of the samples was evaluated by agar diffusion test and direct contact (DCT) against E. faecalis. DCT was conducted in 3 storage times: fresh sealers (T0), after 7 days (T7) and after 30 days (T30) storage, and two contact times with E. faecalis suspension for 10 and 60 minutes. The cytotoxicity of the samples was evaluated according to ISO 10993-12 standards, through extracts prepared in Eagle modified by Dulbecco culture medium. The interactions of MRC-5 fibroblasts cell culture with the extracts serial dilutions (1: 1 to 1: 8) were analyzed by tetrazolium mitochondrial metabolism quantification assay (MTT). Samples flow, radiopacity, solubility and setting time were evaluated according to ISO 6876: 2012. Solubility was evaluated after 24 hours and 7 days of sample immersion and the pH measured after: 3h, 24h, 48h, 72h and 7 days of storage. The results were submitted to statistical analysis by one-way analysis of variance test and Tukey test, with a significance level of 5%. SEM analysis showed a tendency for CHX-HMP NPs to cluster, the effective mean diameter measured by DLS was 169,39 nm and the zeta potential: -10.18 mV. The NPs were individually measured by AFM, showing: 22.99 to 52.75 nm. The chemical elements: C, N, O, Na, P, Cl, identified by EDS, prove the interaction between CHX digluconate and HMP. The antimicrobial action of NPs was preliminarily confirmed in the agar diffusion test and the DCT demonstrated an increase in the antimicrobial action of endodontic sealers after incorporation of NPs, mainly in the MTA Fillapex, totally eliminating the strains after 30 days. There was reduction of flow after NPs incorporation, however without violating the ISO 6876: 2012 standard. The incorporation of NPs did not change the radiopacity of the samples, but MTA Fillapex did not reach the minimum radiopacity recommended. The incorporated samples showed reduced solubility after 24 hours of immersion, however the MTA Fillapex in all samples exceeded the values recommended by ISO 6876:2012.. Regarding the pH, all samples showed a decrease in the value as the immersion time progressed. AH Plus setting time increased after incorporation of NPs and MTA Fillapex did not reached setting under none of the conditions tested. With the obtained results it can be concluded that the incorporation of NPs can benefit the antimicrobial performance of endodontic sealers.(AU)
Assuntos
Fosfatos/farmacologia , Teste de Materiais , Clorexidina/farmacologia , Cimentos Dentários/farmacologia , Nanopartículas , Microscopia Eletrônica de Varredura , Potencial zeta , Microscopia de Força Atômica , Difusão Dinâmica da LuzRESUMO
AIM: To evaluate the in vitro cytotoxicity and cytokine release of three fresh root canal sealers and to determine the type of cell death they induce. METHODOLOGY: The sealers tested were Sealer 26 (S26), AH Plus (AHP), and Endosequence BC Sealer (END). Fresh sealers were cultivated in contact with monocytes and polymorphonuclears (PMNs) obtained from the peripheral blood of humans. Cell viability, apoptosis and necrosis were analysed at 4 h (PMNs) or 24 h (monocytes) using Annexin-V and propidium iodide in a cytometer. The supernatants were used to quantify Interleukin (IL)-4, IL-6, IL-10, IL-12 and tumour necrosis factor-α (TNF-α) in monocytes and IL-8 in PMNs by ELISA. One-way ANOVA and the Tukey post-test were used to compare data for cytotoxicity, and the multiple T-test was used to determine the differences between sealers in the release of cytokines that were statistically significant. RESULTS: After 4 h of treatment, S26 was associated with greater cell viability than the other sealers (P < 0.05) in the PMN culture and had similar values of necrosis as END (P > 0.05). After 24 h of treatment, AHP and END had greater monocyte cell viability than S26 (P < 0.05), which had more necrosis (P < 0.05). END had the lowest levels of IL-12 compared to the other sealers (P < 0.05) and higher levels of IL-6 compared to S26 (P < 0.05). The tested sealers did not differ in the release of IL-8, IL-10, TNF-α and IL-4 (P > 0.05). CONCLUSIONS: The effect of toxic agents released varied depending on the cell type studied. The composition of the sealers appeared to alter the form of self-regulation in the production of these cytokines by cells.