Introduction: This study evaluated the accuracy and reliability of the tactile perception of the ... more Introduction: This study evaluated the accuracy and reliability of the tactile perception of the first apical binding file (FABF) and cone‐beam computed tomographic (CBCT) imaging in estimating the canal diameter at the working length (WL). Methods: Ten anterior mandible segments were obtained from cadavers maintained in formalin and scanned using CBCT and high‐resolution micro–computed tomographic (micro‐CT) imaging. Scans were used to measure the smallest canal diameter of 38 mandibular incisors at 1 mm short of the root apex. After coronal access preparation, the canals of these teeth were explored with a size 08 K‐file up to the radiographic apex, and the WL was established 1 mm shorter. Larger K‐files were passively introduced in the canal up to the WL until binding was felt and the next instrument size could not reach this point. This instrument was regarded as the FABF. The accuracy and level of agreement (reliability) of the FABF and CBCT imaging in determining the initial apical canal size were determined using the Pearson correlation coefficient and the intraclass correlation coefficient, respectively, considering the micro‐CT measurements as the gold standard. Results: The Pearson correlation coefficient and the intraclass correlation coefficient were statistically significant when CBCT imaging was compared with micro‐CT imaging (P < .01), showing a moderate accuracy (r = 0.61) and good reliability (0.74). On the other hand, FABF was inaccurate and unreliable (P > .05). The means of the smallest root canal diameter obtained by micro‐CT and CBCT imaging were 0.22 mm (range, 0.14–0.34 mm) and 0.23 mm (range, 0.13–0.37 mm), respectively. The mean of the FABF diameter was 0.15 mm (range, 0.08–0.30 mm). Conclusions: Although FABF did not accurately reflect the diameter of the apical canal at the WL, CBCT imaging showed good accuracy and reliability. Data from CBCT imaging regarding the initial apical canal size may be used to plan root canal enlargement. Highlights:The accuracy of FABF and CBCT for apical canal gauging was evaluated.High‐resolution micro‐CT imaging was used as the gold standard.CBCT imaging showed moderate accuracy and good reliability.The FABF was inaccurate and unreliable. The mean FABF diameter was 0.15 mm.
AIM To evaluate the effectiveness of a solvent (eucalyptol) in improving filling material removal... more AIM To evaluate the effectiveness of a solvent (eucalyptol) in improving filling material removal from canals connected by isthmuses, and the additional cleaning effect of a finishing instrument. METHODOLOGY The mesial canals from 32 mandibular molars (Vertucci's type II morphology) were instrumented and filled with the single-cone technique using Reciproc R25 gutta-percha points (VDW, Munich, Germany) combined with Sealer 26 (Dentsply, Petrópolis, RJ, Brazil). Each root was then subjected to retreatment using the Mtwo instrument system (VDW), with or without a solvent (n = 16 per group). The volume of filling material in the canals was assessed by micro-computed tomographic (micro-CT) scans taken before and after retreatment. Canals with remnants of filling material received a supplementary procedure with the XP-endo Finisher R instrument (FKG Dentaire, La Chaux-de-Fonds, Switzerland), with or without eucalyptol, and another micro-CT scan was taken. All retreatment procedures were performed inside a cabinet under a controlled temperature (37 °C). Filling material removal was evaluated in the 5-mm apical canal system for the canal+isthmus space or the isthmus alone. Statistical analyses were performed to compare the removal of filling material with and without eucalyptol, and after a supplementary approach with XP-endo Finisher R. The level of significance was set at 5% for all statistical tests (P < 0.05). RESULTS The amount of filling material removed from the canal+isthmus with Mtwo instruments was 83.2% when no solvent was used and 83.8% using the solvent (P > 0.05). When the isthmus area was evaluated separately, most specimens were associated with a reduction in the filling material, with no significant difference between the groups with or without using a solvent (P > 0.05). The supplementary step with XP-endo Finisher R significantly improved removal of filling material from both canal and isthmus area (P < 0.05), regardless of the use of a solvent (P > 0.05). CONCLUSION The use of eucalyptol did not improve filling material removal from Vertucci's type II molar mesial canals and isthmuses. XP-endo Finisher R significantly enhanced removal of filling material from the canals and isthmuses.
To microscopically examine the cleanliness of root canal walls that remained unprepared as reveal... more To microscopically examine the cleanliness of root canal walls that remained unprepared as revealed by micro-CT. The root canals of 10 freshly extracted mandibular premolars with necrotic pulps and apical periodontitis along with the mesiobuccal canals of 11 mandibular molars with vital pulps were prepared using Reciproc instruments R40 and R25, respectively, and 2.5% sodium hypochlorite irrigation. Specimens were scanned in micro-CT before and after preparation, and the unprepared areas were identified. The outer root surface corresponding to the untouched areas was marked on each root third to guide further analysis using histological (for teeth with vital pulps) and scanning electron microscopic (SEM; for necrotic teeth) examination. In the teeth with vital pulps, the root canal area occupied by tissue remnants was calculated. In SEM analysis of teeth with necrotic pulps, scores were attributed for the amount of debris on the untouched areas. The proportion of unprepared areas in the mesiobuccal molar canals was 18.1% and 9.6% over the full canal length and apical canal, respectively. In premolars, corresponding figures were 34.6% and 17.6%, respectively. Histological analysis of canals with vital pulps revealed tissue remnants over the untouched walls almost exclusively in the apical canal. SEM analysis of the canals with necrotic pulps revealed debris along the untouched walls in all root canal thirds. The areas that remain untouched by Reciproc instruments used with 2.5% NaOCl irrigation as revealed by micro-CT analysis were usually covered with debris, in the form of pulp tissue remnants, bacteria and dentine chips, especially in the apical root canal.
This study evaluated the influence of flexibility and reciprocating movement on the fatigue life ... more This study evaluated the influence of flexibility and reciprocating movement on the fatigue life of endodontic instruments subjected to static and dynamic tests. The rotary nickel-titanium instruments used in this study were Reciproc and Mtwo. The instruments were initially subjected to a cantilever-bending test and then to static and dynamic fatigue tests. Reciproc instruments were operated in reciprocating movement, whereas Mtwo instruments were worked in continuous rotation. The means of bending resistance (maximum load in grams) of the instruments were 274.9 for Reciproc and 429 for Mtwo. The mean times (in seconds) to fracture of the instruments subjected to static and dynamic tests were 214.5 (static) and 286.3 (dynamic) for Reciproc and 38.9 (static) and 99 (dynamic) for Mtwo. The Student's t test revealed significant differences in all tests (P < .05). The results of the present study showed longer fatigue life for instruments with higher flexibility, driven by recipr...
This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-t... more This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-titanium instruments, followed by 2 distinct adjunctive procedures in the root canals of extracted mandibular molars by means of a correlative analytical approach. Twenty-two extracted mandibular molars were selected and anatomically matched between groups on the basis of micro-computed tomographic analysis. In the first phase of the experiment, root canals were contaminated with Enterococcus faecalis and subjected to chemomechanical preparation with BT RaCe instruments and 2.5% NaOCl irrigation. Then either XP-Endo Finisher instrument or passive ultrasonic irrigation was used to supplement disinfection. Micro-computed tomography was used to show whether the percentage of unprepared areas correlated to bacterial counts. In the second phase, the same teeth were contaminated once again, and the adjunctive procedures were used. Samples from the isthmus area of mesial roots and the apical 5-mm fragment of distal roots were obtained by cryopulverization. Samples taken before and after treatment steps in both phases were evaluated by quantitative polymerase chain reaction and statistically analyzed. In phase 1, preparation in both groups resulted in substantial decrease of bacterial counts (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). The adjunctive approaches led to a further small bacterial reduction, which was significant for XP-Endo Finisher (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). No significant differences were observed between groups for persisting bacterial counts. Correlative analysis revealed no statistically significant relationship between bacterial reduction and the percentage of unprepared areas (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). In phase 2, both methods had significant antibacterial effects in the main canal, but none of them could predictably disinfect the isthmus/recess areas. Both XP-Endo Finisher and passive ultrasonic irrigation exhibited antibacterial effectiveness, but only the former caused a significant reduction in the bacterial counts after chemomechanical preparation. None of them were effective in predictably disinfecting the isthmus/recess areas.
La barodontalgia no es una patología en sí misma, sino un síntoma de un problema oral subclínico ... more La barodontalgia no es una patología en sí misma, sino un síntoma de un problema oral subclínico que, si bien es poco frecuente, puede afectar a pacientes sometidos a cambios en la presión atmosférica y afectar la seguridad de los vuelos. Este artículo pretende analizar las características clínicas de las patologías relacionadas con la etiología de la barodontalgia, así como los diagnósticos diferenciales, los tratamientos
Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine rem... more Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine removal: a micro-computed tomography study. International Endodontic Journal. Aim To evaluate the effects of progressive apical enlargement on the amount of unprepared root canal surface area and remaining dentine thickness. Methodology The root canals of 30 extracted mandibular incisors with Vertucci 0 s type I configuration were instrumented with rotary HyFlex CM instruments (Coltene-Whaledent, Altst€ atten, Switzer-land) up to 4 instruments larger than the first one that bound at the working length (WL). Teeth were scanned in a micro-computed tomography (micro-CT) device before canal preparation and after instrumen-tation with the 2nd, 3rd and 4th larger instruments. The amount of unprepared surface area in the full canal or in the apical 4 mm as well as the remaining dentine thickness at 10 mm from the WL were calculated and compared. The general linear model for repeated measures adjusted by Bonferroni&#39;s post hoc test was used for statistic analysis. Results There was a significant reduction in the amount of unprepared areas after each increase in preparation size (P &lt; 0.01). This was observed for both the full canal length and the 4-mm apical segment. The amount of remaining dentine was also significantly reduced after each file size (P &lt; 0.01). However, dentine thickness always remained greater than 1 mm, even after using the largest instrument. Conclusion Apical preparations up to 4 instruments larger than the first one to bind at the WL caused a significant progressive reduction in the unprepared canal area.
This study used a multipurpose analytic approach to compare the levels of apically extruded bacte... more This study used a multipurpose analytic approach to compare the levels of apically extruded bacterial and hard tissue debris as well as intracanal bacterial reduction after root canal preparation with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) or Reciproc (VDW, Munich, Germany) instruments. Distobuccal canals from extracted maxillary molars were contaminated with Enterococcus faecalis and randomly distributed into 2 groups according to the instrumentation system: the XP-endo Shaper or Reciproc. Teeth were mounted in an apparatus that simulates the apical resistance offered by the periapical tissues and permitted to collect debris extruded during preparation. Saline was used as the irrigant during preparation, and all treatment procedures were performed inside a cabinet under a controlled temperature of 37°C. DNA extracts from samples taken from the canal before and after preparation were subjected to quantitative real-time polymerase chain reaction for E. f...
The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval... more The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval canals of extracted vital teeth using a correlative analytic approach. Oval distal canals from 33 freshly extracted mandibular molars with pulp vitality were scanned by micro-computed tomographic (micro-CT) imaging for sample selection. Specimens matched by anatomic similarities were distributed into 3 experimental groups according to the instrument system to be evaluated: the Self-Adjusting File (SAF; ReDentNOVA, Ra&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;anana, Israel), TRUShape (Dentsply Sirona, Tulsa, OK), and XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The irrigant was 5.25% sodium hypochlorite heated at 37°C. After rescanning with micro-CT imaging, the unprepared surface areas were identified, measured, and then histologically evaluated for the amount of pulp remnants in each root third. When the apical 4-mm canal segment was evaluated, the SAF exhibited significantly less unprepared areas than the XP-endo Shaper (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05), and there were no significant differences for the other comparisons (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Analysis of the full canal length showed no statistically significant differences between the 3 tested systems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Likewise, the tested systems did not differ significantly in cleaning the unprepared walls (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). There was no significant difference in the amount of unprepared surface areas between the 3 instrument systems, except for the comparison between the SAF and XP-endo Shaper in the apical 4-mm segment. None of them prepared 100% of the root canal walls. The cleaning ability of the 3 systems was similar.
Journal of clinical and experimental dentistry, 2017
To compare the quality of calcium hydroxide paste fillings performed by three different technique... more To compare the quality of calcium hydroxide paste fillings performed by three different techniques. Sixty extracted maxillary central incisors, with previous root canal treatment, were decoronated and the gutta-percha was completely removed from the root canals. Subsequently, the canals were filled with a calcium hydroxide-based paste composed of calcium hydroxide, bismuth carbonate, and glycerin. The study samples were divided into the following three groups on the basis of three insertion techniques (n = 20, each): conventional technique using a hand instrument (MAN), rotary Lentulo spiral (LEN) technique, and a combined technique combining conventional hand files with sonic activation through the EndoActivator device (EA). The quality of fillings was evaluated radiographically by two examiners on the basis of the amount of voids and the apical limit. The canals filled with LEN or MAN had less void volume compared to the EA technique (P >0.01), with no significant differences b...
This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe... more This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) imaging. A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time. There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root...
The purpose of this study was to compare the shaping properties of TRUShape and Reciproc systems ... more The purpose of this study was to compare the shaping properties of TRUShape and Reciproc systems during preparation of oval-shaped canals from contralateral teeth by using micro-computed tomography scanning. Thirteen pairs of freshly extracted contralateral mandibular premolars with a single oval-shaped canal were selected and divided into 2 groups according to the root canal instrumentation technique, TRUShape and Reciproc. The final apical size of instrumentation was 40/.06 for both systems. Data were statistically analyzed for the increase in canal volume and surface area and the amount of unprepared areas promoted by the 2 systems. Preparation with both systems significantly increased the volume and area of the canals (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), with no significant differences between them (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). When the full canal length was evaluated, the amount of uninstrumented areas was significantly larger for Reciproc (30%) than TRUShape (24%) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). However, analysis restricted to the apical 4-mm segment revealed no statistically significant difference in untouched areas (25% for Reciproc and 20% for TRUShape) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Both instrument systems behaved similarly in promoting the increase of root canal volume and surface area. When the full canal length was evaluated, TRUShape instruments showed less unprepared areas than Reciproc. However, this difference did not occur for the apical part of the root canal. None of the techniques could completely prepare oval-shaped root canals.
Objective: The aim of the present study was to compare the effects of EasyClean (EC) on irrigant ... more Objective: The aim of the present study was to compare the effects of EasyClean (EC) on irrigant delivery into simulated lateral canals using an artificial closed canal system. Passive ultrasonic irrigation (PUI) was used as a reference technique for comparison. Materials and Methods: Forty simulated curved root canals manufactured in clear resin and with simulated lateral canals were instrumented with Reciproc R40 files and randomly assigned to four groups (n = 10) according to the irrigant activation technique: PUI group, ECrec group (EC used in reciprocating motion), ECrot group (EC used in rotary motion), and control group (no activation performed). After activation, stereomicro-scope images from each block were taken, and irrigant penetration into lateral canals was measured using Adobe Photoshop software. Data were analysed using ANOVA and Tukey&#39;s post hoc test (α = 0.05). Results: No penetration was observed in the control group. The ECrec group showed lower penetration than the other group (P&lt;0.05). No differences were observed between the ECrot group and the PUI group (P&gt;0.05). Conclusion: EC used in rotary motion was effective in increasing the penetration of the irrigating solution into simulated lateral canals.
Objectives: Bacterial reduction in oval-shaped root canals by a single-instrument technique was c... more Objectives: Bacterial reduction in oval-shaped root canals by a single-instrument technique was compared ex vivo with a conventional nickel-titanium rotary technique. The additional effects of sonic or ultrasonic activation of NaOCl after instrumentation were also analyzed. Data obtained from two quantification methods - quantitative real-time polymerase chain reaction (qPCR) and culture - were also compared. Methods: Oval canals of extracted teeth contaminated with Enterococcus faecalis were instrumented using either a single Reciproc instrument or the BioRaCe instrument series. Supplementary disinfection was also tested by sonically (EndoActivator) or ultrasonically activating NaOCl after preparation with Reciproc or BioRaCe instruments, respectively. Bacteriological samples were taken before (S1), after instrumentation (S2), and after NaOCl activation (S3). Bacterial quantification was performed using qPCR and culture. Results: Intergroup analysis (S2 samples) showed no significa...
A new manufacturing method aiming at to producing more flexible and resistant NiTi endodontic ins... more A new manufacturing method aiming at to producing more flexible and resistant NiTi endodontic instruments has been recently developed (Hyflex, produced with CM wire). The purpose of the study was to determine whether this new manufacturing method produces NiTi instruments (Hyflex) of superior flexibility and/or superior resistance to cyclic fatigue, when compared with instruments produced by a traditional manufacturing process or thermally treated NiTi alloy (M-wire). Twelve .06 size 25 Hyflex instruments (Coltene, Allstatten, Switzerland), and twelve 06.25 Vortex instruments (Dentsply-Tulsa, OK, USA) and twelve 06.25 Endosequence instruments (Brasseler, Savannah, GA, USA) were initially evaluated for stiffness on bending, followed by a cyclic fatigue test. For the stiffness test test procedures strictly followed ISO 3630-1, and bending moment was measured when the instrument attained a 45 degrees bend. The cyclic fatigue test was performed in a customized artificial stainless steel...
This in vitro study evaluated the time-dependent ability of the self-adjusting file (SAF) used wi... more This in vitro study evaluated the time-dependent ability of the self-adjusting file (SAF) used with either of two NaOCl concentrations to reduce bacterial populations in long oval root canals. Oval-shaped canals from extracted teeth were infected with Enterococcus faecalis for 30 days and subjected to preparation with the SAF system using continuous irrigation with either 2.5% NaOCl (n = 11) or 6% NaOCl (n = 11). Bacteriological samples were taken before preparation (baseline) and after 2, 4, and 6 minutes of SAF operation. Intragroup quantitative analyses revealed that the SAF operating for 2, 4, or 6 minutes yielded a highly significant bacterial reduction when compared with counts at baseline (P < .001) irrespective of the NaOCl concentration. No significant differences were found for intragroup analyses comparing the three time periods (P > .05). Likewise, intergroup quantitative analysis showed no significant difference for the SAF with 2.5% NaOCl or 6% NaOCl during 2, 4,...
This ex vivo study evaluated the disinfecting and shaping ability of 3 protocols used in the prep... more This ex vivo study evaluated the disinfecting and shaping ability of 3 protocols used in the preparation of mesial root canals of mandibular molars by means of correlative bacteriologic and micro-computed tomographic (μμCT) analysis. The mesial canals of extracted mandibular molars were contaminated with Enterococcus faecalis for 30 days and assigned to 3 groups based on their anatomic configuration as determined by μCT analysis according to the preparation technique (Self-Adjusting File [ReDent-Nova, Ra'anana, Israel], Reciproc [VDW, Munich, Germany], and Twisted File [SybronEndo, Orange, CA]). In all groups, 2.5% NaOCl was the irrigant. Canal samples were taken before (S1) and after instrumentation (S2), and bacterial quantification was performed using culture. Next, mesial roots were subjected to additional μCT analysis in order to evaluate shaping of the canals. All instrumentation protocols promoted a highly significant intracanal bacterial reduction (P < .001). Intergro...
Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is character... more Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is characterized by a burning or twinging sensation or by partial loss of local sensitivity. Paresthesia related to endodontic treatment can occur because of extravasation of filling material or the intracanal dressing, as a consequence of periapical surgery or because of periapical infection. A literature review of paresthesia in endodontics was undertaken, with a view to identifying and discussing the most commonly affected nerves, the diagnostic process and the treatment options. Among reported cases, the most commonly affected nerves were those passing through the jaw: the inferior alveolar nerve, the mental nerve and the lingual nerve. To diagnose paresthesia, the endodontist must carry out a complete medical history, panoramic and periapical radiography, and (in some cases) computed tomography, as well as mechanoceptive and nociceptive tests. To date, no specific treatment for endodontic-relat...
This study evaluated the antibiofilm effects of 2 endodontic sealers incorporated with quaternary... more This study evaluated the antibiofilm effects of 2 endodontic sealers incorporated with quaternary ammonium polyethylenimine (QPEI) nanoparticles at a 2% concentration (w/w). The materials tested were AH Plus and Pulp Canal Sealer EWT (PCS) in the commercial unmodified form or containing 2% QPEI. Antibiofilm assays were conducted by using direct-contact and membrane-restricted tests for evaluation of bacterial viability in biofilms grown onto membranes or paper disks and the crystal violet microtiter-plate assay to evaluate the effects of sealer extracts on the biofilm biomass. Two Enterococcus faecalis strains (ATCC and an endodontic isolate) were used. Direct contact and membrane-restricted antibiofilm tests revealed that PCS 2% was the only material to promote total killing of E. faecalis ATCC biofilms. All the materials significantly reduced bacterial counts in E. faecalis ATCC biofilms when compared with the positive control in both tests (P < .05). In the direct test against...
This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-t... more This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. Fifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicula...
Introduction: This study evaluated the accuracy and reliability of the tactile perception of the ... more Introduction: This study evaluated the accuracy and reliability of the tactile perception of the first apical binding file (FABF) and cone‐beam computed tomographic (CBCT) imaging in estimating the canal diameter at the working length (WL). Methods: Ten anterior mandible segments were obtained from cadavers maintained in formalin and scanned using CBCT and high‐resolution micro–computed tomographic (micro‐CT) imaging. Scans were used to measure the smallest canal diameter of 38 mandibular incisors at 1 mm short of the root apex. After coronal access preparation, the canals of these teeth were explored with a size 08 K‐file up to the radiographic apex, and the WL was established 1 mm shorter. Larger K‐files were passively introduced in the canal up to the WL until binding was felt and the next instrument size could not reach this point. This instrument was regarded as the FABF. The accuracy and level of agreement (reliability) of the FABF and CBCT imaging in determining the initial apical canal size were determined using the Pearson correlation coefficient and the intraclass correlation coefficient, respectively, considering the micro‐CT measurements as the gold standard. Results: The Pearson correlation coefficient and the intraclass correlation coefficient were statistically significant when CBCT imaging was compared with micro‐CT imaging (P < .01), showing a moderate accuracy (r = 0.61) and good reliability (0.74). On the other hand, FABF was inaccurate and unreliable (P > .05). The means of the smallest root canal diameter obtained by micro‐CT and CBCT imaging were 0.22 mm (range, 0.14–0.34 mm) and 0.23 mm (range, 0.13–0.37 mm), respectively. The mean of the FABF diameter was 0.15 mm (range, 0.08–0.30 mm). Conclusions: Although FABF did not accurately reflect the diameter of the apical canal at the WL, CBCT imaging showed good accuracy and reliability. Data from CBCT imaging regarding the initial apical canal size may be used to plan root canal enlargement. Highlights:The accuracy of FABF and CBCT for apical canal gauging was evaluated.High‐resolution micro‐CT imaging was used as the gold standard.CBCT imaging showed moderate accuracy and good reliability.The FABF was inaccurate and unreliable. The mean FABF diameter was 0.15 mm.
AIM To evaluate the effectiveness of a solvent (eucalyptol) in improving filling material removal... more AIM To evaluate the effectiveness of a solvent (eucalyptol) in improving filling material removal from canals connected by isthmuses, and the additional cleaning effect of a finishing instrument. METHODOLOGY The mesial canals from 32 mandibular molars (Vertucci's type II morphology) were instrumented and filled with the single-cone technique using Reciproc R25 gutta-percha points (VDW, Munich, Germany) combined with Sealer 26 (Dentsply, Petrópolis, RJ, Brazil). Each root was then subjected to retreatment using the Mtwo instrument system (VDW), with or without a solvent (n = 16 per group). The volume of filling material in the canals was assessed by micro-computed tomographic (micro-CT) scans taken before and after retreatment. Canals with remnants of filling material received a supplementary procedure with the XP-endo Finisher R instrument (FKG Dentaire, La Chaux-de-Fonds, Switzerland), with or without eucalyptol, and another micro-CT scan was taken. All retreatment procedures were performed inside a cabinet under a controlled temperature (37 °C). Filling material removal was evaluated in the 5-mm apical canal system for the canal+isthmus space or the isthmus alone. Statistical analyses were performed to compare the removal of filling material with and without eucalyptol, and after a supplementary approach with XP-endo Finisher R. The level of significance was set at 5% for all statistical tests (P < 0.05). RESULTS The amount of filling material removed from the canal+isthmus with Mtwo instruments was 83.2% when no solvent was used and 83.8% using the solvent (P > 0.05). When the isthmus area was evaluated separately, most specimens were associated with a reduction in the filling material, with no significant difference between the groups with or without using a solvent (P > 0.05). The supplementary step with XP-endo Finisher R significantly improved removal of filling material from both canal and isthmus area (P < 0.05), regardless of the use of a solvent (P > 0.05). CONCLUSION The use of eucalyptol did not improve filling material removal from Vertucci's type II molar mesial canals and isthmuses. XP-endo Finisher R significantly enhanced removal of filling material from the canals and isthmuses.
To microscopically examine the cleanliness of root canal walls that remained unprepared as reveal... more To microscopically examine the cleanliness of root canal walls that remained unprepared as revealed by micro-CT. The root canals of 10 freshly extracted mandibular premolars with necrotic pulps and apical periodontitis along with the mesiobuccal canals of 11 mandibular molars with vital pulps were prepared using Reciproc instruments R40 and R25, respectively, and 2.5% sodium hypochlorite irrigation. Specimens were scanned in micro-CT before and after preparation, and the unprepared areas were identified. The outer root surface corresponding to the untouched areas was marked on each root third to guide further analysis using histological (for teeth with vital pulps) and scanning electron microscopic (SEM; for necrotic teeth) examination. In the teeth with vital pulps, the root canal area occupied by tissue remnants was calculated. In SEM analysis of teeth with necrotic pulps, scores were attributed for the amount of debris on the untouched areas. The proportion of unprepared areas in the mesiobuccal molar canals was 18.1% and 9.6% over the full canal length and apical canal, respectively. In premolars, corresponding figures were 34.6% and 17.6%, respectively. Histological analysis of canals with vital pulps revealed tissue remnants over the untouched walls almost exclusively in the apical canal. SEM analysis of the canals with necrotic pulps revealed debris along the untouched walls in all root canal thirds. The areas that remain untouched by Reciproc instruments used with 2.5% NaOCl irrigation as revealed by micro-CT analysis were usually covered with debris, in the form of pulp tissue remnants, bacteria and dentine chips, especially in the apical root canal.
This study evaluated the influence of flexibility and reciprocating movement on the fatigue life ... more This study evaluated the influence of flexibility and reciprocating movement on the fatigue life of endodontic instruments subjected to static and dynamic tests. The rotary nickel-titanium instruments used in this study were Reciproc and Mtwo. The instruments were initially subjected to a cantilever-bending test and then to static and dynamic fatigue tests. Reciproc instruments were operated in reciprocating movement, whereas Mtwo instruments were worked in continuous rotation. The means of bending resistance (maximum load in grams) of the instruments were 274.9 for Reciproc and 429 for Mtwo. The mean times (in seconds) to fracture of the instruments subjected to static and dynamic tests were 214.5 (static) and 286.3 (dynamic) for Reciproc and 38.9 (static) and 99 (dynamic) for Mtwo. The Student's t test revealed significant differences in all tests (P < .05). The results of the present study showed longer fatigue life for instruments with higher flexibility, driven by recipr...
This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-t... more This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-titanium instruments, followed by 2 distinct adjunctive procedures in the root canals of extracted mandibular molars by means of a correlative analytical approach. Twenty-two extracted mandibular molars were selected and anatomically matched between groups on the basis of micro-computed tomographic analysis. In the first phase of the experiment, root canals were contaminated with Enterococcus faecalis and subjected to chemomechanical preparation with BT RaCe instruments and 2.5% NaOCl irrigation. Then either XP-Endo Finisher instrument or passive ultrasonic irrigation was used to supplement disinfection. Micro-computed tomography was used to show whether the percentage of unprepared areas correlated to bacterial counts. In the second phase, the same teeth were contaminated once again, and the adjunctive procedures were used. Samples from the isthmus area of mesial roots and the apical 5-mm fragment of distal roots were obtained by cryopulverization. Samples taken before and after treatment steps in both phases were evaluated by quantitative polymerase chain reaction and statistically analyzed. In phase 1, preparation in both groups resulted in substantial decrease of bacterial counts (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). The adjunctive approaches led to a further small bacterial reduction, which was significant for XP-Endo Finisher (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). No significant differences were observed between groups for persisting bacterial counts. Correlative analysis revealed no statistically significant relationship between bacterial reduction and the percentage of unprepared areas (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). In phase 2, both methods had significant antibacterial effects in the main canal, but none of them could predictably disinfect the isthmus/recess areas. Both XP-Endo Finisher and passive ultrasonic irrigation exhibited antibacterial effectiveness, but only the former caused a significant reduction in the bacterial counts after chemomechanical preparation. None of them were effective in predictably disinfecting the isthmus/recess areas.
La barodontalgia no es una patología en sí misma, sino un síntoma de un problema oral subclínico ... more La barodontalgia no es una patología en sí misma, sino un síntoma de un problema oral subclínico que, si bien es poco frecuente, puede afectar a pacientes sometidos a cambios en la presión atmosférica y afectar la seguridad de los vuelos. Este artículo pretende analizar las características clínicas de las patologías relacionadas con la etiología de la barodontalgia, así como los diagnósticos diferenciales, los tratamientos
Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine rem... more Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine removal: a micro-computed tomography study. International Endodontic Journal. Aim To evaluate the effects of progressive apical enlargement on the amount of unprepared root canal surface area and remaining dentine thickness. Methodology The root canals of 30 extracted mandibular incisors with Vertucci 0 s type I configuration were instrumented with rotary HyFlex CM instruments (Coltene-Whaledent, Altst€ atten, Switzer-land) up to 4 instruments larger than the first one that bound at the working length (WL). Teeth were scanned in a micro-computed tomography (micro-CT) device before canal preparation and after instrumen-tation with the 2nd, 3rd and 4th larger instruments. The amount of unprepared surface area in the full canal or in the apical 4 mm as well as the remaining dentine thickness at 10 mm from the WL were calculated and compared. The general linear model for repeated measures adjusted by Bonferroni&#39;s post hoc test was used for statistic analysis. Results There was a significant reduction in the amount of unprepared areas after each increase in preparation size (P &lt; 0.01). This was observed for both the full canal length and the 4-mm apical segment. The amount of remaining dentine was also significantly reduced after each file size (P &lt; 0.01). However, dentine thickness always remained greater than 1 mm, even after using the largest instrument. Conclusion Apical preparations up to 4 instruments larger than the first one to bind at the WL caused a significant progressive reduction in the unprepared canal area.
This study used a multipurpose analytic approach to compare the levels of apically extruded bacte... more This study used a multipurpose analytic approach to compare the levels of apically extruded bacterial and hard tissue debris as well as intracanal bacterial reduction after root canal preparation with either XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) or Reciproc (VDW, Munich, Germany) instruments. Distobuccal canals from extracted maxillary molars were contaminated with Enterococcus faecalis and randomly distributed into 2 groups according to the instrumentation system: the XP-endo Shaper or Reciproc. Teeth were mounted in an apparatus that simulates the apical resistance offered by the periapical tissues and permitted to collect debris extruded during preparation. Saline was used as the irrigant during preparation, and all treatment procedures were performed inside a cabinet under a controlled temperature of 37°C. DNA extracts from samples taken from the canal before and after preparation were subjected to quantitative real-time polymerase chain reaction for E. f...
The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval... more The present study evaluated the cleaning and shaping ability of 3 instrumentation systems in oval canals of extracted vital teeth using a correlative analytic approach. Oval distal canals from 33 freshly extracted mandibular molars with pulp vitality were scanned by micro-computed tomographic (micro-CT) imaging for sample selection. Specimens matched by anatomic similarities were distributed into 3 experimental groups according to the instrument system to be evaluated: the Self-Adjusting File (SAF; ReDentNOVA, Ra&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;anana, Israel), TRUShape (Dentsply Sirona, Tulsa, OK), and XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland). The irrigant was 5.25% sodium hypochlorite heated at 37°C. After rescanning with micro-CT imaging, the unprepared surface areas were identified, measured, and then histologically evaluated for the amount of pulp remnants in each root third. When the apical 4-mm canal segment was evaluated, the SAF exhibited significantly less unprepared areas than the XP-endo Shaper (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05), and there were no significant differences for the other comparisons (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Analysis of the full canal length showed no statistically significant differences between the 3 tested systems (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Likewise, the tested systems did not differ significantly in cleaning the unprepared walls (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). There was no significant difference in the amount of unprepared surface areas between the 3 instrument systems, except for the comparison between the SAF and XP-endo Shaper in the apical 4-mm segment. None of them prepared 100% of the root canal walls. The cleaning ability of the 3 systems was similar.
Journal of clinical and experimental dentistry, 2017
To compare the quality of calcium hydroxide paste fillings performed by three different technique... more To compare the quality of calcium hydroxide paste fillings performed by three different techniques. Sixty extracted maxillary central incisors, with previous root canal treatment, were decoronated and the gutta-percha was completely removed from the root canals. Subsequently, the canals were filled with a calcium hydroxide-based paste composed of calcium hydroxide, bismuth carbonate, and glycerin. The study samples were divided into the following three groups on the basis of three insertion techniques (n = 20, each): conventional technique using a hand instrument (MAN), rotary Lentulo spiral (LEN) technique, and a combined technique combining conventional hand files with sonic activation through the EndoActivator device (EA). The quality of fillings was evaluated radiographically by two examiners on the basis of the amount of voids and the apical limit. The canals filled with LEN or MAN had less void volume compared to the EA technique (P >0.01), with no significant differences b...
This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe... more This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) imaging. A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time. There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root...
The purpose of this study was to compare the shaping properties of TRUShape and Reciproc systems ... more The purpose of this study was to compare the shaping properties of TRUShape and Reciproc systems during preparation of oval-shaped canals from contralateral teeth by using micro-computed tomography scanning. Thirteen pairs of freshly extracted contralateral mandibular premolars with a single oval-shaped canal were selected and divided into 2 groups according to the root canal instrumentation technique, TRUShape and Reciproc. The final apical size of instrumentation was 40/.06 for both systems. Data were statistically analyzed for the increase in canal volume and surface area and the amount of unprepared areas promoted by the 2 systems. Preparation with both systems significantly increased the volume and area of the canals (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), with no significant differences between them (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). When the full canal length was evaluated, the amount of uninstrumented areas was significantly larger for Reciproc (30%) than TRUShape (24%) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). However, analysis restricted to the apical 4-mm segment revealed no statistically significant difference in untouched areas (25% for Reciproc and 20% for TRUShape) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .05). Both instrument systems behaved similarly in promoting the increase of root canal volume and surface area. When the full canal length was evaluated, TRUShape instruments showed less unprepared areas than Reciproc. However, this difference did not occur for the apical part of the root canal. None of the techniques could completely prepare oval-shaped root canals.
Objective: The aim of the present study was to compare the effects of EasyClean (EC) on irrigant ... more Objective: The aim of the present study was to compare the effects of EasyClean (EC) on irrigant delivery into simulated lateral canals using an artificial closed canal system. Passive ultrasonic irrigation (PUI) was used as a reference technique for comparison. Materials and Methods: Forty simulated curved root canals manufactured in clear resin and with simulated lateral canals were instrumented with Reciproc R40 files and randomly assigned to four groups (n = 10) according to the irrigant activation technique: PUI group, ECrec group (EC used in reciprocating motion), ECrot group (EC used in rotary motion), and control group (no activation performed). After activation, stereomicro-scope images from each block were taken, and irrigant penetration into lateral canals was measured using Adobe Photoshop software. Data were analysed using ANOVA and Tukey&#39;s post hoc test (α = 0.05). Results: No penetration was observed in the control group. The ECrec group showed lower penetration than the other group (P&lt;0.05). No differences were observed between the ECrot group and the PUI group (P&gt;0.05). Conclusion: EC used in rotary motion was effective in increasing the penetration of the irrigating solution into simulated lateral canals.
Objectives: Bacterial reduction in oval-shaped root canals by a single-instrument technique was c... more Objectives: Bacterial reduction in oval-shaped root canals by a single-instrument technique was compared ex vivo with a conventional nickel-titanium rotary technique. The additional effects of sonic or ultrasonic activation of NaOCl after instrumentation were also analyzed. Data obtained from two quantification methods - quantitative real-time polymerase chain reaction (qPCR) and culture - were also compared. Methods: Oval canals of extracted teeth contaminated with Enterococcus faecalis were instrumented using either a single Reciproc instrument or the BioRaCe instrument series. Supplementary disinfection was also tested by sonically (EndoActivator) or ultrasonically activating NaOCl after preparation with Reciproc or BioRaCe instruments, respectively. Bacteriological samples were taken before (S1), after instrumentation (S2), and after NaOCl activation (S3). Bacterial quantification was performed using qPCR and culture. Results: Intergroup analysis (S2 samples) showed no significa...
A new manufacturing method aiming at to producing more flexible and resistant NiTi endodontic ins... more A new manufacturing method aiming at to producing more flexible and resistant NiTi endodontic instruments has been recently developed (Hyflex, produced with CM wire). The purpose of the study was to determine whether this new manufacturing method produces NiTi instruments (Hyflex) of superior flexibility and/or superior resistance to cyclic fatigue, when compared with instruments produced by a traditional manufacturing process or thermally treated NiTi alloy (M-wire). Twelve .06 size 25 Hyflex instruments (Coltene, Allstatten, Switzerland), and twelve 06.25 Vortex instruments (Dentsply-Tulsa, OK, USA) and twelve 06.25 Endosequence instruments (Brasseler, Savannah, GA, USA) were initially evaluated for stiffness on bending, followed by a cyclic fatigue test. For the stiffness test test procedures strictly followed ISO 3630-1, and bending moment was measured when the instrument attained a 45 degrees bend. The cyclic fatigue test was performed in a customized artificial stainless steel...
This in vitro study evaluated the time-dependent ability of the self-adjusting file (SAF) used wi... more This in vitro study evaluated the time-dependent ability of the self-adjusting file (SAF) used with either of two NaOCl concentrations to reduce bacterial populations in long oval root canals. Oval-shaped canals from extracted teeth were infected with Enterococcus faecalis for 30 days and subjected to preparation with the SAF system using continuous irrigation with either 2.5% NaOCl (n = 11) or 6% NaOCl (n = 11). Bacteriological samples were taken before preparation (baseline) and after 2, 4, and 6 minutes of SAF operation. Intragroup quantitative analyses revealed that the SAF operating for 2, 4, or 6 minutes yielded a highly significant bacterial reduction when compared with counts at baseline (P < .001) irrespective of the NaOCl concentration. No significant differences were found for intragroup analyses comparing the three time periods (P > .05). Likewise, intergroup quantitative analysis showed no significant difference for the SAF with 2.5% NaOCl or 6% NaOCl during 2, 4,...
This ex vivo study evaluated the disinfecting and shaping ability of 3 protocols used in the prep... more This ex vivo study evaluated the disinfecting and shaping ability of 3 protocols used in the preparation of mesial root canals of mandibular molars by means of correlative bacteriologic and micro-computed tomographic (μμCT) analysis. The mesial canals of extracted mandibular molars were contaminated with Enterococcus faecalis for 30 days and assigned to 3 groups based on their anatomic configuration as determined by μCT analysis according to the preparation technique (Self-Adjusting File [ReDent-Nova, Ra'anana, Israel], Reciproc [VDW, Munich, Germany], and Twisted File [SybronEndo, Orange, CA]). In all groups, 2.5% NaOCl was the irrigant. Canal samples were taken before (S1) and after instrumentation (S2), and bacterial quantification was performed using culture. Next, mesial roots were subjected to additional μCT analysis in order to evaluate shaping of the canals. All instrumentation protocols promoted a highly significant intracanal bacterial reduction (P < .001). Intergro...
Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is character... more Paresthesia is a neurosensitivity disorder caused by injury to the neural tissue. It is characterized by a burning or twinging sensation or by partial loss of local sensitivity. Paresthesia related to endodontic treatment can occur because of extravasation of filling material or the intracanal dressing, as a consequence of periapical surgery or because of periapical infection. A literature review of paresthesia in endodontics was undertaken, with a view to identifying and discussing the most commonly affected nerves, the diagnostic process and the treatment options. Among reported cases, the most commonly affected nerves were those passing through the jaw: the inferior alveolar nerve, the mental nerve and the lingual nerve. To diagnose paresthesia, the endodontist must carry out a complete medical history, panoramic and periapical radiography, and (in some cases) computed tomography, as well as mechanoceptive and nociceptive tests. To date, no specific treatment for endodontic-relat...
This study evaluated the antibiofilm effects of 2 endodontic sealers incorporated with quaternary... more This study evaluated the antibiofilm effects of 2 endodontic sealers incorporated with quaternary ammonium polyethylenimine (QPEI) nanoparticles at a 2% concentration (w/w). The materials tested were AH Plus and Pulp Canal Sealer EWT (PCS) in the commercial unmodified form or containing 2% QPEI. Antibiofilm assays were conducted by using direct-contact and membrane-restricted tests for evaluation of bacterial viability in biofilms grown onto membranes or paper disks and the crystal violet microtiter-plate assay to evaluate the effects of sealer extracts on the biofilm biomass. Two Enterococcus faecalis strains (ATCC and an endodontic isolate) were used. Direct contact and membrane-restricted antibiofilm tests revealed that PCS 2% was the only material to promote total killing of E. faecalis ATCC biofilms. All the materials significantly reduced bacterial counts in E. faecalis ATCC biofilms when compared with the positive control in both tests (P < .05). In the direct test against...
This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-t... more This cross-sectional study determined the prevalence of apical periodontitis in 1086 root canal-treated teeth from an urban Colombian population and evaluated the association of several factors with the periradicular status. Periapical radiographs were used for analyses, and teeth were classified as healthy or diseased according to the periradicular status. Other factors were also evaluated for their association with the periradicular conditions, including gender, quality of both endodontic treatment and coronal restoration, apical level of filling, and presence of post restoration. Fifty-one percent of the treated teeth were classified as healthy. Only 33% of the teeth had endodontic treatment rated as adequate. The quality of both endodontic treatment and coronal restoration significantly influenced the periradicular conditions (P < .001). Combined data revealed that teeth with both adequate endodontic treatment and adequate restorations showed significantly better periradicula...
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Papers by Flávio Alves