0000000000136356
AUTHOR
Leopoldo Forner
Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions
Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies. Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics. Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant lite…
Evaluation of cytocompatibility of calcium silicate-based endodontic sealers and their effects on the biological responses of mesenchymal dental stem cells.
Aim To investigate in vitro the cytocompatibility of the calcium silicate-containing endodontic sealers MTA Fillapex and TotalFill BC Sealer on human periodontal ligament stem cells (hPDLSCs) by assaying their biological responses and compare them with that observed when using an epoxy resin-based sealer (AH Plus). Methodology Specimens from the three different endodontic sealers were eluated with culture medium for 24 h. The cytotoxicity of these eluates was evaluated using the MTT assay. In addition, an in vitro scratch wound healing model was used to determine their effects on cell migration. Cell adhesion to collagen type I after treatment with the different sealer eluates was also meas…
Comparative Biological Properties and Mineralization Potential of 3 Endodontic Materials for Vital Pulp Therapy: Theracal PT, Theracal LC, and Biodentine on Human Dental Pulp Stem Cells.
INTRODUCTION The aim of this study was to assess the biological properties and mineralization potential of the new Theracal PT (Bisco Inc, Schaumburg, IL) compared with its predecessor Theracal LC (Bisco Inc) and the hydraulic silicate-based cement Biodentine (Septodont, Saint-Maur-des-Fosses, France) on human dental pulp stem cells (hDPSCs) in vitro. METHODS Standardized sample discs were obtained for each material (n = 30) together with 1:1, 1:2, and 1:4 material eluates. Previously characterized hDPSCs were cultured with the different materials in standardized conditions, and the following assays were performed: a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, a woun…
Inclusion of the periodontal ligament in studies on the biomechanical behavior of fiber post-retained restorations: An in vitro study and three-dimensional finite element analysis.
Endodontically treated teeth are known to have reduced structural strength. Periodontal ligament may influence fracture resistance. The purpose of this study was to assess the influence of including the periodontal ligament in biomechanical studies about endodontically treated and restored teeth. Forty human maxillary central incisors were treated endodontically and randomly divided into four groups: non-crowned (with and without an artificial ligament) and crowned (with and without an artificial ligament) with glass-ceramic crowns. All groups received prefabricated glass-fiber posts and a composite resin core. Specimens were tested, under a flexural–compressive load, until failure occurre…
Comparison of diffusion, cytotoxicity and tissue inflammatory reactions of four commercial bleaching products against human dental pulp stem cells
AbstractMultiple side effects related to bleaching were found to occur in the dental pulp tissue, including decreased cell metabolism and viability. In this work we evaluated the in vitro diffusion capacity, cytotoxicity and biocompatibility of four commercial bleaching products on stem cells from human dental pulp (hDPSCs). Two commercial bleaching gels hydrogen peroxide-based (HP), Norblanc Office 37.5% (Nor-HP) and Opalescence Boost 40% (Opal-HP) were applied for 30 min to enamel/dentine discs. Another two gels from the same manufacturers, 16% carbamide peroxide-based (CP), Norblanc Home (Nor-CP) and Opalescence CP 16% (Opal-CP), were applied for 90 min. The diffusion of HP was analysed …
The Use of Atomic Force Microscopy in Determining the Stiffness and Adhesion Force of Human Dentin After Exposure to Bleaching Agents
Introduction: Oxidant bleaching agents may induce several alterations on mineralized teeth tissues. Our aim is to study,at the ultrastructurallevel,mechanicalmodifications induced on dentin after exposure to different bleaching agents.Methods: Nanoindentation performed with atomic force microscopy was used to measure changes in dentin stiffness as well as the adhesion force between the tip and the tissue both in intertubular and peritubulardentin.Foreachspecimen,dentinlocalization, and bleaching agent, 100 independent nanoindentations were performed. Carbamide peroxide (30%) and hydrogenperoxide(35%) wereusedasbleaching agents. Results: A significant reduction of both stiffness and adhesion…
Follow‐up of patients subjected to direct and indirect pulp capping of young permanent teeth. A retrospective study
Abstract Objective A retrospective study of the success rate of direct pulp capping (DPC) and indirect pulp capping (IPC) was carried out in children between 6–14 years‐old, considering separately primary caries or caries affecting teeth with molar incisor hypomineralization (MIH). Material and methods Data were collected in a dental public health service. Following the inclusion criteria, 232 treatments were analyzed. Success was defined by the presence of a functional tooth without clinical signs or symptoms of pulpal or periapical disease. The success rate was correlated to patient gender, the affected tooth and the indication of therapy using the chi‐squared and Fisher exact test. The s…
Thermo-setting glass ionomer cements promote variable biological responses of human dental pulp stem cells.
To evaluate the in vitro cytotoxicity of Equia Forte (GC, Tokyo, Japan) and Ionostar Molar (Voco, Cuxhaven, Germany) on human dental pulp stem cells (hDPSCs).hDPSCs isolated from third molars were exposed to several dilutions of Equia Forte and Ionostar Molar eluates (1/1, 1/2 and 1/4). These eluates were obtained by storing material samples in respective cell culture medium for 24h (n=40). hDPSCs in basal growth culture medium were the control. Cell viability and cell migration assays were performed using the MTT and wound-healing assays, respectively. Also, induction of apoptosis and changes in cell phenotype were evaluated by flow cytometry. Changes in cell morphology were analysed by im…
Effect of Hydrogen and Carbamide Peroxide in Bleaching, Enamel Morphology, and Mineral Composition: In vitro Study
ABSTRACT Aim The aim of the study was to evaluate the bleaching effect, morphological changes, and variations in calcium (Ca) and phosphate (P) in the enamel with hydrogen peroxide (HP) and carbamide peroxide (CP) after the use of different application regimens. Materials and methods Four groups of five teeth were randomly assigned, according to the treatment protocol: HP 37.5% applied for 30 or 60 minutes (HP30, HP60), CP 16% applied for 14 or 28 hours (CP14, CP28). Changes in dental color were evaluated, according to the following formula: ΔE = [(La−Lb)2+(aa−ab)2 + (ba−bb)2]½. Enamel morphology and Ca and P compositions were evaluated by confocal laser scanning microscope and environmenta…
Evaluation of morphological changes produced by orifice opener systems using computerized tomography (CT)
Objectives: To evaluate modifications in root canal morphology following instrumentation with orifice openers using Computerized Tomography (CT). Study design: Experimental in vitro study. A preoperative CT was performed on 49 molars to measure the root canal cross-sections. After preparing the canals with 6 different nickel-titanium (Ni-Ti) rotary system orifice opener type instruments and Gates Glidden burs, a further CT was made and compared with the preoperative one. Kruskal-Wallis and ANOVA statistical analysis were used. Results: Gates Glidden burs were significantly more aggressive in the coronal portion of the canals, although all the instruments removed more dental tissue in the mo…
Root canal adaptation and intra-tubular penetration of three fiber-post cementation systems
Background To measure the penetration of three bonding systems for the luting of fiber glass posts in endodontically treated teeth, using confocal laser scanning microscopy (CLSM). Material and Methods A total of 30 maxillary incisors were shaped with the Mtwo system and filled with gutta-percha and Top Seal cement. The sample was divided into three groups (ni=10) according to the bonding system used to cement the posts: Group 1 (Prime&Bond NT and Rebilda DC with a total-etch technique); Group 2 (Futurabond DC and Rebilda DC with a dentin self-etch technique); and Group 3 (BisCem self-adhesive cement). Rhodamine B was added to the bonding systems to allow visualization by CLSM. Three 1-mm t…
Parental satisfaction with children's primary dental care in Valencia, Spain.
Aim To evaluate parents’ satisfaction with the dental care that their children received in a primary dental care unit in Valencia, Spain. Methods A cross-sectional study was designed. Parents were given a self-administered questionnaire with questions on accessibility, information received from the dentist and hygienist, staff interest in their child, dentist's and hygienist's apparent professional competence, handling of the child's behaviour, cleanliness of the office (surgery), overall parent satisfaction, parent's and child's age, and parental educational level. The chi-square test was used to assess overall parental satisfaction and the other study variables. For the multivariant study…
Thermographic Analysis of Tooth Vascularization Using Thermal Stimulation
Objective: The current pulp diagnostic techniques based on subjective patient response to electrical or thermal stimuli are unable to assess tooth vascularization, which is a true indicator of pulp vitality. The present study evaluates thermography as a pulp vitality test, assessing tooth recovery following thermal stimulation. Methods: A model simulating intrapulpal circulation was developed. Superficial thermographic measurements were obtained from teeth with and without elevation of the intracoronal temperature before and after applying thermal stress with cold. The data were analyzed using analysis of variance (ANOVA), and the level of significance was set at P<0.05. Results: The model …
Oral Health Knowledge and Related Factors among Pregnant Women Attending to a Primary Care Center in Spain
Our aim was to assess the knowledge of pregnant women in terms of oral health and prevention, correlating it with socio-sanitary and educational factors, as well as self-care and oral health state referred. A total of 139 women from a Health Department in Comunidad Valenciana (Valencia, Spain) participated in the study. They underwent an auto-administered survey which included socio-economic and educational factors, self-care in terms of oral hygiene, referred oral health state, and general knowledge on prevention and oral health. Chi-squared test (&chi
Toothguide Training Box for Dental Color Choice Training
The purpose of this study was to evaluate the use of the Toothguide Training Box (TTB) for training dental students in color identification. The seventy-four volunteers who took part in the study attended a seminar on the Vita 3D Master Guide (MG) and the TTB system as well as a demonstration of the equipment before training began. At the end of the training they took the TTB final test. In addition, the participants were asked to recognize ten MG shade tabs in a blind manner before and after TTB training. The training times and percentages of correct answers were compared using the paired t-test. Variations in scores with training times and percentages of correct answers before and after t…
Melatonin Treatment Alters Biological and Immunomodulatory Properties of Human Dental Pulp Mesenchymal Stem Cells via Augmented Transforming Growth Factor Beta Secretion.
Melatonin is an endogenous neurohormone with well-reported anti-inflammatory and antioxidant properties, but the direct biological and immunomodulatory effects of melatonin on human dental pulp stem cells (hDPSCs) has not been fully elucidated. The aim of this study was to evaluate the influence of melatonin on the cytocompatibility, proliferation, cell migration, odontogenic differentiation, mineralized nodule formation, and immunomodulatory properties of hDPSCs.To address the melatonin biological effects on hDPSCs, the cytocompatibility, proliferation, cell migration, odontogenic differentiation, mineralized nodule formation, and immunomodulatory properties of hDPSCs after melatonin treat…
Temperature changes in 2% chlorhexidine gluconate using two activation methods with different intensity levels
Background Chlorhexidine is an irrigant solution widely used in root canal treatment because of its good antimicrobial properties. However, its mixture with sodium hypochlorite results in the appearance of substance called p-chloroaniline, a cytotoxic substance. This is also found when chlorhexidine is heated. The use of passive ultrasonic irrigation is related to an irrigant thermal increase, which can cause the appearance of p-chloroaniline. Thus, the objective is to establish the influence of ultrasonic and sonic activation, with the use of different intensities, upon the temperature of chlorhexidine gluconate (CHX). Material and methods The following groups were established: control (wi…
Human Dental Pulp Stem Cells Exhibit Different Biological Behaviours in Response to Commercial Bleaching Products
The purpose of this study was to evaluate the diffusion capacity and the biological effects of different bleaching products on human dental pulp stem cells (hDPSCs). The bleaching gel was applied for 90, 30 or 15 min to enamel/dentine discs that adapted in an artificial chamber. The diffusion of hydrogen peroxide (HP) was analysed by fluorometry and the diffusion products were applied to hDPSCs. Cell viability, cell migration and cell morphology assays were performed using the eluates of diffusion products. Finally, cell apoptosis and the expression of mesenchymal stem cell markers were analysed by flow cytometry. Statistical analysis was performed using analysis of variance and Kruskal&nda…
Effect of three different irrigation solutions applied by passive ultrasonic irrigation
Objectives This study evaluated the maximum depth and percentage of irrigant penetration into dentinal tubules by passive ultrasonic irrigation (PUI). Materials and Methods Thirty extracted human teeth were instrumented and divided into three groups. According to final irrigation regimen, 5.25% sodium hypochlorite (Group A, NaOCl), 2% chlorhexidine (Group B, CHX) and saline solution (Group C, control group) were applied with Irrisafe 20 tips (Acteon) and PUI. Irrigant was mixed with 0.1% rhodamine B. Sections at 2 mm, 5 mm, and 8 mm from the apex were examined with confocal laser scanning microscopy (CLSM). The percentage and maximum depth of irrigant penetration were measured. Kruskal-Wall…
Cutting efficiency of heat-treated nickel-titanium single-file systems at different incidence angles.
Cutting efficiency of Reciproc R25 (REC) and Reciproc blue R25 (REB) at different inclinations was evaluated. Sixty new files were tested at 90°, 70° and 45° of inclination in relation to the sample (n = 10), using a customised machine. All files were activated in reciprocation against standardised gypsum blocks for 120 s. Cutting efficiency was determined by measuring the block weight loss with an analytical balance and measuring the length of the block surface cut using a digital calliper. Data were statistically analysed (two-way ANOVA, Bonferroni t-test) with the significance level set at P < 0.05. There was no difference for REC among the tested angles. REB had no statistical differenc…
Cone-beam computed tomography analysis of root and canal morphology of mandibular premolars in a Spanish population
Purpose: This study aimed to investigate the clinical anatomy of lower premolar roots in a Spanish population by using cone-beam computed tomography (CBCT), correlating findings with patient gender and tooth type. Materials and Methods: Using 70 CBCT images, we evaluated 126 healthy, untreated, well-developed lower premolars. The number and morphology of roots and root canals, and the foramina number were assessed. Results for gender and tooth type were compared using the chi-squared and ANOVA tests. Results: The average length of teeth and roots was significantly higher in men (p=0.00). All 126 premolars had a single root. One canal was found in 83.3% of the premolars, with no gender or to…
Clinical efficacy of a bleaching enzyme-based toothpaste. A double-blind controlled clinical trial.
Abstract Objectives To assess the efficacy of a bleaching enzyme-based toothpaste. Material and methods A randomized clinical trial was carried out, comprising 48 participants with teeth exhibiting color A3 or higher according to the Vita Classical guide. One-half of the sample received the bleaching enzyme-based toothpaste (White Kin ® ), while the other received placebo toothpaste. Both products were supplied in identical containers and had the same composition except for the active components. The teeth color was measured with a spectrophotometer. The patients were instructed to brush their teeth three times a day during 3 min with the assigned product, during 12 weeks. The color measure…
Hydrogen Peroxide Diffusion through Enamel and Dentin
The purpose of this study was to evaluate the in vitro diffusion of commercial bleaching products (hydrogen peroxide (HP) or carbamide peroxide (CP) based) with different application protocols. Human enamel-dentin discs were obtained and divided into 20 groups. Four commercial products based on HP (Pola Office+(PO), Perfect Bleach (PB), Norblanc Office-automix (NO), and Boost (BT)), and one based on CP (PolaDay CP (PD)), were evaluated with different application protocols (3 applications ×
Dental stem cell signaling pathway activation in response to hydraulic calcium silicate-based endodontic cements: A systematic review of in vitro studies
Abstract Objective To present a qualitative synthesis of in vitro studies which analyzed human dental stem cell (DSC) molecular signaling pathway activation in response to hydraulic calcium silicate-based cements (HCSCs). Methods A systematic electronic search was performed in Medline, Scopus, Embase, Web of Science and SciELO databases on January 20 and last updated on March 20, 2020. In vitro studies assessing the implication of signaling pathways in activity related marker (gene/protein) expression and mineralization induced by HCSCs in contact with human DSCs were included. Results The search identified 277 preliminary results. After discarding duplicates, and screening of titles, abstr…
Retrospective clinical evaluation of root canal treatment with or without photodynamic therapy for necrotic teeth and teeth subjected to retreatment.
PURPOSE To compare the effect of photodynamic therapy (PDT) as a procedure to complement root canal treatment (RCT), for both primary treatment and retreatment. METHODS This was a retrospective study based on analysis of clinical records. A total of 214 teeth that had undergone RCT on either a primary or retreatment basis, with or without complementary PDT, were evaluated. For 118 teeth that met the previously established inclusion criteria, the time until healing was evaluated. Complementarily, the need for application of calcium hydroxide (CaHy) between visits and the number of visits necessary for completing the treatment were assessed. Data were analyzed using the Mann-Whitney and χ2 te…
Could the Calcium Silicate-Based Sealer Presentation Form Influence Dentinal Sealing? An In Vitro Confocal Laser Study on Tubular Penetration
Dentinal tubule penetration influences root canal treatment sealing. The aim of this study was to compare dentinal penetration of two clinical presentations of silicate-based sealers using confocal laser. Sixty single-rooted human teeth from 50–70 year-old patients extracted for orthodontic/periodontal reasons were used. Canals were prepared using Mtwo system up to 35/0.04, with 5.25% NaOCl irrigation and final irrigation using 17% EDTA. Teeth were randomly assigned into study groups (ni = 20): EndoSequence BC sealer (ES, group 1), BioRoot RCS (BR, group 2); and a control group (nc = 20) with AH Plus (AHP). Root canals were obturated with 35/0.04 gutta-percha (single-cone technique). The sa…
The application of casein phosphopeptide and amorphous calcium phosphate with fluoride (CPP-ACPF) for restoring mineral loss after dental bleaching with hydrogen or carbamide peroxide: An in vitro study.
Abstract Objective To conduct an in vitro evaluation of the effect of casein-phosphopeptide and amorphous calcium phosphate with fluoride [CPP-ACPF] upon the calcium [Ca] and phosphorus [P] composition and morphology of dental enamel and dentin after the application of two bleaching agents: 37.5% hydrogen peroxide [HP]) and 35% carbamide peroxide [CP]. Materials and methods The crowns of 40 extracted human teeth were divided into four groups (n = 10 each). The crowns were sectioned along the cervical-incisal axis, and each half was embedded in acrylic resin, leaving a window 3 mm in diameter to explore the enamel or dentin (according to the study group involved). Groups 1a and 1b correspond…
Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth.
Aims To investigate the cytotoxicity and bioactivity of several pulpotomy materials: Biodentine (Septodont, Saint-Maur-des-Fosses, France) MTA (Angelus, Londrina, PR, Brazil), Theracal LC (Bisco Inc., Schamburg, IL, USA) and IRM (Dentsply DeTrey GmbH, Konstanz, Germany), after contact with stem cells isolated from human exfoliated primary teeth (SHEDs). Methodology SHEDs were cultured in the presence of the eluates of various pulpotomy materials for 24, 48 and 72 h. Cell viability was determined by mitochondrial dehydrogenase enzymatic (MTT) assay. Apoptosis and changes in cell phenotype were evaluated by flow cytometry. Also, an in vitro scratch wound-healing assay was used to determine th…
Smear layer removal in canals shaped with reciprocating rotary systems
The aim was to assess the presence of smear layer after canal instrumentation with two reciprocating rotary systems and a continuous motion one. Thirty canals were shaped with Reciproc, WaveOne or Mtwo systems. Smear layer was assessed following a three value scale at coronal, middle and apical levels with a scanning electron microscopy. Reciproc scores: coronal third, 20% of the cases: 0, 60%: 1, 20%: 2; middle third, 10%: 0, 20%: 1, 70%:2; apical third: 2 in all cases. WaveOne scores: coronal third, 0 (40%), 1 (30%) and 2 (30%); middle third, 0 (20%), 1 (50%), 2 (30%); apical third, 0 (20%), 2 (80%) of cases. MTwo scores: coronal third 0 (50%), 1 (30%) 2 (20%); middle third 0 (20%), 1 (50…
Induced post-traumatic apexification: 20 year follow-up and morphological study after new fracture.
Apexification is an endodontic technique used in immature necrotic teeth, the primary goal of which is to induce a calcified barrier in roots with open apices and to promote the continuation of apical root development. A 7-year-old patient with a coronal fracture in a maxillary central incisor was treated with an apexification technique using calcium hydroxide. The apical closure was obtained after one year, then a permanent root canal filling was performed. The tooth was monitored for a period of 20 years, up to when a trauma caused its extraction. The newly formed root was analyzed macroscopically, histologically and through scanning electron microscopy. A morphologically normal root was …
Estudo Comparativo da Infiltração Apical entre Dois Cimentos Endodônticos
ResumoO objectivo deste estudo é comparar a capacidade de selamento apical de dois cimentos endodônticos. Foram utilizados trinta e oito dentes monorradiculares e divididos em dois grupos de 15 elementos, de acordo com o cimento utilizado (Grupo A: AH Plus e Grupo B: Tubli-Seal). Foram utilizados oito dentes nos grupos controlo positivo e negativo que não foram obturados (Grupo C). Os canais foram instrumentados pela técnica de crown-down, utilizando as limas Hero Shaper® and Hero 642® (Micro-Mega S.A., Besançon, France) e irrigados com hipoclorito de sódio a 5,25% entre cada instrumento. O smear layer foi removido utilizando 3ml de EDTA a 17% no final da instrumentação durante 3 minutos, s…
Pulse Oximetry as a Diagnostic Tool to Determine Pulp Vitality: A Systematic Review
Pulse oximetry (PO) can be used as a technique to assess vascularization. Although it is commonly used in the field of medicine, it still has limited use in dentistry. The aim of this study is to evaluate, by means of a systematic review, if pulse oximetry is a viable and effective system to determine pulp vitality and assess the clinical criteria for its use. A literature search was performed in Medline, Scopus, Embase, and Web of Science databases. Clinical studies using pulse oximetry as a tool to determine pulp vitality in permanent teeth were eligible. Quality assessment of the included studies was performed following the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2) gu…
Outcome of Root Canal Treatments Provided by Endodontic Postgraduate Students. A Retrospective Study
The aim of this study was to assess the preoperative, intraoperative, and postoperative factors that influenced complete periapical healing in teeth that underwent primary root canal treatment (RCT), in patients treated by postgraduate students in endodontics. Factors were retrieved and compared with the periapical status during the follow-up visit. Healing was considered as the absence of clinical and radiological symptoms. Variables significantly associated by the chi-squared test were included in a logistic regression model (LRM). Preoperative factors associated with healing were: American Society of Anesthesiology (ASA) status (p = 0.01)
Student evaluation of clickers in a dental pathology course
BACKGROUND: The purpose of this study was to evaluate the degree of satisfaction of students and teachers, and to determine whether the students notice improvements in learning and in the learning environment as a result of the use of clicker. MATERIAL AND METHODS: Descriptive study. Fifty-one students and 8 teachers participated in the use of clicker technology in 8 preclinical seminars in dental pathology. Students and teachers filled a three-domain questionnaire at the end of the preclinical course. We used the Mann-Whitney U-test to compare the results between the two groups. RESULTS: The domain "perception and expectation" showed the use of clickers to be simple and convenient for 80% …
Implementation of augmented reality in operative dentistry learning.
Objective To evaluate the efficacy of augmented reality (AR) in the gaining of knowledge and skills amongst dental students in the design of cavity preparations and analyse their degree of satisfaction. Material and methods AR cavity models were prepared for use with computers and mobile devices. Forty-one students were divided into two groups (traditional teaching methods vs AR). Questionnaires were designed to evaluate knowledge and skills, with the administration of a satisfaction questionnaire for those using AR. The degree of compliance with the standards in cavity design was assessed. The Mann-Whitney U-test was used to compare knowledge and skills between the two groups, and the Wilc…
Effectiveness of passive ultrasonic irrigation in improving elimination of smear layer and opening dentinal tubules
Objective: To compare the ability to eliminate debris and open dentinal tubules of different ultrasound irrigation procedures. Study Design: Forty extracted single-rooted human teeth were instrumented with mechanical rotatory instrumentation, and divided into four groups: (n=10) according to the final irrigation technique: group A (control), 2.5% NaOCl irrigation with the Miraject needle and no ultrasonic agitation; group B, passive ultrasonic irrigation (PUI) with 2.5% NaOCl and Irrisafe 20 tips; group C, PUI with 2.5% NaOCl and Irrisafe 25 tips; group D, PUI with 2.5% NaOCl and K 25 tips. The amount of debris and the number of opened dentinal tubules was established by scanning electronic…
Influence of Operator's Experience on Root Canal Shaping Ability with a Rotary Nickel-Titanium Single-File Reciprocating Motion System
The aim of this study was to evaluate the influence of the operator's experience on the shaping of double-curvature simulated root canals with a nickel-titanium single-file reciprocating motion system.Sixty double-curvature root canals simulated in methacrylate blocks were prepared by 10 students without any experience in endodontics and by 10 professionals who had studied endodontics at the postgraduate level. The Reciproc-VDW system's R25 file was used in the root canal preparation. The blocks were photographed before and after the instrumentation, and the time of instrumentation was also evaluated. Changes in root canal dimensions were analyzed in 6 positions.Significant differences (P.0…
Infrared Thermography. An in Vitro Study on Its Use as Diagnostic Test in Dentistry
Pulp tissue consists of richly vascularized and innervated tissue with a very small circulatory access zone (the apical foramen) [1]. The amount and quality of pulp tissue can only be determined using histological techniques, which imply necrosis of the tissue [2].
Oval fiber posts do not improve adaptation to oval-shaped canal walls.
Abstract Introduction Oval fiber posts attempt to provide better adaptation to root canals. The hypothesis of this study was that there are no differences in adaptation of oval and circular fiber posts to canal walls. Methods Posts were inserted in 20 canals; 10 were oval, and 10 were circular. The posts were cemented with composite cement. Coronal, middle, and apical sections were observed through a microscope. The space occupied by the post and the maximum distance between it and the canal wall were calculated. The 2 groups were compared with analysis of variance. In all the analyses the level of significance was set at P Results The proportion of space occupied by the post showed no sign…
In vitro evaluation of the efficacy of two bleaching procedures
Objective: In vitro comparison of the efficacy of two bleaching procedures, one based on carbamide peroxide (CP) and the other on hydrogen peroxide (HP), simulating clinical conditions. Study Design: Two groups of 20 teeth in each group were selected. Group A: 22% CP, one hour a day for 21 consecutive days. Group B: 37.5% HP, in 2 treatment sessions with an one week interval between each session. At each session the product was applied three successive times for eight minutes. Colour was recorded before treatment, when it was finished and one week after finishing it, with the Vita EasyShade spectrophotometer. CIEL*a*b* and ΔE were established at each moment in the study. Intra-group data wa…
The effect of passive ultrasonic activation of 2% chlorhexidine or 3% sodium hypochlorite in canal wall cleaning.
Objectives: the purpose of this study was to compare debris removal and open tubules effectiveness of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) applied as final irrigation in different protocols Study Design: sixty extracted premolars were divided into six groups according to the final irrigation technique: A and B 3 % NaOCl or 2 % CHX with the Miraject needle and no agitation; C and D, passive ultrasonic irrigation (PUI) with Irrisafe 20 tips and 3 % NaOCl or 2 % CHX; E and F, PUI with Irrisafe 25 tips and 3 % NaOCl or 2% CHX. The remaining dentine debris and opened tubules were evaluated by SEM at three root levels by two blinded investigators. The Kruskal Wallis and the Mann-Wh…
Comparative Surface Morphology, Chemical Composition, and Cytocompatibility of Bio-C Repair, Biodentine, and ProRoot MTA on hDPCs
Biocompatibility is an essential property for any vital pulp material that may interact with the dental pulp tissues. Accordingly, this study aimed to compare the chemical composition and ultrastructural morphology of Biodentine (Septodont, Saint Maur-des-Fosses, France), ProRoot MTA (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA), and Bio-C Repair (Angelus, Londrina, PR, Brazil), as well as their biological effects on human dental pulp cells. Chemical element characterization of the materials was undertaken using scanning electron microscopy and energy dispersive X-ray analysis (SEM-EDX). The cytotoxicity was assessed by analyzing the cell viability (MTT assay), cell morphology …
Dietary Habits in a Child Population in Relation to Caries Experience
Sugar consumption in Spain has remained constant at around 80 g/day since the 1970s. Although intake as sugar has fallen considerably, to around 13.5 g/person/day, the intake in processed foods has risen. Meanwhile, caries prevalence is falling or stabilizing. This situation is common in developed countries, where the impact of diet on caries has altered, probably through greater use of fluoridated products. In the Valencia region, children habitually eat sugary foods and drinks and snacks that contain starches or sugars and starches. The present study analyzed the association between caries experience, quantified as the sum of the dfs and DMFS indices, and the consumption of cariogenic foo…
Microstructure alterations of rotary files after multiple simulated operative procedures.
Aim: To assess morphological alterations of ProTaper rotary NiTi files before and after continuous use by scanning electron microscopy (SEM). Study Design: 30 root canals were chosen with an angle between 15 and 30º. Before starting to prepare the canals the files were observed microscopically using a scanning electronic microscope. The ProTaper sequence recommended by the manufacturer was used, with NaOCl as irrigant. The instruments were sterilised after every three canals were shaped. The instruments were observed with the same microscope after shaping each canal, until 30 root canals were shaped. The criteria used for checking the instruments were: blunt cutting edges, disruption of cut…
Bleaching efficacy of at home 16% carbamide peroxide. A long-term clinical follow-up study.
OBJECTIVE To assess the whitening efficacy of a 16% carbamide peroxidase (CP) gel after 42 months of clinical follow-up. MATERIALS AND METHODS A retrospective clinical study was carried out involving 95 participants. CP 16% was applied for 90 minutes a day for 4 weeks using individualized trays. Tooth color was assessed using spectrophotometry at baseline, 1 week after the end of treatment, and every 6 months until completing 42 months of follow-up. Color parameters were compared using analysis of variance for repeated measures. The analysis by teeth groups was performed using two-way ANOVA. RESULTS The mean baseline L* was 81.7 ± 5.2 versus 83.6 ± 8.8 after 42 months (P<.01). L* showed a d…
Evaluation of changes in ion release and biological properties of NeoMTA‐Plus and Endocem‐MTA exposed to an acidic environment
AIM To analyse in vitro changes in ion release and biological properties of Endocem-MTA (Maruchi, Wonju, Korea) and NeoMTA-Plus (Avalon Biomed Inc, Bradenton, FL, USA) exposed to acidic or neutral environment on human dental periodontal ligament stem cells (hPDLSCs). METHODOLOGY Cell viability and wound healing assays were performed using eluates of each material. Cell death and changes in phenotype induced by the set endodontic sealer eluates were evaluated through flow cytometry. To evaluate cell attachment to the different materials, hPDLSCs were directly seeded onto the material surfaces and analysed by scanning electron microscopy. The chemical composition of the materials was determin…
Biological Effects of New Hydraulic Materials on Human Periodontal Ligament Stem Cells.
Background: The aim of this study was: to evaluate the biological properties of new hydraulic materials: Bio-C Repair and Bio-C Sealer. Methods: Periodontal ligament stem cells were exposed to several dilutions of Bio-C Repair and Bio-C Sealer. The ion release profile and pH were determined. Metabolic activity, cell migration and cell survival were assessed using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), wound-healing assays and Annexin assays, respectively. Cells were cultured in direct contact with the surface of each material. These were then analyzed via scanning electron microscopy (SEM) and energy dispersive X-ray (EDX). Statistical differences were ass…
Biocompatibility of New Pulp-capping Materials NeoMTA Plus, MTA Repair HP, and Biodentine on Human Dental Pulp Stem Cells
The aim of the present study was to evaluate the in vitro cytotoxicity of MTA Repair HP, NeoMTA Plus, and Biodentine, new bioactive materials used for dental pulp capping, on human dental pulp stem cells (hDPSCs).Biological testing was carried out in vitro on hDPSCs. Cell viability and cell migration assays were performed using eluates of each capping material. To evaluate cell morphology and cell attachment to the different materials, hDPSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. The chemical composition of the pulp-capping materials was determined by energy-dispersive X-ray and eluates were analyzed by inductively coupled plasma-mass …
Sealing capacity of a photochromatic flowable composite as protective base in nonvital dental bleaching.
Aim To evaluate microleakage of a flowable composite used as a protective isolating base, applied with different adhesive systems. Methodology Seventy root-filled teeth were divided into seven groups. A flowable composite base (Tetric Flow Chroma) was used with three adhesive techniques (Syntac, Excite, Excite DCS; in the three cases with and without acid etching) and in a control group without dentine conditioning or adhesive placement. A 30% hydrogen peroxide solution was applied for 24 h in the pulp chambers, followed by the placement of a dye (silver nitrate) for 4 h. Each tooth was sectioned longitudinally, and examined under 4× magnification to assess the tooth/restoration dye leaka…
Cytocompatibility and Bioactive Properties of Hydraulic Calcium Silicate-Based Cements (HCSCs) on Stem Cells from Human Exfoliated Deciduous Teeth (SHEDs): A Systematic Review of In Vitro Studies
The implementation of hydraulic calcium silicate-based endodontic cements (HCSCs) in biologically based endodontic procedures for the primary dentition has been recently investigated, focusing on the biological response of stem cells from human exfoliated deciduous teeth (SHEDs) towards them. The present systematic review aimed to present a qualitative synthesis of the available literature consisting of in vitro assays, which assessed the cytocompatibility and bioactive properties of HCSCs in direct contact with SHEDs. Following the PRISMA statement, an electronic database search was carried out in Medline, Scopus, Embase, Web of Science, and SciELO on March 31st and updated on November 16t…
Effects of in-office bleaching on human enamel and dentin. Morphological and mineral changes
Abstract Background The effects of HP-based products upon dental enamel and dentin are inconclusive. Aim To evaluate changes in micromorphology and composition of calcium (Ca) and phosphate (P) in enamel and dentin after the application of 37.5% hydrogen peroxide (HP) and 35% carbamide peroxide (CP) Methods Crowns of 20 human teeth were divided in two halves. One half was used as control specimen and the other as experimental specimen. The control specimens were kept in artificial saliva, and the experimental specimens were divided into four groups (n = 5 each): group 1 (enamel HP for 45 min); group 2 (dentin HP for 45 min); group 3 (enamel CP for 90 min); and group 4 (dentin CP for 90 min)…
In vitro comparison of root-canal measurements with conventional and digital radiology.
Aim The present study compared the efficacy of digital and conventional radiology for root-canal length measurement. Methodology Seventy extracted teeth with pre-served roots were used. Root-canal length measurements were completed with K-Flexofiles (numbers 08, 10 and 15) with conventional and digital radiography using two systems (radiovisiography and photostimulate storage phosphor). All films and sensors were exposed at projections of 0 degrees and 20 degrees to the mesial. The images obtained were evaluated with and without magnification, and analysed using the Cohen's kappa test. The accuracy of the three systems to determine the root-canal length were evaluated by measuring the dista…
Viability and Stimulation of Human Stem Cells from the Apical Papilla (hSCAPs) Induced by Silicate-Based Materials for Their Potential Use in Regenerative Endodontics: A Systematic Review
Blood clot formation in the apical third of the root canal system has been shown to promote further root development and reinforcement of dentinal walls by the deposition of mineralized tissue, resulting in an advancement from traditional apexification procedures to a regenerative endodontic treatment (RET) for non-vital immature permanent teeth. Silicate-based hydraulic biomaterials, categorized as bioactive endodontic cements, emerged as bright candidates for their use in RET as coronal barriers, sealing the previously induced blood clot scaffold. Human stem cells from the apical papilla (hSCAPs) surviving the infection may induce or at least be partially responsible for the regeneration …
Comparative Cytocompatibility and Mineralization Potential of Bio-C Sealer and TotalFill BC Sealer
The aim of this study was to investigate the cytocompatibility and mineralization potential of two premixed hydraulic endodontic sealers compared with an epoxy resin-based root canal sealer. The cellular responses and mineralization capacity were studied in human periodontal ligament stem cells (hPDLSCs) that were exposed to premixed hydraulic sealers, Bio-C Sealer (Angelus, Londrí
Nanostructural changes in dentine caused by endodontic irrigants
Objective: To study nanostructural dentinal changes produced by endodontic irrigants. Study Design: Experimental study. Nanoindentations were performed on peritubular (PD) and intertubular dentine (ID) with an atomic force microscopy. Stiffness and adhesion force were determined before and after application of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA). Normalized differences before and after treatment for stiffness and adhesion forces were calculated. A paired T-test was used to compare stiffnes and adhesion force before and after irrigants application. Results: After treatment with EDTA there was a 29.80% reduction in stiffness in ID and a 63.53% redu…
Fibre post behaviour prediction factors. A review of the literature
Introduction: The advantages of fibre posts over stainless steel posts have been demonstrated in numerous studies. For clinical success, various factors need to be taken into account in post-retained restorations. Material and Methods: A review was made of literature on fibre posts published from 2000 to February 2011, identified through searches of the PubMed/Medline databases. Results: The position of the tooth in the arch, ferrule size, proximal contact, periodontal support and restoration type are survival prediction factors that should be considered when performing post-endodontic restoration. Since fibre posts present good biomechanical behaviour as a result of their elastic modulus, …
Canal shaping with a reciprocating system is easy to learn.
To assess progressive learning of root canal shaping in order to define the number of simulated canals in resin blocks needed to reach a level of learning beyond which no further improvement in performance is observed.A total of 216 simulated canals in resin blocks were instrumented by 18 operators without experience in Endodontics and by 18 Endodontists. The R25 file of the Reciproc system (VDW, Munich, Germany) was used to prepare the canals. The blocks were photographed before and after instrumentation. An analysis was made of the variations in the dimensions of the canals at 6 locations and of the instrumentation time. A Student's t-test was used to analyse the data (P 0.05).The group …
Reliability of Two Color Selection Devices in Matching and Measuring Tooth Color
ABSTRACT Objective The objective of this study was to investigate the intra and interdevice reliability of two tooth color measurement devices: EasyShade (ES) and SpectroShade Micro (SSM). Materials and methods Tooth color was measured in six maxillary and mandibular. L*, a* and b* values and shade matches to VITA Classical and Vitapan 3D-Master shade guide systems were determined for all teeth. ÄE was assessed. Paired t-test and correlation coefficient (ICC) were used. Results Intradevices no significant differences (p > 0.05) were found between L*, a*, b*. Interdevice L* and b* were significantly higher for ES (p < 0.05), while a* was significantly higher for SSM (p < 0.05). ÄE s…
Bioactivity of bioceramic materials used in the dentin-pulp complex therapy : a systematic review
Este es el artículo que se ha publicado de forma definitiva en: https://www.mdpi.com/1996-1944/12/7/1015 Dentistry-applied bioceramic materials are ceramic materials that are categorized asbioinert, bioactive and biodegradable. They share a common characteristic of being specificallydesigned to fulfil their function; they are able to act as root canal sealers, cements, root repair or fillingmaterials. Bioactivity is only attributed to those materials which are capable of inducing a desiredtissue response from the host. The aim of this study is to present a systematic review of availableliterature investigating bioactivity of dentistry-applied bioceramic materials towards dental pulp stemcel…
Biocompatibility of three new calcium silicate-based endodontic sealers on human periodontal ligament stem cells.
Aim To evaluate the biocompatibility of three calcium silicate-based endodontic sealers, Bioroot BC Sealer (Septodont, Saint-Maur-des-Fosses, France), Endoseal MTA (EndoSeal, Maruchi, Seoul, Korea) and Nano-ceramic Sealer (B&L Biotech, Fairfax, VA, USA) (NCS), on human periodontal ligament stem cells (hPDLSCs). Methodology Human periodontal ligament stem cells were cultured in the presence of various endodontic sealer eluates for 24 h. Cell viability was determined using the MTT assay. Cell death and changes in phenotype induced by the set endodontic sealer eluates were evaluated through flow cytometry. Also, an in vitro scratch wound-healing model was used to determine their effects in cel…