0000000000136357
AUTHOR
Carmen Llena
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…
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…
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…
Comparing student and staff perceptions of the “Educational Climate” in Spanish Dental Schools using the Dundee Ready Education Environment Measure
Objective: To compare the perceptions of students and teachers of the “Educational Climate” (EC) in Spanish public dental schools. Methods: A group of 1064 students and 354 teachers from six Spanish public dental schools responded to the DREEM questionnaire. This has 50 items grouped into five subscales: perception of learning (Learning); perception of teachers (Teachers); academic self-perceptions (Academic); perception of the atmosphere in the faculty (Atmosphere); and social self-perceptions (Social). The DREEM scale provides results for each item, each subscale and the overall EC. Results: The EC scores were 123.2 (61.6%) for the students and 134.1 (67.0%) for the teachers (P<.001). The…
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…
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
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…
The tongue biofilm metatranscriptome identifies metabolic pathways associated with halitosis and its prevention
AbstractHalitosis is an oral condition caused by an increase in the concentration of volatile sulfur compounds (VSCs), such as methyl mercaptan and hydrogen sulfide, generated as a consequence of bacterial metabolism on the tongue biofilm. Microbial communities on the tongue of halitosis patients have been studied by bacterial culture, 16S rRNA taxonomic studies and metagenomics. However, there are currently no reports on the microbial gene-expression profiles. In this study, we performed RNAseq of tongue coating samples from control individuals and halitosis patients with different levels and composition of VSCs, as determined by gas chromatography. In this metatranscriptomic study, the ac…
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…
Comparation of the eutectic mixture of lidocaine/prilocain versus benzocaine gel in children
Objective: To compare the anesthetic effect of a non commercial eutectic mixture of 4% lidocaine/ prilocaine (PLO 4%) and 20% benzocaine gel (Hur- ricaine®), as topical anesthetic, prior to inferior al- veolar nerve block and buccal infiltration anesthesia in 5 - 12 year old children. Study design: Infiltrative anesthesia was applied in 50 children, divided in two groups (n = 25) using PLO 4% and Hurricaine® as topical anesthesia prior to infiltration. Physical reac- tions were registered using the Sound-Eyes- Motor Scale. Physiological changes expressed by ar- terial pressure and heart rate. Subjective pain re- sponse was scored on a Facial Image Scale. Physical physiological and subjectiv…
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…
Analysis of the ‘Educational Climate’ in Spanish Public Schools of Dentistry using the Dundee Ready Education Environment Measure: a multicenter study
To analyse the 'Educational Climate' (EC) of dental students in Spain.The study group consisted of 1391 students from nine Spanish Public Schools of Dentistry, who responded to the questionnaire based on 'Dundee Ready Education Environment Measure' (DREEM). This questionnaire has 50 items that are grouped into five domains: Learning, Teachers, Academic, Atmosphere and Social.The global score on the EC was 123.1 (interpretation: 'EC more positive than negative'). The scores obtained in the different domains were: 28.0 in Learning (interpretation: 'a generally positive perception of learning'), 26.8 in Teachers (interpretation: 'teachers are going in the right direction'), 20.8 in Academic (i…
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…
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…
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…
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…
Psychometric validation of the Spanish version of the Dundee Ready Education Environment Measure applied to dental students.
Aim: To carry out a psychometric evaluation of the Spanish-language version of the Dundee Ready Education Environment Measure (DREEM) applied to dental students. Methods: A total of 1,391 students from nine Spanish public schools of dentistry responded to the DREEM questionnaire. To analyse the reliability of the DREEM questionnaire, the internal consistency was assessed and a 'test-retest' carried out. Validity was evaluated through analysis of item response rate, floor and ceiling effects, corrected item-total and item-subscale correlations and factor structure. A confirmatory factor analysis was performed to analyse the structure of the original DREEM scale. Results: Cronbach's alpha coe…
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 …
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…