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ABSTRACT: Objective To assess the influence of final irrigation protocols with chlorhexidine in the coronal leakage of Enterococcus faecalis in filled root canals. Material and Methods Seventy single-root canals from extracted teeth were prepared using ProTaper instruments. The irrigation protocol accomplished an alternating irrigation with 5 mL of 2.5% sodium hypochlorite (NaOCI) and 17% EDTA between each file. The teeth were randomly divided into four experimental groups (n=15) according to the final irrigation regimen: group 1, without final irrigation; group 2, irrigation with 10 mL 2.0% chlorhexidine (CHX); group 3, with a final application of EC40™; and group 4, irrigation with the combination (1:1) of 0.2% CHX + 0.1% cetrimide (CTR). All the teeth were mounted in a two-chamber apparatus and the coronal access was exposed to E. faecalis. The presence of turbidity in the BHI broth over a period of 180 days was observed. The Friedman test was used for statistical analysis. Results EC40™ varnish showed the least leakage at 180 days, and was statistically similar to 2% CHX. No significant differences were observed between the group without final irrigation and the 2% CHX group or 0.2% CHX + 0.1% CTR. Conclusions In this ex vivo study, EC40™ showed the longest delayed coronal leakage of E. faecalis, although without significant differences from 2% CHX.
Journal of applied oral science: revista FOB 01/2013; 21(1):74-9. · 0.39 Impact Factor
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ABSTRACT: The application of a final irrigating solution that remains active over a fairly long period of time stands as one strategy for preventing bacterial recolonization or eliminating the bacteria that persist after root canal treatment. The aim of this study was to evaluate the residual antimicrobial activity of four final irrigation regimens in root canals contaminated with Enterococcus faecalis.
Biofilms of E. faecalis were grown in uniradicular roots for 4 weeks. After preparing the roots chemomechanically, four final irrigation regimens were applied: (1) group EDTA-NaOCl, 17% EDTA followed by 5.25% sodium hypochlorite (NaOCl); (2) group MA-NaOCl, 7% maleic acid (MA) followed by 5.25% NaOCl; (3) group EDTA-CHX + CTR, 17% EDTA followed by 2% chlorhexidine (CHX) + 0.2% cetrimide (CTR); and (4) group MA-CHX + CTR, 7% MA followed by 2% CHX + 0.2% CTR. Samples were collected for 60 days to denote the presence of bacterial growth. The Fisher exact test was used to compare the percentages of specimens without E. faecalis regrowth.
All root canals in which the final irrigant was 5.25% NaOCl yielded positive cultures on the fifth day. Groups EDTA-CHX + CTR and MA-CHX + CTR with a final irrigation of 2% CHX + 0.2% CTR showed respective percentages of samples without regrowth of 72.1% and 66.8% at 60 days. There were no statistically significant differences between these groups.
The combination of 2% CHX + 0.2% CTR would be an effective alternative final irrigation regimen given its antimicrobial action over time.
Journal of endodontics 08/2011; 37(8):1121-3. · 2.95 Impact Factor
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ABSTRACT: To evaluate the sealing capability of Cavit™ G with or without Clearfil™ S3 Bond and Prime & Bond NT placed in the pulp chamber.
Forty single rooted premolars, extracted for orthodontic and periodontal reasons, with intact coronal surface and mature apices, were standardized to a length of 15 mm. The teeth were instrumented, filled with a gutta-percha master cone and divided into three groups to obturate the pulp chambers: Cavit™ G; Clearfil™ S3 Bond plus Cavit™ G and Prime & Bond® NT plus Cavit™ G. A glucose leakage model was used for evaluating the coronal microleakage. The Mann-Whitney test was used to evaluate the differences in the means of the glucose leakage.
An increase in glucose penetration was observed during the first week in groups Cavit™ G and Cavit™ G+PBNT. The glucose penetration values of all groups were similar at 30 and 45 days, and there were no significant differences among them in both time periods (p=0.736 and p=0.581, respectively).
The adhesive systems did not improve the capability of Cavit™ G to seal the pulp chamber over time.
Medicina oral, patologia oral y cirugia bucal 07/2011; 16(4):e556-60.
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ABSTRACT: The use of root canal irrigating solutions exerting antimicrobial activity and prolonged residual activity is desirable in order to control dentin infection and delay reinfection of the root canal. The aim of this study was to evaluate the residual antimicrobial activity and the capacity to eradicate Enterococcus faecalis biofilm of different irrigating solutions, alone and in combination, in a dentin-volumetric test.
Solutions of 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 0.2% cetrimide (CTR), 17% ethylendiaminetetraacetic (EDTA), 7% maleic acid (MA), and regimens of 2.5% NaOCl followed by 17% EDTA or 7% MA and 0.2% CTR or 2% CHX were used to determine their residual activity by exposing treated dentin blocks to E. faecalis for 24 hours. Antimicrobial activity was assayed on 3-week biofilm formed on dentin blocks. Results of residual activity and antimicrobial activity were respectively expressed as the inhibition percentage of biofilm formation and the kill percentage of biofilm.
A 2% CHX and 0.2% CTR solution showed 100% biofilm inhibition; 2.5% NaOCl showed the lowest residual activity (18.10%). The kill percentage of 2.5% NaOCl and 0.2% CTR was 100% followed by 7% MA and 2% CHX, whereas 17% EDTA was the least effective (44%). Solutions of 7% MA or 17% EDTA followed by 0.2% CTR or 2% CHX showed 100% residual and antimicrobial activity.
A 0.2% CTR solution alone and the combinations in which 2% CHX or 0.2% CTR was the final irrigating solution achieved the maximum residual and antimicrobial activity.
Journal of endodontics 03/2011; 37(3):363-6. · 2.95 Impact Factor
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ABSTRACT: To evaluate Cavit TM G, ProRoot TM MTA and Tetric® EvoFlow as intraorifice barriers to prevent coronal microleakage in root canal treatment.
Forty-two human single rooted teeth were divided randomly in three experimental groups of 10 specimens each and two control groups. The experimental groups were prepared with hand instrumentation and cold lateral condensed technique of the gutta-percha. Four millimetres of coronal gutta-percha were removed and replaced by one of the following filling materials: Cavit TM G, Tetric® EvoFlow or ProRoot TM MTA. In the experimental groups, leakage was measured by the concentration of leaked glucose in the apical reservoir at 1, 7, 30, and 45 days, using the enzymatic glucose oxidase method. Data were analyzed by means of Mann-Whitney U and Kruskal-Wallis tests at α=0.05.
The glucose penetration results of three experimental groups increased gradually over time. No significant differences were found among groups at 24 hours and 1 week. At thirty and forty-five days, Cavit TM and Tetric® EvoFlow values were significantly different (p=0.007 and p=0.023, respectively).
The sealing ability of the Cavit TM G, ProRoot TM MTA and Tetric® EvoFlow used as intraorifice materials tends to be similar over time.
Medicina oral, patologia oral y cirugia bucal 01/2011; 16(1):e105-9.
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ABSTRACT: To compare the long-term sealing ability of GuttaFlow® using different obturation techniques.
Three hundred teeth, prepared with a crown-down technique, were divided into thirty experimental groups (n=10) to evaluate the apical and coronal leakage, at 3, 30 and 120 days, of lateral compaction gutta-percha+AH Plus TM, lateral compaction gutta-percha+GuttaFlow®, single cone+AH Plus TM, single cone+GuttaFlow®, and GuttaFlow® only.
Both coronal and apical leakage, at the three times of measurement, no significant differences were found among GuttaFlow®+lateral compaction gutta-percha and GuttaFlow®+single cone groups, whereas the only GuttaFlow® reached the highest leakage values at 30 and 120 days. AH Plus TM, using both techniques, showed high levels of leakage after 120 days to the coronal leakage and after 30 days to the apical leakage when compared silicon based sealer.
GuttaFlow®, using with lateral compaction and single cone techniques, shows a greater apical and coronal sealing ability than AH Plus TM over time. GuttaFlow® when used as only creates a poorer sealing when used with lateral compaction gutta-percha or single cone techniques.
Medicina oral, patologia oral y cirugia bucal 11/2010; 15(6):e936-41.
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ABSTRACT: Chelating agents, such as EDTA or citric acid, can be incorporated into irrigants in order to provide different properties in a single compound. Maleic acid has recently been proposed as an alternative irrigant to EDTA given its better smear layer removal and biocompatibility; however, its antimicrobial activity is not known. The purpose of the present study was therefore to evaluate the in vitro capacity of maleic acid in eradicating Enterococcus faecalis biofilms and to evaluate the combinations of cetrimide with maleic acid, citric acid, and EDTA.
E. faecalis biofilms were grown in the MBEC high-throughput device (Innovotech; Edmonton, Alberta, Canada) for 24 hours and exposed to the irrigating solutions for 30 seconds and 1 and 2 minutes. "Eradication" was defined as 100% bacterial kill. The Student t test was used to compare the efficacy of the irrigant combinations.
Maleic acid eradicated E. faecalis biofilms at a concentration of 0.88% after 30 seconds and at 0.11% after 2 minutes of contact time. When combined with 0.2% cetrimide, it eradicated the biofilms at all three times of exposure. The combination of 0.2% cetrimide with either 15% EDTA or 15% citric acid gave 100% bacterial kill after one minute of contact with the biofilms.
Maleic acid showed antimicrobial activity against E. faecalis biofilm both alone or in association with cetrimide from 30 seconds onward and the combination of EDTA and citric acid with cetrimide eradicated biofilm after 1 minute of contact.
Journal of endodontics 10/2010; 36(10):1673-5. · 2.95 Impact Factor
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ABSTRACT: Enterococcus faecalis is the most commonly isolated bacteria from root canals of teeth with persistent periapical periodontitis. Its ability to grow as a biofilm impedes the elimination of E. faecalis by using irrigating solutions. The purpose of this study was to assess the efficacy of cetrimide and chlorhexidine (CHX), alone and in association, in combined and alternating form, in eradicating biofilms of E. faecalis.
Biofilms grown in the MBEC-high-throughput device for 24 hours were exposed to irrigating solutions for 30 seconds and 1 and 2 minutes. Eradication was defined as 100% kill of biofilm bacteria. The Student t test was used to compare the efficacy of the associations of the 2 irrigants.
Cetrimide eradicated E. faecalis biofilms at concentrations of 0.5%, 0.0312%, and 0.0078% at 30 seconds and 1 and 2 minutes of contact time, respectively. CHX did not eradicate the biofilms at any of the concentrations (4% initial concentration) or times assayed. The association of 0.1% and 0.05% cetrimide with any concentration of CHX, whether in combined or alternating application, effectively eradicated E. faecalis biofilms at all the contact times tested. Eradication was also achieved with 0.02% and 0.01% cetrimide at 2 minutes. Statistical analysis revealed significantly better results with alternating rather than combined use of cetrimide and CHX (P < .05).
The associated use of cetrimide and CHX provided better results than their applications as single agents against E. faecalis biofilms, and the alternating application was significantly more effective than the combined mode of application.
Journal of endodontics 01/2010; 36(1):87-90. · 2.95 Impact Factor
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ABSTRACT: Nickel-titanium rotary instruments reduce procedural errors and the time required to finish root canal preparation. The goal of this study was to evaluate the effectiveness of a manual glide path on the preparation of curved root canals with Mtwo rotary system.
Forty buccal root canals with angles of curvature between 25 to 76 degrees were randomly divided into 4 groups (n = 10); 2 groups were instrumented with Mtwo instruments to the full length, and in the other 2 groups a glide path with #08-15 K files was performed before instrumentation with Mtwo system. Digital double radiographic technique was used to determine apical transportation and the change in angle of curvature. Also working time was calculated.
No statistically significant differences in the angle of canal curvature, apical transportation, and the working time were found between groups with glide path and no glide path. No significant differences were found when comparing the results of 3 variables between degrees of curvature.
The use of a manual glide path before Mtwo rotary system did not influence the apical transportation in curved root canals.
Journal of endodontics 06/2009; 35(5):699-702. · 2.95 Impact Factor
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ABSTRACT: To assess the efficacy of two sealants to preserve the apical seal after root canal preparation and cementation of posts at 24 h or 72 h after endodontic treatment.
Sixty human single-root teeth were instrumented and obturated using lateral compaction technique with EndoFill [30] or AH-Plus) [30] and were prepared in one of three ways, leaving a 3 mm gutta percha remnant in all cases: without cast post preparation, with preparation after 24 h or after 72 h. After cementing the posts, the specimens were thermal cycled at 5 and 55 degrees C in water baths, submerged in 2% methylene blue dye for 72 h, embedded in acrylic resin and cut transversally into three 1-mm apical sections. Dye leakage was quantitatively assessed as the percentage leaked area.
Comparison of the apical sections showed significant differences in leakage with both sealers among the three preparation groups (p<0.001). No significant differences between sealers were found in any preparation group or in the same sections.
Medicina oral, patologia oral y cirugia bucal 11/2007; 12(6):E464-8.
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ABSTRACT: Bonding agents could be used as fissure sealants. This study compares the retention three fissure sealants (Delton, Delton Plus and Concise) and a filled dentin bonding system (Optibond Solo). METHODS. Fifty-six children aged 7-8 years received fissure sealants either in the four permanent first molars, in the four deciduous second molars, or in all eight of these teeth. Every child received a different sealing material in each quadrant on a random basis. Clinical evaluation at 12 months was performed by a single blind examiner, and the retention was classified as either a success (total retention) or a failure (partial retention or not present).
There were no statistically significant differences among the four materials in permanent maxillary molars or deciduous molars. In permanent mandibular molars, Optibond Solo showed a lower percentage of retention (40.9%), significantly different (p=0.002) to that of Delton (89.5%), Delton Plus (87.5%) and Concise (76.5%).
One bottle dentin bonding system used as a sealant does not improve the retention of conventional fissure sealants.
Because of the scarcity of studies on the use of dental adhesives as sealants, further studies are warranted for the final support of that conclusion.
Medicina oral, patologia oral y cirugia bucal 11/2007; 12(6):E459-63.
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ABSTRACT: The objective was to analyze the impact of preventive programmes on oral quality of life in school students aged 11-12 yrs.
In the school year 1996/97, a quasi-experimental study was initiated in Granada province with four groups of students aged 6-7 yrs: Sealant + Fluoride (sealants on first permanent molars applied in the health centre for a 3-yr active programme, and fluoride varnish applied every four months for 3 yrs, n=65), Sealant (only sealants, n=80), Fluoride (only fluoride varnish, n=107) and Control group (n=59). All students were examined every 6 months at school during the 3-yr active programme and received an oral health report after each examination. At 5.5 yrs (school year 2002/03), after 2.5 yrs with no programme, students were again examined and completed a questionnaire on oral quality of life scored from -6 (minimum) to +6 (maximum).
Oral quality of life values (+/- standard deviation) were: 3.31+/-0.30 (Sealant + Fluoride), 3.11+/-0.27 (Sealant), 3.18+/-0.23 (Fluoride) and 2.95+/-0.32 (Control), with no statistically significant differences among them.
Fissure sealant and fluoride varnish programmes had no significant influence on oral quality of life after a 5.5- yr follow-up (3 yrs of active programme plus 2.5 yrs of discontinuation).
Medicina oral, patologia oral y cirugia bucal 10/2007; 12(5):E408-11.
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ABSTRACT: To compare the apical sealing in mesio-buccal canals of extracted molars obturated with low-temperature thermoplasticized gutta-percha or cold lateral condensation techniques using a .06 or a .02 mm/mm tapered gutta-percha master cone. The secondary aim was to evaluate the depth of spreader penetration in root canals using a .06 or a .02 mm/mm tapered gutta-percha master cone.
Forty-four mesio-buccal curved canals (25-40 degree) were instrumented with .06 nickel-titanium rotary instruments and randomly distributed into two control groups (n=4) and three experimental groups (n=12) for obturation by the Ultrafil 3D system or by cold lateral condensation with .06 or .02 tapered master cone. Canal sealer AH-Plus was used. The depth of spreader penetration was recorded in millimetres. Roots were covered with two layers of nail polish, immersed in India ink for 7 days, transversally sectioned and examined with a stereomicroscope. Student s t test was used to determine whether there was a difference in spreader penetration between groups. Kruskal-Wallis test was used to determine whether there was a difference in leakage.
There were no differences among the three groups (p=0.396), which showed a very similar mean microleakage (0.42, 0.75 and 0.42). The difference in spreader penetration between the groups filled by cold lateral condensation was significant (p=0.001)
The Ultrafil 3D system and cold lateral condensation techniques with .06 or .02 tapered master cones were equally effective in the apical sealing of curved canals. The spreader penetrated deeper using a .02 mm/mm tapered gutta-percha master cone.
Medicina oral, patologia oral y cirugia bucal 04/2007; 12(2):E175-9.
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ABSTRACT: The goal of this study was to evaluate the cleaning ability of three acid irrigating solutions after hand and rotary instrumentation. Eighty human teeth were randomly divided in eight groups. Four groups were prepared with hand instrumentation and other four with ProTaper. The irrigating solutions were 15% citric acid plus 2.5% NaOCl; 15% EDTA plus 2.5% NaOCl; 5% orthophosphoric acid plus 2.5% NaOCl; and 2.5% NaOCl alone as control. Canal walls were observed with scanning electron microscopy, and photomicrographs were taken in apical, middle, and coronal thirds. A scoring system for debris and smear layer was used. Acid solutions with 2.5% NaOCl were effective in the elimination of smear layer or debris, and no significant differences were showed in smear layer removal between techniques. However, 2.5% NaOCl did not remove smear layer or debris, and no significant differences in debris were observed between manual and rotary techniques.
Journal of Endodontics 11/2006; 32(10):993-7. · 2.88 Impact Factor
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ABSTRACT: To analyse the effect of a public school odontological programme of fissure sealants on the private demand for restorative dentistry for temporary teeth.
A longitudinal, comparative study was conducted. It had 2 groups, control and sealant, with 3 years monitoring.
Santa Fe Health Area, concretely in the local districts (LD) of Santa Fe and Pinos Puente, Granada, Spain, starting in the school year 1996/1997.
The sealant group was selected from the Santa Fe LD (which had a public programme of fissure sealants) (n=129); and the control group (n=120), from Pinos Puente LD.
All the school students were examined (+ report issued) in the schools every 6 months for 3 years. The sealant group children received at the health centre fissure sealants in their first permanent molars.
The restorations performed in temporary teeth for both groups were analysed (x+/-EE) during the study at 12, 24, and 36 month follow-up. RESULTS. The sealant group had a significantly greater increase in restorative treatment for temporary teeth (P< .05) than the Control group at all monitoring points.
A public programme of fissure sealants raised private restorative treatment for temporary teeth.
Atención Primaria 11/2006; 38(9):496-500. · 0.63 Impact Factor
