[show abstract][hide abstract] ABSTRACT: AimTo evaluate connective tissue reactions to iRoot SP (Innovative Bioceramics, Vancouver, BC, Canada), mineral trioxide aggregate (MTA) Fillapex (FLPX) (Angelus Soluções Odontológicas, Londrina, Brazil), DiaRoot Bioaggregate (DiaDent Group International, Burnaby, BC, Canada) and white MTA (Angelus, Londrina, Brazil) in Wistar rats. MethodologyA total of 128 dentine tubes filled with the materials and 32 empty tubes (control) were implanted into 32 rats. After 7, 15, 30 and 90 days (n = 8 per period), the animals were euthanized, and the tissues were processed for histological evaluation using haematoxylin-eosin (H&E) and Von Kossa (VK) staining. Observations were made for cellular inflammatory components and the presence of multinucleated giant cells (MNGC), macrophages and tissue necrosis. Data were analysed by Fisher's exact and Kruskal–Wallis tests (P < 0.05). ResultsIn all experimental periods, MTA FLPX and iRoot SP scored higher than the other groups for the variable macrophages (P < 0.05). After 30- and 90-day experimental periods, MTA FLPX scored higher than the other groups for the variable MNGC (P < 0.05). After 90 days, the only group that exhibited samples with severe inflammatory response was MTA FLPX. VK positivity was observed in areas of necrosis in all groups, except in the control group. Conclusions
The materials were considered biologically acceptable except MTA FLPX, which remained toxic to subcutaneous tissue even after 90 days.
International Endodontic Journal 11/2013; · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: To analyse the influence of exposure of mineral trioxide aggregate (MTA) with and without calcium chloride (CaCl2 ) to phosphate-buffered saline (PBS) on the push-out bond strength, over different experimental periods.
One hundred and twenty dentine discs with standardized cavities were filled with MTA with and without 10% CaCl2 . The specimens were randomly divided as follows (n = 30): (G1) MTA in contact with a moistened cotton pellet, (G2) MTA immersed in PBS, (G3) MTA + CaCl2 in contact with a moistened cotton pellet and (G4) MTA + CaCl2 immersed in PBS. The samples were stored for 3, 28 and 60 days. The bond strengths were measured with the Instron Testing machine. Data were analysed using the three-way anova and Tukey test (P < 0.05).
In general, the samples of MTA with and without CaCl2 , exposed to PBS, had higher bond strength values in all study periods (P < 0.05). Analysis of the influence of addition of CaCl2 to MTA (G1 × G3) evidenced significant differences in bond strength in the different periods (P < 0.05).
The exposure of MTA to PBS positively influenced the push-out bond strength, whereas the addition of CaCl2 had a negative influence.
International Endodontic Journal 07/2013; · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: Mineral trioxide aggregate (MTA) and Portland cement have been shown to be bioactive because of their ability to produce biologically compatible carbonated apatite. This study analyzed the interaction of MTA and white Portland cement with dentin in vivo.
Seventy-two human dentin tubes were filled with MTA Branco, MTA BIO, and white Portland cement + 20% bismuth oxide (PC1) or PC1 + 10% of calcium chloride (PC2) and implanted subcutaneously in 18 rats at 4 sites from the dorsal area. Empty dentin tubes, implanted in rats of a pilot study, were used as control. After 30, 60, and 90 days, the animals were killed, and the dentin tubes were retrieved for scanning electron microscope analysis.
In the periods of 30 and 60 days, the mineral deposition in the material-dentin interface (interfacial layer) and in the interior of dentinal tubules was detected in more tubes filled with MTA Branco and MTA BIO than in tubes filled with PC1 and PC2. After 90 days, the interfacial layer and intratubular mineralization were detected in all tubes except for 3 and 1 of the tubes filled with PC2, respectively.
It was concluded that all the cements tested were bioactive. The cements released some of their components in the tissue capable of stimulating mineral deposition in the cement-dentin interface and in the interior of the dentinal tubules. MTA BIO and MTA Branco were more effective in promoting the biomineralization process than Portland cements, mainly after 30 and 60 days.
Journal of endodontics 03/2012; 38(3):324-9. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: Milk has been studied extensively and has gained wide acceptance as a suitable storage medium capable of maintenance of avulsed teeth that cannot be replanted immediately. The objective of this study was to evaluate whether the renewal of milk as a storage medium every 24 h for up to 120 h is able to increase its ability to maintain human periodontal ligament fibroblasts (PDLF) viability in vitro. Plates with confluent PDLF were soaked in minimum essential medium (MEM) at 37°C (positive control) and in skimmed milk (22 wells) and water (negative control) for 24, 48, 72, 96, and 120 h at 5 and 20°C. The skimmed milk was renewed every 24 h in 11 of the wells of each plate. After these periods, cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by Kruskal-Wallis and Scheffé tests (α = 5%). At 24 h, milk and MEM performed similarly. However, from 48 h onwards, MEM was significantly better than renewed and not renewed milk at both temperatures. Regardless of temperature (5 or 20°C), renewal of milk with fresh milk did not affect its ability to maintain PDLF viability.
[show abstract][hide abstract] ABSTRACT: Mineral trioxide aggregate (MTA) and calcium hydroxide [Ca(OH)(2)] are promising biomaterials for stimulating dentinogenesis and cementogenesis. This research was undertaken to understand how MTA and CA(OH)(2) participate in the inflammatory, healing, and biomineralization processes. In this part of the study, we evaluated inflammatory signaling molecules promoted by in vivo host interaction with MTA and Ca(OH)(2).
Human dentin tubes were filled with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), Ca(OH)(2), or kept empty. After 12 hours and 1, 3, 7, 15, 30, and 60 days of implantation in subcutaneous tissues in the backs of mice, the tubes and surrounding tissues were retrieved for cytokine level quantification and histological and immunohistochemical analysis.
MTA and Ca(OH)(2) induced proinflammatory cytokine up-regulation for up to 3 days. Moreover, interleukin-10 overexpression was noted on the tissue in contact with the biomaterials during the acute phase of the inflammatory reaction. Immunohistochemical analyses showed an increased expression of myeloperoxidase, nuclear factor kappa B (NF-κB), cyclooxygenase-2, inducible nitric oxide synthase enzymes, and vascular endothelial growth factor on day 1 for all groups.
MTA and Ca(OH)(2) increased the activation of the NF-κB signaling system on day 1 for all groups. This finding can be associated with a proinflammatory and pro-wound healing environment, which was promoted earlier by MTA.
Journal of endodontics 09/2011; 37(9):1225-35. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: Pulse oximetry (PO) is a well-accepted non-invasive method for assessing vascular health, based on oxygen saturation (SaO(2) ) measurements. The objectives of this study were to design and build a custom-made PO dental sensor holder, to evaluate the effectiveness of PO in determining pulp blood flow in primary and permanent teeth, and to compare the SaO(2) levels obtained in teeth and on the little finger of patients. The PO sensor adapted to the custom-made sensor holder is termed as a device to position and hold the PO sensor. This study evaluated SaO(2) readings obtained in the pulp of 123 teeth of 84 children aged 4-13years. The teeth were divided into three groups: group I - primary teeth: 23 central incisors and 28 canines; group II - permanent teeth: 25 central incisors and 28 canines; and group III - endodontically treated teeth (control): 12 permanent central incisors and seven primary central incisors. The pulp blood flow and SaO(2) were measured and were compared with readings of the patient's finger. Data were analyzed by paired t-tests and Pearson's analysis method. The PO was able to identify all the clinically normal pulps contained in the sample, and all the endodontically treated teeth (controls) showed no response. The mean SaO(2) values were 85.27% in the teeth and 92.85% in the fingers. In conclusion, PO readings were effective in determining pulp blood flow in primary and permanent teeth. However, there was no correlation between the SaO(2) values in the fingers and in the teeth of the patients (P<0.05).
[show abstract][hide abstract] ABSTRACT: To evaluate the effectiveness of various storage media at 5 °C for maintaining the viability of human periodontal ligament fibroblasts (PDLF).
Plates with PDLF were soaked in recently prepared Hank's balanced salt solution (HBSS), skimmed milk, whole milk, Save-A-Tooth(®) system's HBSS (Save), natural coconut water, industrialized coconut water or tap water (negative control) at 5 °C for 3, 6, 24, 48, 72, 96 and 120 h. Minimum essential medium (MEM) at 37 °C served as the positive control. PDL cell viability was determined by MTT assay. Data were statistically analysed by Kruskal-Wallis test complemented by the Scheffé test (α=5%).
The greatest number of viable cells was observed for MEM. Skimmed and whole milk, followed by natural coconut water and HBSS, were the most effective media in maintaining cell viability (P<0.05). From 24 to 120 h, Save, industrialized coconut water and tap water were the worst storage media.
Skimmed and whole milk had the greatest capacity to maintain PDLF viability when compared with natural coconut water, HBSS, Save, industrialized coconut water and tap water.
International Endodontic Journal 11/2010; 44(2):111-5. · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: Recently, it was shown that the biomineralization process promoted by the interaction of mineral trioxide aggregate (MTA) with dentin in phosphate-buffered saline (PBS) positively influenced the push-out bond strength of the cement. This study investigated if the use of a PBS intracanal dressing promotes the biomineralization process of MTA apical plugs using an ex vivo apexification model.
White MTA was introduced into single-rooted teeth with standardized artificially created open apices to form 5-mm-thick apical plugs. The specimens were randomly divided into the following three groups of 10 samples each: group 1: the remaining canal space was filled with PBS as an intracanal dressing; group 2: the root segments were introduced in plastic vials containing floral foams with 20 mL of PBS; and group 3: the root segments were placed in the floral foams with 20 mL of PBS and a PBS intracanal dressing was used. After 2 months, the samples were processed for scanning electron microscopic observations. Data were analyzed by using the Kruskall-Wallis test.
In group 1, the formation of an interfacial layer (IL) with intratubular mineralization (ITM) was more evident at the cervical third; however, no mineralization was revealed at the apical third. In group 2, there was no IL and/or ITM formation at the cervical third, but samples denoted IL and ITM formation at the apical third. Group 3 displayed the formation of IL and ITM at the different levels.
It was concluded that the use of a PBS intracanal dressing promotes the biomineralization process at the inner side of MTA apical plugs.
Journal of endodontics 10/2010; 36(10):1648-52. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: Hank's balanced salt solution (HBSS) is recommended for the storage of avulsed teeth. The objective of this study was to evaluate if the HBSS storage time influences its ability to maintain the viability of human periodontal ligament fibroblasts (PDLF) by the analysis of cell metabolic function using MTT assay. PDLF were kept at 20°C for 3, 6, 24, 48, 72, 96 and 120 h in recently prepared HBSS (HBSS), HBSS stored for 6 months (HBSS 6 M), HBSS stored for 12 months (HBSS 12 M), and in Save-A-Tooth system's HBSS (Save). Minimum essential medium (MEM) at 37°C and tap water at 20°C served as positive and negative controls, respectively. Cell viability was determined by the tetrazolium salt-based colorimetric (MTT) assay. Data were statistically analyzed by the Kruskal-Wallis and Scheffé tests (α = 5%). Starting with the 6 h time-point, HBSS was significantly more effective than HBSS 6 M, HBSS 12 M and Save in maintaining cell viability. HBSS 6 M effectiveness was similar to that of HBSS 12 M for up to 48 h, becoming higher at 72 h. In conclusion, the storage time of HBSS had a negative influence on its ability to maintain PDLF viability.
[show abstract][hide abstract] ABSTRACT: The biological processes underlying the ability of mineral trioxide aggregate (MTA) to promote hard-tissue deposition and wound healing remain unclear. To further study these processes, specific signaling molecules related to the inflammatory response and the biomineralization process were analyzed to assess host-MTA interactions in vivo.
For cytokine level quantification and immunohistochemical analysis, human dentin tubes were filled with ProRoot MTA (Dentsply, Tulsa Dental, OK) or kept empty and were implanted in subcutaneous tissues in the backs of mice. Dentin tubes were retrieved and subsequently observed using a scanning electron microscope.
MTA induced a time-dependent proinflammatory cytokine up-regulation up to 3 days. Immunohistochemical analyses showed an up-regulated expression of myeloperoxidase, nuclear factor-kappa B, activating protein-1, cyclooxygenase-2, inducible nitric oxide synthase, and vascular endothelial growth factor on day 1. Scanning electron microscopic examination revealed the presence of apatite-like clusters on collagen fibrils over the surface of tubes containing MTA. With the increase in time after implantation, a more extensive mineralization showing a compact layer of apatite was observed.
MTA induced a proinflammatory and pro-wound healing environment. The biomineralization process occurred simultaneously at the biomaterial-dentin-tissue interface, with the acute inflammatory response. This promoted the integration of the biomaterial into the environment.
Journal of endodontics 08/2010; 36(8):1347-53. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: Many solutions have been examined as possible storage media for avulsed teeth. The purpose of this study was to compare the effectiveness of several storage media to preserve cultured periodontal ligament fibroblasts (PDLF) under different temperatures. The media tested were: sterile Hank's balanced salt solution (sHBSS), non-sterile HBSS (nHBSS), skimmed milk, Save-A-Tooth((R)), Minimum Essential Medium (MEM) and water (negative control). MEM at 37 degrees C was used as positive control. PDLF were obtained from explants of extracted healthy human teeth. Plates containing confluent PDLF were soaked in the various media for 3, 6, 24, 48 and 72 h at 37 degrees C and 20 degrees C. After incubation, viability of the cells was determined using the tetrazolium salt-based colorimetric (MTT) assay and the Trypan Blue exclusion test after 6, 24, 48 and 72 h of incubation at 20 degrees C. The results were analyzed statistically using Kruskal-Wallis, Scheffé and Mann-Whitney (alpha = 5%) tests. Results from the MTT assay at 37 degrees C and 20 degrees C showed that skimmed milk was the best storage medium for up to 24 and 48 h, respectively, followed by nHBSS and sHBSS. Results from the Trypan Blue exclusion test showed that the best storage media were milk, sHBSS and nHBSS, with no statistical differences, for any time period. The Save-A-Tooth((R)) had a detrimental effect on cells after 24 h. The influence of temperature on the effectiveness of the storage media tested showed at 20 degrees C a decreasing order of efficacy as follows: milk > sHBSS and nHBSS > MEM > Save-A-Tooth((R)) > water while at 37 degrees C it was: MEM > nHBSS > milk > sHBSS > Save-A-Tooth((R)) > water. In conclusion, incubation temperature altered the effectiveness of the storage media and skimmed milk at 20 degrees C was better than HBSS in maintaining PDLF viability.
[show abstract][hide abstract] ABSTRACT: Recently, it was shown that the interaction of each of mineral trioxide aggregate (MTA) and Portland cement with dentin in phosphate-buffered saline (PBS) promotes a biomineralization process that leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface. This study analyzes the influence of the biomineralization process on the push-out strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK), MTA Branco (Angelus Soluções Odontológicas, Londrina, PR, Brazil), MTA BIO (Angelus Soluções Odontológicas), or Portland cement with and without calcium chloride.
Dentin discs with standardized cavities were filled with ProRoot MTA, MTA Branco, MTA BIO, white Portland cement + 20% bismuth oxide (PC1), or PC1 + 10% of calcium chloride (PC2). The specimens were randomly divided into two groups: cement in contact with a wet cotton pellet for 72 hours or immersed in PBS for 2 months. The bond strengths were measured with the Instron Testing machine (Model 4444; Instron Corp, Canton, MA), and the fractured surfaces on the root walls were observed by scanning electron microscopy.
All samples immersed in PBS displayed a significantly greater resistance to displacement than that observed for the samples in contact with a wet cotton pellet for 72 hours (p < 0.05). MTAs displayed a significantly greater resistance to displacement than Portland cements.
It was concluded that the biomineralization process positively influenced the push-out bond strength of the cements, particularly the MTA groups.
Journal of endodontics 02/2010; 36(2):286-91. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim is to verify, under scanning electron microscopy, the occurrence of apical root resorption in anterior and posterior teeth with chronic and radiographically visible periapical lesions. Thirty-two teeth were extracted, the apical thirds (n = 39) were removed, and prepared to analyse the external apical root surface. All specimens presented irregular areas of root resorption with different depths, located mainly around the apical foramen. Teeth with chronic periapical lesions present areas of external apical root resorption with irregular surface and different depths located mainly around the apical foramen. Root resorptions may show different configurations and destroy the apical root structure more or less extensively.
Australian Endodontic Journal 12/2009; 35(3):153-7. · 0.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Mineral trioxide aggregate (MTA) has been shown to be bioactive because of its ability to produce biologically compatible carbonated apatite. This study analyzed the interaction of MTA and white Portland cement with dentin after immersion in phosphate-buffered saline (PBS).
Dentin disks with standardized cavities were filled with ProRoot MTA, MTA Branco, MTA BIO, white Portland cement + 20% bismuth oxide (PC1), or PC1 + 10% of calcium chloride (PC2) and immersed in 15 mL of PBS for 2 months. The precipitates were weighed and analyzed by scanning electron microscopy (SEM) and x-ray diffraction. The calcium ion release and pH of the solutions were monitored at 5, 15, 25, and 35 days. The samples were processed for SEM observations. Data were analyzed by using analysis of variance or Kruskall-Wallis tests.
Our findings revealed the presence of amorphous calcium phosphate precipitates with different morphologies. The apatite formed by the cement-PBS system was deposited within collagen fibrils, promoting controlled mineral nucleation on dentin, observed as the formation of an interfacial layer with tag-like structures.
All the cements tested were bioactive. The cements release some of their components in PBS, triggering the initial precipitation of amorphous calcium phosphates, which act as precursors during the formation of carbonated apatite. This spontaneous precipitation promotes a biomineralization process that leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface.
Journal of endodontics 06/2009; 35(5):731-6. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study evaluated the influence of addition of 10% calcium chloride (CaCl(2)) on the setting time, solubility, disintegration, and pH of white MTA (WMTA) and white Portland cement (WPC). A test of the setting time was performed following the #57 ADA specifications and a test of the final setting time according to the ASTM. For the solubility tests disintegration and pH, Teflon rings were filled with the cements and weighed after setting. After 24 h in a desiccator, they were once again weighed. Thereafter, they were immersed in MiliQ water for 24 and 72 h and 7, 14, and 28 days, with maintenance in the desiccator and weighing between periods. The pH of water in which the rings were immersed was measured immediately after contact with them and in the other periods. The addition of CaCl(2) provided a significant reduction (50%) in the initial setting time of cements. The final setting time of WMTA was reduced in 35.5% and the final setting time of WPC in 68.5%. The WMTA with CaCl(2) absorbed water and gained weight with time, except for in the 24-h period. The addition of CaCl(2) to the WPC reduced its solubility. The addition of CaCl(2) increased the pH of WMTA in the immediate period and at 24 and 72 h and for WPC in the immediate period and at 24 h. The addition of CaCl(2) to WMTA and WPC reduced the setting times and solubility of both and increased the pH of cements in the initial periods.
Journal of endodontics 05/2009; 35(4):550-4. · 2.95 Impact Factor
[show abstract][hide abstract] ABSTRACT: Osteogenesis imperfecta (OI), also known as "brittle bone disease," can be difficult to diagnose in its mild form. The authors describe a clinical case of a diagnosis of dentinogenesis imperfecta (DI), in which a literature review combined with an analysis of dental alterations led to indications of OI involvement.
Since DI can be associated with OI, the authors reviewed correlated studies and obtained a new medical history from the patient. They then conducted a radiographic and clinical examination of the dentition and submitted an affected third molar to scanning electron microscopy analysis. They compared their findings with descriptions of OI type I dental alterations in the literature and confirmed their diagnosis by means of a medical evaluation.
In cases in which DI is diagnosed, patients should be examined carefully and the occurrence of OI should be considered since, in its mild form, it might be misdiagnosed.
Journal of the American Dental Association (1939) 08/2008; 139(7):906-14; quiz 994. · 1.82 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the capacity of the ROOT ZX II to locate the apical foramen and to control the apical extent of rotary instrumentation.
Sixty-five extracted human single rooted teeth were selected and measured directly using a size 15 K-Flexofile introduced in the canal until the tip was visible at the major foramen (direct length, DL). The teeth were then measured electronically (EL1) with the ROOT ZX II when used passively, that is without rotation. To test the auto reverse function, the root canals were instrumented with nickel titanium rotary instruments. Instrumentation was carried out apically until rotation was reversed by the automatic apical reverse (AAR) function at different levels (2, 1 and 0.5). The instrumented length at each level was measured and registered as AAR2, AAR1 and AAR0.5, respectively. After instrumentation, a second passive electronic measurement was conducted and noted as electronic length 2 (EL2). All measurements were expressed in millimetres with accuracy set to 0.5 mm. Percentages of acceptable measurements for each electronic reading were calculated and compared using the proportions test. The Wilcoxon's signed rank test was used to compare the differences between DL/EL1 and DL/EL2, and to compare EL2 with the different AAR measurements. The critical value of statistical significance was 5%.
EL1 and EL2 measurements were coincident to DL in 56 (86%) and 54 (83%) of the cases, respectively. The proportions test showed no statistically significant difference between these percentages (P > 0.05). The Wilcoxon's signed rank test did not show any differences (P > 0.05) when comparing the mean difference between DL with EL1 (0.03) and DL with EL2 (0.10). Statistically significant differences were observed when comparing EL2 with AAR2 and with AAR1.
The ROOT ZX II reliably located the major apical foramen, but was not an accurate method for controlling the apical extent of rotary instrumentation. Rotary instrumentation with the automatic apical reverse feature was always closer to the foramen than expected.
International Endodontic Journal 06/2008; 41(6):502-7. · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the effect of different irrigant solutions employed during removal and replacement of calcium hydroxide paste on the diffusion of hydroxyl ions through root canal dentine in vitro.
Thirty-five maxillary and mandibular human canines with straight and fully developed roots were used. After mechanical preparation up to 1mm short of tooth length, 30 canals were filled with calcium hydroxide paste and 5 canals were left empty; all teeth had their coronal accesses properly sealed. Teeth were placed in plastic containers with distilled water, and pH was read after 30 days when the paste from 20 teeth was renewed. After removal of the paste by endodontic instrumentation and irrigation with distilled water, canals were replenished with newly mixed paste in Group 1 and 2. In these groups, final irrigation was conducted with 5 mL of EDTA followed by 5 mL of NaOCl in specimens in Group 1, and 5 mL of NaOCl only in specimens in Group 2. In 10 teeth the paste was not replenished at 30 days (Group 3). All specimens were returned to the containers with fresh distilled water, and the pH was recorded after another 30 days. The differences between the first (30d) and second (60d) pH readings were calculated and submitted to analysis of variance and individual comparisons using the Scheffeé's test.
Results of mean analysis on differences of pH readings showed that greater diffusion had occurred on specimens in Group 3. Individual comparisons using Scheffeé's test showed statistical significance between Groups 2 and 3, and equivalence between all other groups.
It was concluded that the use of EDTA did not enhance diffusion of hydroxyl ions through root canal dentine.
Journal of applied oral science: revista FOB 02/2006; 14(1):1-5. · 0.39 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA.
Twenty premolars from two 6-month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide-propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%.
Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters.
Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls.
International Endodontic Journal 02/2006; 39(1):2-9. · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate ex vivo the capacity of the Tri Auto ZX to locate the apical foramen during root canal retreatment.
The root canals of 62 maxillary and mandibular canines were prepared to a length 1 mm short of the apical foramen, to an apical size 35 using 1% sodium hypochlorite as an irrigant. Once prepared, the length of each tooth was measured directly using a size 15 K-Flexofile introduced in the canal until the tip was visible at the apical foramen. After the file was removed, its length was recorded to a precision of 0.01 mm using a calliper. These direct lengths (DL) became the 'gold standard' for comparison with the electronic lengths (EL) derived from the Tri Auto ZX. After direct measurement, the tooth was measured electronically (EL1) and the canals were filled using lateral condensation of gutta-percha cones and sealer. Seven days later the root filling was removed using solvent, Gates-Glidden burs, and K-files, and new electronic lengths determined (EL2). The electronic lengths (EL1 and EL2) were compared with the DL, and the differences were analysed statistically using the proportions test and Student's t-test.
At a tolerance limit of +/-0.5 mm, EL1 coincided with the DL in 76% of cases. Lengths obtained in the presence of remnant of filling material (EL2) coincided in 81% of cases. The proportions test used to compare these percentages showed no statistically significant difference between EL1 and EL2 (P > 0.05). The Student's t-test revealed a statistically significant difference (P < 0.05) between the means of the differences between DL/EL1 (-0.36 mm) and DL/EL2 (-0.04 mm).
The Tri Auto ZX was accurate to +/-0.5 mm in more than 80% of teeth following removal of root fillings.
International Endodontic Journal 11/2005; 38(10):718-24. · 2.05 Impact Factor