Publications by authors named "Mario Tanomaru-Filho"

174 Publications

Push-Out Bond Strength, Characterization, and Ion Release of Premixed and Powder-Liquid Bioceramic Sealers with or without Gutta-Percha.

Scanning 2021 6;2021:6617930. Epub 2021 May 6.

Department of Restorative Sciences, University of Costa Rica, Montes de Oca, San José 11502, Costa Rica.

Objective: To evaluate the push-out bond strength of premixed and powder-liquid bioceramic sealers with or without gutta-percha (GP) cone.

Materials And Methods: Radicular dentin samples were prepared from 80 single-rooted human teeth. After root canal preparation using ProTaper® and irrigation with NaOCl and EDTA, teeth were divided according to the root canal sealer ( = 20): AH Plus®, EndoSequence® BC Sealer™, ProRoot® Endo Sealer, and BioRoot™ RCS. Samples were randomly divided into two subgroups ( = 10): GP-S: root canal filling using the single-cone technique, or S: filling with only sealer. Specimens were kept at 37°C and 100% humidity in calcium-free PBS for 30 days. The push-out bond strength was measured in MPa. Fractured specimens were observed at 25x to evaluate the type of failure. pH and calcium ion release were measured at different experimental periods. Raman and SEM-EDAX analyses were performed for root canal sealers. Data were analysed using three-way analysis of variance (ANOVA) and post hoc Tukey test at a significance of < 0.05.

Results: Push-out bond strength was greater for samples obturated with only sealers (S) than samples obturated with the single-cone technique (GP-S) ( < 0.05). BioRoot™ RCS had greater bond strength than EndoSequence® BC Sealer™. Adhesive failures between cement and gutta-percha cone (87.5%) were predominant in the GP-S. Cohesive failures were predominant for S (80%). BioRoot™ RCS and ProRoot® ES presented higher alkalinization potential than the premixed sealer (EndoSequence® BC Sealer™). Powder-liquid bioceramic sealers (BioRoot™ RCS and ProRoot® ES) released the highest cumulative amount of calcium (28.46 mg/L and 20.05 mg/L).

Conclusion: Push-out test without gutta-percha cone presents higher bond strength for bioceramic sealers. Powder-liquid calcium silicate-based sealers present greater bioactivity related to alkalinization potential and calcium ion release.
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http://dx.doi.org/10.1155/2021/6617930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121597PMC
May 2021

Physicochemical properties and effect of bioceramic root canal filling for primary teeth on osteoblast biology.

J Appl Oral Sci 2021 3;29:e20200870. Epub 2021 May 3.

Universidade Estadual Paulista "Julio de Mesquita Fillho" (UNESP) - Faculdade de Odontologia de Araraquara - Departamento de Odontologia Restauradora - Araraquara - SP - Brasil.

Objective: Bio-C Pulpecto (Bio-CP) was recently developed as the first bioceramic root filling material for primary teeth. To evaluate the physicochemical properties of radiopacity, setting time, pH, cytocompatibility and potential of Bio-CP to induce mineralisation, compared with (1) Calen thickened with zinc oxide (Calen-ZO), and (2) zinc oxide and eugenol (ZOE).

Methodology: Physicochemical properties were evaluated according to ISO 6876. Saos-2 (human osteoblast-like cell line) exposed to extracts of the materials were subjected to assays of methyl thiazolyl tetrazolium, neutral red, alkaline phosphatase (ALP) activity and mineralised nodule production. The results were analysed using one-way or two-way ANOVA and Tukey's or Bonferroni's post-tests (α=0.05).

Results: All the materials showed radiopacity higher than 3 mm Al. Bio-CP had lower pH than Calen-ZO, but higher pH than ZOE. Calen-ZO and Bio-CP did not set. The setting time for ZOE was 110 min. The cytocompatibility order was Calen-ZO > Bio-CP > ZOE (1:2, 1:4 dilutions) and Calen-ZO > Bio-CP = ZOE (1:12, 1:24 dilutions) and Calen-ZO = Bio-CP > ZOE (1:32 dilution). Bio-CP induced greater ALP activity at 7 days, and greater mineralised nodule production, compared to Calen-ZO (p<0.05). Conclusions Bio-CP showed adequate physicochemical properties, cytocompatibility and potential to induce mineralisation.
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http://dx.doi.org/10.1590/1678-7757-2020-0870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092806PMC
May 2021

Effect of Different Dimensions of Test Samples on the Volumetric Change Assessment Of Endodontic Materials.

Braz Dent J 2021 Jan-Feb;32(1):42-47

Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil.

New methodologies using micro-CT to evaluate solubility besides dimensional and morphological changes of endodontic materials are proposed. However, there is no standardization in the methods. The aim of this study was to assess the effect of different dimensions of test samples on volumetric change evaluation of different endodontic materials. AH Plus, FillCanal and Sealapex root canal sealers, Biodentine, IRM and MTA root-end filling cements were used in the tests. Samples of each material with a thickness of 1.5 mm and different diameters were manufactured: 6.3, 7.75, and 9.0 mm. The samples were scanned in micro-computed tomography (micro-CT) after setting and after 7 days of immersion in distilled water. The volumetric change was evaluated by means of the difference in the total volume of the specimens before and after immersion. Data were submitted to ANOVA and Tukey tests (p<0.05). The size of the samples did not affect the percentage of volumetric change of the materials (p>0.05). All sample sizes had greater volume loss for Sealapex among the sealers and Biodentine for the cements (p<0.05). In conclusion, Biodentine and Sealapex had the highest volume loss after immersion. Samples with 1.5 mm thickness, and diameters ranging between 6.3 and 9.0 mm can be used to assess the stability of endodontic materials using micro-CT without affecting the percentage of volumetric change.
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http://dx.doi.org/10.1590/0103-6440202103507DOI Listing
May 2021

Evaluation of 10 Cone-beam Computed Tomographic Devices for Endodontic Assessment of Fine Anatomic Structures.

J Endod 2021 Jun 7;47(6):947-953. Epub 2021 Mar 7.

OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.

Introduction: The purpose of this study was to classify 10 cone-beam computed tomographic (CBCT) devices using a ranking model according to the detection of fine endodontic structures.

Methods: A dedicated dentate anthropomorphic phantom was scanned 2 times using 10 CBCT devices without any metal (metal-free condition) and with an endodontically treated tooth containing a metallic post (metal condition). A reference image acquired on an industrial micro-CT scanner was used to register all CBCT images, yielding corresponding anatomic slices. Afterward, 3 experienced observers assessed all acquired CBCT images for their ability to assess a narrow canal, isthmus, and apical delta ramification using a categoric rank from 1 (best) to 10 (worst). Fleiss kappa statistics were used to calculate intra- and interobserver agreements for each CBCT device separately. Based on the observers' scores, general linear mixed models were applied to compare image quality among different CBCT devices for performing endodontic diagnostic tasks (α = .05).

Results: The 10 CBCT devices performed differently for the evaluated endodontic tasks (P < .05), with 3 devices performing better for endodontic feature detection. Yet, in the presence of metal, only 2 devices were able to keep a high level of endodontic feature detection.

Conclusions: The evaluated endodontic tasks were CBCT device dependent, and their detection was influenced by the presence of metal.
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http://dx.doi.org/10.1016/j.joen.2021.02.013DOI Listing
June 2021

Biocompatibility and bioactive potential of the NeoMTA Plus endodontic bioceramic-based sealer.

Restor Dent Endod 2021 Feb 17;46(1):e4. Epub 2020 Dec 17.

Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Laboratory of Histology and Embryology, Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.

Objectives: This study evaluated the biocompatibility and bioactive potential of NeoMTA Plus mixed as a root canal sealer in comparison with MTA Fillapex.

Materials And Methods: Polyethylene tubes filled with NeoMTA Plus ( = 20), MTA Fillapex ( = 20), or nothing (control group, CG; = 20) were inserted into the connective tissue in the dorsal subcutaneous layer of rats. After 7, 15, 30 and 60 days, the specimens were processed for paraffin embedding. The capsule thickness, collagen content, and number of inflammatory cells (ICs) and interleukin-6 (IL-6) immunolabeled cells were measured. von Kossa-positive structures were evaluated and unstained sections were analyzed under polarized light. Two-way analysis of variance was performed, followed by the Tukey test ( ≤ 0.05).

Results: At 7 days, the capsules around NeoMTA Plus and MTA Fillapex had more ICs and IL-6-immunostained cells than the CG. However, at 60 days, there was no significant difference in the IC number between NeoMTA Plus and the CG ( = 0.1137) or the MTA Fillapex group ( = 0.4062), although a greater number of IL-6-immunostained cells was observed in the MTA Fillapex group ( = 0.0353). From 7 to 60 days, the capsule thickness of the NeoMTA Plus and MTA Fillapex specimens significantly decreased, concomitantly with an increase in the collagen content. The capsules around root canal sealers showed positivity to the von Kossa stain and birefringent structures.

Conclusions: The NeoMTA Plus root canal sealer is biocompatible and exhibits bioactive potential.
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http://dx.doi.org/10.5395/rde.2021.46.e4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906839PMC
February 2021

A micro-computed tomographic study using a novel test model to assess the filling ability and volumetric changes of bioceramic root repair materials.

Restor Dent Endod 2021 Feb 8;46(1):e2. Epub 2020 Dec 8.

Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil.

Objectives: New premixed bioceramic root repair materials require moisture for setting. Using micro-computed tomography (micro-CT), this study evaluated the filling ability and volumetric changes of calcium silicate-based repair materials (mineral trioxide aggregate repair high-plasticity [MTA HP] and Bio-C Repair, Angelus), in comparison with a zinc oxide and eugenol-based material (intermediate restorative material [IRM]; Dentsply DeTrey).

Materials And Methods: Gypsum models with cavities 3 mm deep and 1 mm in diameter were manufactured and scanned using micro-CT (SkyScan 1272. Bruker). The cavities were filled with the cements and scanned again to evaluate their filling capacity. Another scan was performed after immersing the samples in distilled water for 7 days to assess the volumetric changes of the cements. The statistical significance of differences in the data was evaluated using analysis of variance and the Tukey test with a 5% significance level.

Results: Bio-C Repair had a greater filling ability than MTA HP ( < 0.05). IRM was similar to Bio-C and MTA HP ( > 0.05). MTA HP presented the largest volumetric change ( < 0.05), showing more volume loss than Bio-C and IRM, which were similar ( > 0.05).

Conclusions: Bio-C Repair is a new endodontic material with excellent filling capacity and low volumetric change. The gypsum model proposed for evaluating filling ability and volumetric changes by micro-CT had appropriate and reproducible results. This model may enhance the physicochemical evaluation of premixed bioceramic materials, which need moisture for setting.
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http://dx.doi.org/10.5395/rde.2021.46.e2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906850PMC
February 2021

Safety and Effectiveness of Additional Apical Preparation using a Rotary Heat-treated Nickel-Titanium file with Larger Diameter and Minimum Taper in Retreatment of Curved Root Canals.

Eur J Dent 2021 May 23;15(2):247-252. Epub 2021 Feb 23.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University, São Paulo, Brazil.

Objective:  The aim of this study was to investigate the effect of additional apical preparation using the ProDesign Logic (PDL) 50/.01 rotary heat-treated nickel-titanium (NiTi) file with a larger diameter and minimal taper for retreatment of curved root canals.

Materials And Methods:  Mesial curved root canals of 12 mandibular molars were prepared using PDL 25/.06 and filled using the continuous wave of condensation technique and AH Plus sealer. After retreatment using ProDesign S (PDS) 25/.08, PDL 25/.06 and PDL 35/05, a complementary procedure was performed with PDL 50/.01. Microcomputed tomography (micro-CT) scanning was performed before and after retreatment procedures. The cyclic fatigue resistance of unused PDS 25/.08, PDL 25/.06, PDL 35/.05 and PDL 50/.01 instruments ( = 12) was evaluated in a stainless-steel device.

Statistical Analysis:  Data on the volumes of the root canals and the remaining filling materials were submitted to the paired t-test. Cyclic fatigue resistance data was submitted to one-way ANOVA and Tukey's tests (α = 0.05).

Results:  Use of PDL 50/.01 decreased the remaining filling materials in the apical third ( 0.05). The root canal volume was similar in the cervical and middle thirds before and after preparation using PDL 50/.01 ( 0.05). PDL 50/.01 presented the highest cyclic fatigue resistance ( 0.05).

Conclusions:  Use of the PDL 50/.01 instrument as an additional apical preparation for retreatment of curved root canals improved filling material removal in the apical third, while maintaining the dentin in the cervical and middle thirds. In addition, PDL 50/.01 presented high-flexural resistance.
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http://dx.doi.org/10.1055/s-0041-1723065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184271PMC
May 2021

Effect of obturation technique using a new bioceramic sealer on the presence of voids in flattened root canals.

Braz Oral Res 2021 12;35:e028. Epub 2021 Feb 12.

Universidade Estadual Paulista - Unesp, School of Dentistry , Department of Restorative Dentistry , Araraquara , SP , Brazil .

The aim of this study was to evaluate the filling ability of a new ready-to-use calcium silicate-based sealer using thermoplastic or single-cone technique in flattened root canals. Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were prepared and filled (n = 12), according to the following techniques: thermoplastic or single-cone technique using Bio-C Sealer. The teeth were scanned using Skycan 1176 micro-computed tomography (micro-CT) - voxel size 8.74 µm, before and after filling the root canal. The percentage of voids in the filled root canals was evaluated, and the data were statistically analyzed using the unpaired t-test (α = 0.05). The root canals filled using the thermoplastic technique created a smaller percentage of voids in the cervical/middle thirds than those filled using the single-cone technique (p < 0.05). There was no difference in the percentage of voids using either technique in the apical third (p > 0.05). The flattened root canals in the cervical/middle thirds were better filled using the ready-to-use calcium silicate-based sealer associated to the thermoplastic technique, compared with the single-cone technique. In the apical third, the techniques showed similar filling ability.
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http://dx.doi.org/10.1590/1807-3107bor-2021.vol35.0028DOI Listing
February 2021

Physicochemical, biological, and antibacterial evaluation of tricalcium silicate-based reparative cements with different radiopacifiers.

Dent Mater 2021 02 13;37(2):311-320. Epub 2020 Dec 13.

Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil. Electronic address:

Objective: To evaluate tricalcium silicate-based (TCS) experimental materials, associated with zirconium oxide (ZrO), calcium tungstate (CaWO) or niobium oxide (NbO) radiopacifiers, in comparison with MTA Repair HP (Angelus).

Methods: Physicochemical tests: setting time, radiopacity, pH and solubility. In vitro assays: cytotoxicity: MTT and Neutral Red - NR; cell bioactivity: alkaline phosphatase activity (ALP), Alzarin red staining (ARS) and real time PCR (qPCR). Antibacterial activity: direct contact on Enterococcus faecalis in the planktonic form. Physicochemical and ARS data were submitted to ANOVA/Tukey tests; antibacterial activity, to Kruskall-Wallis and Dunn tests; MTT, NR, ALP and qPCR were analyzed by ANOVA/Bonferroni tests (α = 0.05).

Results: TCS + CaWO presented the longest setting time and MTA HP the shortest. Except for TCS, all the materials presented radiopacity above 3 mmAl. The cements had alkaline pH, antibacterial activity, low solubility and no cytotoxic effects. The highest ALP activity occurred in 14 days, especially to TCS, TCS + ZrO and TCS + CaWO. TCS + ZrO, TCS + NbO and MTAHP had higher mineralized nodule formation than those of the negative control (NC). After 7 days, there was no difference in mRNA expression for ALP, when compared to NC. However, after 14 days there was no overexpressed ALP mRNA, especially TCS + NbO, in relation to the CN. All the materials presented antimicrobial action.

Significance: The pure tricalcium silicate associated with ZrO, CaWO or NbO had appropriate physicochemical properties, antibacterial activity, cytocompatibility and induced mineralization in Saos-2, indicating their use as reparative materials.
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http://dx.doi.org/10.1016/j.dental.2020.11.014DOI Listing
February 2021

Physicochemical properties, cytotoxicity and penetration into dentinal tubules of sodium hypochlorite with and without surfactants.

Restor Dent Endod 2020 Nov 10;45(4):e47. Epub 2020 Sep 10.

Department of Restorative Dentistry, São Paulo State University (UNESP), Araraquara School of Dentistry, Araraquara, SP, Brazil.

Objectives: The aim of this study was to assess the physicochemical properties, cytotoxicity and penetration into dentinal tubules of ChlorCid™ Surf (3% sodium hypochlorite [NaOCl] with surfactant) in comparison to ChlorCid™ (3% NaOCl without surfactant).

Materials And Methods: The physicochemical properties evaluated were pH, surface tension, free available chlorine (FAC) and contact angle. Cytotoxicity was evaluated in L929 fibroblasts exposed to the solutions by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and neutral red assays. Assessment of penetration into dentinal tubules was performed by staining single-rooted permanent human teeth with crystal violet ( = 9), which were irrigated with the solutions and analyzed in cervical, middle and apical segments. Data were analyzed by one-way analysis of variance (ANOVA) and Tukey's -test, 2-way ANOVA and Bonferroni's -test or -test (α = 0.05).

Results: ChlorCid™ Surf and ChlorCid™ FAC values were close to those indicated by the manufacturer. ChlorCid™ Surf showed lower surface tension and contact angle on dentin, and higher pH than ChlorCid™ ( < 0.05). The penetration of ChlorCid™ Surf was higher in cervical and middle segments, compared with ChlorCid™ ( < 0.05). There was no difference in irrigant cytotoxicity ( > 0.05).

Conclusions: ChlorCid™ Surf showed lower surface tension, lower contact angle on root canal dentin, higher penetration into dentinal tubules and more alkaline pH, compared with ChlorCid™. However, both solutions showed similar cytotoxicity and FAC content.
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http://dx.doi.org/10.5395/rde.2020.45.e47DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691254PMC
November 2020

Micro-CT evaluation of filling of flattened root canals using a new premixed ready-to-use calcium silicate sealer by single-cone technique.

Microsc Res Tech 2021 May 5;84(5):976-981. Epub 2020 Dec 5.

Araraquara School of Dentistry, Department of Restorative Dentistry, UNESP-São Paulo State University, Araraquara, SP, Brazil.

The aim of this study was to evaluate the filling ability of a new premixed ready-to-use calcium silicate-based sealer, in comparison with an epoxy resin-based sealer by the single-cone technique in flattened root canals. Thirty-two flattened root canals of maxillary second premolars with buccal-lingual diameter 4 or more times larger than the mesio-distal diameter at 9 mm from the radiographic apex were selected. Root canals were prepared using Hyflex EDM 25/0.08 and additional preparation with ultrasonic tip Flatsonic and ProDesign Logic 25/0.03. After preparation, the root canals were filled with two root canal sealers (n = 16): Bio-C Sealer or AH Plus using the single-cone technique. Scanning was performed before and after root canal obturation using a Skycan 1176 micro-computed tomography (micro-CT) with an isotropic voxel size of 8.74 μm. The percentage of voids was analyzed in the cervical/middle thirds and in the apical third. Data were submitted to the Mann-Whitney test at a significance level of 5%. There was no statistical difference between Bio-C Sealer and AH Plus (p > .05). The percentage of voids in the cervical/middle thirds was 8.94% (1.33-39.95) for Bio-C Sealer and 9.30% (1.19-18.00) for AH Plus (p > .05). In the apical third, this percentage was 11.84% (4.85-27.00) for Bio-C Sealer and 9.21% (1.34-28.78) for AH Plus (p > .05). By using the single-cone technique, neither Bio-C Sealer nor AH Plus provided a voids-free root canal filling. Both sealers had similar filling ability in flattened root canals.
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http://dx.doi.org/10.1002/jemt.23658DOI Listing
May 2021

Influence of voxel size on micro-CT analysis of debris after root canal preparation.

Braz Oral Res 2020 13;35:e008. Epub 2020 Nov 13.

Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil.

The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on the evaluation of debris accumulation after passive ultrasonic irrigation (PUI) in curved root canals prepared with rotary nickel-titanium files. Mesial root canals (n = 24) of mandibular molars with curvature between 25° and 35° were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM). PUI was performed after root canal preparation of all root canals. The specimens were scanned using high-resolution (5 μm voxel size) micro-CT imaging before and after experimental procedures. The percentage of debris was analyzed in the middle and apical thirds using images with 5, 10 and 20 μm voxel sizes. Data were compared using unpaired and paired Student's t-test, ANOVA and Tukey's statistical tests (α = 0.05). There were no differences among the debris analyses performed at different voxel sizes (5, 10 and 20 μm) (p > 0.05). The percentage of debris was similar between the root canals prepared by PDL and HEDM before and after PUI (p > 0.05). In both groups, the percentage of debris decreased in the middle third after PUI (p < 0.05). Within the limitations of this ex vivo study, it can be concluded that the voxel sizes evaluated did not have a significant impact on the analysis of accumulated debris. However, the results showed a tendency for detection of more debris in the analysis performed using a lower voxel size. PUI decreased the debris accumulation in the middle third of curved root canals.
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http://dx.doi.org/10.1590/1807-3107bor-2021.vol35.0008DOI Listing
January 2021

Physicochemical Properties of a Bioceramic Repair Material - BioMTA.

Braz Dent J 2020 Sep-Oct;31(5):511-515

Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil.

This study aimed to assess the physicochemical properties of a repair material in the Brazilian market, BioMTA, in comparison to other two materials currently in use (Biodentine and MTA Angelus). The initial setting time was evaluated using Gillmore needle. The pH was measured with a pH-meter after 24 h, 3, 7, 14 and 21 days. The radiopacity was determined using the equivalence in millimeters of aluminum (mm Al) from digitized occlusal radiographs. Solubility was determined after immersion in water for 7 days. The data were analyzed by one-way ANOVA and Tukey tests (a=0.05). The BioMTA initial setting time (5.2 min) was lower than the other materials (p<0.05). All materials showed an alkaline pH at 21 days. At 24 h, BioMTA was the most alkaline material (p<0.05); and at 3, 7, 14 and 21 days there was no difference between BioMTA and Biodentine (p>0.05), both being more alkaline than MTA Angelus (p<0.05). The radiopacity of BioMTA (4.2 mm Al) was significantly higher compared to Biodentine (p<0.05) and lower than MTA Angelus (p<0.05). The solubility of the materials was -4.2%, -1.6% and 4.1% for BioMTA, MTA Angelus and Biodentine, respectively, with a significant difference between them (p<0.05). Therefore, it can be concluded that BioMTA displayed a shorter setting time, an alkaline pH, a higher radiopacity, and a gain in mass.
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http://dx.doi.org/10.1590/0103-6440202003163DOI Listing
November 2020

Filling Ability and Flow of Root Canal Sealers: A Micro-Computed Tomographic Study.

Braz Dent J 2020 Sep-Oct;31(5):499-504

Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil.

This study evaluated by micro-computed tomography (μCT) the filling ability in curved root canals, besides the flow of AH Plus (AHP) and Neo MTA Plus (NMTAP) sealers using different methodologies. Mandibular molars mesial roots with two root canals and degree of curvature between 20° and 40° were selected. The specimens were prepared with the ProDesign R system up to size 35.05 and were filled with the sealers by a continuous wave of condensation technique, Thermo Pack II (n=12). The teeth were scanned using μCT after root canal preparation and obturation. The volumetric percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 (n=10). Flow and filling were also evaluated in μCT using a glass plate with a central cavity and four grooves from the central cavity (n=6). Flow was linearly calculated into the grooves. The central cavity filling (CCF) and lateral cavity filling (LCF) were calculated in mm³. Data were submitted to non-paired t test with a significance threshold at 5%. The percentage of filling and voids between the root canals filled with AHP or NMTAP was similar (p>0.05). NMTAP presented the lowest flow in conventional test (p<0.05). Using μCT, sealers had similar CCF, LCF and linear flow (p>0.05). In conclusion, NMTAP and AHP had similar filling ability in curved mesial root canals of mandibular molars without presence of isthmus. Although AHP presented better flow than NMTAP using ISO methodology, there was no difference between these materials regarding volumetric filling when evaluated by μCT.
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http://dx.doi.org/10.1590/0103-6440202003328DOI Listing
November 2020

Development and evaluation of reparative tricalcium silicate-ZrO -Biosilicate composites.

J Biomed Mater Res B Appl Biomater 2021 Apr 28;109(4):468-476. Epub 2020 Aug 28.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Sao Paulo, Brazil.

Biosilicate is a bioactive glass-ceramic used in medical and dental applications. This study evaluated novel reparative materials composed of pure tricalcium silicate (TCS), 30% zirconium oxide (ZrO ) and 10 or 20% biosilicate, in comparison with Biodentine. Setting time was evaluated based on ISO 6876 standard, radiopacity by radiographic analysis, solubility by mass loss, and pH by using a pH meter. Cytotoxicity was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and NR assays. Alkaline phosphatase (ALP) activity and alizarin red were used to evaluate cell bioactivity. Antimicrobial activity was assessed on Enterococcus faecalis by the direct contact test. The data were submitted to analysis of variance (ANOVA)/Tukey; Bonferroni and Kruskal-Wallis, and Dunn tests (α = 0.05). The association of Biosilicate with TCS + ZrO had appropriate setting time, radiopacity, and solubility, alkaline pH, and antimicrobial activity. TCS and Biodentine showed higher ALP activity in 14 days than the control (serum-free medium). All cements produced mineralized nodules. In conclusion, Biosilicate + TCS ZrO decreased the setting time and increased the radiopacity in comparison to TCS. Biosilicate + TCS ZrO2 presented lower solubility and higher radiopacity than Biodentine. In addition, these experimental cements promoted antimicrobial activity and mineralization nodules formation, suggesting their potential for clinical use.
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http://dx.doi.org/10.1002/jbm.b.34714DOI Listing
April 2021

Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers.

Restor Dent Endod 2020 Aug 9;45(3):e34. Epub 2020 Jun 9.

Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil.

Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer).

Materials And Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to -test ( < 0.05).

Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer.

Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.
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http://dx.doi.org/10.5395/rde.2020.45.e34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431941PMC
August 2020

Root Canal Preparation and Enlargement Using Thermally Treated Nickel-Titanium Rotary Systems in Curved Canals.

J Endod 2020 Aug 17. Epub 2020 Aug 17.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.

Introduction: The purpose of this study was to evaluate root canal preparation and apical enlargement of curved canals using rotary heat-treated and heat/surface-treated systems by micro-computed tomographic imaging.

Methods: Curved mesial root canals (n = 48) of mandibular molars (20°-40°) were prepared using ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 25/.01 and 25/.06 or HyFlex EDM (HFEDM) 10/.05, HyFlex CM 20/.04, and HFEDM 25/.08. Apical enlargement was performed using PDL 40/.05 or HFEDM 40/.04. Scanning (9 μm) was performed before and after preparation and after apical enlargement using micro-computed tomographic imaging. Volume, percentage of volume increase, debris, untouched root canal surface, and centering ability were analyzed. Statistical analysis was performed using Mann-Whitney, Wilcoxon, and unpaired t tests (α = .05).

Results: HFEDM promoted a higher volume increase of the root canals than PDL after preparation and after apical enlargement (P < .05). The apical enlargement promoted a significant decrease in debris and untouched surface in both groups (P < .05). The percentage of debris and untouched surface were similar between HFEDM and PDL after preparation and after apical enlargement (P > .05). Both systems promoted centered canals (P > .05).

Conclusions: HFEDM instruments promoted greater volume of the root canal than PDL. However, the cleaning ability of the instruments was similar. The apical increase up to size 40 with both instruments provided less debris and untouched surfaces and allowed centralization of the curved root canals.
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http://dx.doi.org/10.1016/j.joen.2020.08.007DOI Listing
August 2020

Dental discoloration caused by Grey-MTAFlow cement: analysis of its physicochemical, biological and antimicrobial properties.

J Appl Oral Sci 2020 5;28:e20200269. Epub 2020 Aug 5.

Faculdade de Odontologia de Piracicaba, Universidade de Campinas, Piracicaba, São Paulo, Brasil.

Tricalcium silicate-based cement are materials used in reparative and regenerative procedures in endodontics. A recently proposed formulation aimed to enhance handling during clinical use with a versatile material applicable by syringe. Although, the use of bismuth oxide as radiopacifier and grey raw powder are drawbacks considering aesthetics. Objectives Evaluate physicochemical, biological, and antimicrobial properties of Grey-MTAFlow (Ultradent) and assess whether the addition of zinc oxide (ZnO) prevents dentinal discoloration caused by bismuth oxide. Methodology Grey-MTAFlow was manipulated in 'thin' consistency for all tests. Luminosity, color change, ion migration to dentine, radiopacity, setting time, ISO 6876:2012 linear flow, volumetric lateral flow and central filling of simulated grooves scanned using micro-computed tomography (μCT), pH, calcium release, volumetric change using μCT, chemical characterisation, cytotoxicity, and antimicrobial activity were assessed. Addition of 5% ZnO to Grey-MTAFlow and a bismuth-containing experimental composition were comparatively tested. Statistical analyses used Shapiro-Wilk, T-test, ANOVA, and Kolmogorov-Smirnov (p<0.05). Results The addition of ZnO to Grey-MTAFlow prevented dentine darkening after 90 days due to bismuth migration reduction, although no statistical difference was found (p=0.863). ZnO addition significantly enhanced Grey-MTAFlow radiopacity without differences in initial setting time. Grey-MTAFlow presented an ISO linear flow of 10.9 mm and a balanced volumetric lateral flow with central filling in μCT evaluation. All compositions presented an alkaline pH after immersion. Grey-MTAFlow had a significantly higher calcium ion release after 28 days in comparison to 24 hours (p=0.011) and volumetric expansion of 0.4±1.8% after immersion. ZnO addition altered the hydrated cement matrix once calcium hydroxide (portlandite) could not be detected in characterisation. Neither of the materials produced inhibition halos nor reduced bacterial turbidity, but all presented cytocompatibility above 100%. Conclusion Grey-MTAFlow expanded after immersion and exhibited higher luminosity values after the evaluation period when ZnO was added, but chemical modifications after this addition occurred.
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http://dx.doi.org/10.1590/1678-7757-2020-0269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406195PMC
October 2020

Radiopacity of endodontic materials using two models for conversion to millimeters of aluminum.

Braz Oral Res 2020 15;34:e080. Epub 2020 Jul 15.

Department of Restorative Dentistry, Araraquara School of Dentistry, Universidade Estadual Paulista, Araraquara, SP, Brazil.

The aims of the present study were to compare conventional radiography, radiographs digitized with a scanner or photographic camera, and digital radiography, used to evaluate the radiopacity of endodontic materials, and to compare the accuracy of linear and quadratic models used to convert radiopacity values to equivalent millimeters of aluminum (mm Al). Specimens of AH Plus, Endofill, Biodentine and BioMTA materials (n = 8) were radiographed next to an aluminum step-wedge using radiographic films and digital radiography systems (FONA CMOS sensor, Kodak CMOS sensor and photosensitive phosphor plate-PSP). Conventional radiographs were digitized using a scanner or photographic digital camera. Digital images of all the radiographic systems were evaluated using dedicated software. Optical density units (ODU) of the specimens and the aluminum step-wedge were evaluated by a photo-densitometer (PTDM), used in conventional radiographs. The radiopacity in equivalent mm Al of the materials was determined by linear and quadratic models, and the coefficients of determination (R2) values were calculated for each model. Radiopacity of the materials ranged from -9% to 25% for digital systems and digitized radiographs, compared to the PTDM (p < 0.05). The R2 values of the quadratic model were higher than those of the linear model. In conclusion, the FONA CMOS sensor showed the lowest radiopacity variability of the methodologies used, compared with the PTDM, except for the BioMTA group (higher than PTDM). The quadratic model showed higher R2 values than the linear model, thus indicating better accuracy and possible adoption to evaluate the radiopacity of endodontic materials.
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http://dx.doi.org/10.1590/1807-3107bor-2020.vol34.0080DOI Listing
September 2020

New Ultrasonic Tip Decreases Uninstrumented Surface and Debris in Flattened Canals: A Micro-computed Tomographic Study.

J Endod 2020 Jul 16. Epub 2020 Jul 16.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.

Introduction: The preparation of flattened root canals using reciprocating or rotary nickel-titanium instruments associated with the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) was evaluated by micro-computed tomographic imaging.

Methods: Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were randomly divided into 2 experimental groups for preparation: a Reciproc Blue (RB; VDW GmbH, Munich, Germany) 40/.06 file in reciprocating motion or ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 40/.01 and 40/.05 files in rotary motion (n = 12). A complementary preparation was performed with the Flatsonic ultrasonic tip for both preparations. Micro-computed tomographic scanning at a resolution of 8.74 μm was performed before and after preparation with the nickel-titanium instruments and after the use of the Flatsonic tip. The percentages of increase in volume, debris, and uninstrumented surface were analyzed. The data obtained were submitted to the paired and unpaired t test, analysis of variance, and the Tukey test (α = 5%).

Results: The percentage increase in volume, debris, and uninstrumented surface was similar between RB and PDL in the entire root canal (P > .05). The PDL promoted a lower percentage of debris in the cervical third and a lower percentage of increase in volume in the apical third in comparison with RB (P < .05). The Flatsonic decreased debris and uninstrumented surface after PDL preparation in all thirds (P < .05). After preparation with RB, the Flatsonic decreases the debris in the cervical third and the uninstrumented surface in the cervical and middle thirds (P < .05).

Conclusions: The preparation of flattened root canals using RB or PDL produced a high percentage of debris and uninstrumented surface. The Flatsonic ultrasonic tip significantly improved the cleaning of flattened root canals.
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http://dx.doi.org/10.1016/j.joen.2020.07.012DOI Listing
July 2020

Biocompatibility and Bioactive Potential of New Calcium Silicate-based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC.

J Endod 2020 Oct 17;46(10):1470-1477. Epub 2020 Jul 17.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.

Introduction: Bio-C Sealer (BC; Angelus, Londrina, PR, Brazil) and Sealer Plus BC (SPBC; MK Life, Porto Alegre, Brazil) are new ready-to-use bioceramic endodontic sealers. The aim of this study was to evaluate the biocompatibility and bioactive potential of BC and SPBC sealers in comparison with AH Plus (AHP; Dentsply DeTrey Gmbh, Konstanz, Germany) in subcutaneous tissue of rats.

Methods: Polyethylene tubes filled with materials and empty tubes, serving as the control group, were implanted in the subcutaneous tissues of rats. After 7, 15, 30, and 60 days, the tubes with connective tissue were removed, and inflammatory cells (ICs)/mm and immunolabeled cells for interleukin (IL)-6 were evaluated. Osteocalcin and von Kossa analysis were also performed. Data were submitted to analysis of variance and Tukey tests, with a significance level of 5%.

Results: At 7 days, SPBC showed lower ICs than BC (P < .05). AHP exhibited greater immunolabeled cells for IL-6 (P < .05). After 15 days, BC showed lower ICs and IL-6 compared with other materials. At 30 days, SPBC and AHP showed higher values for ICs (P < .05). After 60 days, calcium silicate sealers did not show statistical difference (P > .05) for ICs and IL-6, with values lower than AHP (P < .05). The materials showed positive structures to von Kossa staining. BC exhibited osteocalcin labeling in all periods. SPBC showed osteocalcin labeling from 15-60 days. AHP and the control group did not exhibit osteocalcin labeling.

Conclusions: BC and SPBC sealers are biocompatible and present bioactive potential.
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http://dx.doi.org/10.1016/j.joen.2020.07.011DOI Listing
October 2020

How image-processing parameters can influence the assessment of dental materials using micro-CT.

Imaging Sci Dent 2020 Jun 18;50(2):161-168. Epub 2020 Jun 18.

Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil.

Purpose: The aim of this study was to evaluate the influence of voxel size and different post-processing algorithms on the analysis of dental materials using micro-computed tomography (micro-CT).

Materials And Methods: Root-end cavities were prepared in extracted maxillary premolars, filled with mineral trioxide aggregate (MTA), Biodentine, and Intermediate Restorative Material (IRM), and scanned using micro-CT. The volume and porosity of materials were evaluated and compared using voxel sizes of 5, 10, and 20 µm, as well as different software tools (post-processing algorithms). The CTAn or MeVisLab/Materialise 3-matic software package was used to perform volume and morphological analyses, and the CTAn or MeVisLab/Amira software was used to evaluate porosity. Data were analyzed using 1-way ANOVA and the Tukey test (<0.05).

Results: Using MeVisLab/Materialise 3-matic, a consistent tendency was observed for volume to increase at larger voxel sizes. CTAn showed higher volumes for MTA and IRM at 20 µm. Using CTAn, porosity values decreased as voxel size increased, with statistically significant differences for all materials. MeVisLab/Amira showed a difference for MTA and IRM at 5 µm, and for Biodentine at 20 µm. Significant differences in volume and porosity were observed in all software packages for Biodentine across all voxel sizes.

Conclusion: Some differences in volume and porosity were found according to voxel size, image-processing software, and the radiopacity of the material. Consistent protocols are needed for research evaluating dental materials.
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http://dx.doi.org/10.5624/isd.2020.50.2.161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314609PMC
June 2020

Micro-computed tomographic evaluation of the flow and filling ability of endodontic materials using different test models.

Restor Dent Endod 2020 May 8;45(2):e11. Epub 2020 Jan 8.

Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil.

Objectives: This study compared the flow and filling of several retrograde filling materials using new different test models.

Materials And Methods: Glass plates were manufactured with a central cavity and 4 grooves in the horizontal and vertical directions. Grooves with the dimensions used in the previous study (1 × 1 × 2 mm; length, width, and height respectively) were compared with grooves measuring 1 × 1 × 1 and 1 × 2 × 1 mm. Biodentine, intermediate restorative material (IRM), and mineral trioxide aggregate (MTA) were evaluated. Each material was placed in the central cavity, and then another glass plate and a metal weight were placed over the cement. The glass plate/material set was scanned using micro-computed tomography. Flow was calculated by linear measurements in the grooves. Central filling was calculated in the central cavity (mm) and lateral filling was measured up to 2 mm from the central cavity.

Results: Biodentine presented the least flow and better filling than IRM when evaluated in the 1 × 1 × 2 model. In a comparison of the test models, MTA had the most flow in the 1 × 1 × 2 model. All materials had lower lateral filling when the 1 × 1 × 2 model was used.

Conclusions: Flow and filling were affected by the size of the test models. Higher grooves and materials with greater flow resulted in lower filling capacity. The test model measuring 1 × 1 × 2 mm showed a better ability to differentiate among the materials.
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http://dx.doi.org/10.5395/rde.2020.45.e11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239685PMC
May 2020

Immunoinflammatory response and bioactive potential of GuttaFlow bioseal and MTA Fillapex in the rat subcutaneous tissue.

Sci Rep 2020 04 28;10(1):7173. Epub 2020 Apr 28.

Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry - Laboratory of Histology and Embryology, Dental School - São Paulo State University (UNESP), Araraquara, SP, Brazil.

To evaluate the effect of GuttaFlow bioseal (GFB) and MTA Fillapex (MTAF) in comparison with Endofill (EF) in the subcutaneous tissue. Polyethylene tubes with GFB, MTAF, EF or empty tubes (control group; CG) were implanted into subcutaneous of rats. After 7, 15, 30 and 60 days, the capsule thickness, inflammatory reaction, interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), caspase-3, TUNEL-positive cells, von Kossa and ultrastructural features were evaluated. The data were statistically analyzed (p ≤ 0.05). At all periods, the number of IL-6- and VEGF-immunolabelled cells, and capsule thickness were lower in GFB than MTAF, which was lower than EF (p < 0.0001). At 60 days, the number of inflammatory cells was similar in GFB and MTAF (p = 0.58). Significant differences in the number of TUNEL- and caspase-3-positive cells were not observed among GFB, MTAF and CG whereas the highest values were found in EF specimens. The EF specimens exhibited several cells with condensed chromatin, typical of apoptosis. von Kossa-positive and birefringent structures were only observed in GFB and MTAF, suggesting the presence of calcite crystals. Taken together, these results show that cellular and structural damage induced by GFB and MTAF sealers were recovery over time. Moreover, these sealers express bioactive potential in subcutaneous tissue.
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http://dx.doi.org/10.1038/s41598-020-64041-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188821PMC
April 2020

Physical Properties, Antimicrobial Activity and In Vivo Tissue Response to Apexit Plus.

Materials (Basel) 2020 Mar 5;13(5). Epub 2020 Mar 5.

Laboratory of Histology and Embryology, Dental School - São Paulo State University (UNESP), Araraquara 14801-903, Brazil.

We investigated the physical properties, antimicrobial activity, and tissue reaction to Apexit Plus in comparison to Sealapex. Flow, radiopacity, setting time, and solubility were evaluated in each material. The antimicrobial activity against was performed. Polyethylene tubes containing Apexit Plus or Sealapex, and without material (control group) were implanted into the subcutaneous tissue of rats. At 7, 15, 30, and 60 days of implantation, the specimens were paraffin-embedded and the number of inflammatory cells (ICs) and the amount of birefringent collagen (BC) were quantified. The von Kossa reaction followed by immunohistochemistry for detection of alkaline phosphatase (ALP) was also performed. Statistical analysis was performed with ANOVA and Tukey test ( ≤ 0.05). The flow value of Apexit Plus was greater than Sealapex, whereas the radiopacity (3.44 mm Al) was lower than Sealapex (6.82 mm Al). Apexit Plus showed lower solubility and shorter initial and final setting ( 0.0001), whereas the antimicrobial activity was significantly greater than Sealapex. Although the number of ICs was higher in Apexit Plus ( = 0.0009) at 7 days, no significant difference was detected between Apexit Plus and Sealapex at 15, 30, and 60 days. All groups showed higher values for BC in the capsules over time. ALP-immunolabelled cells were observed, mainly around von Kossa-positive structures, either in the capsules of Apexit Plus or Sealapex. Therefore, our results revealed that Apexit Plus exhibited a greater effectiveness against and better physical properties than Sealapex, except for the radiopacity. In vivo findings indicate that Apexit Plus is biocompatible and presents potential bioactivity in the subcutaneous tissue.
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http://dx.doi.org/10.3390/ma13051171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085033PMC
March 2020

Non-Collagenous Dentin Protein Binding Sites Control Mineral Formation during the Biomineralisation Process in Radicular Dentin.

Materials (Basel) 2020 Feb 27;13(5). Epub 2020 Feb 27.

LICIFO-Laboratory of Research in Dental Sciences, Department of Endodontics, Faculty of Dentistry, University of Costa Rica, San Jose 11502 SJO, Costa Rica.

The biomineralisation of radicular dentin involves complex molecular signalling. Providing evidence of protein binding sites for calcium ions and mineral precipitation is essential for a better understanding of the remineralisation process. This study aimed to evaluate the functional relationship of metalloproteinases (MMPs) and non-collagenous proteins (NCPs) with mineral initiation and maturation during the biomineralisation of radicular dentin. A standardized demineralisation procedure was performed to radicular dentin slices. Samples were remineralised in a PBS-bioactive material system for different periods of time. Assessments of ion exchange, Raman analysis, and energy dispersive X-ray analysis (EDAX) with a scanning electron microscope (SEM) were used to evaluate the remineralisation process. Immunohistochemistry and zymography were performed to analyse NCPs and MMPs expression. SEM evaluation showed that the mineral nucleation and growth occurs, exclusively, on the demineralised radicular dentin surface. Raman analysis of remineralised dentin showed intense peaks at 955 and 1063 cm, which can be attributed to carbonate apatite formation. Immunohistochemistry of demineralised samples revealed the presence of DMP1-CT, mainly in intratubular dentin, whereas DSPP in intratubular and intertubular dentin. DMP1-CT and DSPP binding sites control carbonate apatite nucleation and maturation guiding the remineralisation of radicular dentin.
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http://dx.doi.org/10.3390/ma13051053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084694PMC
February 2020

Micro-computed tomography high resolution evaluation of dimensional and morphological changes of 3 root-end filling materials in simulated physiological conditions.

J Mater Sci Mater Med 2020 Jan 21;31(2):14. Epub 2020 Jan 21.

Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil.

The aim of this study was to evaluate volumetric and morphological stability of 3 root-end filling materials in addition to porosity and interface voids, using micro-computed tomography (µCT) in high resolution and a highly accurate approach for image analysis. Following root-end resection and apical preparation, two-rooted maxillary premolars were divided into three groups, according to the filling materials: White MTA Angelus, Biodentine, and IRM. Samples were scanned by µCT at 5 µm after the setting time and at time intervals of 7 and 30 days after immersion in phosphate-buffered saline (PBS). Volumetric and morphological changes besides material porosity and interface voids were evaluated by comparing initial values and those obtained after immersion. Data were analyzed statistically, using ANOVA and t-tests (α = 0.05). All materials showed volumetric stability. Regarding the morphological changes, Biodentine had a significant thickness reduction after storage in PBS when compared with MTA. Biodentine also showed an increase in porosity, as well as in percentage and thickness of voids after 30 days of immersion. In conclusion, µCT in high resolution and an accurate image analysis approach may be used to evaluate morphological changes of endodontic materials. Although Biodentine showed suitable adaptability and lower values of porosity than MTA, after PBS immersion there was a dimensional reduction of this material, besides an increase in porosity and interface voids.
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http://dx.doi.org/10.1007/s10856-019-6355-2DOI Listing
January 2020

Physicochemical Properties and Bioactive Potential of a New Epoxy Resin-based Root Canal Sealer.

Braz Dent J 2019 Nov-Dec;30(6):563-568

Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil.

The aim of this study was to evaluate physicochemical properties and bioactive potential of Sealer Plus, in comparison with MTA Fillapex, Sealapex and AH Plus. Setting time, flow, and radiopacity were evaluated based on ISO 6876 Standard. Flow was also assessed in area (mm²). The solubility and volumetric change of the sealers were evaluated after 7 and 30 days of immersion in distilled water. Solubility was evaluated by the difference in mass of materials before and after immersion. Volumetric change was evaluated by using microcomputed tomography (micro-CT). The bioactive potential was observed by Scanning Electron Microscopy (SEM) after immersion in PBS. Data were compared using ANOVA and Tukey tests (α=0.05). Sealer Plus presented the shortest setting time (196 min.) and Sealapex the longest (912 min.) (p<0.05). AH Plus showed the highest radiopacity (9.5 mm Al) and MTA Fillapex the lowest (2.7 mm Al) (p<0.05). All the sealers presented flow in accordance with ISO 6876/2012 (>17 mm). Sealer Plus showed low solubility and volumetric change (<1%), and MTA Fillapex showed the highest solubility (>25%), and volumetric change (>4%) after all time intervals (p<0.05). MTA Fillapex was the only sealer that showed bioactive potential. In conclusion, Sealer Plus presented proper physicochemical properties. However, this sealer did not present a bioactive potential.
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http://dx.doi.org/10.1590/0103-6440201802861DOI Listing
December 2019

Evaluation of Physicochemical Properties of a New Calcium Silicate-based Sealer, Bio-C Sealer.

J Endod 2019 Oct 22;45(10):1248-1252. Epub 2019 Aug 22.

Department of Restorative Dentistry, São Paulo State University, School of Dentistry, Araraquara, São Paulo, Brazil.

Introduction: Calcium silicate-based materials have been proposed as root canal sealers for root canal treatment. The aim of this study was to evaluate the physicochemical properties of a new calcium silicate-based sealer (Bio-C Sealer; Angelus, PR, Brazil) compared with a calcium silicate endodontic sealer (TotalFill BC Sealer; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) and an epoxy resin sealer (AH Plus; Dentsply DeTrey, Konstanz, Germany).

Methods: The setting time and flow were evaluated based on ISO 6876 standard. The pH value was evaluated after different time intervals of storage in deionized water (1, 7, 14, and 21 days). Radiopacity was evaluated by radiographic analysis in millimeters of aluminum. Solubility and volumetric change were evaluated after 30 days of immersion in distilled water. Solubility was assessed by mass loss (%), and volumetric change was evaluated by micro-computed tomographic imaging. The data were submitted to analysis of variance and Tukey statistical tests (P < .05).

Results: TotalFill BC Sealer and Bio-C Sealer were similar regarding radiopacity, volumetric change, and pH values (P > .05). Bio-C Sealer presented the shortest setting time and the highest flow and solubility (P < .05). AH Plus showed the highest radiopacity and the lowest flow, pH, solubility, and volumetric change (P < .05).

Conclusions: Bio-C Sealer showed a short setting time, alkalinization ability, and adequate flow and radiopacity as well as low volumetric change. However, this sealer had higher solubility than the rates required by ISO 6876 standard.
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http://dx.doi.org/10.1016/j.joen.2019.07.006DOI Listing
October 2019