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

Tanomaru-Filho, Mario,Torres, Fernanda Ferrari Esteves,Pinto, Jader Camilo,Santos-Junior, Airton Oliveira,Tavares, Karina Ines Medina Carita,Guerreiro-Tanomaru, Juliane Maria The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.3

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 t-test (p < 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.

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

Coaguila-Llerena Hernán,Barbieri Isadora,Tanomaru-Filho Mário,Leonardo Renato de Toledo,Ramos Ana Paula,Faria Gisele 대한치과보존학회 2020 Restorative Dentistry & Endodontics Vol.45 No.4

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 (n = 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 post-test, 2-way ANOVA and Bonferroni's post-test or t-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™ (p < 0.05). The penetration of ChlorCid™ Surf was higher in cervical and middle segments, compared with ChlorCid™ (p < 0.05). There was no difference in irrigant cytotoxicity (p > 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.

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

Torres Fernanda Ferrari Esteves,Guerreiro-Tanomaru Juliane Maria,Chavez-Andrade Gisselle Moraima,Pinto Jader Camilo,Berbert Fábio Luiz Camargo Villela,Tanomaru-Filho Mario 대한치과보존학회 2020 Restorative Dentistry & Endodontics Vol.45 No.2

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 (mm3 ) 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.

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

Torres, Fernanda Ferrari Esteves,Guerreiro-Tanomaru, Juliane Maria,Chavez-Andrade, Gisselle Moraima,Pinto, Jader Camilo,Berbert, Fabio Luiz Camargo Villela,Tanomaru-Filho, Mario The Korean Academy of Conservative Dentistry 2020 Restorative Dentistry & Endodontics Vol.45 No.1

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 (㎣) 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.

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

Torres Fernanda Ferrari Esteves,Pinto Jader Camilo,Figueira Gabriella Oliveira,Guerreiro-Tanomaru Juliane Maria,Tanomaru-Filho Mario 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.1

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 (p < 0.05). IRM was similar to Bio-C and MTA HP (p > 0.05). MTA HP presented the largest volumetric change (p < 0.05), showing more volume loss than Bio-C and IRM, which were similar (p > 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.

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

Hoshino Roberto Alameda,Delfino Mateus Machado,da Silva Guilherme Ferreira,Guerreiro-Tanomaru Juliane Maria,Tanomaru-Filho Mário,Sasso-Cerri Estela,Cerri Paulo Sérgio 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.1

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 (n = 20), MTA Fillapex (n = 20), or nothing (control group, CG; n = 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 post hoc Tukey test (p ≤ 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 (p = 0.1137) or the MTA Fillapex group (p = 0.4062), although a greater number of IL-6-immunostained cells was observed in the MTA Fillapex group (p = 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.

Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals

Tavares Karina Ines Medina Carita,Pinto Jáder Camilo,Santos-Junior Airton Oliveira,Esteves Torres Fernanda Ferrari,Guerreiro-Tanomaru Juliane Maria,Tanomaru-Filho Mario 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.4

Objectives This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.

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

Torres Fernanda Ferrari Esteves,Reinhilde Jacobs,Mostafa EzEldeen,Karla de Faria-Vasconcelos,Guerreiro-Tanomaru Juliane Maria,Bernardo Camargo dos Santos,Mário Tanomaru-Filho 대한영상치의학회 2020 Imaging Science in Dentistry Vol.50 No.2

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 (P<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.

How do imaging protocols affect the assessment of root-end fillings?

Torres Fernanda Ferrari Esteves,Jacobs Reinhilde,EzEldeen Mostafa,de Faria-Vasconcelos Karla,Guerreiro-Tanomaru Juliane Maria,dos Santos Bernardo Camargo,Tanomaru-Filho Mário 대한치과보존학회 2022 Restorative Dentistry & Endodontics Vol.47 No.1

Objectives This study investigated the impact of micro-computed tomography (micro-CT)-based voxel size on the analysis of material/dentin interface voids and thickness of different endodontic cements. Materials and Methods Following root-end resection and apical preparation, maxillary premolars were filled with mineral trioxide aggregate (MTA), Biodentine, and intermediate restorative material (IRM) (n = 24). The samples were scanned using micro-CT (SkyScan 1272; Bruker) and the cement/dentin interface and thickness of materials were evaluated at voxel sizes of 5, 10, and 20 µm. Analysis of variance and the Tukey test were conducted, and the degree of agreement between different voxel sizes was evaluated using the Bland and Altman method (p < 0.05). Results All materials showed an increase in thickness from 5 to 10 and 20 µm (p < 0.05). When evaluating the interface voids, materials were similar at 5 µm (p > 0.05), while at 10 and 20 µm Biodentine showed the lowest percentage of voids (p < 0.05). A decrease in the interface voids was observed for MTA and IRM at 20 µm, while Biodentine showed differences among all voxel sizes (p < 0.05). The Bland-Altman plots for comparisons among voxel sizes showed the largest deviations when comparing images between 5 and 20 µm. Conclusions Voxel size had an impact on the micro-CT evaluation of thickness and interface voids of endodontic materials. All cements exhibited an increase in thickness and a decrease in the void percentage as the voxel size increased, especially when evaluating images at 20 µm.