PDT presented negative effects on the bond strength to dentin in the cervical third after cementation using Relyx ARC and on the dentinal penetrability of the etch-and-rinse adhesive system in the cervical and apical thirds of the prosthetic space.
The aim of this study was to evaluate the effect of peracetic acid (PAA) as a single irrigant on the smear layer, on the intraradicular dentinal bond strength, and on the penetrability of an epoxy-based resin sealer into the dentinal tubules. A total of 120 roots were distributed into 4 groups according to the irrigant used in root canal preparation: 1% PAA (PAA); 2.5% NaOCl followed by final irrigation with 17% EDTA and 2.5% NaOCl (NaOCl-EDTA-NaOCl); 2.5% NaOCl (NaOCl); and saline solution (SS). The smear layer was evaluated using scanning electron microscopy. The bond strength of an epoxy-based resin sealer (AH Plus) to root dentin was evaluated by the push-out test and penetrability of the sealer into dentinal tubules was observed by confocal laser microscopy. The results were analyzed by the Kruskal-Wallis and the Dunn post-test (α = 0.05). The use of 1% PAA as single root canal irrigant provided smear layer removal and improved the penetrability and bond strength of AH Plus to root dentin in a manner similar to that of the NaOCl-EDTA-NaOCl group (p > 0.05). The NaOCl and SS groups had higher values of smear layer and lower values of sealer penetrability and dentin bond strength than the PAA and NaOCl-EDTA-NaOCl groups (p < 0.05). Thus, 1% PAA has the potential to be used as a single irrigant in root canals.
This case report presents an apical radicular perforation management using new calcium silicate-based cement (Biodentine) in a combined endodontic-periodontal lesion. The presence of apical radicular perforation may interfere in the endodontic treatment prognosis. Radicular perforation filling with bioactive cement through endodontic surgery is a possible treatment. This study presents an apical radicular perforation with periodontal involvement, due to alveolar bone loss on the buccal radicular surface from an incorrect intracanal preparation for the fiber post placing. The chosen alternative was a periapical surgery, the perforation was filled with a silicate and calcium chloride bioactive cement (Biodentine; Septodont, Saint-Maur-des-Fosses Cedex, France), and the radicular surface was etched with citric acid, because the access from root canal was impossible. The follow-up was for 8 months, through clinical and radiographic analysis. At the end of the follow-up, radiographic analyses showed the bone healing, and no clinical changes in periodontal probing depth, gingival recession, and the height of the interproximal mesial and distal papillae were observed. The root perforation treatment has a difficult management, especially when the dental root has a simultaneous periodontal commitment. The Biodentine proves to be a promising material for use in these situations.
This clinical report described an atypical case where the mineral trioxide aggregate (MTA)-based sealer added with 20% calcium hydroxyde was used for retrograde filling. The patient was subjected to endodontic surgery to remove persistent apical lesion. After the apicoetomy and apical cavity preparation using an ultrasonic device, MTA-based sealer (MTA Fillapex) added with 20% calcium hydroxide (w/w) was used for retrograde filling. After 48 hours, the radiographic analysis showed partial displacement and wash-out of sealer. The case was only clinically controlled and no surgery was performed. After 10 months, the postoperative control showed reduction of periapical radiolucent image and absence of symptoms, radiographic and clinical signs, presented bone periradicular repair showing partial absence of the sealer in cavity retrograde.
How to cite this article
Guiotti FA, Kuga MC, Magro MG, Venção AC, Tonetto MR, Jordão-Basso KCF, Bandeca MC, Dantas AAR. An Atypical Case of Partial Displacement and Wash-out of the Mineral Trioxide Aggregate-based Sealer in Endodontic Surgery. World J Dent 2015;6(2):108-111.
Aim:To evaluate the effect of 37% carbamide peroxide on the bond strength of conventional or resin-modified glass-ionomer cements when used as a cervical barrier in endodonticallytreated teeth.
Materials and methods:After root canal instrumentation and obturation, 40 specimens of the cement-enamel junction were obtained after transversal root canal sectioning from human extracted canines. The root canal specimens were standardized and filled with the following materials (n = 10, each group): G1: zinc phosphate (control), G2: Ketac glass-ionomer, G3: vitrebond glass-ionomer or G4: GC GL glass-ionomer. After 24 hours, the specimens were subjected to an application of 37% carbamide peroxide for 21 days, changed each 7 days and stored in an artificial pulp chamber. The specimens were then submitted to push-out bond strength testing with an electromechanical test machine (EMIC) and the failure mode in each specimen was analyzed with confocal microscopy (LEXT).Results: G3 and G4 showed higher bond strengths values than the other groups (p < 0.05), and were similar to each other (p > 0.05). G1 showed the lowest bond strength value (p < 0.05).
Conclusion:Glass-ionomer cements showed higher bond strength values than the zinc phosphate cement, and resinmodified glass-ionomer cements presented the highest push-out values to root canal dentin (GC, GL and Vitrebond).Clinical significance: Glass ionomer cements are recommended to use as cervical barrier materials before the internal dental bleaching, but its efficiency is questionable.
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