Under ultrasonic agitation, sodium hypochlorite associated with EDTAC removed the smear layer from root canal walls, whereas irrigation with distilled water or 1.0% sodium hypochlorite alone did not remove smear layer.
The instrument binding technique for determining anatomical diameter at WL is not precise. Preflaring of the cervical and middle thirds of the root canal improved anatomical diameter determination; the instrument used for preflaring played a major role in determining the anatomical diameter at the WL. Canals preflared with LA Axxess burs created a more accurate relationship between file size and anatomical diameter.
The purpose of this study was to investigate the influence of cervical preflaring on determination of the initial apical file in mesiobuccal roots of maxillary molars. Fifty first molars with degree of curvature of the mesiobuccal root between 10 degrees and 15 degrees were utilized. After standard access opening and removal of pulp tissue, the working length (WL) was determined at 1 mm from the root apex. Five groups (n=10) were formed at random, according to the type of cervical preflaring performed. In group 1, the size of the initial apical file was determined without cervical preflaring. In groups 2 to 5, the cervical and middle thirds of the canals were preflared with Gates-Glidden drills, K3 Orifice Opener instruments, ProTaper instruments and LA Axxess burs, respectively. Canals were sized manually with K-files, starting with size 08 K-files, inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the file was recorded. The binding instruments were fixed into the canals at the WL with methylcyanacrylate. Cross-sections of the WL region were examined under scanning electron microscopy and the discrepancies between the canal diameter and the diameter of first file to bind at the WL were calculated using UTHSCSA ImageTool software. Data were analyzed statistically by ANOVA and multiple comparisons were done by Tukey's HSD post-hoc test. Significant differences (p<0.001) were found among the groups. The major discrepancy was observed for the group without preflaring (mean 0.1543 mm +/- 0.0216). Cervical preflaring with LA Axxess burs produced the least discrepancies between the canal size and the diameter of the initial apical instrument (mean 0.026 mm +/- 0.0037), followed by ProTaper files (mean 0.0567 mm +/- 0.0354). Canals preflared with Gates-Glidden drills and K3 Orifice Opener instruments showed statistically similar discrepancy results to each other (p>0.05) (means 0.1167 mm +/- 0.0231 and 0.1313 mm +/- 0.0344, respectively). In conclusion, preflaring of the cervical and middle thirds improved the determination of the initial apical instrument. Canals preflared with LA Axxess burs showed a more accurate binding of the files to the anatomical diameter at the WL in the mesiobuccal roots of maxillary first molars.
Limited studies have demonstrated that low intensity laser therapy (LILT) may have a therapeutic effect on the treatment of myofascial pain syndrome (MPS). Sixty (60) patients with MPS and having one active trigger point in the anterior masseter and anterior temporal muscles were selected and assigned randomly to six groups (n=10): Groups I to Ill were treated with GaAIAS (780 nm) laser, applied in continuous mode and in a meticulous way, twice a week, for four weeks. Energy was set to 25 J/cm2, 60 J/cm2 and 105 J/cm2, respectively. Groups IV to VI were treated with placebo applications, simulating the same parameters as the treated groups. Pain scores were assessed just before, then immediately after the fourth application, immediately after the eighth application, at 15 days and one month following treatment. A significant pain reduction was observed over time (p<0.001). The analgesic effect of the LILT was similar to the placebo groups. Using the parameters described in this experiment, LILT was effective in reducing pain experienced by patients with myofascial pain syndrome. Thus, it was not possible to establish a treatment protocol. Analyzing the analgesic effect of LILT suggests it as a possible treatment of MPS and may help to establish a clinical protocol for this therapeutic modality.
The purpose of this study was to investigate the influence of cervical preflaring on the determination of the first file that binds at working length (WL) in buccal roots of maxillary premolars. Five groups (n=10) were formed at random and, after standard access cavities, the WL was determined 1 mm short from the apex. In group 1, the initial apical file was inserted without preflaring of cervical and middle thirds of the root canals. In groups 2 to 5, the cervical and middle thirds were enlarged with sizes 90 and 110 Gates-Glidden drills, K(3) Orifice Opener instruments, ProTaper instruments and LA Axxess burs, respectively. Canals were sized manually with K-files, starting with No. 08 K-files inserted passively up to the WL. File sizes were increased until a binding sensation was felt at the WL and the size of the instrument was recorded. Transversal sections of the WL regions were examined under scanning electron microscopy and the discrepancies between the canal diameter and first file to bind at the WL were assessed. Significant differences (p<0.001) were found between the groups. The major discrepancy was found without preflaring (mean 157.8 microm). LA Axxess burs produced the smallest discrepancy (mean 0.8 microm). Gates-Glidden drills and K(3) Orifice Opener instruments showed no significant differences (p>0.05) between their results (83.2 microm and 73.6 microm, respectively). The discrepancy for ProTaper instruments was 35.4 microm on average. In conclusion, the instrument binding technique for determination of the anatomical diameter at the WL was not precise. Preflaring of the cervical and middle thirds improved the determination of the anatomical diameter at the WL, and the type of instrument played a major role. Canals preflared with LA Axxess burs showed a more accurate binding of the files to anatomical diameter.
The increase in power and frequency of the Nd:YAG laser irradiation produced more visible morphological alterations than the lower settings. The removal of the smear layer increased the number of visible dentinal tubule openings.
Objectives:to compare the apical sealing ability of four root canal sealers. Materials and methods: forty extracted human maxillary canines were instrumented 1 mm short of the anatomical apex and randomly assigned to four groups (n=10), according to the root canal sealer used for obturation: Endofill, AH Plus, EndoREZ and Epiphany. Root canals were obturated with guttapercha points, except for the Epiphany group, in which resin points (Resilon) were used. The teeth were immersed in India ink for seven days and clarified using methyl salicylate. The extent of apical dye penetration was measured with a measuroscope in all aspects of the canal.Results:AH Plus (0.02 mm ± 0.07), Epiphany (0.00 mm ± 0.00) and EndoREZ (0.32 mm ± 0.62) did not differ statistically to each other (p>0.01). EndoFill presented the highest dye penetration mean (0.83 mm ± 0.73) and was statistically different from the other sealers (p<0.01).Conclusions:the resin-based root canal sealers presented lesser apical microleakage than the zinc oxide and eugenol based sealer. No statistical differences were observed among resin based sealers.
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