giulio gavini

Calcium silicate-based sealers are an alternative to be used into root canal, mainly to their biological properties. However, some biological parameters need to be determined in an in vivoanimal research model. So, the aim of the present study was to evaluate in vivothe tissue biocompatibility of a calcium silicate-based sealer (EndoSequence BC Sealer) and an epoxy resin-based sealer (AH-Plus).

Polyethylene tubes were filled with freshly mixed sealers and implanted in connective subcutaneous tissue of 25 rats (5/euthanasia day) (Rattus norvegicus albinus). Empty tubes were used as controls and no tubes as sham. Histopathological (hematoxylin eosin) and histochemical (P icrosirius red) examinations were conducted at 3, 7, 15, 30 and 60days (five rats/day) after the implantation procedure (n=5/group). The type/intensity of inflammation and collagenesis was analyzed statistically with Friedman or Kruskal-Wallis/Dunn tests (P<0.05).

The profile of inflammation induced by AH-Plus (Median=2, Range=2-3) was significantly greater than that by Endosequence BC Sealer (Median=1, Range=1-1) during the 15-day experimentation period (P=0.018). After 30 days, both materials produced similar tissue reaction (P>0.05). AH-Plus and Endosequence BC Sealer (Median=2, Range=1-2) induced a high level of fibrosis after 60-day than control (Median=1, Range=1-1) and sham (Median=0, Range=0-0) groups (P<0.001) of fibrosis based in type I collagen increase (P=0.025 and P=0.021, respectively). Tissue necrosis was not observed and the bioceramic sealer showed significant signs of endocytosed (Median=1, Range=1-1) material after 7 days than other groups (Median=0, Range=0-0) (P<0.05). The calcium silicate-based sealer induced tissue repair faster than the epoxy resin-based sealer tested. However, both materials showed adequate biocompatibility and tolerance by subcutaneous tissues, with few differences in inflammatory profiles, formation of granulation tissue, and collagenesis.

It may be concluded that calcium silicate-based sealer (EndoSequence BCSealer) and an epoxy resin-based sealer (AH-Plus) presented suitable biocompatibility.

This study reports the endodontic treatment performed in a patient who presented with spontaneous bone exposure in the mandible while using intravenous bisphosphonate medication (ZometaÒ, Novartis Pharmaceuticals Co., Basel, Switzerland). A 63-year-old female patient was referred to a private dental clinic at Fortaleza, Brazil. The patient reported that one year before, she had undergone chemotherapy for the treatment of lung cancer and associated bone metastasis. Among the medications administered was the zolendronic acid, with dosage of 4 mg every 21 days. In the oral exam, the presence of extensive bone exposure was observed in the lingual region near tooth 37. The patient reported severe pain on palpation in the region; in the pulpal sensitivity test with cold stimulus, there was an absence of pain, characteristic of pulp necrosis. Radiographically, no periapical lesion was observed. Thus, endodontic treatment was performed, and instrumentation with Reciproc R25 files in the mesial root canals and R40 in the distal canal was done, alongside with abundant 2.5% sodium hypochlorite irrigation. Interappointment medication with calcium hydroxide was maintained for 15 days. In the second session, there was the spontaneous detachment of the exposed cortical bone fragment. The root canals were filled with gutta-percha and Endosequence BC Sealer cement. After two years, complete tissue repair was observed, and the patient presented with normal periapical tissues and the tooth in masticatory function.   It may be concluded that a possible relationship between pulp and periapical infections and osteonecrosis exists in patients who use bisphosphonates.

The failures in endodontic treatments are often related to anatomical variations. Some anatomical changes in anterior teeth occur in patients with cleft lip and palate. This paper aims to report the endodontic retreatment of a maxillary central incisor with two roots and two canals on a patient who presents cleft lip and palate. A male patient, 11-year-old, reported pain when chewing related to the left maxillary central incisor tooth (tooth 21) which featured a sinus tract after primary endodontic treatment. In periapical radiograph, it was observed an alteration on the anatomy of the root on the tooth 21, which featured a radiolucent area on the dental apex and had been properly endodontically treated. In cone-beam computed tomography (CBCT) images the presence of an accessory root in the palatal region was observed, that had not been prepared, or filled. Thus, the non-treated accessory canal was instrumented with the crown-down technique and filled with gutta-percha and endodontic sealer. After 1 year of follow-up, the patient presented the tooth with a normal masticatory function and no painful symptoms. Therefore, it can be concluded that the additional root canals may be present and the CBCT is an important tool to evaluate the internal root morphology. In cleft lip and palate patients, the root canals morphology should be carefully analyzed due to high prevalence of dental anomalies which may influence the success in endodontic treatment

The aim of the present research was to evaluate the effectiveness of 5% malic acid, 17% EDTA and 10% citric acid solutions used to disinfect gutta-percha cones contaminated by Enterococcus faecalis (ATCC 29212).
Methods and Materials: Two hundred and ten previously sterilized gutta-percha cones were contaminated with E. faecalis at concentration of 1.5×108 CFU/mL. The cones were immersed in 5% malic acid, 17% EDTA, 10% citric acid, 1% NaOCl and 2.5% NaOCl for 1, 5 and 10 min. Then each cone was kept in Eppendorf tubes containing BHI sterile solution at 37°C for 48 h. The presence of turbidity in BHI solution was analyzed. The results were statistically analyzed by Kruskal-Wallis test and 5% Dunn comparisons. P-value was considered statistically significant when P Regardless of exposure time, 1% NaOCl and 2.5% NaOCl were the most effective agents for rapid disinfection of gutta-percha cones (P0.05).
Demineralized solutions tested were not effective for elimination of Enterococcus faecalis on the surface of gutta-percha cones.

The aim of the present ex vivo research was to compare the remaining filling material and the volumes of dentine removed after retreatment of curved canals with two rotary systems naming ProTaper Universal Retreatment and Mani NRT-GPR using micro-computed tomography (micro-CT).
Material and Forty mandibular molars containing two completely separated canals, with curvature angle of 25-35° and a curvature radius The mean percentage of remaining filling material was 12.96% for PR group and 24.26% for MR group (P=0.0056). The percentage of dentin removal was greater in the PR group (5.02%) than MR group (1.36%) (P=0.0028). Both systems failed to completely remove the filling material from the canals.
ProTaper Universal Retreatment system was more effective than Mani NRT-GPR system regarding removal of root filling material and also removed significantly more dentine after retreatment of curved mesial root canals of mandibular molars.

Bioactive endodontic sealers have been developed to improve the quality of root canal obturation. EndoSequence Bioceramic (BC) Sealer is amongst calcium silicate-based materials recently developed for permanent root canal filling. The objective of this study was to evaluate the bioactivity of BC Sealer and its micro push-out bond strength to dentin compared to AH-Plus (AH) sealer.
Methods and Materials: To perform the micro push-out test, 24 root canals of mandibular premolars were instrumented and divided into two groups (n=12). Each root was cut into 4 slices and lumens of the canals were filled with the sealers and submitted to micro push-out test. Failure mode was assessed using scanning electron microscopy (SEM). Bioactivity of BC sealer was investigated with scanning electron microscopy/energy-dispersive X-ray (SEM/EDS) and X-ray diffraction (XRD). Bioactivity assessments were reported descriptively. Bond strength data were analyzed by parametric t-test (α=5%).
In micro push-out test AH had higher bond strength mean values (16.29 MPa) than BC sealer (9.48 MPa) (P BC sealer showed indications of bioactivity and lower bond strength to dentine compared to AH.