The effect of short-term calcium hydroxide treatment on dentin bond strengths to composite resin

Influence of particulate alkaline biomaterial remnants in dentin on the adhesion of two resin-based bonding systems

To study aimed to evaluate the influence of infiltrated alkaline biomaterials on the bond strength of composite obtained with etch and rinse and universal adhesive systems. Coronal dentin of extracted human molars was exposed and infiltrated with calcium hydroxide, MTA, or bioactive glass 45S5 powder. Non-infiltrated dentin specimens served as controls. Subsequently, dentin was either acid-etched or not, and remaining alkali content was measured by pH induction in water. Shear bond strength of an etch-and rinse system (Adper Single Bond 2) on etched dentin was then compared to that of a universal counterpart (Single Bond [(Scotchbond) Universal] by the same manufacturer. Data was compared between groups using one-way ANOVA and Tukey's HSD. On sound dentin, the etch-and-rinse system adhered stronger than the universal system (p < .05). All particles rendered the dentin alkaline. Acid etching reduced the alkali content in the infiltrated dentin. However, bond strength values were stronger with the universal system without etching than with the etch-and rinse counterpart, which lost more than 60% of its adhesiveness. The universal adhesive system was less susceptible to alkaline contamination of the dentin than the etch-and-rinse counterpart. Based on the similar composition of the two systems under investigation, this is likely to the due to its 10-MDP component.

Effect of Various Irrigating Devices on the Removal of Two Different Forms of Calcium Hydroxide from Internal Resorption Cavities

The present study aimed to investigate the efficiency of passive ultrasonic irrigation (PUI), EndoActivator (EA), standard needle irrigation (SNI), and XP-endo Finisher files in removing pure calcium hydroxide (pCH) and injectable CH from in vitro root resorption cavities. Using a rotary system, the root canals of 116 extracted single rooted teeth were prepared. Imitated internal resorption cavities were then created in root halves. The specimens were divided into two groups according to the form of CH (n = 58): (I) pCH; (II) injectable CH. The teeth of each group were randomly divided into six subgroups: negative control (n = 5), positive control (n = 5), PUI (n = 12), XP-endo Finisher (n = 12), EA (n = 12), and SNI (n = 12). The root canals were irrigated using NaOCl and EDTA and split longitudinally, and both halves were evaluated with a stereomicroscope. Kruskal–Wallis and Mann–Whitney U tests were used to analyze data. The present results revealed that PUI completely removed pCH in 79% and injectable CH in 70.8% of the internal resorption cavities which was significantly higher than other methods (p < 0.05). There was no statically significant difference between different forms of CH in terms of CH removal (p=0.918). The PUI technique was observed as the most efficient method of P-CH and injectable CH removal from a replicated internal resorption cavity. Finally, according to the findings, different forms of CH were comparable in terms of CH removal.

Zinc oxide eugenol paste jeopardises the adhesive bonding to primary dentine

AIM

This was to evaluate the influence of root canal filling pastes on microshear bond strength (µSBS) of an adhesive system to primary dentine.

METHODS

Human (32) primary molars were randomly assigned into four experimental groups (n = 8): zinc oxide eugenol paste (ZOE); iodoform paste (Guedes-Pinto paste); calcium hydroxide paste thickened with zinc oxide; and no filling paste (control). Flat dentine surfaces were covered with a 1 mm-thick layer of the pastes for 15 min at 37 °C. The pastes were mechanically removed from dentine surfaces, followed by rinsing and drying. After adhesive application (Adper Single Bond 2, 3M ESPE), starch tubes were placed over pre-treated dentine and filled with composite resin (Z250, 3M ESPE). The µSBS test was performed after 24 h of water storage at 37 °C. The failure mode was evaluated using a stereomicroscope. The µSBS values (MPa) were analysed with one-way ANOVA and Tukey post-hoc tests (α = 0.05).

RESULTS

The lowest µSBS values were achieved when ZOE was used. No difference was found among other filling pastes compared with control group. All specimens showed adhesive/mixed failures.

CONCLUSIONS

Zinc oxide eugenol paste negatively influenced the bond strength of adhesive systems to primary dentine. Iodoform-based Guedes-Pinto paste and calcium hydroxide paste thickened with zinc oxide did not influence the microshear bond strength values.

Effects of calcium hydroxide reagent on the bond strength of resin cements to root dentin and the retention force of FRC posts

The aim of this study was to determine the effects of calcium hydroxide (Ca(OH)₂) treatment on bond strength of resin cements to root dentin and retention force of fiber-reinforced composite (FRC) posts. Bovine root dentin was endodontically prepared and treated with Ca(OH)₂ for 7 days. Root dentin for bond strength test was adhered to resin-composite with resin cements. For pull-out test, posts consisting of FRC posts and resin-composites were fabricated and cemented to root. Shear bond and pull-out tests were performed using a universal testing machine. No significant differences in bond strength and post retention force were found between Ca(OH)₂ treated and untreated groups. Significant differences were found among the cements. A positive correlation was indicated between bond strength of cements and retention force of FRC posts. In conclusion, Ca(OH)₂ treatment on root dentin did not affect bond strength of resin cements and retention force of FRC posts.

Effectiveness of four different techniques in removing intracanal medicament from the root canals: An in vitro study

Aim:

To evaluate the effectiveness of different techniques in removing calcium hydroxide (Ca(OH)₂) from the root canal.

Materials and Methods:

Twenty-four freshly extracted mandibular premolars were instrumented using ProTaper rotary instruments. The teeth were longitudinally split into two halves, cleaned of debris. The two halves were then reassembled and filled with Ca(OH)₂ and were divided into four groups. In Group I, the teeth were irrigated with 5 mL of 2.5% sodium hypochlorite (NaOCl) and 5 mL of 17% of ethylenediaminetetraacetic acid. In Group II, the teeth were irrigated with 5 mL of 2.5% NaOCl and a rotary ProTaper F3 instrument was used. In Group III, the teeth were irrigated with 5 mL of 2.5% NaOCl and agitated using an ultrasonic unit. In Group IV, the teeth were irrigated with 5 mL of 2.5% NaOCl and a CanalBrush was used to remove Ca(OH)₂. The roots were disassembled, and photographs were taken. The amount of residual Ca(OH)₂ was calculated using an image analysis software as a percentage of the total canal surface area. The data were analyzed using one-way analysis of variance and post-hoc Tukey test.

Results:

CanalBrush and ultrasonic techniques showed significantly less residual Ca(OH)₂ than irrigants and rotary techniques. There was no significant difference between the rotary and irrigant techniques.

Conclusion:

None of the techniques used were completely able to remove Ca(OH)₂ from the root canals. But the CanalBrush and ultrasonic techniques were significantly better than the rotary instrument and irrigant groups.

Effectiveness of different irrigation protocols on calcium hydroxide removal from simulated immature teeth after apexification

Aim: To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of the irrigation solutions on the removal of calcium hydroxide (Ca(OH)₂) from the simulated immature root canals after apexification.

Materials and methods: One-hundred and one single-rooted teeth were used. The root canals were shaped with ProTaper rotary files up to F5. Simulation of roots with immature apices was carried out using size 4 Unicore drills. An injectable Ca(OH)₂ was injected into each root canal, and packed to the working length. Then, cotton pellets were placed over canal orifices, and apical and coronal parts of the roots were sealed with resin-modified glass ionomer cement, and light cured. Specimens were stored in distilled water for 3 months at 37°C. After 3 months, the temporary coronal seal was removed and the samples were randomly divided into: (a) saline (n = 20), (b) ultrasonic activation of saline (n = 20), (c) sodium hypochlorite (NaOCl) (n = 20), (d) ultrasonic activation of NaOCl (n = 15), (e) chlorhexidine digluconate (CHX) (n = 20) and one positive control group (n = 3) and one negative control group (n = 3). The amount of remaining Ca(OH)₂ on the canal walls was measured under stereomicroscope with 30× magnification. Comparisons between groups were made by the non-parametric Kruskal-Wallis test and Dunn post-test at a significance level of p < 0.05.

Results: There were no significant differences among the saline, ultrasonic activation of saline, NaOCl, ultrasonic activation of NaOCl and CHX (p > 0.05) groups.

Conclusions: Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove Ca(OH)₂ from the simulated immature root canals.

Comparing the reinforcing effects of a resin modified glassionomer cement, Flowable compomer, and Flowable composite in the restoration of calcium hydroxide-treated immature roots in vitro

One hundred and sixty human permanent central incisors were enlarged to a 120 file size after crown removal procedure to simulate immature teeth. The root canals were filled with calcium hydroxide and stored for 15 days (phase I), 30 days (phase II), 90 days (phase III), and 180 days (Phase IV). At the end of these selected time periods, calcium hydroxide was cleaned off the root canals of forty teeth that were randomly selected and obturated with gutta-percha points in the apical 2 mm of the root canals with a sealer. The specimens were further equally divided into four groups. Unrestored Group I served as control and the root canals of teeth in the other three group specimens were reinforced with resin modified glassionomer cement (RMGIC) (Group II), Flowable Compomer (Group III), and Flowable Composite (Group IV), respectively, using a translucent curing post. All specimens were subjected to compressive force using an Instron Testing machine, until fracture occurred. All the materials evaluated substantially reinforced the root specimens compared to the control. At the end of 180 days, Flowable composites showed maximum reinforcement compared to the other groups; however, no significant differences were found between the reinforcement capabilities of Flowable Compomer and RMGIC.

Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls

THE AIM OF THIS STUDY

was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File) in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000). The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05).

Efficacy of sonic and ultrasonic activation for removal of calcium hydroxide from mesial canals of mandibular molars: a microtomographic study

BACKGROUND

The purpose of this study was to use micro-computed tomography (micro-CT) scanning to evaluate the efficacy of sonic and passive ultrasonic irrigation (PUI) on calcium hydroxide (Ca[OH](2)) removal and to measure the volume and percentage of Ca(OH)(2) remaining in the root canal system.

METHODOLOGY

The root canals of 46 extracted human mandibular molar teeth were prepared with rotary instruments and randomly assigned to two experimental groups (n = 40) as well as positive and negative controls (n = 6). In each experimental group, 20 teeth were assigned to each irrigation protocol, sonic or passive ultrasonic irrigation. All experimental teeth and the positive controls were filled with Ca(OH)(2), whereas the negative control teeth did not receive Ca(OH)(2). All teeth were scanned using micro-CT scanning to determine the dressing volume. After 7 days, the Ca(OH)(2) was removed in the experimental groups using rotary instrumentation only, and the teeth were again scanned using micro-CT scanning to calculate volume and percentage of Ca(OH)(2) removed. Positive control teeth were not subjected to rotary instrumentation. Experimental samples were then irrigated using either sonic or passive ultrasonic and the volume of remaining Ca(OH)(2) was calculated using micro-CT.

RESULTS

Remnants of Ca(OH)(2) were found in all experimental groups. No Ca(OH)(2) was found in the negative controls, whereas a mean of 8.7 mm(3) of Ca(OH)(2) was recorded in the positive controls. Rotary plus passive ultrasonic irrigation removed significantly more Ca(OH)(2) (85.7%) than rotary plus sonic irrigation (71.5%) (p < 0.001).

CONCLUSIONS

The combination of rotary instrumentation and passive ultrasonic activation for 3 periods of 20 seconds results in significantly lower amounts of Ca(OH)(2) remnants in the canal compared with sonic irrigation.