• Restorative Dentistry and Endodontics
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• v.48 no.2
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• pp.12.1-12.11
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• 2023

Objectives: The present study evaluated the pulp response of human mandibular incisors subjected to in-office dental bleaching using gels with medium or high concentrations of hydrogen peroxide (HP). Materials and Methods: The following groups were compared: 35% HP (HP35; n = 5) or 20% HP (HP20; n = 4). In the control group (CONT; n = 2), no dental bleaching was performed. The color change (CC) was registered at baseline and after 2 days using the Vita Classical shade guide. Tooth sensitivity (TS) was also recorded for 2 days post-bleaching. The teeth were extracted 2 days after the clinical procedure and subjected to histological analysis. The CC and overall scores for histological evaluation were evaluated by the Kruskal-Wallis and Mann-Whitney tests. The percentage of patients with TS was evaluated by the Fisher exact test (α = 0.05). Results: The CC and TS of the HP35 group were significantly higher than those of the CONT group (p < 0.05) and the HP20 group showed an intermediate response, without significant differences from either the HP35 or CONT group (p > 0.05). In both experimental groups, the coronal pulp tissue exhibited partial necrosis associated with tertiary dentin deposition. Overall, the subjacent pulp tissue exhibited a mild inflammatory response. Conclusions: In-office bleaching therapies using bleaching gels with 20% or 35% HP caused similar pulp damage to the mandibular incisors, characterized by partial necrosis, tertiary dentin deposition, and mild inflammation.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.1.1-1.11
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• 2023

Objectives: This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols. Materials and Methods: Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student's t-test were used for data analysis, with a significance level of 5%. Results: The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019). Conclusions: The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.

• The Journal of Advanced Prosthodontics
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• v.15 no.2
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• pp.80-92
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• 2023

PURPOSE. This study incorporated the nanomaterial, nanostructured silver vanadate decorated with silver nanoparticles (AgVO₃), into heat-cured resin (HT) at concentrations of 2.5%, 5%, and 10% and compared the adhesion of multispecies biofilms, surface characteristics, and mechanical properties with conventional heat-cured (HT 0%) and printed resins. MATERIALS AND METHODS. AgVO₃ was incorporated in mass into HT powder. A denture base resin was used to obtain printed samples. Adhesion of a multispecies biofilm of Candida albicans, Candida glabrata, and Streptococcus mutans was evaluated by colony-forming units per milliliter (CFU/mL) and metabolic activity. Wettability, roughness, and scanning electron microscopy (SEM) were used to assess the physical characteristics of the surface. The mechanical properties of flexural strength and elastic modulus were tested. RESULTS. HT 10%-AgVO₃ showed efficacy against S. mutans; however, it favored C. albicans CFU/mL (P < .05). The printed resin showed a higher metabolically active biofilm than HT 0% (P < .05). There was no difference in wettability or roughness between groups (P > .05). Irregularities on the printed resin surface and pores in HT 5%-AgVO₃ were observed by SEM. HT 0% showed the highest flexural strength, and the resins incorporated with AgVO₃ had the highest elastic modulus (P < .05). CONCLUSION. The incorporation of 10% AgVO₃ into heat-cured resin provided antimicrobial activity against S. mutans in a multispecies biofilm did not affect the roughness or wettability but reduced flexural strength and increased elastic modulus. Printed resin showed higher irregularity, an active biofilm, and lower flexural strength and elastic modulus than heat-cured resin.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.13.1-13.13
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• 2022

Objectives: This study evaluated the efficacy of 3 reciprocating systems and the effects of 2 instruments for irrigant activation on filling material removal. Materials and Methods: Forty mesiobuccal roots of maxillary molars were prepared up to size 25.06 and obturated. Micro-computed tomography (micro-CT) examination #1 was performed. Teeth were then divided into 4 groups (n = 10), according to the retreatment protocol: (1) manual, (2) Reciproc Blue, (3) WaveOne Gold, and (4) X1 Blue. Micro-CT examinations #2 and #3 were performed after filling removal and repreparation, respectively. Next, all teeth were divided into 2 new groups (n = 20) according to the irrigant activation protocol: XP Clean (XP Clean size 25.02) and Flatsonic (Flatsonic ultrasonic tip). Micro-CT examination #4 was performed after irrigant activation. Statistical analysis was performed with a significance level set at 5%. Results: WaveOne Gold removed a significantly greater amount of filling material than the manual group (p < 0.05). The time to reach the WL was similar for all reciprocating systems (p > 0.05). X1 Blue was faster than the manual group (p < 0.05). Only manual group improved the filling material removal after the repreparation stage (p < 0.05). Both activation protocols significantly improved the filling material removal (p < 0.05), without differences between them (p > 0.05). Conclusions: None of the tested instruments completely removed the filling material. X1 Blue size 25.06 reached the working length in the shortest time. XP Clean and Flatsonic improved the filling material removal.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.22.1-22.18
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• 2022

Objectives: This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and Methods: Only in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. Results: The search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. Conclusions: This review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.

• Restorative Dentistry and Endodontics
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• v.47 no.3
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• pp.31.1-31.9
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• 2022

Objectives: This study aimed to evaluate in vitro the effects of the self-adhesive resin cements RelyX U200 (3M ESPE) and seT PP (SDI Limited) on murine macrophages and the interference of the photoactivation. Materials and Methods: Cell viability assays, cell adherence, yeast phagocytosis of Saccharomyces boulardii and production of reactive oxygen species (ROS) were performed in the presence of capillaries containing the respective self-adhesive cement when photoactivated or not. Results: After long periods of contact, both types of cements, when not photoactivated, are more cytotoxic for macrophages. The seT PP cement when only chemically activated seems to interfere more negatively in the process of phagocytosis of yeasts S. boulardii. Both types of cements interfere in the cell adhesion process, independent of photoactivation. None of the types of cements tested was able to induce the production of ROS. Conclusions: Our results highlight the great importance of the photoactivation of self-adhesive resin cements in the dental clinic, since RelyX U200, when photoactivated, presented the best results within the evaluated parameters.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.37.1-37.17
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• 2023

This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I² = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I² = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I² = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.33.1-33.12
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• 2023

Objectives: This study aimed to evaluate the bleaching efficacy and hydrogen peroxide permeability in the pulp chamber by the at-home bleaching gel in protocols applied on different dental surfaces. Materials and Methods: Forty premolars were randomly into 4 groups: control group no bleaching, only application on the buccal surface (OB), only application on the lingual surface (OL) and application in buccal and lingual surfaces, simultaneously (BL). At-home bleaching gel (White Class 7.5%) was used for the procedure. The bleaching efficacy was evaluated with a digital spectrophotometer (color change in CIELAB [ΔE_ab] and CIEDE 2000 [ΔE₀₀] systems and Whitening Index for Dentistry [ΔWI_D]). The hydrogen peroxide permeability in the pulp chamber (㎍/mL) was assessed using UV-Vis spectrophotometry and data were analyzed for a 1-way analysis of variance and Tukey's test (α = 0.05). Results: All groups submitted to bleaching procedure showed bleaching efficacy when measured with ΔE_ab and ΔE₀₀ (p > 0.05). Therefore, when analyzed by ΔWI_D, a higher bleaching efficacy were observed for the application on the groups OB and BL (p = 0.00003). Similar hydrogen peroxide permeability was found in the pulp chambers of the teeth undergoing different protocols (p > 0.05). Conclusions: The application of bleaching gel exclusively on the OB is sufficient to achieve bleaching efficacy, when compared to BL. Although the OL protocol demonstrated lower bleaching efficacy based on the ΔWI_D values, it may still be of interest and relevant in certain clinical scenarios based on individual needs, requiring clinical trials to better understand its specificities.

• Restorative Dentistry and Endodontics
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• v.48 no.3
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• pp.24.1-24.16
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• 2023

This review aimed to answer the following question "Does photobiomodulation treatment of the root surface decrease the occurrence of root resorption in reimplanted teeth?" Electronic searches were performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report databases. Risk of bias was evaluated using SYRCLE Risk of Bias tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool was used to assess the certainty of evidence. In total, 6 studies were included. Five studies reported a reduced occurrence of root resorption in teeth that received photobiomodulation treatment of the root surface prior to replantation. Only 1 study reported contradictory results. The photobiomodulation parameters varied widely among studies. GRADE assessment showed a low certainty of evidence. It can be inferred that photobiomodulation treatment of the root surface prior to replantation of teeth can reduce the occurrence of root resorption. Nonetheless, further clinical studies are needed.

• Restorative Dentistry and Endodontics
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• v.49 no.2
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• pp.22.1-22.12
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• 2024

Objectives: This systematic review addressed the question: "What is the prevalence of apical periodontitis in patients prior to hematopoietic cell transplantation?" Materials and Methods: A systematic search was conducted in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report. Eligibility criteria were based on the condition, content, and population strategy: the condition was the radiographic prevalence of apical periodontitis, the content comprised patients scheduled for hematopoietic stem cell transplantation, and the population consisted of adult and pediatric patients. The revised Risk of Bias in Nonrandomized Studies of Exposure tool was used to assess the quality of studies. The Grading Recommendations Assessments, Development, and Evaluation (GRADE) tool was used to assess the quality of evidence. Results: Eight studies were included in this review. The average number of patients with apical periodontitis was 15.65% (range, 2.1%-43.34%). One study was classified as having a very high risk of bias, 1 with a high risk of bias, and 6 with some concern for bias. GRADE analysis showed a very low certainty of evidence. Significant limitations concerning the absence of control over confounding variables were identified. Conclusions: With the caveat of the very low quality of evidence in the studies reviewed, there was a low to moderate prevalence of apical periodontitis in patients prior to undergoing hematopoietic cell transplantation.