The objective of this study was to compare the time to final set and compressive strength of the white mineral trioxide aggregate (MTA) formulation to the original grey MTA. To test compressive strength, each MTA formulation was placed into Teflon split molds for four hours at 37° Celsius (C) and 100% humidity. Compressive strength of both MTA formulations was measured at 24 hours (n=12) and 21 days (n=19) using an Instron Testing Machine. For determination of time to final set, each MTA formulation (n=6) was placed into a metal mold and maintained at 37° C and 100% humidity while setting. At five-minute time intervals, an indenter needle was lowered onto the surface of the MTA material and allowed to remain in place for five seconds before it was removed from the specimen surface. This process was repeated until the needle failed to make a complete circular indentation in the MTA specimen. Results of a two-way ANOVA indicate that white MTA had a significantly higher compressive strength (mean=32.7 MPa) than grey MTA (mean=25.2 MPa) at 24 hours and no statistically significant differences at 21 days (white mean=38.6 MPa and grey mean=38.0 MPa). Using one-way ANOVA, results indicate that grey MTA had a significantly longer time to final setting time (mean=296 min) compared to white MTA (mean=276 min). Based on this study, the results suggest that white MTA is an effective substitute for grey MTA.

A cirurgia parendodôntica é um recurso utilizado para solucionar casos em que a terapia endodôntica não obteve sucesso, ou ainda na impossibilidade da sua realização. A escolha de um material retroobturador adequado pode contribuir positivamente para o reparo tecidual. Este estudo teve como objetivo avaliar a capacidade seladora de três materiais usados para retroobturação, em dois tempos diferentes, tendo como marcador o corante Rodamina B a 0,2%. Sessenta e seis dentes tiveram as suas coroas seccionadas, os canais preparados com limas manuais e obturados com cimento e guta-percha. Seccionaram-se dois milímetros da porção apical e cavidades retrógradas foram preparadas com pontas de ultra-som lisas; dividindo-se então, em 3 grupos experimentais que receberam os seguintes materiais: MTA Ângelus ® , Real Seal ® e um material experimental desenvolvido pelo IPEN-USP (Instituto de Pesquisas Energéticas e Nucleares da Universidade de São Paulo). Dez elementos de cada grupo foram imersos em soro fisiológico durante 72h a 37°C, antes de serem impermeabilizados e colocados no corante por 24h (grupos I A, II A e III A). Os demais permaneceram 60 dias em soro fisiológico para depois serem impermeabilizados e colocados no marcador (grupos I B, II B e III B). O controle positivo consistiu de 3 espécimes, que não tiveram as cavidades retroobturadas. Outros três espécimes serviram como controle negativo, cada um foi retroobturado com um dos materiais em estudo e foram totalmente impermeabilizados antes de serem imersos no corante. Após o tempo de imersão no corante, todos os espécimes foram lavados, e em seguida, clivados ongitudinalmente no sentido mésio-distal. As superfícies foram avaliadas em lupa estereoscópica com aumento de 20X e fotografadas. A infiltração linear foi medida com auxílio de uma lente reticulada e régua milimetrada. Os resultados foram submetidos aos testes estatísticos de Kruskal-Wallis e verificou-se que não houve diferença entre os grupos do MTA Ângelus ® e do Real Seal ® , sendo que a maior infiltração do corante ocorreu na interface dentina-material experimental, com diferença estatisticamente significante ao nível de 1% (a=0,01). Fazendo a análise estatística de Mann-Whitney entre os grupos com o mesmo material, verificou-se que o tempo de permanência em umidade até 60 dias não influenciou na vedação dos materiais retroobturadores. / Apical surgery is a resource that is used to solve cases in which endodontic therapy was either unsuccessful or could not be done. Choice of root-end filling material contributes for successful. The purpose of this study was to evaluate the sealing ability of three materials used for root-end filling, using 0.2% Rhodamine B. Sixty-six teeth had their crowns removed, and their canals were cleaned and shaped with manual files, and filled with cement and gutta-percha. Two millimeters of the apical portion were sectioned and root-end cavities were prepared in all specimens with smooth ultrasonic tips. Three groups were formed to receive the following materials: MTA Ângelus ® , Real Seal ® , and an experimental material developed by the IPEN-USP (Institute of Energetic and Nuclear Research from São Paulo University). Ten specimens from each group were immersed in a physiological saline solution for 72h at 37°C, before being waterproofed and put in the colorant for 24 h (groups I A, II A, and III A). The others remained in physiological saline solution for 60 days and were then waterproofed and put in the marker (groups I B, II B, and III B). The positive control consisted of three specimens that did not have their cavities root-end filled. Another three specimens served as a negative control, each being root-end filled with one of the materials being studied, and they were totally waterproofed before being immersed in Rhodamine B. After the time of immersion in the colorant, all of the Speci mens were washed and then cleaved longitudinally in the mesio-distal direction. The surfaces were evaluated under a stereoscopic magnifying glass at 20X magnification and photographed. The linear infiltration was measured with a micro metered lens and millimeter rule . The results were submitted to the Kruskal-Wallis statistical tests and it was noticed that there was no difference between the MTA Ângelus ® and Real Seal ® groups. The experimental material presents the most colorant microleakage, with a statistically significant difference (a=0.01). The Mann-Whitney statistical analysis performed in the groups with the same material showed that the period of time the specimen remained exposed to moisture - up to 60 days - did not impact the materials’ sealing capacity.

A cirurgia parendodôntica é um recurso utilizado para solucionar casos em que a terapia endodôntica não obteve sucesso, ou ainda na impossibilidade da sua realização. A escolha de um material retroobturador adequado pode contribuir positivamente para o reparo tecidual. Este estudo teve como objetivo avaliar a capacidade seladora de três materiais usados para retroobturação, em dois tempos diferentes, tendo como marcador o corante Rodamina B a 0,2%. Sessenta e seis dentes tiveram as suas coroas seccionadas, os canais preparados com limas manuais e obturados com cimento e guta-percha. Seccionaram-se dois milímetros da porção apical e cavidades retrógradas foram preparadas com pontas de ultra-som lisas; dividindo-se então, em 3 grupos experimentais que receberam os seguintes materiais: MTA Ângelus ® , Real Seal ® e um material experimental desenvolvido pelo IPEN-USP (Instituto de Pesquisas Energéticas e Nucleares da Universidade de São Paulo). Dez elementos de cada grupo foram imersos em soro fisiológico durante 72h a 37°C, antes de serem impermeabilizados e colocados no corante por 24h (grupos I A, II A e III A). Os demais permaneceram 60 dias em soro fisiológico para depois serem impermeabilizados e colocados no marcador (grupos I B, II B e III B). O controle positivo consistiu de 3 espécimes, que não tiveram as cavidades retroobturadas. Outros três espécimes serviram como controle negativo, cada um foi retroobturado com um dos materiais em estudo e foram totalmente impermeabilizados antes de serem imersos no corante. Após o tempo de imersão no corante, todos os espécimes foram lavados, e em seguida, clivados ongitudinalmente no sentido mésio-distal. As superfícies foram avaliadas em lupa estereoscópica com aumento de 20X e fotografadas. A infiltração linear foi medida com auxílio de uma lente reticulada e régua milimetrada. Os resultados foram submetidos aos testes estatísticos de Kruskal-Wallis e verificou-se que não houve diferença entre os grupos do MTA Ângelus ® e do Real Seal ® , sendo que a maior infiltração do corante ocorreu na interface dentina-material experimental, com diferença estatisticamente significante ao nível de 1% (a=0,01). Fazendo a análise estatística de Mann-Whitney entre os grupos com o mesmo material, verificou-se que o tempo de permanência em umidade até 60 dias não influenciou na vedação dos materiais retroobturadores. / Apical surgery is a resource that is used to solve cases in which endodontic therapy was either unsuccessful or could not be done. Choice of root-end filling material contributes for successful. The purpose of this study was to evaluate the sealing ability of three materials used for root-end filling, using 0.2% Rhodamine B. Sixty-six teeth had their crowns removed, and their canals were cleaned and shaped with manual files, and filled with cement and gutta-percha. Two millimeters of the apical portion were sectioned and root-end cavities were prepared in all specimens with smooth ultrasonic tips. Three groups were formed to receive the following materials: MTA Ângelus ® , Real Seal ® , and an experimental material developed by the IPEN-USP (Institute of Energetic and Nuclear Research from São Paulo University). Ten specimens from each group were immersed in a physiological saline solution for 72h at 37°C, before being waterproofed and put in the colorant for 24 h (groups I A, II A, and III A). The others remained in physiological saline solution for 60 days and were then waterproofed and put in the marker (groups I B, II B, and III B). The positive control consisted of three specimens that did not have their cavities root-end filled. Another three specimens served as a negative control, each being root-end filled with one of the materials being studied, and they were totally waterproofed before being immersed in Rhodamine B. After the time of immersion in the colorant, all of the Speci mens were washed and then cleaved longitudinally in the mesio-distal direction. The surfaces were evaluated under a stereoscopic magnifying glass at 20X magnification and photographed. The linear infiltration was measured with a micro metered lens and millimeter rule . The results were submitted to the Kruskal-Wallis statistical tests and it was noticed that there was no difference between the MTA Ângelus ® and Real Seal ® groups. The experimental material presents the most colorant microleakage, with a statistically significant difference (a=0.01). The Mann-Whitney statistical analysis performed in the groups with the same material showed that the period of time the specimen remained exposed to moisture - up to 60 days - did not impact the materials’ sealing capacity.

Pathological processes in the alveolar and facial bones can lead to bone loss that may not heal with complete regeneration. Biomaterials can be used to facilitate the healing process and/or as a bone substitute, but the mechanisms are not fully understood. Persistent leakage of bacteria/bacterial toxins, after root canal treatment, may lead to a residual bone defect. The healing is dependent on a placed dental biomaterial providing a tight seal. The composition of the filling material may also influence the healing process. The general aim of this study is to investigate surface properties and biological interactions of biomaterials used in dento-alveolar surgery. A dental biomaterial, a bonded compomer (DAP) containing a corroding glass filler, was used as a root end filling material, promoting a new operation technique. The healing (assessed according to Molven´s x-ray criteria) demonstrates a significant improvement in healing results for the compomer group, compared to a commonly used technique. The surface properties and biological interactions of DAP were analyzed. ICP-OES of DAP cell culture medium extract demonstrated a significant release of Sr, Si and F from the dental biomaterial. Human periodontal ligament (PDL) cells grew on and around DAP specimens without any sign of toxic reactions. DAP extract stimulated proliferation of PDL cells, but caused an inhibition of osteoblastic gene expression in mouse bone marrow cells. The surface properties of the glass containing compomer may contribute to improved healing of the periapical lesions. A bovine inorganic bone graft substitute (BO) is commonly used as a treatment option in dento-alveolar surgery with new bone formation in immediate close contact with BO material. ICP-OES dissolution analysis of cell culture media, after incubation with BO particles, demonstrated a dosedependent release of Si and a decrease of Ca and P. An uptake of Ca from the medium to the BO particle was demonstrated with calcium-45 labeling. The Si dissolution varied between different batches, possibly reflecting a variation in food intake in the animals. Stimulated osteogenic response was seen in close contact to the BO particles in cell cultures. Furthermore, it was clearly demonstrated that the study design is a critical factor for correctly understanding biomaterials’ biological interactions. The surface properties of three bone graft substitutes reported to have good results in dento-alveolar surgery were investigated, in order to establish whether or not dissolution-precipitation reactions could contribute to the bone healing. Dissolution-precipitation extracts of BO, bioactive glass 45S5 (BG) and a marine algae hydroxyl apatite (AP) in cell culture media were analyzed. Dissolution of Si at significant levels was detected for BO and 45S5 over time. Significant uptake levels of Ca and P from the culture were seen for both 45S5, BO and AP but at different times. Surface analysis of the biomaterials with SEM/EDAX, before and after immersion in cell culture media, revealed a smoothing of the surface morphology for 45S5 over time. No obvious alterations for BO and AP were detected. Ca/P ratio decreased significantly for 45S5, but no major changes were detected by XPS for BO or AP. XPS further demonstrated a surface charge for BO, changing from negatively to positively charged when exposed to serum. 45S5 and AP had positive surface charges, both in the absence and the presence of serum. These demonstrated surface changes in biomaterials could contribute to adherence of cells and subsequently affect bone healing. Conclusion: Biomaterials used in dento-alveolar surgery interact with biological surroundings through surface and dissolution-precipitation reactions which may have implications for bone healing.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-25T10:17:54Z No. of bitstreams: 2 Tese - Omar Zina - 2013.pdf: 1884367 bytes, checksum: ac70615bb4bc9a680a17fead9dac004b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-25T12:28:09Z (GMT) No. of bitstreams: 2 Tese - Omar Zina - 2013.pdf: 1884367 bytes, checksum: ac70615bb4bc9a680a17fead9dac004b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-11-25T12:28:09Z (GMT). No. of bitstreams: 2 Tese - Omar Zina - 2013.pdf: 1884367 bytes, checksum: ac70615bb4bc9a680a17fead9dac004b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-09-13 / The aim of this study was to determine the solution-powder ration and to evaluate the setting time, solubility, dimensional change, pH and radiopacity of White structural and non-structural Portland cement, ProRoot MTA® and MTA BIO® associated to 2% glycolic solution of Aloe vera. Five samples of each material were used for each test according to American National Standards Institute/American Dental Association specification 57. Statistical analyses were carried out using ANOVA and Tukey’s test at 5% level of significance. When sample distribution was non-normal, nonparametric analysis of variance were performed with Kruskal-Wallis test (α=0.05). The results revealed no statistical difference in the water-powder ratio among the tested materials. ProRoot MTA® had the longest setting time (116.50 ± 4.08) (P<0.05). White structural and nonstructural Portland cements did not have means values on the radiopacity test (109.76 ± 10.40 and 118.75 ± 15.44, respectively) in accordance with ANSI/ADA, being significantly different from the MTA-based cements (P<0.05), and demonstrated higher mean solubility values (2.30 ± 0.36 and 2.81 ± 0.40, respectively) (P<0.05). The values for dimensional change of all tested materials were considered acceptable by ANSI/ADA. There were no significant differences between the mean pH values recorded for the materials (p>0.05). It was alkaline from the beginning to the end of the tests. MTA BIO presented lower setting time and lower solubility. The cements did not showed a higher solubility than 3%. All the assessed cements showed acceptable values of dimensional variation and high pH during the test time. MTA BIO and ProRoot MTA had adequate radiopacity values. / Esse estudo teve como objetivo determinar propriedades físico-químicas dos cimentos Portland branco estrutural e não estrutural, ProRoot MTA® e MTA BIO® associados à solução glicólica de Aloe vera a 2%. Após o estabelecimento da proporção pó/líquido para cada cimento, foram analisadas as propriedaes físicoquímicas: tempo de endurecimento, alteração dimensional, pH e radiopacidade. Cinco amostras de cada cimento foram usadas para cada teste, seguindo a especificação n. 57 da American National Standards Institute/American Dental Association (ANSI/ADA). A análise estatística foi realizada usando ANOVA e o teste de Tukey em nível de significância de 5%. Quando a distribuição das amostras foi não normal, a análise de variância não paramétrica foi realizada com o teste de Kruskal-Wallis (α=0,05). Os resultados não mostraram diferenças estatisticamente significantes (p>0,05) entre os cimentos em relação à proporção pó/líquido, que variou de 3,14 a 3,52 gramas. O ProRoot MTA® apresentou o tempo de endurecimento mais longo (116,50 min) e o MTA BIO® o menor (66,75 min) (p<0,05). Os cimentos Portland brancos estrutural e não estrutural apresentaram valores médios de solubilidade mais elevados (2,30 e 2,81%, respectivamente) (p<0,05). Todos os cimentos testados apresentaram valores de alteração dimensional semelhantes entre si (1,00%). O pH dos cimentos manteve-se elevado do início ao final do experimento, não havendo diferenças significantes entre os valores médios obtidos (cimento Portland branco estrutural, 11,96; cimento Portland branco não estrutural, 11,80; MTA BIO® 12,07; ProRoot MTA® 11,77) (p>0,05). Os cimentos Portland branco estrutural e não estrutural não apresentaram valores médios em conformidade com ANSI/ADA no teste de radiopacidade (109,76 e 118,75 mmAl, respectivamente), significantemente diferentes dos cimentos MTA BIO® (156,83 mmAl) e ProRoot MTA® (157,95 mmAl) (p<0,05), que apresentaram valores de densidade radiográfica acima do degrau 3 do penetrômetro de alumínio. O MTA BIO® evidenciou menor tempo de endurecimento e menor percentual de solubilidade. Nenhum cimento apresentou solubilidade maior que 3%. Todos os xiv cimentos analisados mostraram valores aceitáveis de alteração dimensional e pH elevado durante todo o período de teste. O MTA BIO® e o ProRoot MTA® apresentaram valores de radiopacidade adequados..

Indiana University-Purdue University Indianapolis (IUPUI) / Brasseler USA (Savannah, GA) developed and introduced a bioceramic putty called EndoSequence Root Repair Material (ERRM) that can be used as a retrofilling material for surgical endodontics. The material is said to have many of the same chemical, physical, and biological properties as mineral trioxide aggregate (MTA), but with superior handling characteristics. The material is composed of calcium silicates, monobasic calcium phosphate, zirconium oxide, tantalum oxide, proprietary fillers, and thickening agents. ERRM is said by the manufacturer to bond to adjacent dentin, have no shrinkage, be highly biocompatible, hydrophilic, radiopaque, and antibacterial due to a high pH during setting. Investigations on the sealing properties of this material have not yet been conducted. The purpose of this study was to compare the microbial leakage of Enterococcus faecalis in teeth with root-end fillings using ProRoot MTA and Brasseler’s ERRM in a dual-chamber bacterial leakage model as described by Torabinejad and colleagues. The aim of this investigation was to compare the bacterial microleakage of these two root-end filling materials exists. Sixty-two human, single-rooted, mandibular premolars in which extraction was indicated were accessed and instrumented in an orthograde fashion with hand and rotary files. Root resection of the apical 3 mm was then completed and root-end retropreparations were created for placement of root-end filling material. Twenty-seven of these premolars had root-end fillings using ProRoot MTA and 27 had root-end fillings using ERRM. Two teeth were used as a positive control group with no root-end filling, and two other teeth were used as a negative control group and were sealed and coated with dentin bonding agent. The teeth were then evaluated for microleakage using a dual-chamber bacterial microleakage model for 40 days as described by Torabinejad and colleagues. Microleakage was determined by the presence of turbidity in the lower chamber of the apparatus and was assessed each day. Fresh samples of E. faecalis were used every three days to inoculate the apparatus and serve as a bacterial challenge for the materials. Results were recorded every day for 30 days. The outcome of interest (bacterial turbidity) and time-to-leakage (in days) were determined for each of the samples. Survival analysis was used to compare the two groups with a Kaplan-Meier plot to visualize the results and a nonparametric log-rank test for the group comparison. The microleakage of ERRM was not statistically different (p > 0.05) than leakage of ProRoot MTA when subjected to E. faecalis over the 40 day observation period. Both groups had a small number of early failures (within 4 days) and no leakage was observed for the remaining 40 days of the study. Therefore, the null hypothesis was rejected. The results of this research support the use of either of these two materials when compared with the controls. The microleakage of Brasseler’s EndoSequence Root Repair Material was at least as good as ProRoot Mineral Trioxide Aggregate when tested with E. faecalis.