Orientador: Roberta Okamoto / Banca: Luis Eduardo Marques Padovan / Banca: Idelmo Rangel Garcia Júnior / Resumo: O tratamento de superfície dos implantes está consolidado como um método capaz de acelerar e melhorar a qualidade da osseointegração, possibilitando técnicas de carregamento precoce dos implantes, diminuindo o tempo de tratamento e o número de insucessos. Desta forma, o objetivo deste estudo foi observar o comportamento celular do tecido subcutâneo de ratos submetidos a implantes de discos de titânio tratados com laser e laser e hidroxiapatita. Para isso, foram utilizados 32 discos de Ti cp implantados no tecido subcutâneo da região dorsal anterior e posterior de 16 animais (Rattus norvegicus albinus, Wistar), divididos em 2 grupos: LA - discos tratados com irradiação laser e LHA - discos tratados com irradiação laser e deposição de hidroxiapatita pelo método biomimético. Na análise histológica pôde-se observar que houve formação conjuntiva na periferia das amostras de titânio, com espessura e presença celular semelhantes, em ambos os grupos. Qualitativamente, o grupo LHA mostrou melhor organização tecidual nos tempos iniciais. Na análise morfométrica houve diferença estatisticamente significante entre os grupos, para a>0,01. / Abstract: The treatment of surface of the dental implants is consolidated as a method capable to speed up and to improve the quality of the osseointegration, making possible precocious shipment techniques of the implantations, decreasing the time of treatment and the number of failures. Of this form, the aim of this study was to observe the cellular behavior of the subcutaneous tissue submitted to titanium implantations treated with laser and laser with hydroxyapatite. For this, 32 test implants of grade-I commercially pure titanium had been inserted in the connective tissue of the dorsal region of 16 male rats (Rattus norvegicus albinus, Wistar), divided in 2 groups: LA - test implants treated with laser irradiation and LHA - test implants treated with laser irradiation and deposition of hydroxyapatite by the biomimethic method. In the histological analysis it could be observed that it had conjunctive formation in the periphery of the titanium samples, with thickness and similar cellular presence, in both groups. Qualitatively, the group LHA better showed tissue organization in the initial times. There was statistic significant difference between the groups, of the measure of the thickness of the fibrous connective tissue formed in contact with tested implants, for a>0,01. / Mestre

Resumo: Há grande interesse no desenvolvimento de meios para manutenção ou recomposição alveolar visando a instalação de implantes osseointegráveis. No presente estudo o processo de reparo alveolar após implante de vidro bioativo (Biogran®) foi avaliado histologicamente. Quatro macacos-prego (Cebus apella) adultos tiveram seus incisivos superiores extraídos e os alvéolos preenchidos com vidro bioativo - Biogran® (Grupo Tratado, n=6 alvéolos) ou por coágulo sangüíneo (Grupo Controle, n=4 alvéolos). Aos 100 dias pós-operatórios os animais foram sacrificados e os espécimes removidos para processamento histológico. Observou-se que os alvéolos do Grupo Controle apresentavam tecido ósseo maduro distribuído irregularmente em trabéculas esparsas com grandes espaços medulares. Já no Grupo Tratado, encontravam-se preenchidos por uma rede de tecido ósseo neoformado com configuração lamelar e ampla ocupação alveolar. Os poucos fragmentos remanescentes do material foram vistos rodeados por tecido conjuntivo ou em contato direto com o tecido ósseo. Concluiu-se que o implante intra-alveolar de vidro bioativo favoreceu a neoformação óssea, atuando como agente osteocondutor. / Abstract: Maintenance or reconstruction of alveolar process is a topic of great interest in oral rehabilitation with implants. The aim of this study was to investigate the histological features of alveolar wound healing in dental sockets grafted with bioactive glass. Four adult capuchin monkeys (Cebus apella) have their incisor teeth extracted and alveolus filled with particulate bioactive glass Biogran® (Test Group: n=6 alveolus) or blood coagulum (Control Group: n=4 alveolus). After 100 days, animals were sacrificed and specimens removed for histological processing. It was observed that Control Group presented mature neoformed bone irregularly distributed in few trabeculas with large medullar spaces. Alveolus of Test Group were filled with a net of lamellar neoformed bone. The few remaining particles of bioactive glass were surrounded by connective tissue or in close contact with bone tissue. It was concluded that intra-alveolar bioactive glass improved bone neoformation by osteoconductive action. / Orientador: Wilson Roberto Poi / Coorientador: Lizeti Toledo de Oliveira Ramalho / Banca: Robson Rodrigues Garcia / Banca: Daniela Atili Brandini / Banca: Idelmo Rangel Garcia Júnior / Doutor

Orientador: Paulo Sérgio Perri de Carvalho / Resumo: Foi realizado um estudo retrospectivo para avaliar os resultados da reconstrução do processo alveolar intensamente reabsorvido com diferentes tipos de enxerto ósseo autógeno associados à instalação de implantes simultâneos e mediatos (após 4 meses da instalação do enxerto) realizados no período de 4 anos e 6 meses. Foram selecionados para este estudo 84 pacientes, submetidos à reconstrução de defeitos ósseos dos maxilares, com enxertos ósseos do mento, linha oblíqua da mandíbula, crista ilíaca anterior e calota craniana, com um total de 346 implantes instalados, sendo que, 257 destes implantes encontravam-se, com as próteses implantossuportadas instaladas, e distribuídos em 40 implantes simultâneos e 217 mediatos. Desta forma, foram avaliadas os transtornos de técnica cirúrgica e as complicações relacionadas com as áreas receptoras, bem como a taxa de sobrevivência dos implantes. De acordo com os resultados obtidos, dentre alguns dos transtornos de técnica cirúrgica e complicações estavam a redução da quantidade de mucosa ceratinizada na cortical vestibular e conseqüente perda da profundidade de sulco, assim como, exposição parcial do enxerto, contaminação do enxerto, entre outras complicações verificadas. A taxa de sobrevivência, obtida para os implantes simultâneos e mediatos instalados, foi de 94,55%. Quando a taxa de sobrevivência foi avaliada individualmente para cada grupo, no caso dos implantes simultâneos foi encontrado um resultado de 97,50%, enquanto que para os implantes mediatos obteve-se um resultado de 94,10%%. Portanto com este estudo, conclui-se que dos transtornos de técnica cirúrgica com maior ocorrência estava a redução da quantidade de mucosa ceratinizada sobre a crista do rebordo, complicações como exposição parcial do enxerto entre outras, que as áreas doadoras intrabucais oferecem vantagem...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: A retrospective study was carried out in order to evaluate the outcomes of the reconstruction of the severely resorbed alveolar ridge through different types of autogenous bone grafts associated to the placement of simultaneous and delayed implants (4 months after the bone graft procedure) accomplished during a period of 4 years and 6 months. A total of 84 patients were selected for the present study, which were submitted to reconstruction of the bone defects of the jaws by means of bone grafts from the chin, external oblique ridge, anterior iliac crest, cranial vault, adding up to 346 implants, from which 257 (40 simultaneous and 217 delayed implants), with the installed implant-supported prostheses. The evaluation concerned of the overturn of surgical technique and complications related to the receptor sites, as well as the survival rate of the implants. The results indicated occurrence of the overturn of surgical technique and complications such as reduction in the amount of keratinized mucosa over the buccal cortical plate with consequent decrease in vestibular depth, as well as partial exposure of the graft, contamination of the graft, and others. The survival rate for both simultaneous and delayed implants was 94.55%. Regarding the individual evaluation of each group, the simultaneous implants demonstrated a survival rate of 97.50% in relation to 94.10% for the delayed implants. The most frequent of the overturn of surgical technique were reduction in the amount of keratinized mucosa over the alveolar ridge, complications as partial exhibition of the graft among others, better performance of the intraoral donor sites in relation to the extraoral sites, positive association between implant failures and iliac crest grafts, besides significantly worse outcomes for the female subjects in relation to the males. Better results were observed for the simultaneous implants, what is in disagreement with previous studies. / Doutor

Orientador: Paulo Sérgio Perri de Carvalho / Banca: Marco Antonio Bottino / Banca: Luiz Fernando Pegoraro / Banca: Mauro Antônio Arruda Nóbilo / Banca: Tetuo Okamoto / Resumo: O objetivo deste trabalho foi de estudar em mandíbula de cães, os implantes osseointegrados submetidos a carga imediata considerando a qualidade óssea formada na interface implante-osso, como também medir o contato ósseo da referida interface. Foram utilizados quatro cães que, após as exodontias, receberam três implantes Osseotite 3,75 x 8,5 (Implant Innovations Incorporation) e, após os procedimentos de moldagem e de laboratório para a confecção da prótese em Níquel-Cromo, estas foram instaladas no mesmo dia da instalação dos implantes e submetidas a técnica da carga imediata. Após 240 dias, os implantes mesial e distal foram contra-torqueados medindo-se a resistência do tecido ósseo neoformado. Na seqüência, os animais foram sacrificados (240 dias) e as peças foram processadas para cortes histológicos sem descalcificação. As lâminas obtidas foram coradas pelo azul de toluidina e pelo picro-sirius que foram analisadas pelos microscópios óptico e de luz polarizada, respectivamente. Nas lâminas coradas pelo azul de toluidina, foi possível observar o tecido ósseo neoformado em contato com a superfície dos implantes com ósteons bem definidos. Nestas lâminas foram medidos os perímetros dos implantes para determinar o contato ósseo. As lâminas coradas pelo picro-sirius mostraram deposição de colágeno tipo I. A média de contato ósseo foi de 77,5% e o teste de contratorque aplicado nos implantes apresentou média de 76,13 Ncm. Considerando as limitações deste trabalho, foi possível concluir que a carga imediata em segmentos parcialmente desdentados é uma técnica viável para reabilitação bucal. / Abstract: The objective of this work was to study the osseointegrated implants undergone immediately loading in dog mandibles, considering the bone quality formed in the implant-bone interface as well as bone contact. Four dogs were used, which after exodontics, received three Osseotite implants 3.75 x 8.5 (Implant Innovations Incorporation) and after the full-arch impression with custom tray and laboratorial procedures for the fabrication of the prosthesis in nickel chrome, this one were installed in the same day as the installation of the implants and was undergone a immediately loading. After 240 days, the mesial and distal implants were reverse torqued, measuring like this, the resistance of the neoformed osseous tissue. Soon after, the animals were sacrificed (240 days) and the samples were processed for histological examination by means of undescalcified sections without decalcification. The histologic specimens attained were stained with toluidine blue and with Picrus Sirius. After microscopical examination of the sections stained by toluidine blue with the optical microscope, it was possible to observe the neoformed osseous tissue and with the presence of well defined osteons. The histologic specimens stained with Picrus Sirius were analysed by polarized light microscope and they showed type I collagen deposition. The mean of osseous contact was of 77.5% between the implant and the bone, and the biomechanical test by means of reverse-torque presented a mean of 76.13 Ncm. Considering the limitations of this work it was possible to conclude that the immediately loading in partially edentulous segments is a viable technique for oral rehabilitation. / Doutor

Orientador: Paulo Sérgio Perri de Carvalho / Resumo: Os objetivos do presente estudo foram analisar e comparar, em cães, a reparação óssea em defeitos preenchidos com vidro bioativo e osso desmineralizado liofilizado e comparar com áreas que não receberam biomateriais, antes e após a inserção de implantes dentários de titânio. Cavidades com 6mm de diâmetro foram realizadas em ambos os úmeros de 6 cães machos saudáveis e preenchidas com vidro bioativo, osso liofilizado desmineralizado e coágulo. Após 5 meses de reparação, foi removido tecido ósseo do centro das cavidades para análise de microscopia óptica. A seguir, implantes dentários de titânio foram colocados no centro dessas cavidades e em áreas de osso pré-existente. Três meses depois, realizou-se o teste biomecânico de contra-torque dos implantes. Os cães foram sacrificados e o tecido ósseo encaminhado para processamento e análise de microscopia eletrônica por retroespalhamento de elétrons. No teste biomecânico não foram observadas diferenças estatisticamente significantes entre os 4 grupos. A análise de microscopia óptica demonstrou a presença de ambos os biomateriais e tecido ósseo neoformado na maioria das amostras do grupo experimental. Na microscopia eletrônica por retro-espalhamento de elétrons observou-se neoformação óssea em todos os grupos. Pela análise histométrica, a quantidade de neoformação óssea no grupo do vidro bioativo foi estatisticamente maior em relação aos outros grupos. Concluiu-se que o vidro bioativo apresentou os melhores resultados em porcentagem de neoformação óssea. No entanto, uma reparação satisfatória foi demonstrada em todos os grupos, com adequada qualidade óssea ao redor dos implantes dentários. / Abstract: The objectives of the present study were to analyze and compare, in dogs, the bone healing in large areas grafted with bioactive glass and DFDBA to areas without any grafting, before and after the insertion of titanium dental implants. Cavities (6mm diameter) were drilled in both humeri of 6 healthy male dogs. The cavities were filled in with bioactive glass, DFDBA and clot. After 5 months, bone was removed from the centre of the cavities and processed for light microscopy analysis. Titanium dental implants were placed in these sites and in areas not previously drilled. Three months later, a biomechanical test was performed and the force necessary to unscrew the titanium implants was measured. Dogs were sacrificed and the bone removed. After embedding in PMMA, calcified samples were cut in half and polished for back-scattering SEM analysis. No statistically significant differences were observed among the 4 groups concerning the biomechanical test, according to the test U of Mann- Whitney. Light microscopy analysis showed the presence of both biomaterials among the regenerated bone. In the back-scattering analysis, regenerated bone was seen in all groups, and DFDBA presented the least volume. Remnants of granules of bioactive glass were still present, but in a smaller size. Because granules of DFDBA have the same image density of bone, if present, they couldn't be identified. According to the test U of Mann-Whitney, the amount of bone formation in the bioactive glass group was statistically higher compared to the other groups. Based on the findings of this study, it was concluded that the bioactive glass showed best results in terms of bone volume. However, a satisfactory regeneration of bone in large defects with adequate bone quality was observed around dental implants in all groups. / Doutor

O objetivo do trabalho foi avaliar in vivo a osseointegração de implantes produzidos em zircônia reforçada com ítria (Y-TZP) e compará-los com o implante de titânio usinado e com o de superfície jateada com brushita. Para tanto, nas tíbias de 20 coelhos machos (n=10) e fêmeas (n=10) foram implantadas em uma das tíbias o implante Y-TZP (GE-1, n=10 implantes) e na outra tíbia o titânio usinado (GC, n=5 implantes) ou jateado com brushita (GE-2, n=5 implantes). Os animais receberam marcadores ósseos fluorescentes, tetraciclina (14 e 21 dias), alizarina (28 e 35 dias) e calceína (42 e 49 dias) após a cirurgia de implantação. Ao final de 56 dias, a região dos implantes foi coletada e processada histologicamente para obtenção de cortes teciduais não desmineralizados. Nas imagens obtidas no microscópio confocal foi avaliado o percentual de área para cada marcador. Nos cortes corados pelo azul de toluidina foi avaliado morfologicamente a qualidade do tecido ósseo formado e a existência de interposição de tecido conjuntivo entre osso e implante, e morfometricamente determinado o percentual de contato osso-implante (BIC) e o percentual de tecido ósseo próximo à superfície do implante (BA). Os resultados mostraram que, não houve diferenças estatisticamente significantes entre machos e fêmeas quanto aos parâmetros avaliados. Com relação aos grupos, GE-1 e GC apresentaram cortical óssea remanescente íntegra e formação de um tecido ósseo maduro/lamelar na superfície dos implantes. No GE-2 ocorreu intensa reabsorção da cortical óssea pre-existente próxima ao implante e extensa formação óssea mais imatura em relação aos observados no GE-1 e GC. Essa intensa reabsorção e extensa formação óssea fez com que o percentual de área dos marcadores fluorescentes fosse em média 0,73 vezes maior no GE-2 em relação aos grupos GE-1 e GC. Com relação ao BIC não houve diferença entre os grupos, sendo em média de 47,8%, porém, o BA no grupo GC (66,2%) foi 0,33 vezes maior em relação ao GE-1(51,6%) e GE-2 (48,2%). No modelo utilizado o implante Y-TZP apresentou osseointegração similar ao titânio usinado e superior ao jateada com brushita, podendo ser considerado uma alternativa para substituir o implante titânio quando a estética esta envolvida. / The aim of this work was evaluate in vivo the osseointegration of implants produced with yttria stabilized zirconia (Y-TZP) and compare it with machined titanium implant and sandblasted surface with brushita titanium. Therefore, on the tibia of 20 rabbits males (n=10) and female (n=10) were implanted in one of the tibias the implant Y-TZP (GE-1, n=10 implants) and on the other tibia the machined titanium (GC, n=5 implants) or sandblasted surface with brushita titanium (GE-2, n=5 implants). The animals received fluorescent bone markers, tetracycline (14th and 21th days), alizarin (28th and 35th days) and calcein (42th and 49th days). At the end of 56 days, the implants regions were collected and histomorphometrically processed to obtain tissue sections not demineralized. On images obtained from confocal microscopy was evaluated the percentage of area for each bone markers. On slides stained with toluidine blue was measured morphologically the quality of formed bone tissue and the existence of interposition of connective tissue between bone and implant, and was morphometrically determined the percentage of bone-implant contact (BIC) and the percentage of bone tissue next to the implant surface (BA). The results showed that there were no statistically significant differences between male and female regarding to evaluated parameters. Concerning to the groups, GE-1 and GC exhibited wholesome remaining cortical bone and formation of mature/lamellar bone tissue on implants surface. In GE-2 ocurred intense reabsorption of preexisting cortical bone next to the implant and extensive bone formation more immature than GE-1 and GC. This intense reabsorption and extensive bone formation made the GE-2 area percentage for fluorescent markers 0.73 times higher on average when compared to GE-1 and GC. About the BIC, there were no differences between the groups, with an average of 47.8%, however, the BA on GC group (66.2%) was 0.33 higher compared to GE-1 (51.6%) and GE-2 (48.2%). In the model used, the Y-TZP implant exhibited osseointegration suchlike machined titanium and better than sandblasted surface with brushita titanium, being considered an alternative to replace the titanium implant when aesthetics is involved.

Introdução: A utilização de próteses bucomaxilofaciais é de extrema importância para a reintegração no convívio social dos pacientes acometidos de deformidades congênitas ou adquiridas. Tendo em vista os avanços dos sistemas de retenção, fixação e ancoragem extraoral na reabilitação bucomaxilofacial realizou-se revisão sistemática. Objetivos: verificar a evolução das retenções das próteses bucomaxilofaciais comparando os sistemas osseointegrados, aos sistemas não osseointegrados, analisando algumas variáveis como: taxa de sobrevivência dos implantes ao longo do tempo, idade média dos pacientes, etiologia do defeito facial e sitio dos sistemas de retenção relacionado ao tipo de prótese, em formato de revisão sistemática. Métodos: Realizou-se busca bibliográfica nas bases de dados PubMed e SCOPUS, após elaboração de estratégias de busca, obteve-se 2630 artigos onde foram analisados títulos, resumos e eliminadas duplicidades. Resultados: Obteve-se 25 artigos pré-selecionados que passaram pelos critérios de inclusão e exclusão sendo eleitos 13 artigos para a revisão sistemática. Conclusão: As próteses retidas por implantes superam os sistemas convencionais. A perda dos implantes foi muito pequena nos estudos analisados, apesar do tempo de acompanhamento ser relativamente curto e dos protocolos distintos de tratamento. A idade adulta entre a quarta e quinta década de vida foi a de maior prevalência. A etiologia mais incidente são as neoplasias. Os sistemas osseointegrados fixados por implantes por retenção barra clipe se localizam mais na região auricular e retenção magnética nas regiões nasal e orbital. Os sistemas não osseointegrados, a retenção anatômica é mais utilizada na região ocular, retenção mecânica na região orbital e o uso da retenção por adesivos nas regiões nasal e orbital. / Introduction: The use of maxillofacial prostheses is the most importance for reintegration into social life of patients suffering from congenital or acquired deformities. Given the advances in retention, fixation and extraoral anchorage systems in maxillofacial rehabilitation got systematic review. Objectives: To observe the evolution of the retentions of maxillofacial prostheses comparing osseointegrated systems, non osseointegrated systems, analyzing some variables such as survival rate of implants over time, mean patient age, etiology of facial defect and place restraint systems related kind of prosthesis, in a systematic review format. Methods: We performed a literature search in PubMed and SCOPUS database, after preparation of search strategies, we obtained 2630 articles where were checking titles, abstracts and eliminated duplicates were analyzed. Results: We obtained 25 pre-selected articles that passed the criteria for inclusion and exclusion being elected 13 articles for systematic review. Conclusion: The dentures retained by implants outperform conventional systems. The loss of the implants was very small in the analyzed studies, although the follow-up time is relatively short and the different treatment protocols. Between the fourth and fifth ages of life was the most prevalent. The most frequent etiology are neoplasms. Osseointegrated systems for fixed for implants retention bar clip are located more auricular and magnetic retention in the regions nasal and orbital. Non osseointegrated systems, anatomical retention is most commonly used in the ocular region, mechanical retention in orbital region and the use of adhesives for retention in the regions nasal and orbital.

In the last century, no less than five nobel prizes have been awarded for the construction of carbon-carbon bonds : The Grignard reaction (1912), the Diels-Alder reaction (1950), the Wittig reaction (1979), Olefin metathesis (2005) and palladium cross-coupling reactions (2011). The latter two are transition metal catalyzed transformations and their impact on the synthesis of pharmaceutically active compounds, bulk chemicals, fine chemicals, high tech materials as well as agricultural chemicals has been phenomenal. These reactions have changed the way the scientific community views the science of synthesis. Unlike palladium, gold has long been considered to be an expensive and inert metal and therefore, research on Au catalysis was scarse until the begining of the new millenium. Once the scientific community realized the treasure trove of reactivity that gold had to offer, the number of chemical transformations as well as total syntheses involving Au(I)/Au(III) catalysis has sky rocketed. A methodology initially developped by Toste and coworkers has shown that intramolecular addition of a silyl enol ether on alkynes proceeds via a 5-exo¬-dig¬ process. In the first part of this thesis, we will discuss how the ancilary ligand on Au(I) species can influence pathway selectivity for these cyclizations, therefore opening the door to selective 6-endo-dig cyclizations to generate fused carbocycles. With biological processes as well as other competing processes becoming ever more efficient, the future of chemical synthesis is threatened. If it is to survive, the focus of new chemical transformations will have to be on the cost and the greeness of the process. In the second part of this thesis, we will demonstrate how Ag(I) and Cu(I) complexes can offer even better 6-endo-dig¬ selectivity than analogous Au(I) complexes. Silver is about 56 times less expensive than gold, and copper is about 453 times less expensive than gold. Due to the greatly increased selectivity as well as the diminished cost of the catalysts, we have provided access to an attractive 6-endo-dig¬ cyclization process.

Kainic acid has been used for nearly 50 years as a tool in neuroscience due to its pronounced neuroexcitatory properties. However, the significant price increase of kainic acid resulting from the disruption in the supply from its natural source, the alga Digenea Simplex, as well as inefficient synthesis of kainic acid, call for the exploration of functional mimics of kainic acid that can be synthesized in a simpler way. Aza kainoids analog could be one of them. The unsubstituted aza analog of kainoids has demonstrates its ability as an ionotropic glutamate receptor agonist and showed affinity in the chloride dependent glutamate (GluCl) binding site. This opened a question of the importance of the presence of one nitrogen or both nitrogens in the aza kainoid analogs for binding to glutamate receptors. Therefore, two different pyrrolidine analogs of kainic acid, trans-4-(carboxymethyl)pyrrolidine-3-carboxylic acid and trans-2-carboxy-3-pyrrolidineacetic acid, were synthesized through multi-step sequences. The lack of the affinity of both pyrrolidine analogs in GluCl binding site indicated that both nitrogens in aza kainoid analogs are involved in hydrogen bonding with receptors, significantly enhancing their affinity in GluCl binding site. Another potential functional mimic of kainic acid is isoxazolidine analogs of kainoids whose skeleton can be constituted directly via a 1, 3 dipolar cycloaddition as the key step. The difficulty in synthesizing N-unsubstituted isoxazolidines when applying such common protecting groups as alkyl, phenyl and benzyl groups, and the requirement of a desired enantioselectivity due to the three chiral ceneters in kainic acid, pose great challenges. Hence, several different protected nitrones were studied to establish that diphenylmethine nitrone may be a good candidate as the dipole in that the generated isoxazolidines can be deprotected in mild conditions with high yields. Our investigations also indicated that the exo/endo selectivity of the 1, 3 dipolar cycloaddition can be controlled by Lewis acids, and that the application of a directing group in dipolarophiles can accomplish a satisfied enantioselectivity. Those results demonstrated the synthesis of isoxazoldines analogs of kainic acid is very promising.

Aims Preservation of peri-cervical dentin during the preparation of endodontic access is important to prevent fractures and improve the long-term prognosis. The purpose of this study was to evaluate the impact of rotary file instrumentation (TruNatomy and XP-Endo Shaper) on peri-cervical dentin removal, depending on access size. Materials and Methods Forty 3D printed mandibular first molars, with either a small or large access design, were instrumented using TruNatomy or XP-endo Shaper file systems. Canal volumes were calculated based on micro-computed tomography data obtained pre- and post-operatively. Digital sectioning of each reconstructed volume was performed 90-degrees to the long axis at the floor of the pulp chamber at 5 levels, at the pulp chamber floor (Level 0) as well as 1 and 2mm coronally and apically of Level 0. Linear measurements were taken from the inner wall of the access cavity or canal to the outer surface of the tooth for both instrumentation techniques and compared to the unprepared control dataset. These measurements served as an approximation of remaining peri-cervical dentin after root canal instrumentation. Results Some of the coronal measurements were not reportable for the control group due to incomplete capture of the crown during the microCT scan. The remaining peri-cervical dentin thickness at the level of the pulpal floor and coronally were significantly (p<0.01) affected by the access cavity size, with the smaller access preserving more dentin in all samples. Apical to the pulpal floor, there was no significant difference between instrumentation groups at the data points evaluated. Remaining dentin thickness was largest at coronal section 1 and smallest at apical section 6 with 3.81mm (p = 0.05) and 1.84mm (p = 0.06), respectively. Conclusion Access cavity size had a significant impact on remaining dentin thickness at the level of the pulpal floor and coronally, with more remaining dentin in the conservative access group, irrespective of instrumentation technique. Future studies will evaluate dentin thickness in the furcation and mid root level, as well as apical canal transportation, and procedural errors.