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How do imaging protocols affect the assessment of root-end fillings?
Fernanda Ferrari Esteves Torres, Reinhilde Jacobs, Mostafa EzEldeen, Karla de Faria-Vasconcelos, Juliane Maria Guerreiro-Tanomaru, Bernardo Camargo dos Santos, Mário Tanomaru-Filho
Restor Dent Endod 2022;47(1):e2.   Published online December 15, 2021
DOI: https://doi.org/10.5395/rde.2022.47.e2
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the impact of micro-computed tomography (micro-CT)-based voxel size on the analysis of material/dentin interface voids and thickness of different endodontic cements.

Materials and Methods

Following root-end resection and apical preparation, maxillary premolars were filled with mineral trioxide aggregate (MTA), Biodentine, and intermediate restorative material (IRM) (n = 24). The samples were scanned using micro-CT (SkyScan 1272; Bruker) and the cement/dentin interface and thickness of materials were evaluated at voxel sizes of 5, 10, and 20 µm. Analysis of variance and the Tukey test were conducted, and the degree of agreement between different voxel sizes was evaluated using the Bland and Altman method (p < 0.05).

Results

All materials showed an increase in thickness from 5 to 10 and 20 µm (p < 0.05). When evaluating the interface voids, materials were similar at 5 µm (p > 0.05), while at 10 and 20 µm Biodentine showed the lowest percentage of voids (p < 0.05). A decrease in the interface voids was observed for MTA and IRM at 20 µm, while Biodentine showed differences among all voxel sizes (p < 0.05). The Bland-Altman plots for comparisons among voxel sizes showed the largest deviations when comparing images between 5 and 20 µm.

Conclusions

Voxel size had an impact on the micro-CT evaluation of thickness and interface voids of endodontic materials. All cements exhibited an increase in thickness and a decrease in the void percentage as the voxel size increased, especially when evaluating images at 20 µm.

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Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals
Karina Ines Medina Carita Tavares, Jáder Camilo Pinto, Airton Oliveira Santos-Junior, Fernanda Ferrari Esteves Torres, Juliane Maria Guerreiro-Tanomaru, Mario Tanomaru-Filho
Restor Dent Endod 2021;46(4):e56.   Published online October 27, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e56
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals.

Materials and Methods

Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05).

Results

No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05).

Conclusions

High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.

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A micro-computed tomographic study using a novel test model to assess the filling ability and volumetric changes of bioceramic root repair materials
Fernanda Ferrari Esteves Torres, Jader Camilo Pinto, Gabriella Oliveira Figueira, Juliane Maria Guerreiro-Tanomaru, Mario Tanomaru-Filho
Restor Dent Endod 2021;46(1):e2.   Published online December 8, 2020
DOI: https://doi.org/10.5395/rde.2021.46.e2
AbstractAbstract PDFPubReaderePub
Objectives

New premixed bioceramic root repair materials require moisture for setting. Using micro-computed tomography (micro-CT), this study evaluated the filling ability and volumetric changes of calcium silicate-based repair materials (mineral trioxide aggregate repair high-plasticity [MTA HP] and Bio-C Repair, Angelus), in comparison with a zinc oxide and eugenol-based material (intermediate restorative material [IRM]; Dentsply DeTrey).

Materials and Methods

Gypsum models with cavities 3 mm deep and 1 mm in diameter were manufactured and scanned using micro-CT (SkyScan 1272. Bruker). The cavities were filled with the cements and scanned again to evaluate their filling capacity. Another scan was performed after immersing the samples in distilled water for 7 days to assess the volumetric changes of the cements. The statistical significance of differences in the data was evaluated using analysis of variance and the Tukey test with a 5% significance level.

Results

Bio-C Repair had a greater filling ability than MTA HP (p < 0.05). IRM was similar to Bio-C and MTA HP (p > 0.05). MTA HP presented the largest volumetric change (p < 0.05), showing more volume loss than Bio-C and IRM, which were similar (p > 0.05).

Conclusions

Bio-C Repair is a new endodontic material with excellent filling capacity and low volumetric change. The gypsum model proposed for evaluating filling ability and volumetric changes by micro-CT had appropriate and reproducible results. This model may enhance the physicochemical evaluation of premixed bioceramic materials, which need moisture for setting.

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Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers
Mario Tanomaru-Filho, Fernanda Ferrari Esteves Torres, Jader Camilo Pinto, Airton Oliveira Santos-Junior, Karina Ines Medina Carita Tavares, Juliane Maria Guerreiro-Tanomaru
Restor Dent Endod 2020;45(3):e34.   Published online June 9, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e34
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer).

Materials and Methods

Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05).

Results

There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer.

Conclusions

The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.

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Micro-computed tomographic evaluation of the flow and filling ability of endodontic materials using different test models
Fernanda Ferrari Esteves Torres, Juliane Maria Guerreiro-Tanomaru, Gisselle Moraima Chavez-Andrade, Jader Camilo Pinto, Fábio Luiz Camargo Villela Berbert, Mario Tanomaru-Filho
Restor Dent Endod 2020;45(2):e11.   Published online January 8, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e11
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the flow and filling of several retrograde filling materials using new different test models.

Materials and Methods

Glass plates were manufactured with a central cavity and 4 grooves in the horizontal and vertical directions. Grooves with the dimensions used in the previous study (1 × 1 × 2 mm; length, width, and height respectively) were compared with grooves measuring 1 × 1 × 1 and 1 × 2 × 1 mm. Biodentine, intermediate restorative material (IRM), and mineral trioxide aggregate (MTA) were evaluated. Each material was placed in the central cavity, and then another glass plate and a metal weight were placed over the cement. The glass plate/material set was scanned using micro-computed tomography. Flow was calculated by linear measurements in the grooves. Central filling was calculated in the central cavity (mm3) and lateral filling was measured up to 2 mm from the central cavity.

Results

Biodentine presented the least flow and better filling than IRM when evaluated in the 1 × 1 × 2 model. In a comparison of the test models, MTA had the most flow in the 1 × 1 × 2 model. All materials had lower lateral filling when the 1 × 1 × 2 model was used.

Conclusions

Flow and filling were affected by the size of the test models. Higher grooves and materials with greater flow resulted in lower filling capacity. The test model measuring 1 × 1 × 2 mm showed a better ability to differentiate among the materials.

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