Influence of the methodology and evaluation criteria on determining microleakage in dentin–restorative interfaces

This in vitro study compared microleakage along the dentin–restorative interface using a spectrophotometer protocol and two conventional single-surface methods (scores and percentages), using an organic dye (0.5% buffered methylene blue) or a tracer (50% silver nitrate). Occluso-proximal preparations with gingival margins in dentin were made in 40 human teeth. The teeth were divided into four groups (n=10) according to the solution dyes and adhesive system used: group 1, single bond/methylene blue; group 2, single bond/silver nitrate; group 3, Clearfil SE Bond/methylene blue; and group 4, Clearfil SE Bond/silver nitrate. The dye penetration measurements were made in all groups, using scores and percentages. Groups 1 and 3 were also assessed by UV spectrophotometer. For percentage measurement, the data were submitted to ANOVA and Tukey’s test. For the material factor, there was a statistically significant difference between groups 1 and 3. For the dye factor, there was a statistically significant difference between groups 3 and 4. The score results were submitted to Kruskall–Wallis test and showed differences between groups 1 and 3 and groups 2 and 3. For spectrophotometer measurement, no significant difference was observed between groups 1 and 3. The results of dye penetration suggest that there was a difference between dyes and measurement methods, and this should change the interpretation of microleakage tests.     

Effect of pre-flaring and file size on the accuracy of two electronic apex locators

Objective

This ex vivo study evaluated the effect of pre-flaring and file size on the accuracy of the Root ZX and Novapex electronic apex locators (EALs).

Material and methods

The actual working length (WL) was set 1 mm short of the apical foramen in the palatal root canals of 24 extracted maxillary molars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the "0.0" or ''''APEX'''' signals were observed on the LED or display screens for the Novapex and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the pre-flaring using the S1 and SX Pro-Taper instruments. Two measurements were performed for each condition and the means were used. Intra-class correlation coefficients (ICCs) were calculated to verify the intra- and inter-examiner agreement. The mean differences between the WL and electronic length values were analyzed by the three-way ANOVA test (p<0.05).

Results

ICCs were high (>0.8) and the results demonstrated a similar accuracy for both EALs (p>0.05). Statistically significant accurate measurements were verified in the pre-flared canals, except for the Novapex using a #20 K-file.

Conclusions

The tested EALs showed acceptable accuracy, whereas the pre-flaring procedure revealed a more significant effect than the used file size.     

Histological examination of the potential arrhythmic substrates in the setting of Ebstein’s malformation

Cardiac arrhythmias, notably Wolff-Parkinson-White syndrome, are known to represent a major issue in patients with Ebstein’s malformation of the tricuspid valve. Abnormal conducting circuits, however, can also be produced by pathways extending either from the atrioventricular node or the ventricular components of the atrioventricular conduction axis, direct to the crest of the muscular ventricular septum. We hoped to provide further information on the potential presence of such pathways by investigations of six autopsied examples of Ebstein’s malformation. All were studied by histological sectioning on the full extent of the atrioventricular conduction axis, with limited sectioning of the right atrioventricular junction supporting the inferior and antero-superior leaflets of the deformed tricuspid valve. We used the criteria established by Aschoff (Verhandlungen der Deutschen Gesellschaft für Pathologie, 14, 1910, 3) and Mönckeberg (Verhandlungen der Deutschen Gesellschaft für Pathologie, 14, 1910, 64) over a century ago to define abnormal connections across the atrioventricular junctions, as these definitions retain their validity for the identification of gross myocardial connections across the insulating tissues of the atrioventricular junctions. In one specimen, we found two discrete accessory myocardial connections across the parietal right atrioventricular junction. In all of the hearts, we found so-called nodoventricular connections, and in one heart we also observed a well-formed connection originating from the penetrating atrioventricular bundle. In addition to accessory myocardial connections across the parietal right atrioventricular junction, therefore, our histological findings demonstrate a potential role for direct connections between the atrioventricular conduction axis and the ventricular myocardium in the setting of Ebstein’s malformation.