Influence of endodontic irrigants on bond strength of a self-etching adhesive

The aim of this in vitro study was to evaluate the bond strength of a self-etching adhesive system to dentine irrigated with sodium hypochlorite (NaOCl), chlorhexidine solution (CX) and ethylene diamine tetra acetic acid (EDTA) by microtensile testing. Sixty human third molars were sectioned 3 mm below the occlusal level and then randomly divided into six groups: G1(control), without irrigant solution; G2, 1% NaOCl; G3, 1% NaOCl followed by the application of 17% EDTA; G4, 2% CX; G5, 2% CX followed by the application of 17% EDTA and G6, 17% EDTA. The specimens received the self-etching adhesive system were restored with composite resin, then sectioned and trimmed to obtain four hourglass-shaped slabs from each tooth. The specimens were submitted to the microtensile test in a Universal Testing Machine at a crosshead speed of 0.5 mm min(-1) until fracture. The results were submitted to statistical analysis by anova /Newman-Keuls. The means and standard deviations (MPa) were: G1, 26.88 (±3.81); G2, 19.08 (±3.89); G3, 18.16 (±2.21); G4, 18.14 (±4.32); G5, 34.30 (±3.32); G6, 13.61 (±1.21). It was concluded that the application of 2% CX followed by the application of 17% EDTA resulted in increasing the bond strength of the self-etching adhesive system to dentine, when compared with the results obtained for the other tested groups.     

Prospective Evaluation of Defibrillation Threshold and Postshock Rhythm in Young ICD Recipients

Background: Adaptation of implantable cardioverter defibrillator (ICD) systems to the needs of pediatric and congenital heart patients is problematic due to constraints of vascular and thoracic anatomy. An improved understanding of the defibrillation energy and postshock pacing requirements in such patients may help direct more tailored ICD therapy. We describe the first prospective evaluation of defibrillation threshold (DFT) and postshock rhythm in this population. Methods: We prospectively studied patients ≤60 kg at time of ICD intervention. DFTs were obtained using a binary search protocol with three VF inductions. Postshock pacing was programmed using a stepwise protocol, lowering the rate prior to each VF induction. Results: Twenty patients were enrolled: 11 had channelopathy, five congenital heart disease, and four cardiomyopathy. The median age was 16 years, median weight 48 kg. Twelve patients had a transvenous high‐voltage coil; eight had pericardial +/? subcutaneous coil(s). Median DFT was 7 J (range 3–31 J); 19/20 patients had DFT ≤15 J and all patients <25 kg had DFT ≤9 J (n = 6). There was no difference in DFT between patients with transvenous versus pericardial +/? subcutaneous coils (median 7 J vs 6 J, P = 0.59). No patient with normal atrioventricular conduction prior to defibrillation required postshock pacing (n = 16). There were no adverse events. Conclusions: These data suggest that many pediatric ICD patients have low DFTs and adequate postshock escape rhythm. This may help determine appropriate parameters for future design of pediatric‐specific ICDs. (PACE 2012;35:1487–1493)     

Influence of chlorhexidine and ethanol on the bond strength and durability of the adhesion of the fiber posts to root dentin using a total etching adhesive system

Introduction

The aim of this study was to investigate the effects of pretreatment of gel chlorhexidine (CHX) and ethanol (EtOH) on the bond strength and durability of the adhesion of the fiber post relined with resin composite to the root dentin using a total etch adhesive system.

Methods

Forty bovine incisor roots were divided into four groups after phosphoric acid etching: irrigation with physiologic solution (control), 5 minutes with CHX, 1 minute with EtOH, and 5 minutes with chlorhexidine followed by 1 minute with EtOH. Fiber posts relined with resin composite were cemented with either RelyX ARC (3M ESPE, St Paul, MN) and a total etch adhesive system Scotchbond Multi-Purpose (3M ESPE). Each group was randomly divided into two subgroups: 24 hours of storage and 12 months of storage. All roots were sectioned transversely, and the push-out test was performed. Failure modes were observed, and the bond strength means were analyzed by analysis of variance and the Tukey test (α = 0.05).

Results

CHX irrigation resulted in homogeneous bond strength values at 24 hours and 12 months of storage (P < .05). A significant bond strength decrease was noticed after 12 months of storage when irrigations were performed with physiologic solution and EtOH application only or associated with CHX (P < .05).

Conclusions

The use of CHX pretreatment could preserve the bond strength of the fiber post relined with resin composite to root dentin for 12 months. The use of EtOH and CHX followed by EtOH did not preserve the bond strength of the total etch adhesive system Scotchbond Multi-Purpose.     

Effectiveness of calcium and sodium hypochlorite in association with reciprocating instrumentation on decontamination of root canals infected with Enterococcus faecalis

The aim of this study was to evaluate the antimicrobial activity of sodium and calcium hypochlorite utilising reciprocating instrumentation. Sixty root canals were inoculated with E. faecalis for 14 days. Samples were divided into six groups according to decontamination protocol: G1: no treatment, G2: distilled water, G3: 2.5% sodium hypochlorite, G4: 2.5% calcium hypochlorite, G5: 5.25% sodium hypochlorite and G6: 5.25% calcium hypochlorite. Instrumentation was performed with Wave One reciprocating system (Dentsply Sirona Endodontics, York, PA, USA) in groups G2 to G6. Colony‐forming units (CFUs) counting was performed and the data were subjected to Anova and Tukey (α  =  0.05). Group 1 and 2 showed the highest mean contamination, with a significant difference between them (P < 0.05). Groups 3, 4, 5 and 6 showed the lowest contamination means with no significant difference between them (P < 0.05). Sodium and calcium hypochlorite, in association with reciprocating instrumentation, can be an effective decontamination protocol in root canals infected with E. faecalis.     

Catheter Ablation of a Right Atrial Appendage to the Right Ventricle Connection in a Neonate

SHAH, M.J., et al. : Catheter Ablation of a Right Atrial Appendage to the Right Ventricle Connection in a Neonate. A neonate with incessant supraventricular tachycardia refractory to multiple antiarrhythmic medications was referred to our institution for radiofrequency ablation. An unusual accessory pathway between the right atrial appendage and right ventricle was successfully ablated. This case also emphasizes the congenital origin of such an accessory pathway.     

Bond strength of Resilon/Epiphany compared with Gutta‐percha and sealers Sealer 26 and Endo Fill

This study evaluated the bond strength of Epiphany^®/Resilon^® to radicular dentine and compared this with that of Gutta‐percha sealed with Sealer 26 and also Endo Fill^®. Fifteen human single‐rooted extracted teeth had their root canals enlarged to a standardised internal root diameter of 1.5 mm. The teeth were filled with: Group I – Epiphany^®/Resilon^® cones, Group II – Sealer 26^®/Gutta‐percha cones and Group III – Endo Fill^®/Gutta‐percha cones. Three 2 mm‐thick cross‐sections were obtained from each tooth (n = 15) and subjected to a push‐out test (1 mm min^?1). The means (MPa) were compared using anova /Newman–Keuls tests. There were no statistically significant differences between Group I and Group II (P > 0.01). Both bond strengths were significantly higher than that of Group III (P < 0.01). The root canal filling system Epiphany^®/Resilon^® showed bond strength similar to that of Sealer 26^®/Gutta‐percha. Both were higher than that of Endo Fill^®/Gutta‐percha.     

Evaluation of the colour change in enamel and dentine promoted by the interaction between 2% chlorhexidine and auxiliary chemical solutions

To evaluate the colour change in enamel and dentine, promoted by interaction of 2% chlorhexidine gluconate (CHX) with 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA). Fragments containing enamel and dentine were obtained from the crowns of extracted bovine incisors. Before and after immersion of the samples in the substances, they were evaluated with reference to the colour of the enamel and dentine. The values obtained in numerical scores were subjected to statistical analysis using Wilcoxon test. A colour change in the enamel and dentine in groups treated with CHX gel + NaOCl and CHX gel + NaOCl + EDTA, and a change in colour only in the dentine in groups treated with CHX solution + NaOCl and CHX solution + NaOCl + EDTA. When used prior to NaOCl, CHX has the ability to induce a colour change in dental structures.     

Comparative Evaluation of Calcium Hypochlorite and Sodium Hypochlorite Associated with Passive Ultrasonic Irrigation on Antimicrobial Activity of a Root Canal System Infected with Enterococcus faecalis: An In Vitro Study

Introduction

The purpose of this study was to compare in vitro the effectiveness of calcium hypochlorite (Ca[OCl]₂) and sodium hypochlorite (NaOCl) associated with passive ultrasonic irrigation in root canals of bovine teeth infected with Enterococcus faecalis.

Methods

The root canals of 60 single-rooted bovine extracted teeth were enlarged up to a file 45, autoclaved, inoculated with Enterococcus faecalis, and incubated for 30 days. The samples were divided into 6 groups (n = 10) according to the protocol for decontamination: G1: no treatment; G2: distilled water; G3: 2.5% NaOCl; G4: 2.5% Ca(OCl)₂; G5: 2.5% NaOCl with ultrasonic activation; and G6: 2.5% Ca(OCl)₂ with ultrasonic activation (US). Microbiological testing (colony-forming unit [CFU] counting) was performed to evaluate and show, respectively, the effectiveness of the proposed treatments. Data were subjected to 1-way analysis of variance followed by the post hoc Tukey test (α = 0.05).

Results

Groups 1 and 2 showed the highest mean contamination (3.26 log₁₀ CFU/mL and 2.69 log₁₀ CFU/mL, respectively), which was statistically different from all other groups (P < .05). Group 6 (Ca[OCl]₂ + US) showed the lowest mean contamination (1.00 log₁₀ CFU/mL), with no statistically significant difference found in groups 3 (NaOCl), 4 (Ca[OCl]₂), and 5 (NaOCl + US) (P < .05).

Conclusions

Ca(OCl)₂ as well as passive ultrasonic irrigation can aid in chemomechanical preparation, contributing in a significant way to the reduction of microbial content during root canal treatment.