The historical development of Endodontics as a specialty in Colombia, South America was due prima... more The historical development of Endodontics as a specialty in Colombia, South America was due primarily to the influence of a few key endodontists from the United States and the industriousness and dynamic vision of leading dental professionals from Bogotá and Medellín, Colombia.
Recalcitrant bacteria play an important role of the persistence of periapical disease following r... more Recalcitrant bacteria play an important role of the persistence of periapical disease following root canal procedures, especially when they a part of a complex and stable biofilms that are found in the intricacies of the apical root canal anatomy. This is particularly true in cases that are deemed as a “failure in root canal treatment.” However, the literature is replete with confusion with regard to this concept of failure, as general terms, such as endodontic pathology or endodontic infection are used to denote factors implicated in the failure, without specifically identifying the issues of concern and their eradication, especially as they relate to the overall systemic health of the patient. Thus, attention for the cause of the failure immediately focuses on bacterial species without considering a vast array of potential causes. In doing so many studies tend to look at only one specific species as being the causative agent in the presence of the diagnosed failure (E. faecalis) a...
INTRODUCTION Endodontic sealers play a vital role in the obturation of root canal space. The aim ... more INTRODUCTION Endodontic sealers play a vital role in the obturation of root canal space. The aim of this study was to evaluate the utility of a recently developed Polyurethane Expandable Sealer (PES), along with its cytotoxicity and dimensional changes. METHODS L929 fibroblasts and an MTS assay were used to determine the cytotoxicity of dental sealers (AH Plus, Sure-Seal Root™, and the PES) at 24, 48, 72, and 96 hours. An advanced choroidal neovascularization (CNV) model was used to assess the effect of these sealers on angiogenesis. Thirty-six extracted single-rooted human teeth were prepared and randomly divided into three groups (n=12). Obturation was performed with gutta-percha and a sealer using lateral compaction: group 1 - AH Plus, group 2 - Sure-Seal, and group 3 - PES. The average depth of sealer penetration into dentinal tubules was measured with an SEM. Data were analyzed using one-way ANOVA and Post-hoc Tukey tests (level of significance, P <0.05). RESULTS The values of MTS, CNV, and penetration depth of PES were significantly higher than in other experimental groups (P <0.05). The lowest values were seen in specimens of AH Plus, while the highest were detected in PES groups. CONCLUSIONS PES showed promising results in terms of biocompatibility and dentinal tubules adaptation and penetration.
In the late 1800s, subsequent to the identification of the role of oral bacteria in the demise of... more In the late 1800s, subsequent to the identification of the role of oral bacteria in the demise of the dental pulp by Willoughby D. Miller, the dentist was faced with the major challenge of removing gangrenous pulp tissue from the small root canal spaces in the tooth. Under these clinical circumstances, investigators viewed the root canal contents as a test tube filled with gelatinous, decaying matter along with being overwhelmed by a wide range of bacterial species. One of the first attempts to eradicate the root canal contents was achieved through the use of kalium (potassium) and natrium (sodium) in their metallic state and with that approach the sparks did fly.
The efficient elimination of microorganisms and their byproducts from infected root canals is com... more The efficient elimination of microorganisms and their byproducts from infected root canals is compromised by the limitations in conventional root canal disinfection strategies and antimicrobials. Silver nanoparticles (AgNPs) are advantageous for root canal disinfection, mainly due to their wide-spectrum anti-microbial activity. Compared to other commonly used nanoparticulate antibacterials, AgNPs have acceptable antibacterial properties and relatively low cytotoxicity. Owing to their nano-scale, AgNPs penetrate deeper into the complexities of the root canal systems and dentinal tubules, as well as enhancing the antibacterial properties of endodontic irrigants and sealers. AgNPs gradually increase the dentin hardness in endodontically treated teeth and promote antibacterial properties when used as a carrier for intracanal medication. The unique properties of AgNPs make them an ideal additive for different endodontic biomaterials. However, the possible side effects of AgNPs, such as c...
Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended f... more Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended for effectively removing organic and inorganic components in the smear layer. This layer is found on root canal walls after root canal instrumentation. However, high-concentration EDTA reduces the strength of dentin and the dissolution efficacy of organic substances in NaOCl solution. The objective of this study was to investigate the efficacy of applying nano and submicron diamonds in irrigation solutions with sonic and ultrasonic oscillation for removing the smear layer during endodontic treatment. Extracted single-rooted human teeth were instrumented with ProTaper® Gold (Dentsply Sirona) nickel–titanium rotary instruments. Subsequently, each canal was irrigated with 3% NaOCl, 17% EDTA, distilled water, and 10–1000 nm-sized nano and submicron diamond irrigation solutions, respectively. Sonic and ultrasonic instruments were compared for oscillating the irrigation solutions. The teeth wer...
INTRODUCTION Diabetes Mellitus (DM) may affect the physical and mechanical properties of dentin, ... more INTRODUCTION Diabetes Mellitus (DM) may affect the physical and mechanical properties of dentin, which could potentially have an impact on root canal procedures. This study aimed to compare the amount of dentin removed by an endodontic rotary file, comparing dentin from diabetic patients to dentin from control patients under laboratory conditions. METHODS The amount of dentin removed was tested using new F2 ProTaper files applied against the surface of prepared dentin disks for three different groups; diabetic type I (D1), diabetic type II (D2), and non-diabetic (Normal). Dentin removed was determined by measuring the depth of penetration of the file using a digital caliper, and by measuring the weight loss. Data was analyzed using Kolmogorov-Smirnov, ANOVA, Post-Hoc Tukey, and Pearson Correlation tests (P < 0.05). RESULTS Significantly more dentin was removed and the penetration of the F2 instrument was significantly higher (P<0.05) in DM specimens. The statistical analysis revealed significant differences between D1, D2, and Normal groups (P<0.05) for the weight loss of the specimen, as well as the penetration depth at point B (P<0.05). Both the weight loss and depth of penetration showed a very high positive correlation (P<0.05). CONCLUSIONS Dentin of patients suffering from both D1 and D2 exhibited an increased amount of dentin removed when compared to the non-diabetic dentin specimens. This can be observed by the increased penetration of the rotary instruments into dentin. Under certain circumstances, this may impact instrumentation, increasing procedural accidents, and leading to a subsequent weakening of root canal treated teeth in diabetic patients.
Introduction: The thickness threshold for detecting endodontic biomaterials depends on many facto... more Introduction: The thickness threshold for detecting endodontic biomaterials depends on many factors, such as the nature of the radiopacifier and the particle size. Aim: The aim of this study was to determine the effect of thickness on radiodensity of various endodontic biomaterials; and evaluate the impact of radiopacifier particle size on radiodensity. Materials and Methods: This in-vitro study was conducted between August 2018 to December 2019. The study was divided in two parts, in first part, Six endodontic biomaterials (AH26, EndoSequence, Endoseal Mineral Trioxide Aggregate (MTA), Nano-MTA, Endocem Zr, and MTA without radiopacifier) were selected and evaluated in different thicknesses, in second part, MTA mixed with Bismuth oxide 10 μm, 200 μm, 120 nm (Groups 1-3), and Zirconium oxide 5 μm, 1 μm and 20 nm (Groups 4-6) were placed in frames with 1 mm, 0.5 mm, 0.2 mm, 0.1 mm thicknesses to evaluate the radiopacity. Results: The mean radiodensity was significantly different among...
Objectives: The aim of this study was to assess the potential of a smear-layer removing agent (ci... more Objectives: The aim of this study was to assess the potential of a smear-layer removing agent (citric acid) vs. an accepted gutta-percha-softening agent (Xylol) as an alternative substance for removing the root canal filling materials, while investigating the potential for associated demineralization effects. Materials and Methods: Seventy healthy, recently extracted premolars were used, ten as control, with sixty with their canals enlarged, shaped and cleaned and obturated using lateral compaction. Teeth were distributed into 3 groups as follows: 1) no solvent and mechanical removal of the filling materials; 2) 1ml of Xylol for 1 minute followed by mechanical removal; and 3) 10% citric acid for 1 minute followed by mechanical removal. Two sections of the root were used, one for Raman spectroscopy analysis to evaluate morphological changes in dentine surface and the other for micro-hardness testing (Vickers). Results: The use of 10% citric acid in in the removal of gutta-percha and ...
The historical development of Endodontics as a specialty in Colombia, South America was due prima... more The historical development of Endodontics as a specialty in Colombia, South America was due primarily to the influence of a few key endodontists from the United States and the industriousness and dynamic vision of leading dental professionals from Bogotá and Medellín, Colombia.
Recalcitrant bacteria play an important role of the persistence of periapical disease following r... more Recalcitrant bacteria play an important role of the persistence of periapical disease following root canal procedures, especially when they a part of a complex and stable biofilms that are found in the intricacies of the apical root canal anatomy. This is particularly true in cases that are deemed as a “failure in root canal treatment.” However, the literature is replete with confusion with regard to this concept of failure, as general terms, such as endodontic pathology or endodontic infection are used to denote factors implicated in the failure, without specifically identifying the issues of concern and their eradication, especially as they relate to the overall systemic health of the patient. Thus, attention for the cause of the failure immediately focuses on bacterial species without considering a vast array of potential causes. In doing so many studies tend to look at only one specific species as being the causative agent in the presence of the diagnosed failure (E. faecalis) a...
INTRODUCTION Endodontic sealers play a vital role in the obturation of root canal space. The aim ... more INTRODUCTION Endodontic sealers play a vital role in the obturation of root canal space. The aim of this study was to evaluate the utility of a recently developed Polyurethane Expandable Sealer (PES), along with its cytotoxicity and dimensional changes. METHODS L929 fibroblasts and an MTS assay were used to determine the cytotoxicity of dental sealers (AH Plus, Sure-Seal Root™, and the PES) at 24, 48, 72, and 96 hours. An advanced choroidal neovascularization (CNV) model was used to assess the effect of these sealers on angiogenesis. Thirty-six extracted single-rooted human teeth were prepared and randomly divided into three groups (n=12). Obturation was performed with gutta-percha and a sealer using lateral compaction: group 1 - AH Plus, group 2 - Sure-Seal, and group 3 - PES. The average depth of sealer penetration into dentinal tubules was measured with an SEM. Data were analyzed using one-way ANOVA and Post-hoc Tukey tests (level of significance, P <0.05). RESULTS The values of MTS, CNV, and penetration depth of PES were significantly higher than in other experimental groups (P <0.05). The lowest values were seen in specimens of AH Plus, while the highest were detected in PES groups. CONCLUSIONS PES showed promising results in terms of biocompatibility and dentinal tubules adaptation and penetration.
In the late 1800s, subsequent to the identification of the role of oral bacteria in the demise of... more In the late 1800s, subsequent to the identification of the role of oral bacteria in the demise of the dental pulp by Willoughby D. Miller, the dentist was faced with the major challenge of removing gangrenous pulp tissue from the small root canal spaces in the tooth. Under these clinical circumstances, investigators viewed the root canal contents as a test tube filled with gelatinous, decaying matter along with being overwhelmed by a wide range of bacterial species. One of the first attempts to eradicate the root canal contents was achieved through the use of kalium (potassium) and natrium (sodium) in their metallic state and with that approach the sparks did fly.
The efficient elimination of microorganisms and their byproducts from infected root canals is com... more The efficient elimination of microorganisms and their byproducts from infected root canals is compromised by the limitations in conventional root canal disinfection strategies and antimicrobials. Silver nanoparticles (AgNPs) are advantageous for root canal disinfection, mainly due to their wide-spectrum anti-microbial activity. Compared to other commonly used nanoparticulate antibacterials, AgNPs have acceptable antibacterial properties and relatively low cytotoxicity. Owing to their nano-scale, AgNPs penetrate deeper into the complexities of the root canal systems and dentinal tubules, as well as enhancing the antibacterial properties of endodontic irrigants and sealers. AgNPs gradually increase the dentin hardness in endodontically treated teeth and promote antibacterial properties when used as a carrier for intracanal medication. The unique properties of AgNPs make them an ideal additive for different endodontic biomaterials. However, the possible side effects of AgNPs, such as c...
Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended f... more Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended for effectively removing organic and inorganic components in the smear layer. This layer is found on root canal walls after root canal instrumentation. However, high-concentration EDTA reduces the strength of dentin and the dissolution efficacy of organic substances in NaOCl solution. The objective of this study was to investigate the efficacy of applying nano and submicron diamonds in irrigation solutions with sonic and ultrasonic oscillation for removing the smear layer during endodontic treatment. Extracted single-rooted human teeth were instrumented with ProTaper® Gold (Dentsply Sirona) nickel–titanium rotary instruments. Subsequently, each canal was irrigated with 3% NaOCl, 17% EDTA, distilled water, and 10–1000 nm-sized nano and submicron diamond irrigation solutions, respectively. Sonic and ultrasonic instruments were compared for oscillating the irrigation solutions. The teeth wer...
INTRODUCTION Diabetes Mellitus (DM) may affect the physical and mechanical properties of dentin, ... more INTRODUCTION Diabetes Mellitus (DM) may affect the physical and mechanical properties of dentin, which could potentially have an impact on root canal procedures. This study aimed to compare the amount of dentin removed by an endodontic rotary file, comparing dentin from diabetic patients to dentin from control patients under laboratory conditions. METHODS The amount of dentin removed was tested using new F2 ProTaper files applied against the surface of prepared dentin disks for three different groups; diabetic type I (D1), diabetic type II (D2), and non-diabetic (Normal). Dentin removed was determined by measuring the depth of penetration of the file using a digital caliper, and by measuring the weight loss. Data was analyzed using Kolmogorov-Smirnov, ANOVA, Post-Hoc Tukey, and Pearson Correlation tests (P < 0.05). RESULTS Significantly more dentin was removed and the penetration of the F2 instrument was significantly higher (P<0.05) in DM specimens. The statistical analysis revealed significant differences between D1, D2, and Normal groups (P<0.05) for the weight loss of the specimen, as well as the penetration depth at point B (P<0.05). Both the weight loss and depth of penetration showed a very high positive correlation (P<0.05). CONCLUSIONS Dentin of patients suffering from both D1 and D2 exhibited an increased amount of dentin removed when compared to the non-diabetic dentin specimens. This can be observed by the increased penetration of the rotary instruments into dentin. Under certain circumstances, this may impact instrumentation, increasing procedural accidents, and leading to a subsequent weakening of root canal treated teeth in diabetic patients.
Introduction: The thickness threshold for detecting endodontic biomaterials depends on many facto... more Introduction: The thickness threshold for detecting endodontic biomaterials depends on many factors, such as the nature of the radiopacifier and the particle size. Aim: The aim of this study was to determine the effect of thickness on radiodensity of various endodontic biomaterials; and evaluate the impact of radiopacifier particle size on radiodensity. Materials and Methods: This in-vitro study was conducted between August 2018 to December 2019. The study was divided in two parts, in first part, Six endodontic biomaterials (AH26, EndoSequence, Endoseal Mineral Trioxide Aggregate (MTA), Nano-MTA, Endocem Zr, and MTA without radiopacifier) were selected and evaluated in different thicknesses, in second part, MTA mixed with Bismuth oxide 10 μm, 200 μm, 120 nm (Groups 1-3), and Zirconium oxide 5 μm, 1 μm and 20 nm (Groups 4-6) were placed in frames with 1 mm, 0.5 mm, 0.2 mm, 0.1 mm thicknesses to evaluate the radiopacity. Results: The mean radiodensity was significantly different among...
Objectives: The aim of this study was to assess the potential of a smear-layer removing agent (ci... more Objectives: The aim of this study was to assess the potential of a smear-layer removing agent (citric acid) vs. an accepted gutta-percha-softening agent (Xylol) as an alternative substance for removing the root canal filling materials, while investigating the potential for associated demineralization effects. Materials and Methods: Seventy healthy, recently extracted premolars were used, ten as control, with sixty with their canals enlarged, shaped and cleaned and obturated using lateral compaction. Teeth were distributed into 3 groups as follows: 1) no solvent and mechanical removal of the filling materials; 2) 1ml of Xylol for 1 minute followed by mechanical removal; and 3) 10% citric acid for 1 minute followed by mechanical removal. Two sections of the root were used, one for Raman spectroscopy analysis to evaluate morphological changes in dentine surface and the other for micro-hardness testing (Vickers). Results: The use of 10% citric acid in in the removal of gutta-percha and ...
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