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Biomedical subjects

J D Pecora

Publications and source records attributed to J D Pecora.

12 recordsLinked to original sources

Influence of cervical preflaring on apical file size determination.

AIM: To investigate the influence of cervical preflaring with different instruments (Gates-Glidden drills, Quantec Flare series instruments and LA Axxess burs) on the first file that binds at working length (WL) in maxillary central incisors. METHODOLOGY: Forty human maxillary central incisors with complete root formation were used. After standard access cavities, a size 06 K-file was inserted into each canal until the apical foramen was reached. The WL was set 1 mm short of the apical foramen. Group 1 received the initial apical instrument without previous preflaring of the cervical and middle thirds of the root canal. Group 2 had the cervical and middle portion of the root canals enlarged with Gates-Glidden drills sizes 90, 110 and 130. Group 3 had the cervical and middle thirds of the root canals enlarged with nickel-titanium Quantec Flare series instruments. Titanium-nitrite treated, stainless steel LA Axxess burs were used for preflaring the cervical and middle portions of root canals from group 4. Each canal was sized using manual K-files, starting with size 08 files with passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL, and the instrument size was recorded for each tooth. The apical region was then observed under a stereoscopic magnifier, images were recorded digitally and the differences between root canal and maximum file diameters were evaluated for each sample. RESULTS: Significant differences were found between experimental groups regarding anatomical diameter at the WL and the first file to bind in the canal (P < 0.01, 95% confidence interval). The major discrepancy was found when no preflaring was performed (0.151 mm average). The LA Axxess burs produced the smallest differences between anatomical diameter and first file to bind (0.016 mm average). Gates-Glidden drills and Flare instruments were ranked in an intermediary position, with no statistically significant differences between them (0.093 mm average). CONCLUSIONS: The instrument binding technique for determining anatomical diameter at WL is not precise. Preflaring of the cervical and middle thirds of the root canal improved anatomical diameter determination; the instrument used for preflaring played a major role in determining the anatomical diameter at the WL. Canals preflared with LA Axxess burs created a more accurate relationship between file size and anatomical diameter.

Analysis of Variance↗

Effect of Er:YAG laser and EDTAC on the adhesiveness to dentine of different sealers containing calcium hydroxide.

AIM: To evaluate the effect of 15% EDTAC solution and Er:YAG laser irradiation on the adhesiveness to dentine of root canal sealers containing calcium hydroxide. METHODOLOGY: The crowns of 60 maxillary human molars were ground until dentine was exposed. The teeth were divided into three groups of 20 teeth: group I, the dentine surface received no treatment; group II, 15% EDTAC solution was applied to the dentine; group III, the dentine received Er:YAG laser application (11 mm focal distance with perpendicular incidence to dentine surface; 4 Hz frequency; 200 mJ energy; 2.25 W potency; 62 J total energy; 1 min application time). Aluminium cylinders filled with the sealers, Sealer 26, Apexit, Sealapex and CRCS, were then applied to the treated surfaces. Adhesiveness was measured with a universal testing machine, with traction results given in MegaPascals (MPa). These results were submitted to anova tests. RESULTS: Statistical analysis showed significant differences (P < 0.01) amongst adhesiveness values of the sealers and treatments tested. Thus, sealers could be ranked in decreasing adhesiveness values: Sealer 26, CRCS, Apexit, Sealapex. Er:YAG laser irradiation and EDTAC solution application increased adhesiveness values only for Sealer 26 and Apexit. Laser irradiation was superior to EDTAC application only for Sealer 26 adhesiveness values. CONCLUSIONS: Er:YAG laser is as efficient as EDTAC solution in increasing adhesiveness of root canal sealers containing calcium hydroxide to human dentine.

Adhesiveness↗

Assessing microleakage of different class V restorations after Er:YAG laser and bur preparation.

This study assessed in vitro marginal leakage of class V cavities prepared by turbine and Er:YAG laser and restored with different materials. Sixty cavities with enamel and dentine margins were prepared and assigned to six groups: I, II, III by turbine and IV, V, VI by Er:YAG laser. The following restorative systems were used: groups I and IV: Bond 1 + Alert; II and V: Fuji II LC; III and VI: SBMP + Dispersalloy. After finishing, specimens were thermocycled for 8 h and 45 min (500 cycles), isolated, immersed in a 0.2% Rhodamine B solution, sectioned oro-facially and analysed for leakage. The dye penetration means (%) were: occlusal I: 10.09 (+/- 21.28), II: 3.25 (+/- 10.27), III: 0, IV: 41.77 (+/- 42.48), V: 23.37 (+/- 33.79), VI: 12.66 (+/- 24.06); cervical I: 16.49 (+/- 26.67), II: 4.34 (+/- 13.71), III: 0, IV: 37.71 (+/- 30.47), V: 39.56 (+/- 43.35) and VI: 72.53 (+/- 37.79). The use of Er:YAG laser for cavity preparation yielded higher degree of marginal leakage, as compared with the use of conventional air-turbine. The enamel interface provided better marginal sealing, comparing with dentine/cementum margin. As to the cavity preparation device (i.e. laser or bur), the analysis of the results showed that bonded amalgam and Fuji II LC provided less infiltration, than Alert. On the other hand, for lased cavities, Alert provided the best results, similar to those of Fuji II LC and superior to those reached by bonded amalgam.

Composite Resins↗

Evaluation of smear layer removal by EDTAC and sodium hypochlorite with ultrasonic agitation.

AIM: To evaluate smear layer removal by different irrigating solutions under ultrasonic agitation. METHODOLOGY: Twenty recently extracted mandibular incisors with a single root canal were divided into four equal groups. Three groups were instrumented using the modified double-flared technique, the fourth remained unprepared. Each group was irrigated with either distilled water, 1.0% sodium hypochlorite alone or associated with 15% EDTAC between each file size. The final group was not instrumented but irrigated with 1.0% sodium hypochlorite and 15% EDTAC. A size 15 file energised by ultrasound was used with small amplitude filing movements against the canal walls in all groups. The teeth were split longitudinally and the roots measured to provide three sections of the same size (cervical, middle and apical). Samples were examined under the scanning electron microscope and assessed for the amount of smear layer by three independent and calibrated examiners. The scoring system ranged from 1 (no smear layer) to 4 (all areas covered by smear layer). Due to the non-parametric nature of the data, Friedman's test was used for statistical analysis. RESULTS: Canal walls were covered with smear layer in the group irrigated with 1% sodium hypochlorite alone and the group irrigated with distilled water. Canals irrigated with 1.0% sodium hypochlorite associated with 15% EDTAC had less smear layer throughout the canal (P < 0.001). There were no statistical differences for the amount of smear layer found on the cervical, middle and apical thirds when each group was analysed separately. CONCLUSIONS: Under ultrasonic agitation, sodium hypochlorite associated with EDTAC removed the smear layer from root canal walls, whereas irrigation with distilled water or 1.0% sodium hypochlorite alone did not remove smear layer.

Dental Pulp Cavity↗

Clinical and macroscopic study of maxillary molars with two palatal roots.

AIM: To report an anatomical variation in maxillary first molars. SUMMARY: A case report is presented of a maxillary first molar requiring root-canal treatment that had two palatal roots with distinct canals and foramena at the apical level. Root-canal treatment was performed using mechanical instrumentation with NiTi files. An anatomical study on two extracted maxillary second molars with the same variation revealed their internal structure. This case demonstrates an uncommon anatomical condition and supplements previous reports of such cases affecting maxillary molars. KEY LEARNING POINTS: Clinicians should be aware of uncommon anatomical variations in maxillary molars. The majority of maxillary first molars have three roots and four canals. Maxillary molars may have two canals in the palatal root.

Adult↗

Two methods to evaluate the antimicrobial action of calcium hydroxide paste.

The objective of this study was to analyze two methods for determining the antimicrobial effectiveness of (i) calcium hydroxide plus saline, (ii) calcium hydroxide plus polyethylene glycol, and (iii) calcium hydroxide plus camphorated paramonochlorophenol. Four microorganisms (Staphylococcus aureus (ATCC 6538), Enterococcus faecalis (ATCC 29212), Pseudomonas aeruginosa (ATCC 27853), and Bacillus subtilis (ATCC 6633)), one yeast (Candida albicans (ICB/USP-562)), and one mixture of these organisms were used. The strains were inoculated in Brain Heart Infusion (BHI) and incubated at 37 degrees C for 24 h. Two methods, the direct exposure test and the agar diffusion test were used to evaluate antimicrobial effects. For the direct exposure test (DET) 288 paper points were contaminated with the standard microbial suspensions and exposed to the intracanal dressings for 1, 24, 48, and 72 h. The points were immersed in Letheen Broth, followed by incubation at 37 degrees C for 48 h. An inoculum of 0.1 ml obtained from Letheen Broth was then transferred to 7 ml of BHI under identical incubation conditions, and microbial growth was evaluated. Pastes showed activity between 1 and 72 h, depending on the microorganism/mixture tested. For the agar diffusion test 36 Petri plates with 20 ml of BHI agar were inoculated with 0.1 ml of the same microbial suspension used for the DET, using sterile swabs that were spread on the medium. Five cavities were made in each of two agar plates (total = 10) and completely filled with one of the calcium hydroxide pastes. The plates were preincubated for 1 h at environmental temperature and then incubated at 37 degrees C for 24 to 48 h. The inhibition zone around each well was recorded in millimeters, and the results were submitted to ANOVA and Tukey test (alpha = 0.05). All intracanal dressings induced inhibition zones (range 5.0-10.0 mm). Data obtained showed that both the DET and agar diffusion test are useful in establishing the calcium hydroxide antimicrobial spectrum, thus improving infection control protocols. The direct exposure method is independent of other variables and is a practical laboratory procedure. A complete antimicrobial effect was observed after 48 h on indicator microorganisms, in both tests, irrespective of the calcium hydroxide paste vehicle.

Analysis of Variance↗

Evaluation of dentin root canal permeability after instrumentation and Er:YAG laser application.

BACKGROUND AND OBJECTIVES: Smear layer removal with EDTA from root canal walls allows greater cleaning and disinfection of root canals. However, because Er:YAG laser acts on the removal of the smear layer, the objective of investigation was to analyze in vitro the effect of Er:YAG laser on dentin root canal wall permeability after endodontic instrumentation and irrigation with water or sodium hypochlorite and Er:YAG laser application. STUDY DESIGN/MATERIALS AND METHODS: A total of 25 extracted human maxillary incisors were divided into five groups: Group I, instrumentation with deionized distilled water as the irrigating solution; Group II, instrumentation with 1% sodium hypochlorite as the irrigating solution; Group III, instrumentation with deionized distilled water as the irrigating solution and Er:YAG laser application; Group IV, instrumentation with 1% sodium hypochlorite solution as the irrigating solution and Er:YAG laser application; Group V, instrumentation only up to #20 file with deionized distilled water as the irrigating solution and Er:YAG laser irradiation. The laser parameters were 15 Hz, 140 mJ, total energy 42 J, 300 pulses (Kavo Key Laser). Copper sulfate (10%) was used to evaluate dentin permeability. The penetration of copper ions into the dentinal tubules was observed using 1% rubeanic acid, which reveals copper ions, forming a stained compound ranging in color from deep blue to black. Transverse sections (500-microm thick) were obtained with a diamond disk from the cervical, middle, and apical thirds. RESULTS: The instrumentation of the root canal that used water as the irrigating solution followed by Er:YAG laser irradiation promoted the greatest increase in dentin permeability. The use of Er:YAG laser, 1% sodium hypochlorite + Er:YAG, and 1% sodium hypochlorite used alone showed an intermediate capacity of increasing dentin permeability. The use of water as the irrigating solution without Er:YAG laser promoted the least dentin permeability. CONCLUSIONS: The use of water as the irrigating solution after instrumentation and Er:YAG laser irradiation was an effective procedure for increasing dentin permeability.

Dental Pulp Cavity↗

Periapical cemental dysplasia: case report.

The authors present a case of periapical cemental dysplasia affecting the mandibular left canine, with vital pulp, in a 43-year-old black female patient, an occurrence that follows the classical cases found in the literature. The need of a careful history, clinical and radiographic exams and vitality tests are emphasized in order to reach the correct diagnosis of this disease.

Adult↗

A comparison of techniques for cleaning endodontic files after usage: a quantitative scanning electron microscopic study.

One-hundred ten new endodontic files were used to prepare canals and were then cleaned using three different techniques: (a) gauze soaked with alcohol, (b) sponge soaked with alcohol, and (c) ultrasonic bath. The cleaning ability of each of these techniques immediately after use and after 1 h of delay were compared. Identical areas on each file were examined by using a custom-made jig. Morphometric analysis of debris was carried out using a Bioquant image analysis system. Sponge/alcohol was the worst cleaning method; this was significantly different from the other two techniques. The gauze/alcohol and ultrasonic bath were similar. The 1-h delay before instrument cleaning did not affect the ability of any of the techniques tested. None of the methods tested were able to totally clean the files.

Decontamination↗