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Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals.

AIM: To evaluate the effect of different root canal irrigating regimes on dentine penetration of Patent Blue dye. METHODOLOGY: Eighty extracted single-rooted human mandibular premolar teeth with narrow root canals were prepared using ProFile instruments. After each instrument, canals were irrigated with 1% sodium hypochlorite. Subsequently, teeth were randomly assigned to receive a 10 mL rinse of aqueous 17% (w/v) ethylenediaminetetraacetic acid or tap water for 2 or 10 min, followed by a final rinse with a 2% Patent Blue dye solution for 2 or 10 min (eight groups, n = 10 teeth per group). Teeth were then horizontally sectioned 3, 6 and 9 mm from the apex. Sections were digitally photographed and dye penetration was calculated as percentage of total dentine area using NIH Image J. Values were compared using one-way anova and Bonferroni correction with the alpha-type error set at <0.05. Representative tooth sections from all groups were further analysed using scanning electron microscopy. RESULTS: No significant impact of irrigating protocols on dye penetration was found. Dye penetration was significantly (P < 0.001) greater in the coronal than middle, and in middle than in apical root thirds. When observed microscopically, irrigant penetration was independent of the presence of a smear layer, but was rather a function of tubular sclerosis. CONCLUSIONS: Tubular sclerosis, a physiological phenomenon that starts in the third decade of life in the apical root region and advances coronally with age, was the main factor influencing penetrability of root dentine.

Analysis of Variance↗

The effect of two smear layer cleansers on shear bond strength to dentin.

Prevention of microleakage and post-operative sensitivity depends upon maintenance of the integrity of the bond between the resin composite and the tooth. Removal of the dentinal smear layer allows for better bond strengths for the newer dentinal bonding agents. The purpose of this study was to evaluate the shear bond strengths of a light-cured composite to dentin treated with one proprietary and one experimental cleansing agent. Bond strengths for the teeth cleansed with the experimental cleansing agent were significantly (p less than 0.05) greater than bond strengths of teeth cleansed with EDTA.

Acrylic Resins↗

Immunocytochemical evaluation of thyroid neoplasms on thin-layer smears from fine-needle aspiration biopsies.

BACKGROUND: Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool for thyroid nodules. A difficult cytologic diagnosis may be supported by an immunocytochemical study. The efficacy of a panel made up of RET, HBME-1, and Galectin-3 antibodies was evaluated in smears processed by thin-layer cytology (TLC). DESIGN: Thyroid FNABs (n = 99) with both conventional (CS) and thin-layer cytology (TLC) smears were studied. The cases were diagnosed as follows: 5 benign lesions (BL), 13 papillary carcinomas (PC), and 81 follicular proliferations (FP). The category of FP was divided into three subgroups according to nuclear features of follicular cells: Follicular neoplasm (FN NOS), oxyphilic follicular neoplasm (OFN), and follicular lesion with nuclear pleomorphism (FLWNP). Immunostains for HBME-1, Galectin-3, and RET were carried out on TLC slides. RESULTS: Among 49 cases undergoing surgery, all 10 PC and 2 BL were histologically confirmed, whereas 15 out of 37 FP (40.5%) were malignant. The complete immunocytochemical panel (ICCP) was positive in 9 of 10 malignancies (90%) and negative in both BLs. Out of 37 FP, the ICCP yielded positive in 15 cases (4 benign, 11 malignant) and negative in 11 (all benign). In the FLWNP subgroup, the ICCP was positive in 11 (84.6%) and negative in 2 histologically benign cases. CONCLUSION: The combined panel of antibodies and the nuclear pleomorphism of follicular cells were effective in distinguishing between thyroid nodules requiring surgery from thyroid nodules requiring just follow-up.

Adolescent↗

The effects of oxalate treatment on the smear layer of ground surfaces of human dentine.

The layer was evaluated by scanning electron microscopy and by measurement of hydraulic conductance before and after 2-min topical treatment with potassium chloride, neutral potassium oxalate, half-neutralized oxalic acid or both neutral and acidic oxalates. The treated smear layers were then re-evaluated microscopically and functionally both before and after acid challenge. The layers treated with KCl were not altered either microscopically or functionally and were susceptible to acid etching. Dentine surfaces treated with either oxalate solutions became less permeable and were acid-resistant.

Dentin↗

The production of a root surface smear layer by instrumentation and its removal by citric acid.

The purpose of this study was to characterize, using the scanning electron microscope, the nature of root surfaces denuded by (1) root planing alone or (2) root planing plus citric acid treatment. Six teeth were extracted from three squirrel monkeys, and the coronal half of the root surface was planed to remove attached periodontal ligament fibers and cementum. Citric acid, pH 1, was topically applied to the denuded surfaces of 3 teeth. The surface of only root-planed specimens had an irregular surface which corresponded to a smear layer. Root surfaces that had received acid treatment after root planing exhibited funnel-shaped orifices of dentinal tubules, and intertubular zones with a fibrillar, mat-like morphology. The implications of the different root-surface characteristics are discussed.

Administration, Topical↗

[Intracanal aspiration technique for root canal irrigation: evaluation of smear layer removal].

A new irrigation technique (intracanal aspiration technique, IAT) was developed to minimize the extrusion of root canal irrigant. Fifteen instrumented canals of extracted canines were divided into one control and four experimental groups of 3 teeth each. Each root was fixed in a case and surrounded with colored saline agar to measure the meter value of the Root ZX and to evaluate the extrusion of the irrigant. In control teeth, no irrigation was performed. In Groups 1 and 2, the root canal was irrigated using IAT with an aspiration needle placed 2 or 3 mm short of the apex. In Groups 3 and 4, the root canal was irrigated in a conventional manner with a washing needle placed 2 or 3 mm short of the apex. The file folder of a Root ZX was attached to the aspiration needle in Groups 1 and 2, and to a washing needle in Groups 3 and 4. Each canal was irrigated with 9 ml of 14% EDTA solution and 6 ml of 6% NaClO in experimental groups, and the meter value of the Root ZX during irrigation was recorded. After the irrigation, cleanliness of the canal was evaluated using a SEM and extrusion of NaClO by discoloration of the agar. Irrigation using IAT was more effective for removing smear layer compared to the conventional method and extrusion of the irrigant was minimized. In addition, the Root ZX measurement during IAT could monitor the extent of the irrigant in the apical canal.

Dental Pulp Cavity↗

[Incidence and elimination of parietal smear layer in endodontics].

During canal preparation, the repeated passage of instruments provokes the formation of smear on the surface of the dentin. It is advisable to eliminate that, so as to increase antisepsis and filling impermeability. This is obtained by means of an irrigation, using a chelate compound of 6% citric acid for 60 seconds, at the end of the preparation.

Bacterial Adhesion↗

Effects of smear layer and surface moisture on dentin bond strength of a waterless all-in-one adhesive.

The purpose of this study was to evaluate the microtensile bond strength (MTBS) of a waterless all-in-one adhesive system, Absolute, to dentin. Eighteen human molars were either ground with 600-grit SiC paper or cut with a diamond bur. The following dentin bonding procedures were then performed: dentin surface was kept moist; dentin surface was dried; or dentin surface was dried but equivalent amount of water was added to the adhesive (1:1 by volume). After adhesive curing, a resin composite was incrementally built up. After the specimens were kept in water for one day, MTBSs were measured at a cross-head speed of 1 mm/min. Two-way ANOVA (p = 0.05) indicated that the MTBS of the adhesive system was not influenced by surface texture, but enhanced by the presence of water on tooth surface. It was concluded that water is essential to obtaining good dentin bonding for this adhesive system.

Analysis of Variance↗

Hybridization effectiveness of a two-step versus a three-step smear layer removing adhesive system examined correlatively by TEM and AFM.

PURPOSE: The objectives of this study were (1) to compare the hybridization effectiveness of two adhesive systems that are applied in respectively three and two steps, and (2) to determine the best resin-dentin interface preparation technique for atomic force microscopy (AFM). MATERIALS AND METHODS: The resin-dentin interface produced by the three-step OptiBond Dual-Cure (Kerr) and its simplified two-step successor OptiBond Solo (Kerr) was ultramorphologically examined using transmission electron microscopy (TEM) and AFM. Four different methods were used to prepare interface specimens for AFM: (1) polishing to a 0.1-micron finish with a silicon oxide suspension, (2) polishing to a 0.05-micron finish with an aluminum oxide suspension, (3) argon-ion etching, and (4) sectioning with a diamond knife. RESULTS: Both TEM and AFM demonstrated that some collapse of the exposed collagen fibril network, due to gentle postconditioning air-drying of the dentin surface, may not have been totally recovered through hybridization by the two-step adhesive formulation as opposed to the three-step precursor. From the four interface preparation methods, only diamond-knife sectioning revealed sufficient ultramorphologic detail and high resolution that can capitalize on the high resolution offered by AFM. CONCLUSION: First, the findings suggest that simplifying the application procedure of adhesives by combining the primer and adhesive resin into a single application step may reduce hybridization effectiveness. Future research should confirm this effect for other two- versus three-step adhesive systems. Second, diamond-knife sectioning should be used for future topographic imaging and physicomechanical testing of resin-dentin interfaces by AFM.

Bisphenol A-Glycidyl Methacrylate↗

Effect of the dentin smeared layer on tensile strength of cemented posts.

The tensile strengths for post lengths of 4 and 7 mm were compared in vitro with 3 different cementing media. In one group, the post preparation was rinsed with 5.25% NaOCl and in the other with 17% EDTA followed by 5.25% NaOCl. The EDTA-NaOCl flush had a profound effect when unfilled resin was used to cement the posts. A 4 mm post cemented with resin in the EDTA-NaOCl group was one and one-half times as retentive as a 7 mm post cemented with zinc phosphate and twice as strong as the 7 mm post with polycarboxylate cement. The 7 mm post cemented with the resin after the EDTA-NaOCl rinse was twice as resistant to displacement as the 7 mm post cemented with zinc phosphate and three times stronger than the polycarboxylate cement.

Bisphenol A-Glycidyl Methacrylate↗

The risk of intentional dissolution of the smear layer after mechanical preparation of root canals.

The root canals of 27 caries-free human cuspids were divided into 3 groups of 9 teeth each. Group I was mechanically prepared with reamers and files. Alternate irrigation with 5.25% NaOCl and 3% hydrogen peroxide was used between each instrument. The group II root canals were prepared with the use of alternate irrigation with the same concentrations of NaOCl and hydrogen peroxide and finally flushed with 17% EDTA and NaOCl solution. Group III was prepared mechanically with the use of sterile distilled water as an irrigant followed by a final flush with 17% EDTA solution. The root canals of all specimens were obturated with gutta-percha points and Tubliseal by means of the lateral condensation technique. After the root canals were obturated, samples of each of the three groups were immersed in separate flasks containing Streptococcus mutans, Staphylococcus epidermidis, and Corynebacterium hofmannii. All the microorganisms tested invaded the coronal dentin--where the access cavity had been sealed with Fynal--and/or the main foramen.

Adult↗