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This study evaluated the effect of 2.5% sodium hypochlorite (SH) or calcium hypochlorite (CH) submitted to passive ultrasonic irrigation (PUI) or conventional irrigation (CI) on the incidence of residues and the bond strength of the cementation system to post-space dentin. Distilled water (DW) and 2.5% SH followed by 17% EDTA (SH-ED) were used as negative and positive control groups, respectively. The cervical, middle, and apical thirds of the post space were evaluated. One hundred and twenty bovine incisors were endodontically treated and post-space preparation was performed. The specimens were randomly assigned to six groups, according to the solution and irrigation method: DW-CI, SH-ED-CI-SH, SH-CI, SH-PUI, CH-CI, and CH-PUI. The incidence of residues (n=10) over the dentin was evaluated by scores using SEM images. Other specimens were irrigated as previously described and the post cementation was immediately performed using a conventional dual resin cement and a two-step etch-and-rinse adhesive system. Push-out and failure modes were performed for bonding evaluation. Kruskal-Wallis and Dunn test for incidence of residues data and one-way ANOVA and Tukey tests for bond strength data were used at a significance level of 5%. The protocols that showed a lower incidence of residues were: SH-ED-CI-SH, SH-PUI, and CH-PUI for the cervical third and SH-ED-CI-SH for the middle third (p<0.05). In the apical third, the protocols were similar to each other (p>0.05). Bond strength values were higher after irrigation with DW-CI for all thirds (p<0.05). 2.5% sodium or calcium hypochlorite negatively impacted the adhesion interface and exhibited a greater incidence of residues over the post-space radicular dentin., (©Operative Dentistry, 2024.)

The objective of the study was to evaluate the effects of dentin deproteinization protocols for post space using different formulations containing sodium hypochlorite before fiber post cementation with self-adhesive resinous cement. The groups were divided according to the irrigation protocol (DWC, SHS, SHT and SHG). The residue cleanliness, bond strength, adhesive failure pattern, and tag formation at the adhesive interface between the self-adhesive cement and the dentin were evaluated. For this, analysis in scanning electron microscope, push-out test and confocal laser scanning microscopy were performed. The SHT protocol showed the highest residue cleanliness on the dentin surface of the post space (p<0.05). In addition, SHT protocol showed highest bond strength and tag formation in the cervical and middle thirds (p<0.05). Dentin deproteinization with sodium hypochlorite with surfactant provided the best dentin cleaning of residues, bond strength and tag formation after cementation of the fiber post with self-adhesive cement.

Objective: To evaluate the cleaning potential of 95% ethanol, acetone, and amyl acetate solutions used solely or in association, to remove epoxy resin-based sealer residues from pulp chamber dentin and their microstructural effects., Materials and Methods: One hundred and eighty bovine incisor specimens were divided into nine groups according to the cleaning protocol: ET (ethanol); AC (acetone); AA (amyl acetate); E1: AA+AC; E2: AA+ET; E3: AC+ET; E4: AA+AC+ET; PC (positive control), and NC (negative control). All groups were impregnated with epoxy resin-sealer, except NC. Ninety specimens were divided into groups (n = 10) for evaluation of persistence of residues and amount of open dentinal tubules by SEM analysis and evaluation of chemical compounds on the dentin surface after cleaning with electron dispersive spectroscopy. The others 90 specimens were submitted to Knoop microhardness evaluation. Persistence of residues data were submitted to the Kruskal Wallis and Dunn tests (α = 0.05). Open dentinal tubules and microhardness data were submitted to one-way ANOVA and Mann Whitney tests (α = 0.05)., Results: AA and E4 protocols showed the lowest persistence of residues. E4 group had the highest incidence of open dentinal tubules. E3 and E4 groups showed no changes in the atomic ratio Ca/P, which was similar to NC group. E4 group did not present W, an element presents in all the other groups. ET and E4 protocols showed the smallest reduction in dentin microhardness., Conclusions: The combination of amyl acetate, acetone and ethanol is the most effective and safe protocol to remove epoxy sealer residues on pulp chamber dentin. Moreover, it has the lowest microhardness reduction., Clinical Significance: The combined use of amyl acetate, acetone, and ethanol enhanced the cleaning of pulp chamber dentin with minimal microstructural damage., (© 2022 Wiley Periodicals LLC.)

Objective: The aim of this study was to evaluate the effectiveness of cleansing protocols to remove sealer residues using different cleaning strategies and the effect of bond strength of two universal adhesives to dentin impregnated with epoxy resin-based sealer., Materials and Methods: Fifty bovine dentin specimens were impregnated with epoxy resin-based sealer containing calcium hydroxide (Sealer Plus) and submitted to cleansing protocols (n = 10): negative control (NC), positive control (PC), 95% ethanol (ET), xylol (XI), and amyl acetate (AA). Specimens were evaluated by scanning electron microscope (SEM). Other 100 specimens were submitted to the same protocols (n = 20). Each protocol was divided into subgroups (n = 10) according to the universal adhesive system used: Scotchbond Universal (SU); Ambar Universal (AU). Bond strength was evaluated by micro-shear bond test (μSBT). Persistence of residues data were assessed with Kruskal-Wallis and Dunn's tests. μSBT data were analyzed with two-way ANOVA (α = 5%)., Results: ET presented higher persistence of residues compared to AA and XI (p < 0.05). AA and XI were similar from each other (p > 0.05). AU and SU presented similar μSBT values, regardless of the cleansing solution (p > 0.05). SU-NC presented the highest μSBT among all conditions (p < 0.05)., Conclusion: The bond strength of universal adhesives was not affected by different amounts of sealer residues after different cleaning protocols., Clinical Significance: Non-polar substances such as amyl acetate and xylol are effective for removing residues from epoxy resin-based endodontic sealers., (© 2022 Wiley Periodicals LLC.)

This study evaluated the effect of irrigation protocols using 95% ethanol (ET) or 1% peracetic acid (PA) prior the use of 2% chlorhexidine (CHX) compared to distilled water (DW) on the chemical smear layer (CSL) formation and incidence of open dentin tubules at the apical, medium, and cervical third of the post-space dentin. Scanning electron microscopy (SEM) and electron dispersive spectroscopy (EDS) images were used. Forty bovine roots were endodontically treated. After, post-space preparation was performed and the roots were randomized in four groups (n = 10) according to the irrigation protocol: DW, CHX, CHX-ET and CHX-PA. The chemical composition of CSL and the incidence of open dentin tubules at the post-space thirds were evaluated by EDS (500× magnification) and SEM (2000× magnification) images, respectively. Data from chemical composition of CSL were descriptively analyzed, while the incidence of open dentin tubules was evaluated by scores and submitted to Kruskal-Wallis and Dunn test (p = .05). Cl, Bi, and Si were the chemical elements most found over the dentin after the irrigation with CHX and CHX-ET. Moreover, CHX and CHX-ET showed the highest incidence of CSL (p < .05), but without difference between them (p > .05), regardless of the post-space third. DW and CHX-PA showed similar incidence of CSL (p > .05). No difference on the incidence of open dentin tubules was found for any irrigation protocol and post-space third (p > .05). The use of 1% PA prior the post-space irrigation with CHX decrease the incidence of CSL. RESEARCH HIGHLIGHTS: The post-space irrigation with chlorhexidine results in the formation of chemical smear layer. Ethanol is not capable to remove the chemical smear layer. Peracetic acid is more effective to remove the chemical smear layer., (© 2022 Wiley Periodicals LLC.)

The aim of this study was to evaluate the effects of cleaning protocols on the presence of residues, open dentinal tubules, and bond strength of a self-etch adhesive plus a dual-cure resin cement to dentin in the fiber-post space. The methods for cleaning utilized were conventional irrigation (CI), rotary brush with continuous rotary movement (RB), and continuous ultrasonic irrigation (CUI). Sixty bovine incisors were used for fiber-post space preparation. Thirty roots were divided into three groups (n = 10) according to the cleaning protocols and submitted to scanning electron microscope to evaluate presence of residues and relative quantity of open dentinal tubules on dentin surface. Similar protocols were performed in the other thirty roots (n = 10) using a self-etching adhesive system (Scotchbond Universal) and a dual-cure resin cement (Relyx Unicem 2). After 6 months cervical, middle, and apical thirds sections of fiber-post space were submitted to push-out testing. To data ANOVA and Tukey's test were employed (α = 5%). RB and CUI showed the lowest presence of residues on dentin surface (p = .015) and the highest bond strength values (p < .001), regardless of the dentin third. CUI presented the highest quantity of open dentinal tubules in middle and apical thirds (p < .001). CI presented the lowest bond strength value of resin cement, regardless of dentin third (p < .001). Mechanical cleaning protocols, such as RB and CUI, presented better surface cleaning capabilities and higher bond strength than CI with dual-cure resin cement employed. The use of a mechanical cleaning protocol seems to cause appropriate condition on the root dentin surface. Mechanical cleaning of root dentin provided greater bond strength of the self-etching system with dual resin cement. Conventional irrigation did not provide adequate root dentin cleaning. RESEARCH HIGHLIGHTS: • The use of a mechanical cleaning protocol seems to cause appropriate condition on the root dentin surface. • Mechanical cleaning of root dentin provided greater bond strength of the self-etching system with dual resin cement. • Conventional irrigation did not provide adequate root dentin cleaning., (© 2022 Wiley Periodicals LLC.)

Background: The COVID-19 pandemic has significantly influenced the routine of healthcare workers. This study investigated the impact of the pandemic on dental practice and dentists' feelings in Latin America., Methods: A survey was conducted with dentists from 11 Spanish-speaking Latin American countries in September-December 2020. Professionals were invited by email and via an open campaign promoted on social media. The questions investigated dental care routines, practice changes, and feelings about the pandemic. Descriptive statistics were used to identify frequencies and distributions of variables. Proportions were compared using chi-square tests., Results: A total of 2127 responses were collected from a sample with diverse demographic, sex, work, and education characteristics. The impact of COVID-19 was considered high/very high by 60% of respondents. The volume of patients assisted weekly was lower compared with the pre-pandemic period (mean reduction = 14 ± 15 patients). A high rate of fear to contracting the COVID-19 at work was observed (85%); 4.9% of participants had a positive COVID-19 test. The main professional challenges faced by respondents were reduction in the number of patients or financial gain (35%), fear of contracting COVID-19 (34%), and burden with or difficulty in purchasing new personal protective equipment (22%). The fear to contracting COVID-19 was influenced by the number of weekly appointments. A positive test by the dentists was associated with their reports of having assisted COVID-19 patients. The most cited feelings about the pandemic were uncertainty, fear, worry, anxiety, and stress. Negative feelings were more prevalent for professionals who did not receive training for COVID-19 preventive measures and those reporting higher levels of fear to contract the disease., Conclusion: This multi-country survey indicated a high impact of the pandemic on dental care routines in Latin America. A massive prevalence of bad feelings was associated with the pandemic., (© 2022. The Author(s).)

Background: This study evaluated the effects of final agitation methods of irrigants to remove methylene blue and sodium hypochlorite residues after PDT-assisted endodontic treatment on the bond strength of fiber posts cemented with etch-and-rinse adhesive and conventional resin cement., Methods: Ninety bovine teeth were endodontically treated. In sequence, post space preparation followed by methylene blue-mediated PDT and sodium hypochlorite (NaOCl) irrigation were performed. Six final irrigations protocols for dye and NaOCl removal were performed prior to cementation with etch-and-rinse adhesive (Adper Scocthbond Multipurpose) and conventional dual resin cement (RelyX ARC): Conventional endodontic irrigation (CEI), passive ultrasonic irrigation (PUI), mechanical agitation with XP Endo Finisher (XPF), XP Clean (XPC) or Easy Clean (ECL) and distilled water (NCO - control). After fiber post cementation, push-out bond strength test was performed at different thirds of the post space. Failure mode was also analyzed. ANOVA and Tukey's post-hoc test was used for data analysis (α=5%)., Results: PUI, XPF e XPC protocols showed the highest bond strength values with no difference among them (p > 0.05), although they were similar to NCO, regardless of the post space third. CEI e ECL showed similar bond strength values, regardless of the third (p > 0.05). Adhesive failure was the most incident for CEI and ECL, while mixed and cohesive failures were predominant in PUI, XPF, XPC and NCO groups., Conclusions: Mechanical agitation of distilled water with XPF, XPC and PUI after methylene blue-mediated PDT and irrigation with 2.5% sodium hypochlorite promoted bond strength of the resin cementation system in post space dentin comparable to control group., (Copyright © 2021. Published by Elsevier B.V.)

Objective: This study aimed to evaluate the effect of fiber post customization on the bond strength (24 hours and 6 months), resin cement thickness, and dentinal penetrability of Adper Scotchbond Multi-Purpose - RelyX ARC (AS-RA), RelyX U200 (R2), and Scotchbond Universal - RelyX Ultimate (SU-RU) cementation systems to root dentin from the cervical-, middle-, and apical-thirds of the post space., Methods: One hundred twenty bovine incisors were endodontically treated. After post space preparation, the roots were divided into six groups, according to the luting protocols (AS-RA, R2, SU-RU) and the type of fiber post [noncustomized post (NC) and customized post (C)]. Customization procedures were peformed using a resin composite (Z350 XT). 24 hours (n=60) or 6 months later (n=60), specimens from the cervical-, middle-, and apical-thirds of the post space were submitted to cementation system thickness measurement, bond strength evaluation, and dentinal penetrability analysis with Confocal Laser Scanning Microscopy (CLSM). Failure mode was classified as adhesive, cohesive, or mixed. Data were submitted to ANOVA and Tukey tests (α=0.05)., Results: Cementation protocols with customized fiber posts presented the lowest cementation system thickness, regardless of the cementation system or post space-third (p<0.05), and the highest bond strength values (p<0.05), regardless of the third space (p>0.05), for both periods (24 hours or 6 months). The comparison of push-out bond strength values between 24 hours and 6 months showed a reduction in all groups for the cervical-third (p<0.05). For the middle-third, only noncustomized groups showed reduction (p<0.05). For the apical-third, no reduction was observed (p>0.05)., Conclusions: Anatomical customization favored both the bond strength of cements to dentin and the dentinal penetrability, but with lower cementation system thickness, regardless of cement composition and adhesive strategy., (©Operative Dentistry, 2022.)

Aim: This study aimed to evaluate the cleaning protocol of dentin impregnated with epoxy resin-based sealer (AH Plus) and the effects on the adhesive interface using 95% ethanol (E) or formamide solution (F) associated with microabrasion with glass microparticles (M)., Methodology: Forty dentin specimens were impregnated with sealer (AH Plus). Specimens were cleansed according to the following protocols ( n = 10): G1 (E); G2 (F); G3 (E = M); and G4 (F = M). No treatment was performed in G5 (control). Specimens were subjected to standard error of the mean to evaluate the residues persistence (×500) and open dentinal tubules counting (×2000). Another fifty specimens were subjected to similar procedures and cleaning protocols. Seven days later, composite-resin-made specimens were performed on dentin using etch-and-rinse adhesive system, then submitted to microshear test., Results: G2 and G4 showed higher residues' persistence and lower incidence of open dentinal tubules than G1 and G3 ( P < 0.05). No difference was found between G1 and G3 or G2 and G4 ( P > 0.05). Adhesive system bond strength was similar in all groups ( P > 0.05)., Conclusions: Microabrasion negatively affected the epoxy resin-based sealer residues' removal protocols' action; all groups presented residues on the dentin surface. However, 7 days later, the protocols did not affect the bond strength of adhesive system to sealer-impregnated dentin., Competing Interests: There are no conflicts of interest.

The aim of the study was to evaluate the effects when acid etching on the dentin surface was immediately performed (I) or 7 days (D) after calcium silicate-based sealer (MTA Fillapex) removal, using 95% ethanol (E) or xylol (X). First study, 60 bovine incisor dentin specimens were impregnated with sealer and divided into six groups (n = 10): (EI), E + I; (XI), X + I; (ED), E + D; (XD), X + D, (UN), untreated and (MR), mechanical removal of sealer. Scanning electron microscopy (SEM) images (500×) were obtained from each specimen and scores assessed the sealer residues persistence. Second study, 60 specimens were similarly treated; however, the specimens were restored with composite resin after the removal protocols. Hybrid layer formation was evaluated using confocal laser microscopy (1,024×). Third study, 60 specimens were similarly obtained and subjected to micro-shear test to evaluate the effects of removal protocols on the bond strength of etch-and- rinse adhesive system to dentin. XI showed the highest persistence of sealer residues (p < .05), similar to MR (p > .05). EI showed the greatest hybrid layer extension, except in relation to UN (p < .05). XI and MR presented the lowest bond strength adhesive system to dentin (p < .05). Acid etching immediately after calcium silicate-based endodontic sealer removal using xylol presented the highest residues persistence and negatively affected the adhesive interface between dentin and etch-and-rinse adhesive system., (© 2018 Wiley Periodicals, Inc.)

Objectives: To evaluate the effect of desensitizing agent containing calcium phosphate nanoparticles on the bond strength of etch-and-rinse adhesive system (Scotchbond Multi-Purpose), presence of precipitate, dentinal tubule obliteration and hybrid layer formation in dentin in comparison with potassium nitrate plus sodium fluoride or strontium chloride compounds., Methods: 150 bovine incisors were treated with (n = 10): G1, Desensibilize Nano P (Ca 3 (PO 4 ) 2 +5%KNO 3 +0.9%NaF); G2, Desensibilize (10%SrCl 2 +5%KNO 3 ); G3, Desensibilize KF2% (5%KNO 3 +0.2%NaF); G4, Ultra EZ (3%KNO 3 +0.25%NaF) and G5, no treated (control). Scanning electron microscopy was used to assess the incidence of precipitates (500×) and obliterated dentinal tubule counts (1.000×). The adhesive system was used after all desensitization treatments. The bond strength (n = 40) and the fracture pattern were evaluated. Confocal laser microscopy was used to quantify the hybrid layer formation in dentin., Results: G1 and G2 presented higher adhesive system bond strength (MPa) than G4 and G5, however no significant differences were observed in comparison with G3. Cohesive fracture was frequently found: G1 (58.5%), G2 (51.3%) and G3 (43.8%). G1 showed the highest incidence of precipitates and the highest number of blocked dentinal tubules. G1 and G2 presented similar hybrid layer formation and the highest hybrid layer formation values., Conclusions: Desensibilize Nano P (G1) favored the bond strength of the adhesive system to dentin, increased the precipitation of residues, obliteration of dentinal tubules, and hybrid layer formation in comparison with other agents., Clinical Relevance: Desensitizers promote dentin obliteration, however, may affect dentin bonding., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Statement of Problem: The optimal irrigating solution with antimicrobial and dentin cleansing properties for post space preparation for fiber posts is unclear. Peracetic acid is one option but is available in various chemical formulations that require evaluation., Purpose: The purpose of this in vitro study was to evaluate dentin surface cleanliness based on the presence of a smear layer and the number of open dentin tubules. It also investigates the chemical composition of residues after canal irrigation with a 1% peracetic acid solution (PA) at low or high concentration of hydrogen peroxide during the preparation of intracanal fiber posts., Material and Methods: After filling the root canals of 40 mandibular incisors, a rotary instrument was used for intracanal preparation to place fiber posts. The teeth were divided into 4 groups (n=10) according to the post space irrigation protocol as follows: CG (control): distilled water; NA (NaOCl): 2.5% sodium hypochlorite; LH: PA with low concentration of hydrogen peroxide; and HH: PA with high concentrations of hydrogen peroxide. After irrigation, the teeth were sectioned, and the intracanal dentin surface was subjected to analysis using energy dispersive spectroscopy to evaluate chemical composition and to scanning electron microscopy (×500) to evaluate the presence of the smear layer. The number of open dentin tubules was measured by scanning electron microscopy analysis (×2000) using photo-editing software. ANOVA and the Tukey test (α=.05) were used to evaluate the data, except for the presence of a smear layer, for which the Kruskal-Wallis and Dunn tests were used (α=.05)., Results: The highest concentrations of oxygen in the dentin residues were detected in LH and HH (P<.05); CG and NA showed similar oxygen concentrations (P>.05). NA had a higher concentration of chlorine (P<.05), whereas LH had a lower amount of smear layer and a larger number of open dentin tubules than the other groups (P<.05). These were equivalent to each other (P>.05), except for HH, which also had a larger number of open dentin tubules than CG and NA (P<.05)., Conclusions: PA 1% with a low concentration of hydrogen peroxide yielded a lower amount of smear layer and a larger number of open dentin tubules in the dentin of the post space when compared with PA 1% with a high concentration of hydrogen peroxide, despite maintaining a similar oxygen concentration in these dentin residues., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)