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Introduction: The anatomical configuration classified as Vertucci's type III is described as the second most prevalent in mandibular incisors. Methods: Thirty-six Vertucci's type III mandibular incisors were evaluated by micro-computed tomography (micro-CT) and divided into 3 groups (n = 12) according to the root canal preparation protocol (HyFlex CM [HCM], HyFlex EDM [HEDM], and Sequence Rotary File [SRF]). The teeth were scanned before and after performing 0.25 mm and 0.40 mm apical diameter preparations. The canal volume, dentin thickness, percentage of accumulated debris and untouched canal areas, transportation, and centering ability were measured. The data were statistically analyzed by ANOVA, Tukey, Kruskal-Wallis, and Dunn tests (P < 0.05). Results: The volume increase was more evident in the apical third. After 0.40 mm preparation, the SRF system provided a higher reduction (P < 0.05) in dentin thickness on the buccal surface 1 mm from the apex. There was higher canal transportation in the bucco-lingual direction. The 0.40 mm apical preparation reduced the percentage of untouched canal areas. The apical third had the highest percentage of untouched canal areas. The cervical third had the lowest volume of accumulated debris. Conclusions: Increasing the apical preparation to a diameter of 0.40 mm with the HCM, HEDM, and SRF systems in Vertucci's type III root canals of mandibular incisors proved to be safe and effective, reducing untouched canal areas. Clinical relevance: Root flattening can be intense to the point of generating a root canal bifurcation. Despite the decrease in the root canal diameter, a greater enlargement of the apical region is necessary and safe.

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OBJECTIVE: The effects of brushing on shaping with three different instruments were assessed in oval canals. DESIGN: Mandibular incisors were assigned to 6 groups (n = 12/group) according to the system, each one with or without brushing: Reciproc Blue, VDW.Rotate, and Race EVO. Micro-computed tomography was performed before and after preparation. RESULTS: Brushing strokes caused no increase in canal volume, surface area, and structure model index independently of the system (p > 0.05), except for RaCe EVO in the full canal surface area (p < 0.05). Brushing did not increase the prepared areas (p > 0.05), except for Reciproc in the apical canal (p < 0.05). Reciproc with no brushing exhibited less pericervical dentin than with brushing (p < 0.05), while RaCe EVO with brushing resulted in less remaining dentin (p < 0.05). CONCLUSIONS: The brushing motion had no effects on the overall shaping performance of the 3 instruments tested. An exception was the increase in prepared surface area in the apical canal segment when the Reciproc instrument was used with brushing strokes.

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INTRODUCTION: This study aimed to evaluate the effects of root canal enlargement on the danger zone (DZ) of mandibular molars. METHODS: Thirty mesial roots of mandibular first molars were scanned in micro-computed tomography (S1). Canals were sequentially enlarged with rotary instruments up to sizes 30/0.04 (S2) and 30/0.06 (S3). The dentin thickness was measured at 0.1-mm intervals after each preparation step (n = 2964 slices). Root level and position of the DZ were also recorded. Data were compared using analysis of variance with Bonferroni pairwise comparison, Cochran's Q method, and Pearson's test (α = 5%). RESULTS: Comparing the specimens before (S1) and after (S2 and S3) preparations showed a significant reduction in the thickness of the DZ (P < .05), as well as between S2 and S3 steps (P < .05). At S1, the DZ was mostly located in the middle third of the root, but after preparation, it shifted toward the coronal direction (P < .05). Both S2 (P = .004, r = 0.508) and S3 (P = .004, r = 0.506) preparation steps showed a positive correlation between canal length and the root level of the DZ. At S1, the DZ was positioned toward the distal and mesial in 73.4% (n = 22) and 26.6% (n = 8) of the specimens, respectively. After S3, the number of specimens with DZ positioned toward the mesial aspect of the root significantly reduced to 3.3% (n = 1), whereas none of the specimens with DZ positioned toward the distal changed its position after root canal enlargements (P > .05). CONCLUSION: Overall, the enlargement of mesial canals of mandibular first molars with final instruments sizes 30/0.04 and 30/0.06 affected the thickness, root level, and position of the DZ.

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OBJECTIVES: This study evaluated factors associated with vertical root fracture in endodontically treated teeth, using a cone-beam computed tomography (CBCT) image database. MATERIALS AND METHODS: The sample for this case-control study consisted of 81 CBCT scans of teeth with vertical root fracture (VRF) and 81 CBCT scans of non-fractured teeth, matched by age, sex, and tooth position. The analyzed variables included dentin thickness, an intraradicular post, an adjacent implant, and a missing adjacent tooth. Student's t test test was used to compare the quantitative variables. The chi-square test was used to compare the categorical variables. Logistic regression was performed to evaluate the association between the presence of VRF and the independent factors assessed. RESULTS: The mean dentin thickness of fractured teeth was 1.3 mm, whereas that of non-fractured ones was 1.5 mm (p < 0.001). There was no difference between the fractured and non-fractured groups, regarding implant frequency or missing adjacent tooth (p > 0.05). There were a significantly larger number of teeth with posts in the fractured versus non-fractured group (p = 0.007). However, dentin thickness ≤ 1.3 mm was the only factor associated with VRF in the multiple regression model (OR = 3.60, 95%CI = 1.76-7.37). CONCLUSIONS: Dentin thickness may influence the development of VRF. Dentin thickness ≤ 1.3 mm is associated with a greater likelihood of fracture than ≥ 1.4 mm. CLINICAL RELEVANCE: This study suggests there may be a minimum amount of safe dentin thickness that should be preserved after endodontic instrumentation.

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Objective: The aim of this study was to evaluate and compare the microtensile bond strengths of four current adhesive materials that contain different monomers at deep and superficial dentin. Material and Methods: Forty non-carious human third molars (n=5) were used in the study. Specimens were divided into two main groups according to dentin thickness as superficial and deep dentin. Groups were further divided into four subgroups in terms of the adhesive systems used: Nova Compo B Plus (NCBP), Nova Compo B (NCB), Futurabond M (FB) and Clearfil S3 Bond Plus (CS3). All specimens were bonded to resin composite and stored in 37 °C water for 9-months. Teeth were sectioned into 3 x 3 mm thick beams. Microtensile bond strength test was carried out by using a universal testing device (1 mm/min). After fracture, failure types were observed using an optical microscope and the fractured dentin surfaces were observed by a scanning electron microscopy (SEM). One-way ANOVA and Tukey tests were used to compare the adhesive system in each dentin group. An unpaired T-test was used to compare the dentin thickness in each adhesive material. Results: As compared to deep dentin, superficial dentin showed higher µTBS values in groups NCBP, FB and CS, as opposed to group NCB. Only NCB revealed higher bond strength at deep dentin layers when compared to superficial dentin. In the superficial dentin group, NCBP showed the highest bond strength value while NCB showed the lowest bond strength. In the deep dentin group, while NCB showed the highest bond strength value, NCBP revealed the lowest bond strength value after 9-months storage. While 4-META and 10-MDP monomer combination (NCBP) resulted in the highest bond strength value among the adhesive systems in the superficial dentin group, the GPDMA and 4-META monomer combination (NCB) resulted in the highest bond strength in deep dentin group. Conclusions: Microtensile bond strength performance are affected by both the type of monomer in the adhesive combination and the depth of the dentin. (AU)

Objetivo: o objetivo deste estudo foi avaliar e comparar a resistência de união à microtração de quatro materiais adesivos atuais que contêm monômeros diferentes na dentina profunda e superficial. Material e Métodos: Quarenta terceiros molares humanos não cariados (n = 5) foram usados no estudo. Os espécimes foram divididos em dois grupos principais de acordo com a espessura da dentina em superficial e profunda. Os grupos foram subdivididos em quatro subgrupos quanto aos sistemas adesivos usados: Nova Compo B Plus (NCBP), Nova Compo B (NCB), Futurabond M (FB) e Clearfil S3 Bond Plus (CS3). Todos os espécimes foram aderidos à resina composta e armazenados em água a 37 ° C por 9 meses. Os dentes foram seccionados em palitos de 3 x 3 mm de espessura. O teste de microtração foi realizado com o uso de um dispositivo de teste universal (1 mm / min). Após a fratura, os tipos de falha foram observados em microscópio óptico e as superfícies de dentina fraturadas por microscopia eletrônica de varredura (MEV). Os testes ANOVA e Tukey um fator foram usados para comparar o sistema adesivo em cada grupo de dentina. Um teste T não pareado foi usado para comparar a espessura da dentina em cada material adesivo. Resultados: Em comparação com a dentina profunda, a dentina superficial apresentou maiores valores de µTBS nos grupos NCBP, FB e CS, ao contrário do grupo NCB. Apenas NCB revelou maior resistência de união na dentina profunda quando comparada à dentina superficial. No grupo de dentina superficial, NCBP apresentou o maior valor de resistência de união, enquanto NCB apresentou a menor resistência de união. No grupo de dentina profunda, enquanto NCB apresentou o valor de resistência de união mais alto, NCBP revelou o valor de resistência de união mais baixo após 9 meses de armazenamento. Enquanto a combinação de monômero 4-META e 10-MDP (NCBP) resultou no maior valor de resistência de união entre os sistemas adesivos no grupo de dentina superficial, a combinação de monômero (NCB) resultou na maior força de união no grupo de dentina profunda. Conclusões: O desempenho da resistência de união à microtração é afetado tanto pelo tipo de monômero na combinação adesiva quanto pela profundidade da dentina. (AU)

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INTRODUCTION: This study compared the shaping ability of ProTaper Next (Dentsply Sirona, Tulsa, OK) and BT-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) instrument systems in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) imaging. METHODS: A total of 17 type IV mesial roots of extracted first mandibular molars were scanned using micro-CT imaging before and after root canal preparation with the 2 instrument systems. Both systems were used in the same root but alternating the mesial canals from root to root. The following parameters were analyzed: root canal volume, surface area, unprepared surface areas, transportation, canal/root width ratio, and preparation time. RESULTS: There were no statistically significant differences between the 2 systems for all evaluated parameters (P > .05). The unprepared surface areas for the full canal length and the apical 5-mm segment were 33% and 14% for BT-RaCe and 31% and 14% for ProTaper Next, respectively. After preparation, all root canals had a diameter that was not larger than 35% of the root diameter at the coronal and middle segments. CONCLUSIONS: The 2 systems showed no differences in any of the evaluated shaping parameters. None of the tested systems put the roots at risk of fracture because of excessive dentin removal.

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This study evaluated the temperature variation in the pulp chamber during photoactivation of two restorative composite resins (Filtek P90 silorane-based composite and Heliomolar methacrylate-based composite) with either a quartz-tungsten-halogen (QTH) or light-emitting diodes (LED) light-curing unit (LCU) and using dentin thicknesses (0.5 and 1.0 mm). Standardized cavities (2x2x2 mm) were prepared in 80 bovine incisors, which were randomly assigned to 8 groups according to the photoactivation method and dentin thickness. Filtek P90 and Heliomolar (both in shade A3) were used with their respective adhesive systems (P90 self-etch primer / P90 adhesive bond and Excite adhesive). All experiments were carried out in a controlled environment (37°C). The temperature variations (°C) were recorded using a digital thermometer attached to a K-type thermocouple. The results were analyzed statistically by ANOVA and Tukey's test (α=0.05). For composite/dentin thickness interaction, temperature increase was significantly higher in 0.5 mm dentin thickness (40.07°C) compared with 1.0 mm dentin thickness (39.61°C) for Filtek P90. For composite/LCU interaction, the temperature increase was significantly higher for Filtek P90 (39.21°C - QTH and 40.47°C - LED) compared with Heliomolar (38.40°C - QTH and 39.30°C - LED). The silorane-based composite promoted higher temperature increase in the pulp chamber than the methacrylate-based composite.

Este estudo avaliou a variação de temperatura na câmara pulpar durante a fotoativação de duas resinas compostas (Filtek P90 – compósito à base de silorano e Heliomolar – compósito à base de metacrilato) com as unidades foto-ativadoras (UFs) luz de quartzo-tungstênio-halogênio (QTH) ou diodo emissor de luz (LED) e utilizando espessuras de dentina (0,5 e 1,0 mm). Cavidades padronizadas (2×2×2 mm) foram preparadas em 80 incisivos bovinos, as quais foram aleatoriamente divididas em 8 grupos de acordo com os métodos de fotoativação e espessura da dentina. Filtek P90 e Heliomolar (ambos na cor A3) foram utilizadas com seus respectivos sistemas adesivos (Primer P90 auto-condicionante / adesivo P90 e adesivo Excite). Todos os experimentos foram realizados em um ambiente controlado (37°C). As variações de temperatura (°C) foram mensuradas usando um termômetro digital conectado a um termopar tipo-K. Os resultados foram analisados estatisticamente por ANOVA e teste de Tukey (α=0,05). Para interação compósito/espessura de dentina, o aumento da temperatura foi estatisticamente superior para a espessura de dentina de 0,5 mm (40,07°C) quando comparado com a espessura de dentina de 1,0 mm (39,61°C) para a Filtek P90. Para a interação compósito/UFs, o aumento de temperatura foi estatisticamente superior para o Filtek P90 (39,21°C – QTH e 40,47°C – LED) quando comparado ao Heliomolar (38,40°C – QTH e 39,30°C – LED). Compósitos à base de silorano promovem maior aumento da temperatura na câmara pulpar em relação aos compósitos à base de metacrilato.

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OBJECTIVE: The aim of this study was to determine the influence of different energy densities on the heat generated during photoactivation of Filtek Z250 (3M/ESPE) and Z100 (3M/ESPE) composite resins with different dentin and composite thickness. MATERIAL AND METHODS: The temperature increase was registered with a type-K thermocouple connected to a digital thermometer (Iopetherm 46). A chemically polymerized acrylic resin base was prepared to serve as a guide for the thermocouple and as a support for 0.5-, 1.0-, and 1.5-mm-thick bovine dentin discs. Circular elastomer molds (1.0 mm-height x 3.0-mm diameter or 2.0-mm height x 3.0-mm diameter) were adapted on the acrylic resin base to standardize the composite resin thickness. A conventional halogen light-curing unit (XL 2500, 3M/ESPE) was used with light intensity of 700 mW/cm². Energy density was calculated by the light intensity applied during a certain time with values of 28 J/cm² for Z100 and 14 J/cm² for Filtek Z250. The temperature change data were subjected to three-way ANOVA and Tukey's test at 5 percent level. RESULTS: The higher energy density (Z100) promoted greater temperature increase (p<0.05) than the lower energy density (Filtek Z250). For both composites and all composite thicknesses, the lowest dentin thickness (0.5 mm) yielded significantly higher (p<0.05) temperature increase than the other two dentin thicknesses. The 1-mm-thick composite resin layer yielded significantly higher (p<0.05) temperature changes for both composites and all dentin thicknesses. CONCLUSIONS: Temperature increase was influenced by higher energy density and dentin/composite thickness.

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