2. Universidad Cardenal Herrera-CEU

Purpose: The aim of this study was to evaluate the chemomechanical properties, antibacterial activity, and cytotoxicity of an experimental adhesive resin containing halloysite nanotubes (HNT), doped with alkyl trimethyl ammonium bromide (ATAB). Materials and Methods: A filler of HNT doped with ATAB was obtained (ATAB:HNT) and incorporated (5 wt%) into a resin blend made of bisphenol A glycerolate dimethacrylate, 2-hydroxyethyl methacrylate and a photoinitiator/co-initiator system (GATAB:HNT). The same resin blend without ATAB:HNT was used as control (Ctrl). The ATAB:HNT filler was assessed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The two tested adhesives were evaluated for degree of conversion (DC) in vitro and in situ, softening in alcohol, dentin microtensile bond strength (μTBS), antibacterial activity, and cytotoxicity (n = 5). Results: SEM showed that the nanotubes had a characteristic tubular-needle morphology, while the TEM analysis confirmed the presence of ATAB inside the lumens of HNT. The incorporation of ATAB:HNT induced no reduction (p > 0.05) of the DC either in situ or in vitro. No difference was encountered after the softening challenge test (p > 0.05) and no difference was found in μTBS between the two adhesives, both at 24 h (p > 0.05) and after 6 months of storage in distilled water (p > 0.05). However, ATAB:HNT reduced Streptococcus mutans viability (p < 0.05) without a cytotoxic effect on pulp cells (p > 0.05). Conclusions: GATAB:HNT adhesive demonstrated appropriate polymerization without significant differences in softening after solvent immersion, while concomitantly maintaining reliable bond strength after 6 months of water aging. Moreover, the ATAB:HNT filler can provide antibacterial activity to the adhesive resin without affecting pulp cell viability.

Introduction: This study compared bacterial percolation and sealer penetration of a novel obturation technique with the ones of warm vertical condensation technique. Methods and Materials: A bacterial percolation test was carried out with 80 single rooted human teeth divided into 5 groups; A (n=20): warm vertical condensation and AH-Plus, B (n=20): CPoint with AH-Plus, C (n= 20): CPoint with EndoSequence BC, +ve Control (n=10): teeth with no canal obturation, -ve Control (n=10): teeth with no access cavity. The samples were inoculated with a multispecies bacterial incoulum. Bacterial percolation was evaluated by turbidity. Confocal laser scanning microscopy (CLSM) was used to observe the presence of gaps and voids. Further 48 extracted human mandibular single-canal premolars were used to determine the sealer penetration. Slices of the samples were observed by CLSM to evaluate tubules penetration of the sealer. Kaplan Meyer survival, ANOVA one way and Tuckey HSD test and a Wilcoxon signed-rank test were utilised. Results: A Kaplan-Meier test showed no significant difference overall (P>0.05) between groups A, B and C. At 43 days, the group B showed a significantly inferior ability to prevent bacterial passage (P<0.05). The group C showed a deeper sealer penetration than group A and B with statistically significant differences (P<0.05) for the total penetration (ANOVA one way and Tukey HSD). A Wilcoxon signed-rank test showed statistically significant differences for the penetration in the middle-and apical third of the 3 groups. Conclusion: Based on this in vitro study, the single polymer-cone obturation technique with a resin based- and bioceramic based-sealer behaved similarly to the warm vertical obturation technique in preventing bacterial passage. The bioceramic sealer showed the deepest penetration but did not fully prevent bacterial leakage.

This study aimed at evaluating the e cacy of a novel silver-citrate root canal irrigation solution (BioAKT) on smear layer removal, sealer penetration after root canal instrumentation and antibacterial activity. Single-root teeth were endodontically treated, sealed with an epoxi-amine resin sealer and irrigated using: Group I: 5.25% sodium hypochlorite (NaOCl); Group II: silver-citrate solution (BioAKT); Group III: phosphate bu er solution (PBS); Group IV: 17% ethylenediaminetetraacetic acid (EDTA). Smear layer removal and silver deposition at the coronal, middle and apical portion of each canal were analyzed using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). Sealer penetration into dentinal tubules at coronal, middle and apical portion was assessed through dye-assisted confocal microscopy (CSM). Both SEM and CSM micrographs were evaluated by two examiners ( = 0.86), who were blind to the irrigation regimens; scores were given according to the degree of penetration of the sealer. Data analysis included Pearson’s x2 and Sidak’s multiple comparisons. Dentin discs were polished and sterilized. Enterococcus faecalis biofilms were grown using a continuous-flow bioreactor under anaerobic conditions for 72 h. Specimens were irrigated with the tested solutions, and bacterial viability was assessed using a tetrazolium salt assay (MTT). Statistical analysis included one-way ANOVA and Student’s post-hoc t-test (p < 0.05). BioAKT and EDTA were the most e cient solutions both in removing the smear layer and allowing sealer penetration. However, at the apical portion BioAKT performed significantly better compared to EDTA both in smear layer removal and sealer penetration (p < 0.05). BioAKT and NaOCl showed comparable antibacterial e ect (p = 0.53). In conclusion, BioAKT represents a suitable smear layer removal agent, which allows for reliable sealer penetration at the apical portion of the root canal system and o ers significant antibacterial properties.