Influência do cimento temporário e do protocolo de limpeza do espaço protético para pino de fibra de vidro sobre a resistência de união na dentina radicular do cimento resinoso autocondicionante
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Data
2018-03-09
Autores
Morais, Jéssika Mayhara Pereira [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Os objetivos dos estudos foram avaliar os efeitos da cimentação provisória intrarradicular de um pino metálico com cimentos temporários, de composição química diferentes, e analisar a influência da irrigação com agitação ultrassônica passiva (PUI), sobre a resistência de união do cimento resinoso autoadesivo (Relyx U200) na dentina do espaço radicular preparado para pino de fibra de vidro. Noventa raízes unirradiculares de dentes humanos, foram padronizadas com o comprimento de 17,0 mm, a partir do ápice radicular. Os canais radiculares foram instrumentados até o instrumento F5, irrigados a cada troca de instrumento com 5 mL de hipoclorito de sódio a 2,5% e obturados com cimento contendo resina epóxi (AH Plus; Dentsply DeTrey GmbH, Konstanz, GER). Após 7 dias, foi preparado o espaço intrarradicular para pino de fibra de vidro, na extensão de 11mm, a partir da face cervical radicular, com brocas tipo Largo #1 e #2, e dada a conformação final com a broca #2 do sistema White Post DC (FGM, Joinville, SC, BR). No estudo 1, quarenta espécimes foram distribuídos em 4 grupos (n =10), de acordo com o tipo de protocolo de cimentação provisório do pino metálico: G1 (CO), sem a realização prévia da cimentação provisória do pino metálico intrarradicular; G2 (PR), cimentação provisória do pino metálico com o sistema Provy (Dentsply); G3 (RT) cimentação provisória do pino metálico com o sistema Relyx Temp NE (3M) e G4 (TB), cimentação provisória do pino metálico com o sistema Temp Bond NE (Sybron Kerr). Em todos os grupos, com exceção do CO, pinos metálicos foram cimentados provisoriamente no espaço intrarradicular preparado para pino, e mantidos em 90% de umidade relativa, a 37oC. Após 7 dias, estes pinos metálicos foram removidos por meio de tração axial e repassada a broca #2 do sistema White Post (FGM, Joinville, SC, Brasil) no espaço intrarradicular previamente preparado. O local foi irrigado com 5 mL de água destilada. Após a secagem do canal radicular, os pinos de fibra DC2 (FGM, Joinville, SC, Brasil) foram anatomizados com resina composta e imediatamente cimentados com o cimento resinoso autocondicionante (Relyx U200; 3M, Sumaré, SP, Brasil), incorporado com Rhodamine B, na concentração de 0,01% em massa, em relação ao cimento resinoso. No estudo 2, cinquenta espécimes foram distribuídos em 5 grupos (n =10), de acordo com o tipo de protocolo de cimentação provisório do pino metálico e irrigação prévia do espaço intrarradicular preparado para pino de fibra com agitação ultrassônica: G1 (CO), sem a realização prévia da cimentação provisória do pino metálico intrarradicular; G2 (RT), cimentação provisória do pino metálico com o sistema Provy (Dentsply) e irrigação convencional com água destilada; G3 (RT-PUI) cimentação provisória do pino metálico com o sistema Provy e posterior agitação ultrassônica da solução de irrigação no espaço preparado intrarradicular; G4 (RT-PUI), cimentação provisória do pino metálico com o sistema Relyx Temp e posterior agitação ultrassônica da solução de irrigação no espaço preparado intrarradicular e G5 (TB-PUI), cimentação provisória do pino metálico com o sistema Temp Bond NE e posterior agitação ultrassônica da solução de irrigação 12 no espaço preparado intrarradicular. Todos os espécimes foram mantidos em 100% de umidade, a 37oC, por 7 dias. Na sequência, foram obtidas secções transversais de todos as raízes, com 2 mm de espessura, dos terços cervical, médio e apical radicular. Em seguida, as secções foram submetidas ao ensaio mecânico de push-out, em máquina de ensaio eletromecânica acoplada com célula de carga de 5 kN, na velocidade de 0,5 mm/minuto. Após a conclusão do teste de push out, o padrão de fratura foi classificado, com análise em estereomicroscópio, em: adesiva, entre o cimento resinoso e a dentina radicular (tipo 1): adesiva entre o cimento resinoso e o pino de fibra (tipo 2); coesiva, no cimento resinoso ou mista, envolvendo dois ou mais tipos de fratura. Os dados obtidos foram submetidos aos testes de ANOVA a 1 critério e posteriormente ao teste de Tukey (p = 0.05). No estudo 1, em todos os terços radiculares, CO demonstrou a maior resistência de união do cimento resinoso autocondicionante na dentina radicular (p < 0.05). Por outro lado, não houve diferença entre os grupos em que a cimentação de um pino provisório foi realizada previamente à cimentação definitiva do pino de fibra de vidro. No estudo 2, nos grupos em que a irrigação ultrassônica passiva (PUI) foi realizada, independentemente do tipo de cimento provisório utilizado, a resistência de união do cimento resinoso autocondicionante foi similar ao CO (p > 0,05), apenas no terço cervical radicular. No terço médio radicular, a resistência de união do cimento resinosos autocondicionante nestes grupos foram iguais entre si (p > 0,05), porém inferior ao CO (p < 0,05), mas superior ao da irrigação convencional (p > 0,05). Por outro lado, no terço apical radicular houve similaridade entre todos os grupos (p > 0,05), que demonstraram menores valores de resistência de união do cimento resinoso em relação ao CO (p < 0,05). Portanto, a cimentação provisória e posterior remoção por tração de um pino metálico no espaço intrarradicular preparado para pino, independentemente do tipo de cimento provisório utilizado, interferiu negativamente sobre a resistência de união do cimento resinoso autocondicionante (Relyx U200) na dentina radícular (p < 0,05). Porém, nos terços cervical e médio radicular, a irrigação com agitação ultrassônica da solução irrigadora (água destilada) no espaço preparado para pino proporcionou o restabelecimento da resistência de união do cimento resinoso na dentina radicular em relação ao RT (p < 0,05), mas similar somente no terço cervical foi similar ao CO (p > 0,05).
The aims of this study are to evaluate the effects of temporary intraradicular cementation of a metallic pin with temporary cements made from different chemical composition, and to analyze the influence of agitation with passive ultrasonic irrigation (PUI) on the bond strength of the self-adhesive resin cement (Relyx U200) in the root space dentin prepared for fiberglass pin. Ninety one-root human teeth were standardized with a length of 17.0 mm from the radicular apex. The root canals were instrumented up to instrument F5, irrigated at each instrument change with 5 mL of 2.5% sodium hypochlorite and filled with cement containing epoxy resin (AH Plus; Dentsply DeTrey GmbH, Konstanz, GER). After 7 days, the intraradicular space, 11mm in length, was prepared for the fiberglass pin, from the root cervical face with Largo # 1 and # 2 drills, and given the final conformation with the drill # 2 from White Post DC system (FGM, Joinville, SC, BR). In study 1, forty specimens were distributed into 4 groups (n = 10), according to the type of provisional cementation protocol of the metal pin: G1 (CO), without executing beforehand the provisional cementation of the intraradicular metallic pin; G2 (PR), provisional cementation of the metallic pin with Provy system (Dentsply); G3 (RT) temporary cementation of the metallic pin with Relyx Temp NE (3M) and G4 (TB) system, provisional cementing of the metallic pin with Temp Bond NE system (Sybron Kerr). In all groups, with exception of CO, metallic pins were provisionally cemented in the intraradicular space prepared for the pin, and maintained at 90% relative humidity at 37oC. After 7 days, these metal pins were removed by means of axial traction and then transferred to the # 2 drill of the White Post system (FGM, Joinville, SC, Brazil) in the previously prepared intraradicular space. The location was irrigated with 5 mL of distilled water. After drying the root canal, the DC2 fiber pins (FGM, Joinville, SC, Brazil) were anatomized with composite resin and immediately cemented with self-etching resin cement (Relyx U200; 3M, Sumaré, SP, Brazil), incorporated with Rhodamine B, at the concentration of 0.01% by mass, in relation to the resin cement. In study 2, fifty specimens were distributed into 5 groups (n = 10), according to the type of provisional cementation protocol of the metal pin and previous irrigation of the intraradicular space prepared for the fiber pin with ultrasonic irrigation: G1 (CO), without previously executing the provisional cementation of the intraradicular metallic pin; G2 (RT), provisional cementation of the metallic pin with Provy system (Dentsply) and conventional irrigation with distilled water; G3 (RT-PUI) provisional cementation of the metallic pin with Provy system and subsequent ultrasonic agitation of the irrigation solution in the prepared intrarradicular space; G4 (RT-PUI), temporary cementation of the metallic pin with Relyx Temp system and subsequent ultrasonic agitation of the irrigation solution in the prepared intraradicular space and G5 (TB-PUI), provisional cementation of the metallic pin with Temp Bond NE system and posterior Ultrasonic agitation of the irrigation solution in the prepared intraradicular space. All specimens were kept at 100% humidity at 37oC, for 7 14 days. Afterwards, cross sections of all roots, 2 mm thick, of the cervical, middle and apical roots were obtained. Then, the sections were submitted to the mechanical push-out test, in an electromechanical test machine coupled with a load cell of 5 kN, at the speed of 0.5 mm / minute. After the push-out test conclusion, the fracture pattern was classified, with stereomicroscopic analysis, in: adhesive, between resin cement and root dentin (type 1): adhesive between resin cement and fiber pin (type 2); cohesive, in resinous or mixed cement, involving two or more types of fracture. The data were submitted to ANOVA tests at 1 criterion and after the Tukey test (p = 0.05). In study 1, in all radicular thirds, CO showed the highest bond strength of the self-etching resin cement in the radicular dentin (p <0.05). On the other hand, there was no difference among groups in which cementation of a provisional pin was performed prior to definitive cementation of fiberglass pin. In study 2, in groups where passive ultrasonic irrigation (PUI) was performed, regardless the type of temporary cement used, the bond strength of self-etching resin cement was similar to CO (p> 0.05), only in the cervical of the root. In the middle third of the root, the bond strength of the self-etching resin cement in these groups was similar (p> 0.05), but lower than CO (p <0.05), but higher than in conventional irrigation (p> 0, 05). On the other hand, in the apical third of the root there was similarity among all groups (p> 0.05), which showed lower values of resin bond strength in relation to CO (p <0.05). Therefore, provisional cementation and subsequent traction removal of a metallic pin in the intrarradicular space prepared for the pin, regardless the type of temporary cement used, interfered negatively on the bond strength of the selfetching resin cement (Relyx U200) in the root dentine (p < 0.05). However, in the cervical third and middle third of the root, agitation with ultrasonic irrigation of the solution (distilled water) in the prepared space has promoted a bond strength restoration of the resin cement in the root dentin in relation to RT (p <0.05), but similar only in the cervical third was similar to CO (p> 0.05). The highest incidence for all groups and in all thirds was the mixed fracture pattern, with a prevalence over the displacement between the self-adhesive resin cement and the dentin substrate.
The aims of this study are to evaluate the effects of temporary intraradicular cementation of a metallic pin with temporary cements made from different chemical composition, and to analyze the influence of agitation with passive ultrasonic irrigation (PUI) on the bond strength of the self-adhesive resin cement (Relyx U200) in the root space dentin prepared for fiberglass pin. Ninety one-root human teeth were standardized with a length of 17.0 mm from the radicular apex. The root canals were instrumented up to instrument F5, irrigated at each instrument change with 5 mL of 2.5% sodium hypochlorite and filled with cement containing epoxy resin (AH Plus; Dentsply DeTrey GmbH, Konstanz, GER). After 7 days, the intraradicular space, 11mm in length, was prepared for the fiberglass pin, from the root cervical face with Largo # 1 and # 2 drills, and given the final conformation with the drill # 2 from White Post DC system (FGM, Joinville, SC, BR). In study 1, forty specimens were distributed into 4 groups (n = 10), according to the type of provisional cementation protocol of the metal pin: G1 (CO), without executing beforehand the provisional cementation of the intraradicular metallic pin; G2 (PR), provisional cementation of the metallic pin with Provy system (Dentsply); G3 (RT) temporary cementation of the metallic pin with Relyx Temp NE (3M) and G4 (TB) system, provisional cementing of the metallic pin with Temp Bond NE system (Sybron Kerr). In all groups, with exception of CO, metallic pins were provisionally cemented in the intraradicular space prepared for the pin, and maintained at 90% relative humidity at 37oC. After 7 days, these metal pins were removed by means of axial traction and then transferred to the # 2 drill of the White Post system (FGM, Joinville, SC, Brazil) in the previously prepared intraradicular space. The location was irrigated with 5 mL of distilled water. After drying the root canal, the DC2 fiber pins (FGM, Joinville, SC, Brazil) were anatomized with composite resin and immediately cemented with self-etching resin cement (Relyx U200; 3M, Sumaré, SP, Brazil), incorporated with Rhodamine B, at the concentration of 0.01% by mass, in relation to the resin cement. In study 2, fifty specimens were distributed into 5 groups (n = 10), according to the type of provisional cementation protocol of the metal pin and previous irrigation of the intraradicular space prepared for the fiber pin with ultrasonic irrigation: G1 (CO), without previously executing the provisional cementation of the intraradicular metallic pin; G2 (RT), provisional cementation of the metallic pin with Provy system (Dentsply) and conventional irrigation with distilled water; G3 (RT-PUI) provisional cementation of the metallic pin with Provy system and subsequent ultrasonic agitation of the irrigation solution in the prepared intrarradicular space; G4 (RT-PUI), temporary cementation of the metallic pin with Relyx Temp system and subsequent ultrasonic agitation of the irrigation solution in the prepared intraradicular space and G5 (TB-PUI), provisional cementation of the metallic pin with Temp Bond NE system and posterior Ultrasonic agitation of the irrigation solution in the prepared intraradicular space. All specimens were kept at 100% humidity at 37oC, for 7 14 days. Afterwards, cross sections of all roots, 2 mm thick, of the cervical, middle and apical roots were obtained. Then, the sections were submitted to the mechanical push-out test, in an electromechanical test machine coupled with a load cell of 5 kN, at the speed of 0.5 mm / minute. After the push-out test conclusion, the fracture pattern was classified, with stereomicroscopic analysis, in: adhesive, between resin cement and root dentin (type 1): adhesive between resin cement and fiber pin (type 2); cohesive, in resinous or mixed cement, involving two or more types of fracture. The data were submitted to ANOVA tests at 1 criterion and after the Tukey test (p = 0.05). In study 1, in all radicular thirds, CO showed the highest bond strength of the self-etching resin cement in the radicular dentin (p <0.05). On the other hand, there was no difference among groups in which cementation of a provisional pin was performed prior to definitive cementation of fiberglass pin. In study 2, in groups where passive ultrasonic irrigation (PUI) was performed, regardless the type of temporary cement used, the bond strength of self-etching resin cement was similar to CO (p> 0.05), only in the cervical of the root. In the middle third of the root, the bond strength of the self-etching resin cement in these groups was similar (p> 0.05), but lower than CO (p <0.05), but higher than in conventional irrigation (p> 0, 05). On the other hand, in the apical third of the root there was similarity among all groups (p> 0.05), which showed lower values of resin bond strength in relation to CO (p <0.05). Therefore, provisional cementation and subsequent traction removal of a metallic pin in the intrarradicular space prepared for the pin, regardless the type of temporary cement used, interfered negatively on the bond strength of the selfetching resin cement (Relyx U200) in the root dentine (p < 0.05). However, in the cervical third and middle third of the root, agitation with ultrasonic irrigation of the solution (distilled water) in the prepared space has promoted a bond strength restoration of the resin cement in the root dentin in relation to RT (p <0.05), but similar only in the cervical third was similar to CO (p> 0.05). The highest incidence for all groups and in all thirds was the mixed fracture pattern, with a prevalence over the displacement between the self-adhesive resin cement and the dentin substrate.
Descrição
Palavras-chave
Adesivos dentinários, Pinos dentários, Cimentos dentários, Dentin adhesive, Tooth pins, Dental cement