A. J. E. Qualtrough

The effect of smear layer on the push-out bond strength of root canal calcium silicate cements

INTRODUCTIONnThe aim of this study was to evaluate the effect of smear layer removal on the push-out bond strength between radicular dentin and three calcium silicate cements (CSC) in comparison with gutta percha and sealer.nnnMETHODSnEighty human anterior extracted teeth were decoronated, cleaned and shaped to size 50/0.05 apically and randomly divided into 2 major groups: (A) smear layer preserved, and (B) smear layer removed using irrigation with 17% EDTA. Roots within each major group were further divided into 4 subgroups according to the obturation material used: (1) ProRoot MTA, (2) Biodentine, (3) Harvard MTA, (4) Gutta percha and AH-plus sealer. Obturated roots were stored in synthetic tissue fluid for 7 days to allow maximum setting of the root filling materials. Three 2-mm-thick slices were obtained from each root at different section levels (coronal, middle, apical). The canal diameters and slice thickness were measured, and the adhesion surface area for each slice was calculated. Push-out bond strength test was carried out using a universal testing machine. The bond failure mode was assessed under an optical microscope at 40×.nnnRESULTSnThe mean push-out bond strength in groups 1A, 2A and 3A were 7.54 (±1.11), 7.64 (±1.08) and 8.79 (±1.55)MPa respectively, while those for groups 1B, 2B and 3B were 6.58 (±1.13), 6.47 (±1.08), 7.71 (±1.81)MPa, respectively. In the gutta percha and sealer groups the push-out bond strength means were: 1.98 (±0.48) and 2.09 (±0.51)MPa in the preserved and removed smear layer groups respectively. The push-out strength values were significantly reduced when the smear layer was removed in the CSC groups (P<0.05) while no significant difference was detected in the gutta percha and sealer groups.nnnCONCLUSIONSnBased on the conditions of this ex vivo study, it can be concluded that smear layer removal is detrimental to the bond strength between calcium silicate cements and dentin.

A micro-computed tomography evaluation of mineral trioxide aggregate root canal fillings.

INTRODUCTIONnThe aim of this study was to assess the effect of indirect ultrasonic activation on the incidence of voids within mineral trioxide aggregate (MTA) root canal fillings and at their interface with the canal walls by using a nondestructive 3-dimensional (3D) micro-computed tomography (micro-CT) analysis.nnnMETHODSnExtracted human teeth with single canals and minimal curvatures were decoronated, instrumented to size 50/05 apically, and randomly allocated into 4 groups (n = 12). MTA was compacted manually by using hand pluggers in group A (MC). Indirect ultrasonic activation was applied to each increment of manually compacted MTA for 1 second in group B (1 sec-UC), 5 seconds in group C (5 sec-UC), and 10 seconds in group D (10 sec-UC). Filled roots were scanned with a micro-CT device, and 3D analysis of void incidence was carried out by using the SkyScan software.nnnRESULTSnStatistical analysis showed a significantly lower incidence of voids (P < .05) in the manual compaction (MC) group (0.7%) compared with the ultrasonic activation for 1 second (3.8%), 5 seconds (1.7%), and 10 seconds (1.6%) groups.nnnCONCLUSIONSnManual compaction produced significantly denser root fillings than those achieved with ultrasonic activation.

Resorption: Part 1. Pathology, classification and aetiology

This paper will explore the pathological process involved in dental resorption as well as its classifications and aetiology. The second subsequent paper will look at its diagnosis and management.

A laboratory evaluation of the physical and mechanical properties of selected root canal sealers

AIMnTo evaluate and compare the porosity, degree of conversion (DC) and hardness of two resin-based sealers; RealSeal and EndoRez, and a silicon-based sealer; GuttaFlow to that of a traditional zinc oxide-based sealer; TubliSeal.nnnMETHODOLOGYnFor porosity, four samples from each sealer were prepared and scanned using a SkyScan 1072 Micro-CT. Porosity was then calculated using specialized software. For DC, 10 samples from each sealer were prepared and placed onto a Fourier transform infrared spectroscopy spectrometer. Spectra readings were carried out before and after curing of the sealers, and the DC for each sealer was calculated. For hardness, 10 samples from each sealer were prepared and then tested using a Wallace hardness tester. SPSS software was used for statistical analysis of the data using one-way anova and independent t-tests.nnnRESULTSnTubliSeal had the highest percentage porosity (3.52%), whilst RealSeal had the lowest percentage porosity (0.41%). Statistically significant differences (P = 0.01) in porosity were present between all groups except between RealSeal and EndoRez groups. RealSeal exhibited a significantly higher DC% than EndoRez (P = 0.01), whereas EndoRez had the highest hardness number [28.54 Vickers hardness number (VHN)] whilst TubliSeal showed the lowest (13.57 VHN). Statistically significant differences in hardness were found between all groups (P = 0.01) except between RealSeal and EndoRez groups.nnnCONCLUSIONSnResin-based sealers had less porosity, greater hardness and a high DC.

Effect of retained fractured instruments on tooth resistance to vertical fracture with or without attempt at removal.

AIMSnTo investigate the effect of retained fractured endodontic instruments on root strength and to evaluate the effectiveness of several root filling materials in reinforcing roots that had undergone unsuccessful attempt at removal of fractured instruments.nnnMETHODOLOGYnSeventy five mandibular premolar roots were divided into five groups. In group A (control), canals were prepared to a size F5-ProTaper instrument and filled with gutta-percha and TubliSeal sealer fragments. In the experimental groups (B, C, D and E), 4 mm of F5-ProTaper instruments were fractured in the apical one-third of the canal and then treated as follows: in group B, the fragments were left in situ without attempt at removal, and canals were filled with gutta-percha and TubliSeal sealer (GP No Removal). In groups C, D and E, an attempt at removal of the fragment was simulated by preparing a staging platform coronal to the fragment using modified Gates Glidden burs (No 2-5). Canals in group C were filled with gutta-percha and TubliSeal sealer (GP Removal), group D filled with Resilon (Resilon Removal) and group E with mineral trioxide aggregate (MTA Removal). Roots then underwent vertical fracture. Data were analysed using the one-way anova at P<0.05.nnnRESULTSnRoots in the GP Removal group had significantly lower values for mean force for fracture (404.9 N). There was no significant difference between the control group and GP No Removal (765.2 and 707.8, respectively). Resilon Removal and MTA Removal groups (577.3 and 566.6 N) were not significantly different from the GP No Removal group.nnnCONCLUSIONSnLeaving fractured instruments in the apical one-third of the canal does not appear to affect the resistance of the root to vertical fracture; Resilon and MTA appear to compensate for root dentine loss that occurred as a consequence of attempts at retrieval of fractured instruments when used as canal filling materials.