Ali Erdemir

Effect of Medications for Root Canal Treatment on Bonding to Root Canal Dentin

Use of resin-based restorative materials recently has become widely accepted for treatment of endodontically treated teeth. However, some solutions routinely used during endodontic treatment procedures may have an effect on bond strengths of adhesive materials to root canal dentin. The purpose of this in vitro study was to evaluate the effect of various medications on microtensile bond strength to root canal dentin. Fourteen extracted human single-rooted teeth were used. The crowns and the pulp tissues were removed. The root canals were then instrumented and widened to the same size. The teeth were randomly divided into seven groups of two teeth each. The root canal dentin walls of the roots were treated with 5% sodium hypochloride (NaOCI), 3% hydrogen peroxide (H2O2), the combination of H2O2 and NaOCl, or 0.2% chlorhexidine gluconate for 60 s; or calcium hydroxide or formocresol for 24 h. The teeth in control group were irrigated with water. The root canals were obturated using C&B Metabond. After 24 h of storage in distilled water, serial 1-mm-thick cross-sections were cut, and approximately 12 samples were obtained from each group. Microtensile bond strengths to root canal dentin were then measured by using an Instron machine. The data were recorded and expressed as MPa. The results indicated that NaOCI, H2O2, or a combination of NaOCl and H2O2 treatment decreased bond strength to root canal dentin significantly (p < 0.05). The teeth treated with chlorhexidine solution showed the highest bond strength values (p < 0.05). In conclusion, chlorhexidine is an appropriate irrigant solution for root canal treatment before adhesive post core applications.

Evaluation of the effect of endodontic irrigation solutions on the microhardness and the roughness of root canal dentin.

The purpose of this study was to evaluate the effect of 0.2% chlorhexidine gluconate on the microhardness and roughness of root canal dentin compared with widely used irrigation solutions. Ninety, mandibular, anterior teeth extracted for periodontal reasons were used. The crowns of the teeth were removed at the CEJ. The roots were separated longitudinally into two segments, embedded in acrylic resin, and polished. A total of 180 specimens were divided into 6 groups of 30 teeth at random according to the irrigation solution used: group 1: 5.25% NaOCl for 15 min; group 2: 2.5% NaOCl for 15 min; group 3: 3% H2O2 for 15 min; group 4: 17% EDTA for 15 min; group 5: 0.2% chlorhexidine gluconate for 15 min; and group 6: distilled water (control). Each group was then divided into 2 subgroups of 15 specimens: groups 1a, 2a, 3a, 4a, 5a, and 6a were submitted to Vickers microhardness indentation tests; groups 1b, 2b, 3b, 4b, 5b, and 6b were used for determination of the roughness of root dentin. The data were recorded as Vickers numbers and Ra, microm for roughness test. The results were analyzed statistically by using one-way ANOVA and Tukey tests. The results indicated that all the irrigation solutions except chlorhexidine significantly decreased microhardness of root canal dentin (p < 0.05); 3% H2O2 and 0.2% chlorhexidine gluconate had no effect on roughness of the root canal dentin (p > 0.05). Although there are many other factors for irrigation solution preference, according to the results of this study, 0.2% chlorhexidine gluconate seems to be an appropriate endodontic irrigation solutions because of its harmless effect on the microhardness and roughness of root canal dentin.

Effects of different curing units and luting agents on push-out bond strength of translucent posts.

INTRODUCTION The aim of this study was to evaluate the effects of different curing units and 2 luting cements on the push-out bond strength of a translucent fiber post. METHODS Thirty maxillary incisor roots were endodontically treated. Post spaces were prepared, and the smear layers were removed. Posts (FRC Postec Plus) were luted with either a self-etch cement (Panavia F 2.0) or a self-adhesive cement (Maxcem). Luting agents were then light-activated with a quartz-tungsten-halogen, a blue light-emitting diode, or a plasma-arc curing unit. Roots/cemented posts were transversally sectioned from coronal to apical. Push-out tests were performed, and data were analyzed by using three-way analysis of variance and Tukey tests. RESULTS Push-out bond strengths were significantly affected by the type of luting agent (P < .05) and root region (P < .05). The type of light source used in curing did not affect push-out bond strengths (P > .05). CONCLUSIONS Self-adhesive resin cement provided higher bond strength than the self-etch cement when smear layer was removed before the post cementation. The push-out bond strength in the apical portion of the root was significantly lower than in the coronal region. The use of different curing units in the photoirradiation of dual-cured resin cement did not affect the retention of the fiber post as a result of the limited light transmission capability of this post.

Effect of Solvents on Bonding to Root Canal Dentin

The long-term success of resin cementation of post/cores is likely increased with improvement in resin-root canal dentin bonding. The adverse effect of some irrigation constituents (NaOCl, H2O2) or medications (eugenol) on the bond strengths of resins to dentin have been reported. The purpose of this in vitro study was to evaluate the effect of two gutta-percha solvents (chloroform versus halothane) on microtensile bond strength to root canal dentin. Thirty, extracted, human, single-rooted teeth were instrumented to a #70 file and randomly divided into 3 groups of 10 each. The root canals were treated with water, chloroform, or halothane for 60 s. All root canals were obturated using C&B Metabond. After 24 h of storage in distilled water, serial 1-mm-thick cross-sections were cut and trimmed. Microtensile bond strength to apical, middle, and coronal root canal dentin were measured using an Instron machine. Using pooled data, the results indicated that water-treated roots had significantly higher resin-dentin bond strengths compared with chloroform or halothane treatment groups (control: 23.9 MPa; chloroform: 18.3 MPa; halothane: 17 MPa; p < 0.05). Gutta-percha solvents have an adverse effect on bond strengths of adhesive cements to root canal dentin.

Accuracy of two electronic apex locators in primary teeth with and without apical resorption: a laboratory study

AIM To evaluate the accuracy of the Root ZX (J Morita Corp., Kyoto, Japan) and Tri Auto ZX (J Morita Corp.) devices for measuring root canal length in primary teeth with and without apical resorption. METHODOLOGY Thirty-four extracted human primary molar teeth with resorption and 19 primary teeth without resorption were collected. After endodontic access preparation, the actual lengths of the teeth were determined. The teeth were then embedded in an alginate model to determine the electronic working length measurement. Statistical evaluation was completed using Students t-tests. RESULTS For the Root ZX, there was no significant difference between those teeth with root resorption and those without. However, for the Tri Auto ZX, there was a significant difference in the electronic measurements between those teeth with root resorption and those without (P < 0.05). Significant differences were found amongst the measurements of the two apex locators (P < 0.05). For root canals with resorption, the respective accuracy rates (within +/-0.5 mm) of Root ZX and Tri Auto ZX were 83.33% and 89.47%; within +/-1 mm, the Root ZX and Tri Auto ZX demonstrated 98.95% and 100% accuracy, respectively. For root canals with no resorption, the percentage of measurements within +/-0.5 mm of the apical construction was 89.28% for the Root ZX and 80.35% for the Tri Auto ZX. The accuracy within +/-1 mm of the Root ZX and the Tri Auto ZX was 98.22% and 100%, respectively. CONCLUSION Within the limitations of this laboratory study, the presence of resorption affected the performance of the Tri Auto ZX more than the Root ZX.

Effect of Gutta-percha Solvents on Mineral Contents of Human Root Dentin Using ICP-AES Technique

The purpose of this in vitro study was to evaluate the mineral contents of root-canal dentin before and after treatment with two commonly used gutta-percha solvents: chloroform and halothane. Twenty extracted human premolars, whose crowns and apical thirds had been removed, were used. Pulp tissues were removed and the teeth were randomly divided into two groups including 10 teeth each. Root canals were enlarged with Gates Glidden burs (#1, 2, and 3). Dentin chips were obtained and saved in plates to serve as a control. Root-canal-dentin walls were then treated with chloroform or halothane for 15 min. Dentin chips were again obtained using Gates Glidden burs (#4, 5, and 6). The levels of five elements, calcium, phosphorus, magnesium, potassium, and sulfur, in each specimen were analyzed using ICP-AES (inductively coupled plasma atomic emission spectrometry) technique. Changes in the levels of the chemical elements were recorded. Differences between the groups were statistically analyzed using Mann-Whitney U test. There was a significant decrease in Ca level and significant increase in Mg level after treatment with halothane (p < 0.05). There was a significant increase in Mg level after treatment with chloroform. The changes in other elements levels after treatment with gutta-percha solvents were minimal and statistically not significant (p > 0.05). As a result it was concluded that gutta-percha solvents have effect on mineral contents of root dentin.

Comparison of different irrigation activation techniques on smear layer removal: an in vitro study.

The purpose of this study was to evaluate the efficiency of different irrigation activation techniques on smear layer removal. About 80 single‐rooted human maxillary central teeth were decoronated to a standardized length.The samples were prepared by using ProTaper system to size F4 and divided into eight equal groups (n = 10) according to the final irrigation activation technique; distilled water was used as an irrigant in Group 1. The other groups were treated with 2.5% NaOCl and 17% EDTA, respectively. Conventional syringe irrigation (CSI) was used in Group 2. Irrigation solutions were activated using passive ultrasonic irrigation (PUI, Group 3), EndoVac apical negative pressure (ANP, Group 4), diode laser (Group 5), Nd:YAG laser (Group 6), Er:YAG laser (Group 7), and Er:YAG laser using with photon‐induced photoacoustic streaming (PIPS™, Group 8). Teeth were split longitudinally and subjected to scanning electron microscope (SEM). PIPS showed the best removal of smear layer when compared with PUI, ANP, Nd:YAG, and Er:YAG, but the difference was not statistically significant (P > 0.05). Smear layer scores obtained with PIPS technique were statistically significant different from those of obtained with control, CSI and diode laser groups (P < 0.05). All experimental irrigation techniques except ANP and diode laser removed smear layer more effectively at the coronal and middle levels compared to the apical level (P < 0.05). Irrigation activated/delivered techniques except diode laser have a positive effect on removing of smear layer. Microsc. Res. Tech. 78:230–239, 2015.

The effects of three different desensitizing agents on the shear bond strength of composite resin bonding agents

The aim of this study was to evaluate the effects of three desensitizing agents on the shear bond strengths of four different bonding agents used to bond composite resin to dentin. A total of 160 extracted human molars were sectioned parallel to the occlusal plane under water cooling, polished and randomly divided into 4 groups of 40. Each group was treated with a different desensitizing agent (Tooth Mousse, Ultra-EZ, Cervitec Plus), except for an untreated control group. Each group was then randomly subdivided into 4 groups of 10, and a different dentin bonding agent (XP Bond, AdheSE, Adper Prompt L-pop, GBond) was applied to each group in order to bond the specimens to a resin composite (Gradia Direct) built up using a plastic apparatus. A Universal Testing Machine was used to measure the shear bond strength of each specimen. Statistical analysis was performed using one-way ANOVA and Tukeys tests. With the exception of the Control/AdheSE and Ultra-EZ/XP Bond groups, no statistically significant differences were found in the shear bond strength values of the groups tested. These findings suggest that the use of different desensitizing agents does not affect the shear bond strength of various adhesive systems used to bond resin composite to dentin.

Effects of Different Chlorhexidine Formulations on Shear Bond Strengths of Orthodontic Brackets

OBJECTIVE To test the hypothesis that the application of different chlorhexidine formulations to the etched enamel will not affect shear bond strength (SBS). MATERIALS AND METHODS Forty-four freshly extracted human premolars were collected and stored in distilled water. The teeth were etched with 37% phosphoric and were rinsed and dried. The teeth then were divided into four equal groups. While Group 1 served as a control, Groups 2 to 4 were treated before bonding with a chlorhexidine formulation that included solution (2%), gel (1%), and mouthwash (0.2%). Orthodontic brackets were bonded with Transbond XT (3M Unitek, Monrovia, Calif). Bond strength results were evaluated with the use of one-way analysis of variance (ANOVA) (P < .05) and post hoc tests. Modes of failures were verified by means of scanning electron microscopy. RESULTS Although no statistically significant difference was observed between Groups 1 and 4 (P > .05), both were statistically superior to Groups 2 and 3 (P < .05). In this in vitro study, the observed measures for Groups 2 and 3 (14.5-10.6 MPa) were lower than those for Groups 1 and 4 (27.3-24.9 MPa), but these values were much higher than those required for clinical use (6-8 MPa). CONCLUSION The hypothesis is rejected. The application of chlorhexidine mouth rinse before bonding had no significant effect on the SBS value, and the application of chlorhexidine solution and gel significantly decreased SBS.

Effect of different light sources in combination with a light‐transmitting post on the degree of conversion of resin composite at different depths of simulated root canals

AIM The aim of this study was to evaluate the degree of conversion (DC) of composite resin at different depths of simulated immature root canals using light-transmitting plastic post (LTPP) and three different light sources. METHODOLOGY Composite resin was packed into 60 black plastic cylinders 12mm in length with 4mm internal diameters to simulate immature root canals. LTPPs were inserted into half of the simulated canals and the other half acted as controls. Both the simulated canals with LTPPs and the controls were divided into three groups of 10, and each group was cured using either a quartz-tungsten-halogen (QTH), light-emitting diode (LED), or plasma arc (PAC) curing unit. Specimens were sectioned in three horizontally 24h after curing to represent cervical, middle, and apical levels. DC for each section of composite resin was measured using a Fourier transform infrared spectrophotometer, and data were analyzed using three-way anova and Tukey tests. RESULTS At the cervical level, no significant differences were found between specimens cured using different light sources or between specimens with and without LTPPs (P>0.05). However, DC was significantly higher in specimens with LTPPs than in those without LTPPs at both the middle and apical levels (P<0.05). The mean DC of all specimens with LTPPs was significantly higher than that of specimens without LTPPs (P<0.05). PAC unit showed lower DC than QTH and LED units at both the middle and apical levels; however, the differences were not statistically significant (P > 0.05). CONCLUSIONS The results of this study suggest that the use of a LTPP increased the DC of composite resin at the middle and apical levels of simulated immature root canals, but that DC was independent of type of light source.