Cumhur Aydin

Is Endodontic Treatment Necessary During Coronectomy Procedure

PURPOSE Close proximity of the inferior alveolar nerve (IAN) to the third molar roots can result in nerve injuries during extraction of third molars. Consequently, it is necessary to determine the relationship of the nerve and roots to avoid damage to the IAN. Computed tomography scans are widely used to determine the correct relationship between the IAN and lower third molars. PATIENTS AND METHODS The study consisted of 10 patients with 16 lower third molars in close relationship with the IAN who were divided into a study group and a control group. The patients in the study group were treated via coronectomies performed with endodontic treatments. The patients in the control group underwent coronectomies without endodontic treatment. The patients were followed up for at least 1 year. RESULTS We had to extract 7 of the roots because of the infection in 8 patients belonging to the study group, which were treated endodontically. Moreover, there were 3 cases of IAN damage because of the extraction in the study group. However, in the control group, no infection was determined and IAN damage was absent. CONCLUSION Coronectomy appears to be a reliable technique to protect the IAN from damage. This procedure has a low incidence of complications. Endodontic treatment does not affect the success of this method according to our results.

Bacterial reduction by extensive versus conservative root canal instrumentation in vitro

Objective. This study aimed to test the hypothesis that aggressive dentin removal through greater-tapered instrumentation reduces the intracanal bacteria more effectively than conservative dimension instrumentation. Material and methods. Twenty extracted human lower premolar teeth were used. After extirpation of the pulps, the teeth were autoclaved and immersed in a broth inoculated with Enterococcus faecalis and incubated for 7 days to allow infection of the dentinal tubules. The teeth were divided into 2 experimental groups, each comprising 10 teeth. The teeth were instrumented either with ProTaper or with Hero Shaper nickel-titanium rotary instrumentation techniques. It was calculated that ProTaper theoretically has the potential to remove at least twice the dentin volume compared with Hero Shaper. The apical preparation was standardized to file size 30. Saline solution was used for irrigation. Bacteriological samples were taken before and after instrumentation and plated onto tryptic soy agar, and the reduction in numbers was calculated. Results. Both instrumentation techniques significantly reduced the number of bacteria in the root canal (p<0.05). Reduction in absolute bacterial numbers was up to 98%. There was no statistically significant difference between the two techniques. Conclusions. Preparation with an instrumentation technique removing substantial amounts of dentin did not reduce the intracanal bacteria more effectively than a more conservative instrumentation technique.

Solubility and apical sealing characteristics of a new calcium silicate-based root canal sealer in comparison to calcium hydroxide-, methacrylate resin- and epoxy resin-based sealers.

Abstract Aim. To assess and compare the water sorption, solubility and apical sealing ability of iRoot SP and three other widely used root canal sealers. Materials and methods. Solubility was assessed by immersing standardized samples of calcium silicate- (iRoot SP), calcium hydroxide- (Sealapex), methacrylate resin- (EndoREZ) and epoxy resin- (AH Plus) based sealers in distilled water and measuring weight gain and weight loss at 6 h, 24 h and daily for 14 days. Roots of extracted mandibular premolars (n = 80) were prepared with 0.04-taper nickel-titanium rotary files to a final size 40. Roots were then randomly divided into four experimental groups (n = 18) and two control groups (n = 4), root canal sealers were applied and apical leakage was assessed using the fluid filtration method. Data was analyzed using Kruskal Wallis analysis of variance and Mann-Whitney U-tests, with the level of significance set at p ≤ 0.05. Results. EndoREZ exhibited the highest water sorption, followed by iRoot SP, Sealapex and AH Plus. Sealapex exhibited significantly higher solubility than the other sealers, whereas no significant differences in solubility levels were observed between the other three sealers tested. AH Plus exhibited significantly lower microleakage than Sealapex and EndoREZ, whereas no difference in microleakage was found between AH Plus and iRoot SP. Conclusions. In view of the study findings, all tested sealers except Sealapex met the ANSI/ADAs requirements for solubility and no difference was found between AH Plus and iRoot SP in terms of apical sealing ability.

Comparison of Cyclic Fatigue Resistance of Three Different Rotary Nickel-Titanium Instruments Designed for Retreatment

INTRODUCTION A number of rotary nickel-titanium (NiTi) systems have been developed to provide better, faster, and easier cleaning and shaping of the root canal system, and recently, rotary NiTi systems designed for root canal retreatment have been introduced. Because the main problem with the rotary NiTi files is fracture, the aim of this study was to compare the cyclic fatigue resistance of 3 different rotary NiTi systems designed for root canal retreatment. METHODS Total of 60 instruments of 3 different rotary NiTi systems designed for root canal retreatment were used in this study. Twenty R-Endo R3, 20 ProTaper D3, and 20 Mtwo R (Retreatment) 25.05 instruments were tested. Cyclic fatigue testing of instruments was performed by using a device that allowed the instruments to rotate freely inside an artificial canal. Each instrument was rotated until fracture occurred, and the number of cycles to fracture for each instrument was calculated. Representative samples were also evaluated under a scanning electron microscope to confirm the fracture was flexural. Data were analyzed by using 1-way analysis of variance test. RESULTS R-Endo R3 instruments showed better cyclic fatigue resistance than ProTaper D3 and Mtwo R 25.05 instruments, and the difference was statistically significant (P < .05). There was no significant difference between ProTaper D3 and Mtwo R 25.05 groups. CONCLUSIONS The R-Endo R3 instruments were more resistant to fatigue failure than ProTaper D3 and Mtwo R 25.05.

Structural effects of sodium hypochlorite solution on RaCe rotary nickel-titanium instruments: an atomic force microscopy study

OBJECTIVE The aim of this study was to investigate the effect of sodium hypochlorite immersion on the surface characteristics of RaCe rotary nickel-titanium instruments using atomic force microscopy (AFM). STUDY DESIGN Four new RaCe instruments were used in this study (two 30.06 and two 30.02). One 30.06 and one 30.02 instrument were immersed in sodium hypochlorite solution for 5 min. Surface topography of the instruments was evaluated using the AFM. The instruments were analyzed on 11 points along a 3-mm section. Root mean square (RMS) values were used to compare the topographic deviations. The data were analyzed using Student t test. RESULTS Mean RMS values for NaOCl measurements were higher than the measurements on new files, and the difference was statistically significant (P < .01). CONCLUSION The AFM results show that NaOCl causes deterioration on the surface of RaCe instruments and should be used with care during clinical use because of the risk of unexpected failure.

Comparison of shaping ability of RaCe and Hero Shaper instruments in simulated curved canals

OBJECTIVE This study compared the shaping ability of Hero Shaper and RaCe instruments in simulated curved canals. STUDY DESIGN Forty simulated canals in resin blocks were divided into 2 experimental groups, each comprising 20 resin blocks, and prepared with Hero Shaper and RaCe using the crown-down technique. Preoperative and postoperative photographs, recorded using a digital camera, were superimposed and aberrations were recorded. Material removal was measured at 10 points beginning 1 mm from the end point of the canal. Mean total widths, outer and inner width measurements, were determined on each central canal path and differences were statistically analyzed using Student t test. RESULTS The Hero Shaper and RaCe instruments removed almost the same amount of material from the inner side of the simulated canals. On the outer canal wall, the RaCe instruments removed significantly more material from the first 3 mm (P < .05). However, Hero Shaper removed more material from the middle and coronal aspects of the canal and the differences were statistically significant (P < .01). CONCLUSION RaCe instruments removed more resin from the outside of the curvature at the apical thirds, while Hero Shaper removed more material from the middle and coronal thirds on the outer canal wall. Hero Shaper instruments showed better centering ability and fewer aberrations. No instrument fractures but some deformations were observed for both systems.

Comparison of cyclic fatigue resistance of used and new RaCe instruments

OBJECTIVE The aim of this study was to evaluate cyclic fatigue resistance of used and new RaCe rotary nickel-titanium instruments. STUDY DESIGN Forty RaCe (FKG Dentaire, La-Chaux-de-Fonds, Switzerland) instruments of sizes 30/.06, 30/.02, 25/.04, and 25/.02 were selected and divided into 2 groups: group A = 20 new instruments; group B = 20 used instruments. In group B, each instrument was used for shaping 5 curved molar root canals. Cyclic fatigue testing of new and used instruments was performed using a device that allowed the instruments to rotate freely inside a stainless steel artificial canal. Data were analyzed using t test to determine any statistical significance between used and new instruments of the same file size. RESULTS For all sizes, new instruments were more resistant to failure then the used ones (P < .05). A reduction in lifespan was observed ranging from 18% (30/.06) to 51% (25/.02). CONCLUSION The results showed that clinical use significantly reduced cyclic fatigue resistance of RaCe rotary instruments compared with new ones.

Cyclic fatigue resistance of new and used Mtwo rotary nickel‐titanium instruments in two different radii of curvature

The fracture of nickel-titanium rotary instruments is a serious problem that can jeopardise the outcome of root canal treatment. The aim of this study was to compare the cyclic fatigue resistance of new and used Mtwo rotary nickel-titanium instruments in artificial canals with two different radii of curvature. Four hundred and twenty Mtwo instruments were used in the present study. Thirty new and 30 used instruments of each size were tested for cyclic fatigue in artificial canals with radii of curvature of 5 or 10 mm. Each instrument was rotated until fracture occurred and the number of cycles to fracture was calculated by multiplying time to fracture and rotational speed. Data were analysed using a t-test. According to the results of the study, radius of curvature was an important factor on cyclic fatigue resistance and clinical use significantly reduced the instrument lifespan.