Emre Altundasar

Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles

The purpose of this study was to compare the amount of apically extruded irrigant using 2 Ni-Ti rotary systems. Forty mandibular premolars with single canals were randomly assigned into 4 groups. Flower arrangement foam cubes were weighed with a precision balance before being attached to the apical portions of all teeth. In group 1, preparation was completed with ProTaper files. In group 2 canals were prepared with RaCe files. In groups 1 and 2, the irrigant was delivered with a 30-gauge conventional dental needle. In groups 3 and 4, teeth were prepared as in groups 1 and 2 with the exception that the irrigant was delivered with a side-vented irrigation needle. The weight of the extruded material (irrigant and debris) for each group was calculated by comparing the pre- and postinstrumentation weights of the foams used for periapical modeling. Obtained data were analyzed by Kruskal-Wallis and Mann-Whitney U tests, with P equals .05 as the level for statistical significance. ProTaper files used with regular needle irrigation had the highest fluid extrusion. The lowest irrigant extrusion was observed with the RaCe system combined with a side-vented irrigation needle. Within the limitations of this study, it can be concluded that irrigation needle and rotary instruments have an effect on the amount of extruded root canal irrigant.

Management of a perforating internal resorptive defect with mineral trioxide aggregate: a case report.

INTRODUCTION A radicular perforation caused by an inflammatory internal root resorption was present in a maxillary lateral incisor. METHODS The root canal preparation was completed with hand files and thorough irrigation. Calcium hydroxide was placed as a temporary dressing for 10 days. At the second visit, the root canal with resorption lacuna was filled with warm vertical compaction of gutta-percha. The coronal access was restored with composite resin. A surgical flap was elevated to repair the resorption defect with gray mineral trioxide aggregate. The bony defect adjacent to the perforated lesion was filled with Unigraft (Unicare Biomedical, Laguna Hills, CA). RESULTS The tooth was in function with satisfactory clinical and radiographic results after 48 months. CONCLUSIONS According to the long term results of this case, successful sealing of a perforating defect is possible with mineral trioxide aggregate.

The effect of master point taper on bond strength and apical sealing ability of different root canal sealers.

OBJECTIVE The aim of this study was to compare the bond strength and apical sealing ability of master gutta-percha points with different tapers, as used in conjunction with different root canal sealers. STUDY DESIGN Roots of extracted human maxillary incisors (n = 135) were prepared with 0.06-taper nickel-titanium rotary files to final size 30. The roots were then randomly divided into 3 groups according to the root canal sealer used: 1) AH Plus; 2) Ketac-Endo; and 3) EndoREZ. Each sealer was combined with 1 of the following obturation techniques: 0.02-tapered gutta-percha master cone using lateral condensation, 0.04-tapered gutta-percha master cone using lateral condensation, or 0.06-tapered gutta-percha as a single cone. The bond strength and apical sealing ability were measured with the push-out test and dye penetration test, respectively. The data were statistically analyzed by using Kruskal-Wallis test with Bonferroni correction at P = .05. RESULTS Both the taper of the gutta-percha point and root canal sealers had significant effects on push-out bond strength (P < .001). According to the microleakage data, AH Plus exhibited significantly lower overall leakage, whereas no difference was found between master cone points (P = .093). CONCLUSIONS The use of matched-taper gutta-percha points in canals prepared with tapered rotary instruments may be advocated to improve bond strength ability of root canal filling material. Furthermore, AH Plus may be preferable to EndoRez and Ketac-Endo in terms of improved sealing and bonding quality of filling material.

Effect of EDTA, Sodium Hypochlorite, and Chlorhexidine Gluconate with or without Surface Modifiers on Dentin Microhardness

INTRODUCTION This study aimed to evaluate the effects of root canal irrigants on the microhardness of root canal dentin in the presence and absence of surface-modifying agents. METHODS Forty-eight root halves were prepared by longitudinal splitting of the distal roots of 24 freshly extracted mandibular human third molars and embedded in autopolymerizing acrylic resin, leaving the dentin surface exposed. After polishing, the microhardness values of the untreated dentin surfaces were recorded by using Vickers tester at the mid-root level. The root halves were randomly assigned to 6 groups composed of 8 samples each and treated for 5 minutes with one of the following irrigants: 17% EDTA, REDTA, 2% chlorhexidine gluconate (CHX), 2% CHX with surface modifiers (CHX-Plus), 6% NaOCl, or 6% NaOCl with surface modifiers (Chlor-XTRA). After surface treatment, dentin microhardness values were recorded at close proximity to the initial indentation areas. Experimental data were statistically analyzed by using the t test and one-way analysis of variance, followed by Tukey honestly significant difference test at α = 0.05. RESULTS EDTA, REDTA, NaOCl, and Chlor-XTRA significantly decreased the microhardness of root dentin compared with intact controls (P < .05). CONCLUSIONS The addition of surface modifiers to the irrigants did not affect the microhardness of the samples.

Effect of different intraorifice barriers on the fracture resistance of roots obturated with Resilon or gutta-percha.

INTRODUCTION This study investigated and compared the root reinforcement potential of 3 different intraorifice barriers (mineral trioxide aggregate [MTA], resin-modified glass ionomer cement [Vitremer], and fiber-reinforced composite [FRC]) placed over root canals obturated with gutta-percha or Resilon. METHODS Crowns of 80 extracted human mandibular premolars were sectioned off to obtain 14-mm-long root specimens. After preparation of root canals with nickel-titanium rotary files, the roots were obturated with either the Resilon/Epiphany system or gutta-percha + AH Plus sealer. In both obturation groups, specimens were further subgrouped with respect to the intraorifice barrier material placed after removal of 3-mm coronal portion of the root fillings: (1) MTA, (2) Vitremer, and (3) FRC. The specimens were loaded vertically at 1 mm/min crosshead speed until vertical root fracture occurred. Results were evaluated statistically with two-way analysis of variance and Tukey tests. RESULTS Fracture resistance of roots was significantly affected by the type of intraorifice barrier (P < .05), but not by the type of obturation system used (P > .05). CONCLUSIONS The use of Vitremer and FRC significantly improved the fracture resistance, whereas MTA did not exhibit any reinforcing effect as an intraorifice barrier.

Effect of bleaching agents on sealing properties of different intraorifice barriers and root filling materials

Objective: To evaluate the effect of intracoronal bleaching agents on the sealing properties of different intraorifice barriers and root filling materials. Study Design: The root canals of extracted human premolars (n=180) were prepared by using System GT rotary files and filled with either gutta-percha+AH Plus or Resilon+Epiphany sealer. In both groups, the coronal 3mm of root filling was removed and replaced with one of the following materials applied as intraorifice barriers (n=30/group): 1. ProProot-MTA; 2. Conventional Glass ionomer cement; and 3. Hybrid resin composite. In each subgroup, intracoronal bleaching was performed using either sodium perborate with distilled water or 35% hydrogen peroxide gel for 3 weeks. The leakage of specimens was measured using fluid-filtration and dye penetration tests. The data were analyzed statistically with One-way ANOVA, Repeated Measures t-test and Independent Samples t-test (p=0.05). Results: The fluid conductance values of the test groups were not influenced by the type of the bleaching agent, the intraorifice barrier, or the root filling material (all p>0.05). However, the extent of dye leakage was significantly affected by the type of intraorifice barrier material (p<0.05), which showed the following statistical ranking: glass ionomer cement > resin composite > ProRoot-MTA (p<0.05). Conclusions: The effect of 35% hydrogen peroxide gel or sodium perborate/distilled water on the sealing properties of tested intraorifice barriers and root filling materials varied conforming leakage assessment. These properties were not affected by using fluid filtration test, while the glass ionomer barrier showed the greatest amount of dye leakage in both gutta-percha and Resilon root-filled teeth. Key words:Tooth Bleaching, root canal filling materials, glass ionomer cement, mineral trioxide aggregate, micro leakage

The importance of soft tissue examination in post-traumatic decision-making: A case report

Dental and facial traumas involving teeth and supporting tissues are common sports-related injuries. In this case report treatment of a 23-year-old student who had been elbowed by an opponent player during a basketball game, which caused oblique fractures on both maxillary incisor teeth is presented. The patient presented 17 days following trauma having completed full recovery of soft tissues. A fragment of upper incisor tooth had been embedded in lower lip at the time of trauma, which was covered by healing tissues. At the 1 month control the patient complained of a hard structure in his lower lip. The elusive broken fragment was revealed by a radiograph and then removed surgically. This case report is a good example of the importance of the training of general dentists about sports-related traumatic injuries as well as emphasising the importance of the use of mouthguards during contact sports.

Sealing Properties of Different Obturation Systems Applied over Apically Fractured Rotary Nickel–Titanium Files

This study investigated the sealing properties of cold laterally compacted gutta percha and Thermafil applied over different apically fractured rotary nickel-titanium files. Extracted human premolars were prepared by using ProTaper (Dentsply-Maillefer, Ballaigues, Switzerland) or ProFile (Dentsply-Maillefer) systems (n = 40 for each), after which half of the specimens in each subgroup were subjected to instrument separation at the apical level. For each rotary system, roots with and without apically separated instruments (n = 10 for each) were filled with the two obturation systems and the levels of fluid conductance were recorded. In the absence of instrument separation, the leakage of Thermafil (Dentsply Maillefer) was significantly less than that achieved with cold lateral compaction (p < 0.05), whereas Thermafil yielded similar amounts of leakage in roots prepared with the ProTaper and ProFile systems (p < 0.05). Roots with fractured ProTaper instruments displayed significantly less leakage than those filled without ProTaper fragments, regardless of the obturation technique used (p < 0.05). However, intracanal separation of ProFile instruments increased the leakage (p < 0.05), but the obturation method did not influence fluid conduction (p > 0.05). These results reveal the variability of leakage associated with apically fractured ProFile and ProTaper files and different obturation methods used.

Influence of different final irrigation regimens and various endodontic filling materials on vertical root fracture resistance

AIM The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture (VRF) resistance. MATERIALS AND METHODS Eighty human teeth were prepared then assigned into two groups (n = 40) according to the final irrigations. G1: 5 mL, 5.25% sodium hypochlorite (NaOCl), G2: 5 mL, 2% chlorhexidine gluconate (CHX). Each group was assigned into four subgroups according to the obturation system used (n = 10): A: iRoot SP/single gutta-percha cone (SGP), B: Only iRoot SP, C: Mineral trioxide aggregate (MTA)-Fillapex/SGP, D: AH26/SGP. The specimens were embedded in acrylic molds and subjected to compressive loading at a rate of 1 mm min until VRF occurred. Data were analyzed via three-way ANOVA tests. RESULTS The statistically significant difference was found among groups (P < 0.05). The G1A and G1B and G1D revealed significantly higher-VRF values than G1C (P = 0.023). The roots filled with MTA-Fillapex revealed lower-VRF values than the other subgroups (P < 0.05). Groups irrigated with NaOCl had significantly lower-VRF values than the groups irrigated with CHX (P < 0.05). CONCLUSION Final irrigation regimens could alter VRF resistance of root canals filled with different obturation technique and root canal sealers.