Gamze Topçuoğlu

The effect of medicaments used in endodontic regeneration technique on the dislocation resistance of mineral trioxide aggregate to root canal dentin.

INTRODUCTION The aim of this study was to evaluate the effect of calcium hydroxide (CH) and antibiotic pastes, including a mixture of metronidazole and ciprofloxacin, with and without minocycline or cefaclor, on the dislocation resistance of mineral trioxide aggregate (MTA) to root dentin. METHODS Eighty single-rooted human mandibular premolars were selected. The teeth were prepared by using the ProTaper system. The prepared teeth were then instrumented to a #6 Peeso reamer to obtain a standard internal diameter of 1.5 mm. The reamers were passed 1 mm beyond apex to simulate immature teeth. The specimens were then randomly divided into a control group (no intracanal medicament was used) and 4 experimental groups that were treated with an intracanal medicament: CH, double antibiotic paste (DAP) with metronidazole and ciprofloxacin, triple antibiotic paste (TAP) with minocycline, or TAP with cefaclor (n = 16). After 3 weeks, the medicaments were removed, and approximately 3 mm of MTA was placed in the coronal third of the canals. A push-out test was used to measure the dislocation resistance between the root dentin and MTA. Data were analyzed by using one-way analysis of variance and Tukey post hoc tests. RESULTS The dislocation resistance values of the CH, TAP with minocycline, and TAP with cefaclor groups were similar to those of the control group (P > .05), whereas the DAP group had the lowest dislocation resistance when compared with the other groups (P < .05). Overall, there was a predominance of cohesive failures between root dentin and MTA. CONCLUSIONS The results of this study indicate that the application of DAP as an intracanal medicament reduced the dislocation resistance of MTA to root dentin.

Effect of glide path and apical preparation size on the incidence of apical crack during the canal preparation using Reciproc, WaveOne, and ProTaper Next systems in curved root canals: A stereomicroscope study

This study evaluated the effect of creating a glide path and apical preparation size on the incidence of apical cracks during canal preparation in mandibular molar teeth with curved canals. One hundred and forty extracted teeth were used. The teeth were randomly assigned to one control group or six experimental groups (n = 20 per group) for canal preparation. No preparation was performed on teeth in the control group. In three of the six experimental groups, a glide path was not created; a glide path was created on the curved mesial canals of all teeth in the remaining three experimental groups. All teeth in experimental groups were then instrumented with the following systems: Reciproc, WaveOne (WO), and ProTaper Next (PTN). Digital images of the apical root surfaces of these teeth were recorded before preparation, after instrumentation with size 25 files, and after instrumentation with size 40 files. The images were then inspected for the presence of any new apical cracks and propagation. There was no significant difference between the experimental groups during canal preparation using size 25 files (p > 0.05). Reciproc and WO caused more new apical cracks than did PTN during canal preparation using size 40 files (p < 0.05). However, canal preparation using size 40 files did not cause propagation of existing cracks (p > 0.05). Performing a glide path prior to canal preparation did not change the incidence of apical crack during preparation. Additionally, increasing apical preparation size may increase the incidence of apical crack during canal preparation. SCANNING 38:585-590, 2016.

The effect of various backfilling techniques on the fracture resistance of simulated immature teeth performed apical plug with Biodentine

AIM To evaluate the fracture resistance of simulated immature teeth that had been backfilled using different materials after using Biodentine as the apical plug material. DESIGN Seventy-five single-rooted teeth were divided into five groups (n = 15). The 15 teeth in group 1 served as a negative control group and received no treatment. The remaining 60 teeth were instrumented to a #6 Peeso reamer to obtain a standard internal diameter of 1.5 mm. The apical 4 mm of 60 teeth was filled with Biodentine. The backfilling was then performed on each group as follows: group 2--no backfilling (positive control), group 3--gutta-percha, group 4--fiber post, and group 5--Biodentine. Specimens were then subjected to fracture testing. The force required to fracture each specimen was recorded, and the data were statistically analyzed. RESULTS The mean fracture values of groups 1 and 4 were significantly higher than groups 2, 3, and 5 (P < 0.05). The values of groups 3 and 5 were significantly higher than group 2 (P < 0.05). CONCLUSIONS The backfilling with fiber post after an apical Biodentine plug provided the highest fracture resistance among all experimental groups.

Effectiveness of different irrigation procedures for removal of dentin debris from a simulated internal resorption cavity

Purpose The aim of this study was to compare the efficiency of different final irrigation techniques to remove artificially placed dentinal debris from a simulated internal root resorption (IRR) cavity. Methods Seventy teeth were prepared using the ProTaper system. The roots were then split longitudinally into two halves, in each of which standardized IRR cavities were prepared. Five teeth were set aside to serve as negative control group. Each cavity of the remaining 65 teeth was filled with dentin debris mixed with 2.5% NaOCl. Another 5 teeth (positive control) were not subjected to the debris removal procedure. Sixty teeth were randomly divided into four experimental groups (n = 15), according to the final irrigation technique used: conventional syringe irrigation (CSI), the Self-Adjusting File (SAF), passive ultrasonic irrigation (PUI), and the EndoActivator (EA). Ten milliliters of 2.5% NaOCl was used during the debris removal procedure. The root halves were disassembled, and the amount of remaining debris was evaluated under a stereomicroscope at 30x magnification. Results SAF and PUI removed debris significantly better than CSI and EA (P<.05). CSI was the least effective in debris removal (p<0.05). Conclusions None of the irrigation techniques used was able to completely remove debris from simulated IRR cavities.

Effectiveness of conventional syringe irrigation, vibringe, and passive ultrasonic irrigation performed with different irrigation regimes in removing triple antibiotic paste from simulated root canal irregularities

Background: This study evaluated the efficacy of a sonic device (Vibringe), passive ultrasonic irrigation (PUI), and conventional syringe irrigation (CSI) in the removal of triple antibiotic paste (TAP) from artificial standardized grooves in the apical and coronal thirds of a root canal. Materials and Methods: One-hundred eighteen root canals were prepared using the ProTaper system. The roots were split longitudinally, and a standardized groove was prepared in the apical and coronal parts of one segment. The grooves were filled with TAP, and the roots were reassembled. The roots were randomly divided into nine experimental groups and two control groups, according to the following irrigation methods: (1) CSI with sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA), (2) CSI/EDTA, (3) CSI/NaOCl, (4) PUI/NaOCl + EDTA, (5) PUI/EDTA, (6) PUI/NaOCl, (7) Vibringe/NaOCl + EDTA, (8) Vibringe/EDTA, and (9) Vibringe/NaOCl. The amount of remaining medicament was evaluated under a stereomicroscope. Results: In the apical third, Vibringe/NaOCl + EDTA and PUI/NaOCl + EDTA were superior to the other groups (P < 0.05); there was no significant difference between the other experimental groups (P > 0.05). In the coronal third, there was no significant difference between the experimental groups (P > 0.05). Conclusions: The use of the NaOCl/EDTA combination together with sonic or ultrasonic agitation improved the removal of TAP from the apical third.

Evaluation of apically extruded debris during root canal preparation in primary molar teeth using three different rotary systems and hand files

AIM To assess the amount of debris extruded apically during root canal preparation using various nickel titanium instrumentation systems and hand files in primary molar teeth. DESIGN Sixty extracted primary first mandibular molar human teeth were randomly assigned to four groups (n = 15 teeth for each group). The canals were then instrumented with the following instrument systems: Revo-S, Mtwo, ProTaper Next, and hand files. Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. The data were analyzed using one-way analysis of variance (anova) and Tukeys post hoc tests. RESULTS ProTaper Next files were associated with less apically extruded debris than the Mtwo, Revo-S, and hand files (P < 0.05). Hand files extruded more debris than Mtwo and Revo-S instruments (P < 0.05), but there was no significant difference found between the Mtwo and Revo-S instruments (P > 0.05). CONCLUSIONS All instruments were associated with apical extrusion of debris. ProTaper Next files caused less debris extrusion compared to the other systems used.

The bond strength of adhesive resins to AH plus contaminated dentin cleaned by various gutta-percha solvents

The optimal bonding of adhesives to dentin requires the sealer to be completely removed from dentinal walls. The aim of this study was to investigate the effect of different cleaning procedures using gutta-percha solvents on bond strength of adhesive resins to AH Plus contaminated dentin (APCD). The pulp chamber dentin surfaces were contaminated with AH Plus and cleaned with five different techniques (dry cotton, chloroform, orange oil, eucalyptol, and ethanol). Then, Clearfil SE Bond (CSE) (Kuraray), and Tetric N Bond (TNB) (Ivoclar Vivadent) were applied and filled with a composite resin. The serial sticks (1 × 1 mm) were obtained and tested for microtensile bond strength. Scanning electron microscopy (SEM) was used for analysis of debonded surfaces. Ethanol exhibited the highest bond strength to APCD followed by dry cotton. There was no statistically significant difference between ethanol and dry cotton (p > 0.05). Eucalyptol showed the lowest bond strength to APCD and statistically significant differences (p < 0.05) in comparison with other groups. APCD reduced the bond strength of all adhesive resins. Dry cotton, ethanol, and chloroform were the most suitable techniques when used with CSE together, whereas ethanol was best with TNB.

Postoperative pain after the removal of root canal filling material using different techniques in teeth with failed root canal therapy: a randomized clinical trial

Abstract Objectives: This study evaluated the intensity and duration of postoperative pain after the removal of root canal filling material in retreatment procedures of upper incisor teeth with chronic apical periodontitis, using different techniques. Materials and methods: One hundred and thirty-five patients requiring retreatment of upper incisor teeth with chronic apical periodontitis were included in the study. The patients were assigned to three groups of 45 patients, according to the method used to remove old canal filling material. In group 1, canal filling material was removed using hand files. In group 2, the canal filling material was removed with ProTaper universal retreatment (PTUR) instruments. In group 3, Reciproc instruments were used to remove canal filling material. Teeth were then medicated with calcium hydroxide and sealed using temporary filling material. The presence of postoperative pain was assessed after 6, 12, 24, 48 and 72 h, 7 days, and finally after 10 days. Results: In all time intervals, except for 72 h, 7 days and 10 days, group 1 participants reported more intense postoperative pain than those in groups 2 and 3 (p = 0.02). In all time intervals, there was no difference in the pain scores between groups 2 and 3 (p = 0.08). In all groups, the intensity of postoperative pain decreased over time. The required time to remove canal filling material was less for the Reciproc group compared to the hand and ProTaper retreatment groups (p = 0.032). Conclusions: Hand files caused greater postoperative pain after non-surgical endodontic retreatment (NSER) of upper incisor teeth with chronic apical periodontitis compared to the ProTaper retreatment and Reciproc files.

The Effect of Apical Positive and Negative Pressure Irrigation Methods on Postoperative Pain in Mandibular Molar Teeth with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

Introduction: This study compared the effect of conventional needle irrigation (positive pressure) and the EndoVac system (Discus Dental, Culver City, CA) (negative pressure) on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis. Methods: One hundred sixteen patients with symptomatic irreversible pulpitis were selected. Teeth were randomly assigned to 2 groups according to the irrigation methods performed during root canal preparation. In group 1, root canal irrigation was performed using a syringe and a 31‐G side‐port needle (NaviTip; Ultradent, South Jordan, UT). In group 2, the EndoVac system was used for irrigation. Teeth were then obturated with gutta‐percha and a resin‐based sealer using the cold lateral compaction technique. The presence of postoperative pain was assessed after 6, 24, 48, and 72 hours and 1 week. Results: At 6‐, 24‐, and 48‐hour time intervals, group 1 patients reported more intense postoperative pain than patients in group 2 (P < .05). There was no significant difference between the 2 groups at the other time intervals (P > .05), and in both groups the intensity of postoperative pain decreased over time. Conclusions: Apical positive pressure irrigation caused greater postoperative pain after endodontic therapy of mandibular molar teeth with symptomatic irreversible pulpitis compared with the apical negative pressure irrigation system.

The Effect of Different Irrigation Agitation Techniques on Postoperative Pain in Mandibular Molar Teeth with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

Introduction This study compared the effect of several final irrigation agitation techniques (sonic agitation, passive ultrasonic irrigation, and manual dynamic agitation [MDA]) in comparison with needle irrigation on postoperative pain in mandibular molar teeth with symptomatic irreversible pulpitis. Methods One hundred sixty‐eight patients with a single tooth diagnosed as symptomatic irreversible pulpitis were selected. Teeth were randomly assigned to 4 groups based on the final irrigation methods. In group 1 (needle irrigation), irrigation was conducted without agitation with a side‐port needle; in group 2, sonic agitation was used; in group 3, passive ultrasonic irrigation was used; and in group 4, MDA was used. Teeth were then obturated with gutta‐percha and a resin‐based sealer using the cold lateral compaction technique. The presence of postoperative pain was assessed after 6, 24, 48, and 72 hours and 1 week. Results At the 6‐ and 24‐hour time intervals, group 4 patients reported more intense postoperative pain than those patients in groups 1, 2, and 3 (P < .05). There was no significant difference among the groups at the other time intervals (P > .05), and in all groups the intensity of postoperative pain decreased over time. Conclusions MDA caused greater postoperative pain after endodontic therapy in mandibular molar teeth with symptomatic irreversible pulpitis compared with the other methods in the first 24 hours.