Jale Tanalp

Photodynamic therapy in dentistry: a literature review

ObjectivesThe purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry.Materials and methodsA review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords “photodynamic therapy”, “dentistry”, “periodontology”, “oral surgery”, and “endodontics”. It is anticipated that this overview will create a specific picture in the practitioner’s mind regarding the current status and use of PDT.ResultsIn spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry.ConclusionPDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections.Clinical relevanceOral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.

Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts

BACKGROUND   The purpose of this study was to compare the fracture resistances of immature teeth treated with MTA along with root canal obturation methods using AH Plus, MetaSEAL, MTA Fillapex sealers + lateral compaction technique, and Unicore quartz fiber posts. MATERIALS AND METHODS   Fifty single-rooted maxillary anterior teeth were divided into five groups. The crowns were dissected and root canals were enlarged. #6 Peeso reamers were allowed to protrude 1 mm. beyond the apex to simulate immature teeth. The apical 4-5 mm of each tooth was filled using Angelus white MTA. The remaining portions of canals were obturated as follows: Group 1: No backfilling (control), Group 2: AH Plus + gutta-percha, lateral compaction, Group 3: MetaSEAL + gutta-percha, lateral compaction, Group 4: MTA Fillapex + gutta-percha, lateral compaction, Group 5: UniCore Fiber posts luted using PermaFlo DC. The specimens were embedded into self-curing acrylic poured into identical cylinders which were mounted on a jig providing a 45° angle. A compressive load increasing at 1 mm min(-1) was applied and the maximum load at which fracture occurred was recorded. Statistical analysis was performed using Kruskal-Wallis and Dunns multiple tests. RESULTS   The highest fracture resistance was obtained with Group 5 (Fiber posts) whereas Group 4 (MTA Fillapex) yielded the lowest values. The mean fracture resistance value of Group 2 (AH Plus) was significantly higher than Group 4 (MTA Fillapex) (P = 0.001). The mean fracture value of Group 5 (Fiber posts) was significantly higher than Group 2 (AH Plus), Group 3 (MetaSEAL), and Group 4 (MTA Fillapex) (P = 0.02, 0.004, and 0.0001, respectively). CONCLUSION   Within the limitations of this study, UniCore quartz fiber posts provided the highest resistance. This methodology may specifically be advantageous for teeth with arrest of development at early stages, as these teeth are more susceptible to fracture owing to their excessively weak dentinal walls.

Microleakage of various root filling systems by glucose filtration analysis

OBJECTIVE The aim of this study was to evaluate the microleakage of Resilon + Epiphany, EndoRez, Activ GP, and conventional AH Plus + gutta-percha technique using the glucose filtration model. STUDY DESIGN One hundred twenty maxillary incisors were divided into 5 experimental and 2 control groups. After root canal shaping, the experimental groups were filled with AH Plus + gutta-percha (lateral compaction), Resilon + Epiphany (lateral compaction), AH Plus + Protapers proprietory cone, EndoRez + sealer, or Activ GP + sealer). The specimens were mounted on a glucose model and samples were taken for 3 weeks for leakage measurement. RESULTS No statistically significant difference was observed between the leakage of all groups at the 3 testing periods (P > .05). CONCLUSION The filling materials with the monoblock concept do not seem to be superior to the conventional AH Plus + gutta-percha system regarding microleakage.

The Effect of Endodontic Irrigants on the Microtensile Bond Strength of Dentin Adhesives

INTRODUCTION The purpose of this study was to evaluate the microtensile bond strength of a total etch (XP-Bond) and a self-etch (Clearfil SE Bond) adhesive system to dentine surfaces treated using endodontic irrigants. METHODS Twenty-four freshly extracted third molars were used. After creating a smear layer on the coronal midthird portion of the crowns, the teeth were divided into three groups and surfaces were irrigated with distilled water, 5.25% NaOCl + 17% EDTA, and 1.3% NaOCl + BioPure MTAD, respectively. Each group was divided into two subgroups, and a self-etching adhesive and an etch-and-rinse adhesive were applied respectively. The teeth were restored with a composite material and sectioned to produce sticks for microtensile bond testing. RESULTS The microtensile bond strength of the MTAD + Clearfil SE group was found to be significantly lower than the microtensile bond strength of the distilled water + Clearfil SE Bond group and the NaOCl, EDTA, + Clearfil SE Bond group (p = 0.0001, p = 0.009). CONCLUSIONS Because of the significant reduction of Clearfil SE Bond to coronal dentine after MTAD application, an etch-and rinse adhesive such as XP-Bond may be preferred if this irrigant has been chosen during endodontic treatment.

Comparison of the Radiopacities of Different Root-End Filling and Repair Materials

This study evaluated the radiopacity of 3 repair materials, Biodentine, MM-MTA, and MTA Angelus. Standardized cylindrical rings were prepared. Samples of Biodentine MM-MTA and MTA Angelus were prepared (n = 10 in each group), filled into the rings, and preserved at 37°C until setting. A 1 mm thick dentin slice was used as control. All set specimens were removed and radiographed along with the dentine slice and a graduated aluminium step wedge. Digital images were transferred to the computer using a software. The radiographic densities of the specimens were determined, and the values were converted into millimetres of aluminium (mm Al). One-way ANOVA was used for intergroup comparison, whereas Tukey HSD test was used for detecting the group with the difference. The mean radiopacities of Biodentine, MTA Angelus, and MM-MTA were 2.8 ± 0.48, 4.72 ± 0.45, and 5.18 ± 0.51 mm Al, respectively. The radiopacity of Biodentine was significantly lower compared to other materials (P = 0.001), whereas no significant difference was noted between MTA Angelus and MM-MTA (P = 0.109). All materials had significantly higher radiopacities compared to dentine. The relatively lower radiopacity of Biodentine can be improved to achieve more reliable results in procedures such as retrograde fillings.

An overview of clinical studies on fiber post systems.

Intraradicular posts are useful adjuncts in the restoration of endodontically treated teeth. These systems have undergone a significant evolution in recent years, and fiber-reinforced systems have started to be incorporated into routine clinical care more frequently. Despite the high number of laboratory studies pertaining to the characteristics of fiber posts, clinical studies evaluating their general success rates are rather limited. Since clinical investigations are reliable means to achieve information about the general behavior pattern of materials or techniques, assessment of this data will be beneficial to have a better understanding of fiber-reinforced intraradicular post systems. The purpose of this paper was to make a summary of clinical studies regarding various fiber posts. A PubMed search was conducted and articles dating back to 1990 were retrieved. The paper provides an overview of clinical studies on fiber posts specifically in the last decade as well as commentary analysis.

Evaluation of dental students' perception and self‑confidence levels regarding endodontic treatment

Objectives: The aim of this study was to obtain information about senior dental students′ perceptions and self-confidence levels regarding endodontic practice. Materials and Methods: Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. Results: The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). Conclusions: The results showing students′ lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment.

Cross-sectional evaluation of post-operative pain and flare-ups in endodontic treatments using a type of rotary instruments.

Abstract Aim. The purpose of this clinical study was to evaluate the general incidence of post-operative pain and flare-ups in patients who were endodontically treated by two endodontics specialists using rotary instruments (Hero 642, Micro Mega, France) with the same treatment protocol. Methods. Records of 382 teeth belonging to 268 patients treated by two endodontics specialists during a 6-month period were kept and evaluated. Post-operative pain between treatment visits was categorized using a pre-established scoring system. Ninety-five patients were males, whereas 173 were females. Results. Pulpal necrosis without periapicalpathosiswas determined as the most common indication for endodontic treatment (21.7%) followed by irreversible pulpitis and re-treatment without periapical lesions (18.3%, 18.3%, respectively). The general prevalence of post-operative pain and flare-ups was determined as 8.1%, whereas cases that could be classified as real flare-ups which were severe and required an unscheduled visit (scores 2 and 3) comprised 3.4% of the cases. No statistically significant correlation was determined between gender and post-operative pain and flare-up (p = 0.05). There was a significant correlation between number of appointments and the presence of pain and flare-ups. Teeth undergoing multiple visits had a higher risk of developing post-operative pain and flare-ups compared to those with single appointments with a statistical significance (p = 0.03). Conclusions. Teeth with pre-operative pain were more prone to developingpost-operative pain and discomfort with a statistically significant difference (p = 0.02). While no significant correlation was determined between tooth vitality and pain and flare-ups (p = 0.5), a statistically significant relationship existed between the presence of a periapicalpathosisand post-operative pain and flare-ups. Cases with a periapical lesion had a higher risk of developingpain and flare-upscompared to those with no periapical involvement (p = 0.0001). Future studies may focus on the influence of rotary instrumentation systems in more specific groups of cases. Meanwhile; microbiological as well as psychological aspects of flare-ups are topics that warrant further investigation.

Endodontic and surgical management of a maxillary lateral incisor with type III dens invaginatus: a 12-month follow-up

This article reports the endodontic and surgical management and 12-month follow-up of a maxillary lateral incisor diagnosed as type III dens invaginatus. A 21-year-old male patient presented to our clinics with complaints of pain and swelling in the right maxillary region. Intraoral and radiographical examination disclosed the presence of a peg-shaped maxillary right lateral incisor diagnosed as type III dens invaginatus. Root canal treatment combined with periapical surgery was initiated. After the completion of root canal treatment for both maxillary right central and lateral incisors, periapical surgery was scheduled. During the surgery, periapical granulation tissue was curreted and bovine-derived hydroxil apatite (Unilab-Surgibone, Mississauga, Ontario, Canada) covered with collagen membrane (Unilab-Surgibone) was placed in the resorptive areas. ProRoot MTA (Dentsply, Tulsa, OK) was placed as a root end filling material. Postoperative 12-month follow-up revaled a satisfactory healing process.

Evaluation of Senior Dental Students' General Attitude towards the Use of Rubber Dam: A Survey among Two Dental Schools

The purpose of this study was to evaluate the general attitude of senior dental students towards rubber dam use, specifically focusing on endodontic practices prior to starting to serve community. Questionnaires were distributed to senior year students of a private school and a state school in Istanbul. Questions were asked about areas where the students used rubber dam, its advantages and difficulties, and whether they agreed or disagreed with some aspects of the rubber dam. The private school students rated isolation whereas those of the state school selected prevention of aspiration which the top advantage rubber dam provides. Students of the state school agreed with the opinion that isolation cannot be achieved without rubber dam and it extended the procedure with a significantly higher ratio compared to the private school. Within the limitations of the present study, it can be concluded that the perceptions of dental students on rubber dam needs to be improved and strategies should be developed so that this valuable adjunct will comprise one of the indispensable elements of dental care.