Kadir Tolga Ceyhanli

Efficacy of several techniques for the removal of calcium hydroxide medicament from root canals

AIM To compare the efficacy of several techniques for the removal of calcium hydroxide (Ca(OH)(2)) from root canals. METHODOLOGY The root canals of 24 freshly extracted human mandibular premolars were prepared with ProTaper rotary instruments. The teeth were sectioned longitudinally along the length of the instrumented canals. The roots were subsequently reassembled with wires. After Ca(OH)(2) was placed into the canals, four techniques were used for its removal. In Group I, the teeth were irrigated with 5 mL of 2.5% NaOCl. Group II was treated in the same manner as Group I, but 5 mL of 17% EDTA was used in addition to NaOCl. In Group III, the teeth were irrigated with 5 mL of 2.5% NaOCl and agitated by an ultrasonic unit. In Group IV, the teeth were irrigated with 5 mL of 2.5% NaOCl and a CanalBrush was used to remove the Ca(OH)(2) . The roots were disassembled and digital photographs were taken. Measurements of residual Ca(OH)(2) were performed as percentages of the overall canal surface area. The data was analysed with one-way ANOVA with post hoc Tukey test. RESULTS Significantly less residual material was obtained with a CanalBrush and passive ultrasonic agitation of NaOCl than the other groups (P < 0.05). There was no significant difference between syringe delivery of NaOCl and NaOCl+EDTA (P > 0.05). CONCLUSIONS None of the techniques removed the Ca(OH)(2) dressing completely. CanalBrush and ultrasonic agitation of NaOCl were significantly more effective than irrigant-only techniques.

Comparative micro‐computed tomography evaluation of apical root canal transportation with the use of ProTaper, RaCe and Safesider systems in human teeth

The aim of this study was to compare apical centring ability of nickel titanium (NiTi) ProTaper, RaCe and mainly stainless steel Safesider systems using micro-computed tomography. Thirty freshly extracted mandibular molars with two separate mesial canals and separate foramina were used for the study. Mesial roots were embedded in acrylic resin and instrumented with the ProTaper, RaCe or Safesider systems. Root canal transportation and centring ability of the instruments were evaluated using superimposed micro-computed tomography images of the apical 4 mm of the roots taken at 1 mm intervals. One-way analysis of variance and post hoc Tukeys tests were performed to compare apical transportations. Significant differences were observed between groups at the apical 1, 2 and 3 mm levels (P < 0.05). The reciprocating Safesider system transported root canals significantly more than the other two NiTi systems in the apical 1 mm level (P = 0.001) and more than RaCe system in the apical 2 mm level (P = 0.003). The ProTaper instruments caused more apical root canal transportation than did RaCe instruments at apical 3 mm (P = 0.045). NiTi instrumentation systems showed better centring ability than the mainly stainless steel Safesider system because of the flexible structure of the NiTi alloy.

Push-Out Bond Strength Between Composite Core Buildup and Fiber-Reinforced Posts After Different Surface Treatments

OBJECTIVE The aim of this study was to evaluate the effects of different surface treatments on the pushout bond strength of fiber-reinforced posts to composite resin cores. MATERIALS AND METHODS Twenty-five translucent glass fiber posts were divided into five groups according to surface treatment methods as follows: an untreated control group, a group coated with silicated alumina particles (Co-Jet system, 3M ESPE, St. Paul, MN), and three groups undergoing surface preparation with erbium:yttrium-aluminum-garnet (Er:YAG) laser under three different power settings (150, 300, and 450 mJ at 10 Hz for 60 sec at 100 μs duration). After surface treatment, fiber posts were built up to a dual cure composite resin core. All of the specimens were set and sectioned perpendicularly along the long axis of the post using a saw. Two discs (thickness of 2 mm) were obtained from each post-core sample; finally, each group consisted of 10 samples. For artificial aging, the specimens were stored in water (37°C) for 24 h and subjected to thermal cycling (5000 cycles, 5-55°C, and 30 sec dwell time). Pushout tests were performed using a universal testing machine at a crosshead speed of 0.5 mm/min. The pushout pressure values were measured in MPa and analyzed using one way analysis of variance (ANOVA) and Tukeys honestly significant difference (HSD) post-hoc test (p<0.05). Fiber post surface images were obtained using a scanning electron microscope (SEM). RESULTS The bond strength values ranged between 14,949 and 23,879 MPa. The lowest values were observed in the groups treated with the Er:YAG laser at 150 mJ. Irradiation by the Er:YAG laser at 450 mJ affected the bond strength significantly (p<0.05). After Co-Jet sandblasting, the bond strength increased relatively (19,184 MPa). CONCLUSIONS Er:YAG laser irradiation enhanced the bond strength of fiber-reinforced posts to composite resin cores depending upon the power applied; Co-Jet sandblasting also increased the bond strength.

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.

Bond strength of calcium silicate-based sealers to dentine dried with different techniques.

Objective: To assess the influence of various canal-drying techniques on the push-out bond strength between radicular dentine and both MTA Fillapex and iRoot SP sealers. Materials and Methods: Eighty extracted single-root teeth were instrumented with ProTaper Universal rotary instruments to a size F4. The teeth were randomly assigned to 1 of 4 groups as follows: group 1, excess fluid in the canals was removed using a Luer vacuum adapter; group 2, the canals were dried with a single paper point; group 3, the canals were dried with 3-5 paper points, and group 4, the canals were rinsed with 95% ethanol and then dried with 3-5 paper points. In each group, the specimens were subgrouped according to root canal sealer into either subgroup A (MTA Fillapex) or subgroup B (iRoot SP sealer). Horizontal sections (thickness 1 ± 0.1 mm) were obtained from each specimen and a push-out test was performed using a universal testing machine at a crosshead speed of 1 mm/min on root slices. Statistical analysis was done using the Kruskal-Wallis test and Dunns test for pair-wise comparisons. p < 0.05 was considered statistically significant. Results: Canals dried with only 1 paper point and obturated with the iRoot SP sealer (subgroup 2B) showed significantly higher bond strengths to the root canal wall compared to all other subgroups (p < 0.05), except for subgroup 1B (p > 0.05). Conclusions: The canal-drying technique influenced the adhesive bond strength between calcium silicate-based root canal sealers and the root canal wall.

Microleakage of 4 post-luting cements evaluated by the computerized fluid filtration method.

Purpose The aim of this study was to evaluate the microleakage of 4 fiber post-luting systems using the computerized fluid filtration method. Methods 60 extracted human mandibular permanent premolar teeth were used for the study. The teeth were instrumented with Hedstroem files up to size 60, post spaces were prepared and then Unicore fiber posts were cemented using 4 luting systems. Group1: Duolink, Group 2: Resinomer, Group 3: Fuji Plus, Group 4: Multilink Sprint, Group 5: Positive Control, and Group 6: Negative Control. The samples were stored in distilled water for 2 weeks and then microleakage was evaluated. Data were analyzed with 1 way-ANOVA and Dunett T3 tests (P<.05). Groups 2 and 3 significantly exhibited higher microleakage values than groups 1 and 4 (P<.05). Results Resin cements used with total etch-bonding systems demonstrated lower microleakage values than the other cements. Conclusions Reduction of steps in dentin conditioning of resin luting cements may have a promoting effect on microleakage.

Different treatment approaches in a multiple dental traumatic injury

This case report describes the management of crown- and root-fractured maxillary and mandibular anterior permanent teeth in a 22-year-old patient because of a bicycle accident. Six teeth (11, 21, 22, 23, 31, and 32) of patient were affected by trauma. A nonsurgical endodontic treatment was performed to coronal root fragments of teeth 11, 21, and 22. The coronal parts of the canals were filled with mineral trioxide aggregate (MTA). These teeth were restored with a fiber-reinforced hybrid composite resin bridge. Other root-fractured teeth 23 and 32 were healed spontaneously. The tooth 31 with complicated crown-fractured was prepared and filled with gutta-percha and sealer. After, a glass-fiber post was applied, the restoration of this tooth was performed a hybrid composite resin using an incremental technique. The teeth were in function with satisfactory clinical and radiographic results after 24-month. Healing was achieved without any need for further endodontic surgical intervention. This case shows that traumatized teeth can be managed with endodontic and prosthetic treatments, which can result in satisfactory periradicular healing.