Kürşat Er

Comparative Study of 6 Rotary Nickel-Titanium Systems and Hand Instrumentation for Root Canal Preparation in Severely Curved Root Canals of Extracted Teeth

INTRODUCTION Some improvements have been developed with new generations of nickel-titanium (NiTi) rotary instruments that led to their successful and extensive application in clinical practice. The purpose of this in vitro study was to compare the root canal preparations performed by using GT Series X and Twisted File systems produced by innovative manufacturing process with Revo-S, RaCe, Mtwo, and ProTaper Universal systems manufactured directly from conventional nitinol and with stainless steel K-Flexofile instruments. METHODS The mesiobuccal root canals of 140 maxillary first permanent molars that had between 30°-40° curvature angle and 4- to 9-mm curvature radius of the root canal were used. After root canal preparations made by using GT Series X, Twisted File, Revo-S, RaCe, Mtwo, and ProTaper Universal NiTi rotary systems and stainless steel K-Flexofile instruments, transportation occurred in the root canal, and alteration of working length (WL) was assessed by using a modified double-digital radiographic technique. The data were compared by the post hoc Tukey honestly significant difference test. RESULTS NiTi rotary systems caused less canal transportation and alteration of WL than K-Flexofile instruments (P < .05). There was no significant difference between NiTi rotary system groups at any levels (P > .05) except 2.5 mm from the WL. At this level ProTaper Universal system caused significant canal transportation (P < .05). CONCLUSIONS GT Series X and Twisted File rotary systems produced with innovative process were concluded to shape the curved canals to result in minimal canal transportation, similar to Revo-S, RaCe, Mtwo, and ProTaper Universal rotary systems manufactured by traditional methods.

Effects of dentin surface treatments including Er,Cr:YSGG laser irradiation with different intensities on the push-out bond strength of the glass fiber posts to root dentin

Abstract Objective. Intra-canal post systems are commonly used to restore root-filled teeth. Bond strengths of the posts can be affected by various surface treatments of the post or the dentin. The aim of this study was to evaluate the effects of dentin surface treatments including erbium-chromium; yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation with different intensities on the push-out bond strength of the glass fiber posts to root dentin. Materials and methods. Forty single-rooted human maxillary incisors were filled and post spaces were prepared. After these procedures, the specimens were divided randomly into four groups according to the dentin surface treatments, as follows: (i) untreated surface (control), (ii) 1W Er,Cr:YSGG laser application, (iii) 2W Er,Cr:YSGG laser application and (iv) 3W Er,Cr:YSGG laser application. Then the posts were cemented into the root canals using dual-cured resin cement. Bonded specimens were cut into 1-mm-thick slices and push-out tests were performed using a universal testing device. All specimens were loaded until fracture and the failure modes were evaluated with a stereomicroscope at 32× magnification. Representative specimens were analyzed by scanning electron microscopy. Data were analyzed using a one-way ANOVA, Tukey and Wilcoxon tests. Results. The bond strength values ranged from 3.22–4.68 MPa. There were no statistically significant differences among the groups, regardless of the different levels. The coronal and middle levels of the post space had significantly higher bond strength values compared with the apical level (p < 0.05). Conclusion. Er,Cr:YSGG laser irradiation with different intensities did not increase the bond strength of the fiber posts to the root canal dentin walls.

Veneer Ceramic to Y‐TZP Bonding: Comparison of Different Surface Treatments

PURPOSE The purpose of this study was to evaluate the effects of various surface-treatment techniques for enhancing the bond strength between veneering ceramic and yttria-stabilized tetragonal zirconia polycrystals (Y-TZP). MATERIALS AND METHODS Pre-sintered Y-TZP specimens were divided into eight groups (n = 10) according to the surface-treatment technique used: (a) untreated (control); (b) air abrasion with aluminum oxide particles; (c) erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation at different energy intensities (1 to 6 W). All specimens were then sintered and veneered with veneering ceramic according to the manufacturers instructions. The obtained zirconia-ceramic specimens were immersed in 37°C distilled water for 24 hours before a shear bond strength test using a universal testing device at a 1 mm/min crosshead speed. The average values were calculated. After debonding, the Y-TZP surfaces were examined under a stereomicroscope to determine their fracture pattern, and the surface topography was evaluated with scanning electron microscopy after surface treatments. RESULTS The bond strength ranged from 13.24 to 20.54 MPa. All surface treatments increased the bond strength between the veneering ceramic and Y-TZP; however, the value for the 6 W irradiation group was significantly different from the values for other groups (p ˂ 0.05). CONCLUSIONS The present studys findings showed that higher energy densities were needed for the laser irradiation to improve the bond strength between the veneering ceramic and zirconia. CLINICAL IMPLICATION Y-TZP is commonly used as a core material in fixed restorations. The bond strength between zirconia and the veneering ceramic can be affected by various surface treatments.

Resin cement to indirect composite resin bonding: Effect of various surface treatments

Debonding at the composite-adhesive interface is a major problem for indirect composite restorations. The aim of this study was to evaluate the bond strength (BS) of an indirect composite resin after various surface treatments (air-abrasion with Al2O3, phosphoric acid-etchig and different applications of NdYAG laser irradiations). Fifty composite disks were subjected to secondary curing to complete polymerization and randomly divided into five experimental groups (n = 10) including Group 1, untreated (control); Group 2, phosphoric acid-etched; Group 3, air-abrasion with Al2 O3 ; Group 4, Nd:YAG laser irradiated with non-contact and Group 5, Nd:YAG laser irradiated with contact. They were then bonded to resin cement and shear BS was determined in a universal testing device at a crosshead speed of 1 mm/min. One way analysis of variance (ANOVA) and Tukey post-hoc tests were used to analyze the BS values. The highest BS value was observed in Group 4 and followed by Group 3. Tukey test showed that there was no statistical difference between Group1, 2 and 5. Furthermore, differences in BSs between Group 4 and the other groups except Group 3 were significant (p < 0.05) and also there were significant differences in BSs between Group 3 to 1 and Group 3 to 2 (p < 0.05). This study reveals that air-abrasion with Al2 O3 and Nd:YAG laser irradiation with non-contact provided a significant increase in BS between indirect composite and resin cement.

Pulp tissue dissolution capacity of QMix 2in1 irrigation solution.

Objective: The aim of this study was to evaluate the tissue dissolution efficacy of four root canal irrigation solutions (sodium hypochlorite [NaOCl], chlorhexidine gluconate [CHX], Octenidine [OCT], and QMix 2in1) on bovine pulp tissue. Materials and Methods: Fifty bovine pulp tissue samples, each weighing 6.55 mg, were prepared and randomly divided into four experimental groups and one control group (n = 10) according to the dissolution irrigants used: (1) 5.25% NaOCl group; (2) 2% CHX group; (3) OCT group; (4) QMix 2in1 group; and (5) control group (saline solution). These samples were then placed into special bovine dentin reservoir models and immersed for 1 h with each test solution (0.1 mL of each) at room temperature. The pulp samples were then blotted dry and weighed again. The percentage of weight loss was calculated. Statistically analyzed with one-way analysis of variance and post-hoc Tukey tests (P = 0.05). Results: Saline solution did not dissolve the bovine pulp tissue. All groups, except OCT, dissolved pulp samples more effectively than the control group (P < 0.05). The highest tissue dissolution was observed in 5.25% NaOCl group (P < 0.05). No statistically significant difference was found between the tissue-dissolving effect between QMix 2in1 and those of 2% CHX. Conclusions: Within the limitations of this in vitro study, NaOCl exhibited the best tissue-dissolving effect out of all solutions tested. CHX and QMix 2in1 were able to dissolve pulp tissue but less than NaOCl. OCT and saline solutions could not exhibit significantly tissue-dissolving effectiveness. This study shown that QMix 2in1 has little capacity to dissolve pulp tissue therefore used alone is not sufficient for this purpose.

In vitro comparison of four different electronic apex locators to determine the major foramen using the clearing technique

OBJECTIVES The aim of this study was to evaluate the accuracy of four electronic apex locators (EALs) (DentaPort ZX, Raypex 5, Endo Master and VDW Gold) in detecting the major foramen using the clearing technique. MATERIALS AND METHODS Forty-eight extracted single-rooted extracted teeth with mature apices were used for the study and divided into four groups of 12 teeth each. All teeth were embedded in an alginate model. Electronic measurements were taken using a size 15 K-file attached to the holder. Then, the teeth were cleared and photographed under a stereomicroscope with a digital camera. The distance between the tip of the file and the major foramen was measured by using an image analysis software program. Positive and negative values were recorded when the file tip was beyond or short of the major foramen and zero value when the file tip and the major foramen coincided. Statistical analysis was performed using the Kruskal-Wallis and Chi-square tests at a significance level of 0.05. RESULTS Mean distance from the file tip to the major foramen were 0.302 ± 0.202, 0.065 ± 0.293, 0.117 ± 0.475, and 0.258 ± 0.160 mm in the DentaPort ZX, Raype 5, Endo Master, and VDW Gold groups, respectively. There were no statistically significant differences among the devices (P > 0.05) . CONCLUSION Under the experimental conditions, all EALs showed an acceptable determination of the major foramen.

The effect of orthodontic tooth movement on endodontically treated teeth

There is often the need of moving teeth, which was endodontically treated or teeth still in endodontic treatment. Orthodontic movement of endodontically treated teeth was approached with suspicion for many years, and clinicians abstain from applying orthodontic movement to teeth. This movement inevitably causes biological reactions in periodontal ligament and pulp. Application of a severe orthodontic force for a long time can cause irreversible pulpitis and necrosis in pulp by increasing pulp inflammation process. Use of moderate and intermittent forces enables sufficient tooth movement, limits the damage in the pulp, and allows the damaged pulp healing. Microscopic root resorption occurs in all teeth during orthodontic treatment, which is clinically insignificant and cannot be determined radiographically. The aim of this review is to determine issues to be considered for endodontic terms before orthodontic treatment, the alterations which may be occurred in the pulp, hard tissues, and periapical region of the teeth during and after treatment and how these changes affect the results of treatment.

Electrophysiological evidence on epileptiform activity enhanced by electrical stimulation of teeth in rats

Abstract The aim of this study was to evaluate the possible effects of electrical stimulation (ES) of tooth on penicillin-induced epileptiform activity in rats. Experiment was realized on 24 adult male Sprague Dawley rats. Rats were assigned three groups [stimulation group (SG), penicillin group (PG), and penicillin+stimulation group (PSG)]. In SG, ES was only applied. Ten pulses of electrical current were delivered to the teeth for a duration of 2 milliseconds at 1-second intervals from a stimulator. Currents were applied in the range of 40–240 μA with 40 μA steps. Electrocorticography (ECoG) recordings were taken before and after ES. In PG, ECoG recordings were taken before and during the injection of penicillin. In PSG, after epileptiform activity was induced, ES was applied and ECoG recordings were taken as in SG. All the data were analyzed with Student’s t test. Applied currents did not cause any epileptiform activity in SG. When the PSG was compared with the PG it was seen that the spike frequency of epileptiform activity increased in a statistically significant way after application of 240 μA (P < 0·05). On the other hand current application caused an increase in the spike amplitude of the PSG compared with the amplitude of the PG, but it was not statistically significant. We concluded that ES of tooth with high current can trigger epileptiform activity in rats. For this reason, further research is required to evaluate the effects of ES of tooth for pulp testing on epileptic human subjects and antiepileptic drug users.

Comparison of influence of different manufacturing methods on the cleaning efficiency of rotary nickel–titanium files

The purpose of this study was to evaluate and compare cleaning effectiveness of TwistedFile, GT series X, Revo‐S, RaCe, Mtwo, and ProTaper Universal rotary files in curved canals. Seventy mesiobuccal canals of extracted human first maxillary molars were divided into seven groups of 10 samples each. Canals were prepared with six nickel–titanium (NiTi) rotary systems and manual K‐Flexofile. Irrigation was performed with 2 mL 2.5% NaOCl solution after each file, and 5 mL 2.5% NaOCl was used for the final flush. After the roots were split longitudinally, the presence of debris and smear layer was visualized using scanning electron microscopic photomicrographs taken at coronal, middle, and apical third. Mean scores for debris and the smear layer were calculated and statistically analyzed for significance between groups using the Kruskal–Wallis nonparametric analysis of variance (P < 0.05) and Mann–Whitney U test (P < 0.001). There was no significant difference among the groups in terms of debris and smear layer scores (P > 0.05). Without considering the preparation method used, while no statistically significant difference was found between the coronal third and the middle third (P > 0.05), higher amount of debris and smear layer were found in apical third (P = 0.001). The new generation of NiTi rotary files including the Twisted File and GT Series X presented similar cleaning effectiveness compared with traditionally ground NiTi rotary files. Microsc. Res. Tech. 76:231–236, 2013.

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.