Mark K. Pagnillo

An In Vitro Study of the Cytotoxicity of Two Root Canal Sealers

The purpose of this in vitro study was to determine the cytotoxicity of two root canal sealing materials (AH26 and AH-Plus). This cytotoxicity test (agar diffusion test) was conducted based on the procedures described in the International Organization for Standardization. The biological reactivity of a mammalian monolayer, L929 mouse fibroblast cells, in response to the tested agents was determined. After the 48-h observation period, the cell cultures exposed to the test articles discs for AH26 and AH-Plus exhibited severe reactivity (grade 4). The positive control article exhibited moderate reactivity (grade 3). No signs of reactivity (grade 0) were noted for the negative control article or the negative control discs. The tested samples of AH26 and AH-Plus are considered cytotoxic and do not meet the requirement of the agar diffusion test. Similar cytotoxicity results have been found in the literature for AH26 and other root canal sealing cements.

Four different core materials measured for fracture strength in combination with five different designs of endodontic posts

The purpose of this in vitro study was to determine the fractural load of four core materials supported by five post designs. This study was divided into 20 groups with 10 samples per group. Specimens were placed in a special jig at a 45-degree angle, and the fracture load values, in pounds, were obtained with the use of a universal testing machine. A 5 x 4 factorial design was used to assess and compare the fractural strength, and a two-way analysis of variance was used to determine whether the buccolingual, mesiodistal, and height dimensions differed across groupings. Mean fracture load values were obtained. Flexi-Post dowel/Ti-Core material at 277.1 pounds and ParaPost dowel/ Tytin silver amalgam at 277.3 pounds recorded the greatest mean values. These values were not statistically different. ParaPost dowel/Ketac-Silver material had the lowest mean value (49.6 pounds). For all posts Tytin silver amalgam and Ti-Core material were significantly stronger than Ketac-Silver and G-C Miracle Mix material. Ketac-Silver and G-C Miracle Mix materials did not differ from each other. Results indicated that Ti-Core composite material is at least as strong as Tytin silver amalgam.

Cyclic fatigue testing of five endodontic post designs supported by four core materials

PURPOSE This pilot study examined the cyclic fatigue of five endodontic post systems (AccessPost, Flexi-Flange, Flexi-Post, ParaPost, and Vlock) with four core materials (Tytin silver amalgam, Ti-Core, Ketac-Silver and G-C Miracle Mix). MATERIAL AND METHODS In vitro cyclic fatigue was performed with a machine designed to simulate masticatory fatigue forces. An instantaneous force of 22.2 N (5 pounds) was applied to each post and core combination for a test configuration of 4,000,000 repetitions, or until failure occurred. The type of failure and number of repetitions at failure was recorded for each sample tested. Two-way analysis of variance (ANOVA) was used to compare groups. RESULTS All posts/core samples with Ti-Core composite and Tytin silver amalgam completed the test with no failures. All posts/core samples with Ketac-Silver material failed before the 4,000,000 test cycle configuration and all failures were core failures. All posts/core samples with G-C Miracle Mix material failed in a similar manner. Newman-Keuls multiple comparison test illustrated that, with this simulated fatigue test, Ti-Core material and Tytin silver amalgam were superior to both G-C Miracle Mix and Ketac-Silver materials.

Retention of a core material supported by three post head designs

STATEMENT OF PROBLEM There are few studies on the retention of core build-up materials to prefabricated post head designs, especially for a new ceramic post design. PURPOSE This in vitro study compared the retention of 2 types of core build-up materials (Ti-Core titanium-reinforced composite and a GC Miracle Mix silver-reinforced glass ionomer) supported by 3 post head designs (Flexi-Post, AccessPost, and Cerapost dowel). For all test groups, heads of the posts were placed into the core material at a 90-degree angle to the surface. Test specimens (unloaded) were then placed into a special jig and retention test was performed using an 810 MTS testing machine. MATERIAL AND METHODS This study consisted of 6 groups with 10 specimens per group. A 3 x 2 factorial design was used to test for statistical significance and results were considered significant when P <.05. RESULTS Results of the retention test were as follows: group 1, Flexi-Post/Ti-Core 220.0 lb (982.1 N), group 2, AccessPost/Ti-Core 212.7 lb (949.6 N), group 3, Cerapost/Ti-Core 41. 8 lb (186.6 N), group 4, Flexi-Post/Miracle Mix 43.4 lb (193.8 N), group 5, AccessPost/Miracle Mix 61.6 lb (275 N), and group 6, Cerapost/Miracle Mix 7.5 lb (33.5 N). Results of the ANOVA revealed a highly significant difference between posts and cores (P <.0001). CONCLUSION Post head designs of the stainless steel AccessPost and Flexi-Post dowels offers greater retention then the smooth ceramic head design of the Cerapost dowel. In addition, the composite core material (Ti-Core) offers greater retentive strength values than the glass ionomer material (Miracle Mix).

COMPARISON OF THE RETENTIVE PROPERTIES OF SIX PREFABRICATED POST OVERDENTURE ATTACHMENT SYSTEMS

STATEMENT OF PROBLEM There are few research studies concerning prefabricated posts overdenture attachment systems using multiple pull cycles. PURPOSE This study tested 6 prefabricated post overdenture attachment systems (AccessPost Overdenture, ERA white and ERA grey, Flexi-Overdenture, O-SO and ZAAG) measured to simulate wear over a 2000 pull cycle and compared the in vitro retention, measured (pounds). MATERIAL AND METHODS Records of the pounds of force necessary to separate each system were made at the beginning of testing, at pull 10 and then at every 50th pull until the 2000th pull was attained. All pulls were performed manually with a Shimpo force gauge. Absolute force (AF) and relative force (RF) were compared, AF being the force required at any pull to separate the overdenture device, whereas RF is the force required at the first pull. RESULTS There was considerable difference of the force required at pull 1 for the ERA white, O-SO and ZAAG anchor systems, then the AccessPost overdenture, and finally the Flexi-Overdenture and ERA grey attachment systems. CONCLUSION At pull 2000, there was no statistical difference between any of the attachments studied. The amount of force necessary to offer functional retention to a specific patient wearing an overdenture may vary considerably, depending on the many factors in fabricating the overdenture, and the age, strength, musculature, and the expectations of the patient.

Comparison of the torsional forces at failure for seven endodontic post systems.

Resistance to torsional forces is critical in restoration of endodontically treated teeth. Seven post designs (Flexi-Post, Flexi-Flange, Para-Post, AccessPost, World Post, Vlock, and Dentatus posts) were cemented in roots of natural teeth with zinc phosphate and Flexi-Flow cements, which resulted in 11 different groupings that were subjected to torsional forces in a clockwise direction. In addition, clockwise and counterclockwise torque was applied to the Flexi-Post and Flexi-Flange systems cemented with zinc phosphate and Flexi-Flow cements. A total of 150 samples were prepared, and groups for this study were: group 1, Flexi-Post/zinc phosphate clockwise and counterclockwise; group 2, Flexi-Post/Flexi-Flow clockwise and counterclockwise; group 3, Flexi-Flange/zinc phosphate clockwise and counterclockwise; group 4, Flexi-Flange/Flexi-Flow clockwise and counterclockwise; group 5, Para-Post/zinc phosphate clockwise; group 6, AccessPost/zinc phosphate clockwise; group 7, AccessPost/Flexi-Flow with grooved dentin clockwise; group 8, World Post/zinc phosphate clockwise; group 9, World Post/Flexi-Flow with grooved dentin clockwise; group 10, Vlock Post/zinc phosphate clockwise; and group 11, Dentatus post/zinc phosphate clockwise. Torsional forces for the groups ranged from 17 ounce-inches (Dentatus/zinc phosphate) to 81 ounce-inches (Flexi-Post/zinc phosphate). Flexi-Post and Flexi-Flange threaded posts exhibited statistically greater resistance to torsional forces. Analyses were computed with one-way and three-way analysis of variance followed by Duncans multiple range test. Duncans multiple range test indicated that Flexi-Post/zinc phosphate/clockwise was similar to Flexi-Post/Flexi-Flow/clockwise and that both had significantly higher torque levels than the other treatment conditions in the clockwise direction (p 0.0001). Dentatus/zinc phosphate/clockwise had significantly lower torque levels than the other treatment conditions (p 0.031).

Effect of power settings versus temperature change at the root surface when using multiple fiber sizes with a Holmium YAG laser while enlarging a root canal.

The aim of this study was to determine if there is an increase in temperature at the root surface as the canal is enlarged when using a Holmium:YAG laser. An increase might be expected because, as the canal is enlarged, there is less dentin between the canal walls and the outer cementum surface of the root to absorb the heat. Sixty single-rooted human teeth were randomly assigned to 1 of 3 groups according to laser power settings: 0.50, 0.75, and 1.00 W. Each tooth in each power group was subjected to lasing using fiber sizes of 140, 245, 355, and 410 microns. The dependent variables in these analyses included: (a) change in temperature, measured with T-type thermocouples placed 2 mm from the coronal and apical ends of the root; (b) depth of laser in the tooth; (c) depth that a conventional fiber could be inserted after lasing; and (d) tooth physical dimensions. ANOVA for coronal temperature showed no interaction between fibers and power settings. Repeated-measures ANOVA for apical temperature showed a significant difference between fibers, but not between power settings. No interaction between fibers and power settings was observed. For the depth of tooth during lasing (how far the fiberoptic guide penetrated into the tooth), no interaction between fibers and power settings was observed. Pairwise contrasts revealed that all fibers were different from one another, with depth decreasing as fiber size increased. Depth files could be inserted that showed the depth significantly decreased as file size increased from 50 through 70. ANOVAs illustrated that there were no significant differences between power settings for any of the five tooth physical dimensions. All temperature differences observed apically and coronally were between 0 degree to 10 degrees C, with the majority (> 98%) being between 0 degree to 5 degrees C. After lasing with the 410-micron fiber, the root canals were widened to at least 45 or 50 K-files (450 or 500 microns). However, by using a 410-micron fiber, the laser did not seem to widen the canal beyond a 500-micron diameter.

Comparative study of two precision overdenture attachment designs

In this study two precision overdenture attachment designs were tested for retention--a nylon overdenture cap system and a new cap and keeper system. The new cap and keeper system was designed to reduce the time involved in replacing a cap worn by the conditions of the oral environment. Six groups were tested at two different angles and retentive failure was examined at two different angles (26 and 0 degrees). Failure was measured in pounds with a force gauge over a 2000 pull cycle. The amount of force required to remove caps for two overdenture caps and a replaced cap for the metal keeper system was determined. Two dependent variables were absolute force and relative force. Repeated measures analysis of variance (RMANOVA) was used to compare the between-subjects effects of cap and angle, and the within-subjects effect of pull. The results indicated a significant difference between cap types (p < 0.0001) with respect to the relative force required to remove the cap. There was no effect of angle. For absolute force, RMANOVA revealed a highly significant interaction between pull and cap (p < 0.0001). Thus, the way that force changed over pulls depended on which cap was used (no effect of angle). For relative force, RMANOVA revealed no interaction between pull and cap, but there was a main effect of cap type (p < 0.0001) (no effect of angle). The nylon cap design required less force for removal but showed more consistency in the force required over the course of the 2000 pulls when compared with the keeper with cap insert. The results obtained in this study were consistent with similar studies in literature.

Effects of three bonding systems on the torsional resistance of titanium-reinforced composite cores supported by two post designs☆☆☆

STATEMENT OF PROBLEM There are no studies that have investigated the effects of bonding agents on the resistance to torque of a composite core supported by a prefabricated post. PURPOSE This study investigated the ability of bonding agents to resist rational forces applied to titanium-reinforced composite cores supported by 2 post designs. MATERIAL AND METHODS Two post designs (AccessPost and ParaPost dowels) with titanium-reinforced core material and 4 bonding conditions (AllBond-2, ScotchBond Multi-Purpose, Tenure A&B, and without a bonding agent) were studied. A total of 80 specimens in 8 experimental groups were prepared and subjected to clockwise torsional forces until failure. RESULTS Torsional values ranged from 53.31 in. x oz (ParaPost/ScotchBond Multi-Purpose) to 72.31 in. x oz (AccessPost/ScotchBond Multi-Purpose). Two-way of analysis of variance failed to demonstrate a significant difference among posts or type of bonding system. CONCLUSION The use of a multistep bonding agent had no significant effect on the torsional resistance of a core supported by a passive endodontic post.

Fracture strengths of three core restorative materials supported with or without a prefabricated split-shank post

PURPOSE The aim of this study was to compare the fracture strengths of three restorative materials, a lanthanide reinforced composite (Ti-Core Natural), a silver amalgam (Tytin), and a hybrid glass ionomer (Advance), supported by either a multitiered, threaded split-shank post (Flexi-Flange) or with a dentin spur without a post. MATERIAL AND METHODS A total of 60 recently extracted single-rooted human teeth were divided into six groups of 10. All groups were stored at 100% humidity at room temperature for 1 week before testing. Each specimen was placed in a special jig at a 45-degree angle to the buccolingual axis and subjected to a load that was recorded in pounds and converted to Newtons on a universal testing machine, with a crosshead speed of 0.63 cm/minute until failure. Two-way analysis of variance followed by the Newman-Keuls pairwise multiple comparisons test were used to compare the results. RESULTS There was a statistically significant difference between core materials (p < 0.001), but not regarding post conditions. Ti-Core Natural material had a significantly larger mean failure threshold for fracture than either Tytin silver amalgam or Advance material and the letter two core materials (Tytin and Advance) do not differ from each other. There was no statistical difference between Ti-Core material supported by a post and Ti-Core material supported without a post.