Sema Belli

Evaluation of Two Post Core Systems Using Two Different Methods (Fracture Strength Test and a Finite Elemental Stress Analysis)

The aim of this study was to compare a fiber composite laminate (FCL) post core and a conventional cast post core system by using two different methods. The first method was a conventional fracture strength test, and the second was a finite elemental stress-analysis method (FEM). For the conventional fracture strength test, 20 extracted, human upper, central incisors were used. The teeth were decoronated, treated endodontically, and restored with two post core systems. After embedding the samples in resin blocks, a loading force was applied to the teeth at a crosshead speed of 5 mm/ min at an angle of 45 degrees to the long axis of the tooth. The data were recorded, and the results were compared by using the Mann-Whitney U test. There was no statistically significant difference between the two post systems (p > 0.05). For FEM analysis, a pseudo three-dimensional model of a maxillary central incisor, theoretically restored with either a cast post or an FCL, was used. The analysis was performed by using the structural analysis program (SAP90). FEM analysis showed that stress was accumulated within the cast post core system, and transmission of stress to supportive structures and the tooth was low. This is an advantage for tooth and supporting tissues. When the FCL post core system was evaluated by FEM, the results indicated that this system transferred stress to supportive structures and the tooth while stress accumulation within the post system was low. This is an advantage for the restoration but disadvantage for the supporting tissues.

Ultrastructural Correlates of in vivo/in vitro Bond Degradation in Self-etch Adhesives

The morphologic correlates of bond degradation in self-etching primers have not been fully elucidated. We hypothesized that there is no difference between the mechanism of degradation of self-etching primers in vivo and in vitro. Class I cavities prepared in vivo in 24 caries-free human molars were bonded with Clearfil SE Bond or Clearfil Protect Bond, and restored with resin composites. Eight teeth were extracted after 24 hrs, and the rest after 1 yr. The same protocol was repeated in vitro with extracted molars. Degradation of resin-dentin bonds was assessed by microtensile bond testing and TEM of interfaces after tracer immersion. Both in vivo and in vitro bond strengths decreased with time for SE Bond but not for Protect Bond, with more pronounced water treeing observed in the former adhesive under both aging conditions. There is no difference between the mechanism of degradation of self-etch adhesives in vivo or in vitro.

Evaluation of the effect of endodontic irrigation solutions on the microhardness and the roughness of root canal dentin.

The purpose of this study was to evaluate the effect of 0.2% chlorhexidine gluconate on the microhardness and roughness of root canal dentin compared with widely used irrigation solutions. Ninety, mandibular, anterior teeth extracted for periodontal reasons were used. The crowns of the teeth were removed at the CEJ. The roots were separated longitudinally into two segments, embedded in acrylic resin, and polished. A total of 180 specimens were divided into 6 groups of 30 teeth at random according to the irrigation solution used: group 1: 5.25% NaOCl for 15 min; group 2: 2.5% NaOCl for 15 min; group 3: 3% H2O2 for 15 min; group 4: 17% EDTA for 15 min; group 5: 0.2% chlorhexidine gluconate for 15 min; and group 6: distilled water (control). Each group was then divided into 2 subgroups of 15 specimens: groups 1a, 2a, 3a, 4a, 5a, and 6a were submitted to Vickers microhardness indentation tests; groups 1b, 2b, 3b, 4b, 5b, and 6b were used for determination of the roughness of root dentin. The data were recorded as Vickers numbers and Ra, microm for roughness test. The results were analyzed statistically by using one-way ANOVA and Tukey tests. The results indicated that all the irrigation solutions except chlorhexidine significantly decreased microhardness of root canal dentin (p < 0.05); 3% H2O2 and 0.2% chlorhexidine gluconate had no effect on roughness of the root canal dentin (p > 0.05). Although there are many other factors for irrigation solution preference, according to the results of this study, 0.2% chlorhexidine gluconate seems to be an appropriate endodontic irrigation solutions because of its harmless effect on the microhardness and roughness of root canal dentin.

Effects of Mineral Trioxide Aggregate on Cell Survival, Gene Expression Associated with Mineralized Tissues, and Biomineralization of Cementoblasts

The purpose of this study was to investigate the effects of mineral trioxide aggregate (MTA) on survival, mineralization, and expression of mineralization-related genes of cementoblasts. Immortalized cementoblasts (OCCM) were maintained with Dulbecco modified Eagle medium containing 10% fetal bovine serum. Methyl-thiazol-diphenyl-tetrazolium experiments were performed at 24 and 72 hours to evaluate bioactive components released by MTA (0.002-20 mg/mL) on the cell survival of OCCM. Von Kossa staining was used to evaluate biomineralization of OCCM cells. Images of cementoblasts were taken on day 3 by using inverted microscopy. Gene transcripts for bone sialoprotein (BSP), OCN, collagen type I (COL I), and osteopontin (OPN) were evaluated on days 3 and 5 by using semiquantitative reverse transcriptase polymerase chain reaction. The 20 mg/mL concentration of MTA was toxic for OCCM cells, whereas other concentrations of MTA tested exhibited similar cell numbers when compared with control group, and the 0.02 mg/mL concentration of MTA increased OCCM cell survival at 72 hours. Although an apparent decrease in mineralization was observed in the highest 3 concentrations of MTA used, 0.02 and 0.002 mg/mL concentrations of MTA induced greater biomineralization of OCCM cells than seen in the control. Moreover, increased BSP and COL I mRNA expression was observed at 0.02 and 0.002 mg/mL concentrations of MTA. MTA did not have a negative effect on the viability and morphology of cementoblasts and induced biomineralization of cementoblasts at the concentrations of 0.02 and 0.002 mg/mL. Based on these results MTA can be considered as a favorable material regarding cell-material interaction.

In vitro antibacterial activities of root-canal sealers by using two different methods.

The purpose of this in vitro study was to evaluate the antibacterial activity of five different root-canal sealers (RoekoSeal, Ketac-Endo, AH Plus, Sealapex, Sultan). With the use of Enterococcus faecalis as a test organism, both the agar-diffusion test (ADT) and direct-contact test (DCT) were performed. For DCT, sealers were mixed and placed on the sidewall of microtiter plate wells. A 10-microl bacterial suspension was placed on the tested material samples. Bacteria were allowed to directly contact to the sealers for 1 h at 37 degrees C. Bacterial growth was then spectrophotometrically measured through every 30 min for 19 h by using an Anthos Labtec HT 2. For ADT, a 200-microl bacterial suspension was spread on brain-heart infusion agar plates. Freshly mixed sealers were poured into uniform wells punched in the agar. After periods of incubation at 37 degrees C for 24 h and 7 days in humid atmosphere, the zones of inhibition of bacterial growth on agar plates were observed and measured. Ketac-Endo, Sultan, and AH Plus had similar results for DCT. These sealers were more potent bacterial-growth inhibitors than Sealapex and RoekoSeal. According to ADT, RoekoSeal showed no antibacterial activity. There was no significant difference among AH Plus, Sealapex, and Sultan (p > 0.05). Ketac-Endo demonstrated lower antimicrobial activity than these sealers (p < 0.05). Time had no effect on the antibacterial activity of the tested sealers (p > 0.05). The antibacterial efficiency of the materials varied according to the tests used. It was concluded that the technique, time, and ingredients of the tested material can affect the results of the microbiological studies.

Adhesive sealing of the pulp chamber

The purpose of this in vitro study was to evaluate quantitatively the ability of four different filling materials to seal the orifices of root canals as a secondary seal after root canal therapy. Forty extracted human molar teeth were used. The top of pulp chambers and distal halves of the roots were removed using an Isomet saw. The canal orifices were temporarily sealed with a gutta-percha master cone without sealer. The pulp chambers were then treated with a self-etching primer adhesive system (Clearfil SE Bond), a wet bonding system (One-Step), a 4-methacryloyloxyethyl trimellitate anhydride adhesive system (C&B Metabond), or a reinforced zinc oxide-eugenol (IRM). The specimens were randomly divided into four groups of 10 each. A fluid filtration method was used for quantitative evaluation of leakage. Measurements of fluid movement were made at 2-min intervals for 8 min. The quality of the seal of each specimen was measured by fluid filtration immediately and after 1 day, 1 wk, and 1 month. Even after 1 month the resins showed an excellent seal. Zinc oxide-eugenol had significantly more leakage when compared with the resin systems (p < 0.05). Adhesive resins should be considered as a secondary seal to prevent intraorifice microleakage.

The Effect of Two Different Root Canal Sealers and Smear Layer on Resistance to Root Fracture

The purpose of this in vitro study was to test the effect of Ketac-Endo (KE) and AH 26 on resistance to root fracture and also to evaluate the effect of smear layer. Seventy-two human maxillary canine teeth were randomly divided into six groups (n = 12) and were prepared using six different methods: group 1: KE, without smear layer (smear -); group 2: KE, with smear layer (smear +); group 3: AH 26, smear (-); group 4: AH 26, smear (+); group 5 (negative control): nonprepared; group 6 (positive control): prepared but unfilled. After storing 1 week in 100% humidity at 37 degrees C, the coronal lingual walls and root canal spaces were lowered 2 mm below the buccal walls of the roots. The samples were placed into acrylic resin blocks so that 10 mm of buccal roots were exposed and were placed in a specially designed steel pad at an angle of 15 degrees to the long axis of the root. A slowly increasing force was applied at the junction of the buccal wall and root canal space until fracture occurred. The force required to fracture each tooth was recorded as kg and statistically analyzed using one-way analysis of variance and Duncan tests. The results indicated that instrumentation of the root canals significantly weakened the tooth structure to fracture (p < 0.05). The canals obturated with either sealer were significantly stronger than roots whose canals were instrumented but not obturated (p < 0.05), and there was no difference between the sealers. The presence or absence of the smear layer did not cause any significant effect on the root fracture resistance of the teeth (p > 0.05).

Monoblocks in root canals: a finite elemental stress analysis study

AIM To investigate using finite element stress analysis (FEA) primary, secondary and tertiary monoblocks created either by adhesive resin sealers or by different adhesive posts and to evaluate the effect of interfaces on stress distribution in incisor models. METHODOLOGY Seven maxillary incisor FEA models representing different monoblocks using several materials were created as follows: (a) primary monoblock with Mineral Trioxide Aggregate; (b) secondary monoblock with sealer (MetaSEAL) and Resilon; (c) tertiary monoblock with EndoREZ; (d) primary monoblock with polyethylene fibre post-core (Ribbond); (e) secondary monoblock with glass-fibre post and resin cement; (f) tertiary monoblock with bondable glass-fibre post; (g) tertiary monoblock with silane-coated ceramic post. A 300 N load was applied from the palatal surface of the crown with a 135° angle to the tooth long axis. Materials used in the study were assumed to be homogenous and isotropic except the glass-fibre post; the results are expressed in terms of von Mises criteria. RESULTS Maximum stresses were concentrated on force application areas (18-22.1 MPa). The stresses within the models increased with the number of interfaces both for the monoblocks created by the sealers (1.67-8.33 MPa) and for the monoblocks created by post-core systems (1.67-11.7 MPa). CONCLUSIONS Stresses within roots increased with an increase in the number of the adhesive interfaces. Creation of a primary monoblock within the root canal either by an endodontic sealer or with an adhesive post-core system can reduce the stresses that occur inside the tooth structure.

Regional Bond Strengths of Adhesive Resins to Pulp Chamber Dentin

Microleakage of oral microorganisms, which can occur due to the lack of sealing ability of permanent restorative materials, may cause failure of root canal treatments. Although a great deal of research has been done on sealing enamel and coronal dentin with resins, little research has been done on the adhesion of resins to the walls of pulp chambers. The purpose of this study was to evaluate regional bond strengths of two adhesive systems to the walls of pulp chambers. A section was made horizontally through the middle of the pulp chamber of extracted human third molars to divide the chamber into upper and lower halves. The pulp tissue was removed and the tooth segments were then divided into treatment subgroups. The pulp chambers were bonded with C&B Metabond (Parkell) or One-Step (Bisco), with or without 5% NaOCI pretreatment. The microtensile bond strengths of these resins to four different pulp chamber regions (bottom, wall, roof, and pulp horn areas) were then measured using an Instron machine. The data were expressed in MPa and were analyzed by a three-way ANOVA. Statistically significant differences were found among the test groups (p < 0.001). One-Step produced higher bond strengths to all pulp chamber regions except the floor, compared with C&B Metabond. The results indicated that high bond strengths can be achieved between adhesive resins and the various regions of the pulp chamber. This should permit the use of a thick layer of unfilled resin along the floor of the pulp chamber and over the canal orifices as a secondary protective seal after finishing root canal therapy.

Effect of Solvents on Bonding to Root Canal Dentin

The long-term success of resin cementation of post/cores is likely increased with improvement in resin-root canal dentin bonding. The adverse effect of some irrigation constituents (NaOCl, H2O2) or medications (eugenol) on the bond strengths of resins to dentin have been reported. The purpose of this in vitro study was to evaluate the effect of two gutta-percha solvents (chloroform versus halothane) on microtensile bond strength to root canal dentin. Thirty, extracted, human, single-rooted teeth were instrumented to a #70 file and randomly divided into 3 groups of 10 each. The root canals were treated with water, chloroform, or halothane for 60 s. All root canals were obturated using C&B Metabond. After 24 h of storage in distilled water, serial 1-mm-thick cross-sections were cut and trimmed. Microtensile bond strength to apical, middle, and coronal root canal dentin were measured using an Instron machine. Using pooled data, the results indicated that water-treated roots had significantly higher resin-dentin bond strengths compared with chloroform or halothane treatment groups (control: 23.9 MPa; chloroform: 18.3 MPa; halothane: 17 MPa; p < 0.05). Gutta-percha solvents have an adverse effect on bond strengths of adhesive cements to root canal dentin.