Sibel Koçak

Evaluation of Microcrack Formation in Root Canals After Instrumentation With different NiTi Rotary File Systems: A Scanning Electron Microscopy Study

The aim of this study was to evaluate the dentinal microcrack formation of ProTaper Universal, ProTaper Next, and WaveOne. Sixty extracted mandibular molars were selected. The mesial roots were resected and randomly divided into four groups (n = 15). The canals were prepared with hand files (group 1), ProTaper Universal (group 2), ProTaper Next (group 3), and WaveOne (group 4) instrument systems. The roots were separated horizontally at 3, 6, and 9 mm from the apex. Digital images were captured at ×40 magnification using scanning electron microscopy to detect microcrack formation. Statistical analysis was performed by Pearson Chi-square test. The prevalence of microcracks in group 2, group 3, and group 4 were significantly higher when compared to group 1 (p < 0.001). Group 2, group 3, and group 4 demonstrated similar prevalence of microcracks without significant difference (p > 0.05) in all sections. All instruments caused microcracks except for hand file. The highest percentage of microcrack was recorded in 3 mm section for all groups.

Efficacy of different solvents in removing gutta-percha from curved root canals: a micro-computed tomography study.

The aim of this study was to compare the root filling material that remained after retreatment of curved root canals with chloroform and Endosolv R as solvents. The evaluation employed micro-computed tomography (CT) imaging. Thirty-six extracted molar teeth with curved roots were selected. After preparation with ProTaper rotary instruments, the canals were filled with gutta-percha and AH26 sealer. The teeth were randomly divided into three groups according to solvent used (n = 12) as follows: group 1: chloroform; group 2: Endosolv R; group 3: no solvent (negative control). ProTaper Universal Retreatment files were used to remove each root canal filling and then the self-adjusting file was applied for two minutes. Preoperative and postoperative micro-CT images were used to assess the percentage of residual filling material. The mean percentage of residual filling material was quantified. There were no statistically significant differences between the groups in terms of percentage volume of residual root canal filling.

Efficiency of 2 electronic apex locators on working length determination: A clinical study.

Aims: The aim of this clinical study was to evaluate the clinical accuracy of two electronic apex locators (EALs). Materials and Methods: A total of 120 patients with 283 roots were randomized into three groups including, traditional radiographic method, EAL (Root ZX mini), and apex locating endodontic motor (VDW Gold) for working length (WL) determination. Root canals were instrumented to a size ProTaper F3 nickel titanium file. The obturation quality of matched tapered master cone (ProTaper F3) was determined for the accuracy of WL. Statistical Analysis Used: Descriptive statistics were expressed as numbers and percentages. Pearson Chi-square test was used to determine for differences between groups. P < 0.05 was considered statistically significant for all tests. Results: There was no statistically significant difference between the three tested groups (P = 0.894). Conclusions: The success of both apex locators was similar to the radiographic WL determination technique.

Sealing ability of retrofilling materials following various root-end cavity preparation techniques

The aim of this study is to compare the sealing efficacy of the retrograde cavity preparations prepared and filled with different equipment and materials. In the study, low speed burs, ultrasonic or Er, Cr:YSGG laser devices were used for cavity preparations and ProRoot MTA and MTA-Angelus as filling materials. Seventy-eight single-rooted teeth were instrumented, root filled, and grouped. Root-end cavities were prepared and filled by using the following: Group 1: Low-speed carbide bur + ProRoot MTA; Group 2: Low-speed bur + MTA-Angelus; Group 3: Ultrasonic retrotips + ProRoot MTA; Group 4: Ultrasonic retrotips + MTA-Angelus; Group 5: Er, Cr:YSGG laser tips + ProRoot MTA; Group 6: Er, Cr:YSGG laser tips + MTA-Angelus. Microleakage was measured using a fluid filtration technique. Differences in the fluid movement among groups were analyzed with a two-way analysis of variance (ANOVA) and LSD test. The results showed a significant difference between the groups prepared with laser and carbide bur (p < 0.05). No difference was found between root-end filling materials (p > 0.05). According to the results of the study, the cavities prepared with Er, Cr:YSGG laser demonstrated significantly lower microleakage in all the filling materials considered.

Evaluation of the biocompatibility of experimentally manufactured portland cement: an animal study

Objectives: The purpose of this study was to evaluate the biocompatibility of MTA and the experimentally manufactured portland cement (EMPC). Study design: Twenty one Sprague Dawley (SD) rats were allocated to testing of three groups. Group I and Group II included ProRoot MTA and the EMPC. The materials were mixed with distilled water and placed in polyethylene tubes. The tubes were implanted subcutaneously in the dorsal region of the animals. Group III served as control; the implanted polyethylene tubes remained empty. At 7, 14, and 28 days after the implantation, the animals were sacrificed and the implants were removed with the surrounding tissues. The specimens were prepared for histological examination to evaluate the inflammatory response. Results: No significant difference was found between tissue reactions against the tested materials (p>0.05). Also, control group showed similar results (p>0.05). Conclusions: Results suggest that the EMPC has the potential to be used in clinical conditions in which ProRoot MTA is indicated. MTA and the EMPC show comparable biocompatibility when evaluated in vivo. Although the results are supportive for the EMPC, more studies are required before the safe clinical use of the EMPC. Key words:Mineral trioxide aggregate, portland cement, subcutanous implantation.

The effect of glide path on the surface quality of new and used rotary and reciprocating single files: OneShape versus WaveOne

The aim of this study was to evaluate the effect of glide path preparation on the surface topography changes of WaveOne and OneShape single files using atomic force microscopy analysis. Two commercially available brands of single file systems were analyzed, including 15 specimens/brand as following: Group I; WaveOne 0.08/25 (Dentsply Maillefer, Ballaigues, Switzerland) and Group II; OneShape 0.06/25 (Micro Mega, Besançon, France). In each group, 3 new files were subjected to AFM analysis as received from manufacturer, and 12 files were analyzed after preparation of root canals. A total of 20 human maxillary molar teeth were selected. In each group, 12 files were divided into 4 subgroups according to instruments that were used in one or three root canals with or without a previous glide path (n = 3). After preparation the surface analysis of single files was performed on 11 different points located along a 3-mm section starting at the tip of each file using AFM. Root mean square (RMS) values were recorded to investigate the surface features of endodontic files. The differences between RMS values were tested by one-way ANOVA. There was no statistically significant difference between the groups (p > 0.05). Creation of a glide path did not affect the surface topography of single file systems.

Comparison of calcium hydroxide removal by self-adjusting file, EndoVac, and CanalBrush agitation techniques: An in vitro study.

Objectives: This study comparatively evaluated the efficacy of self-adjusting file (SAF), Endovac, and CanalBrush irrigant agitation protocols in removing calcium hydroxide (Ca(OH)2) from the root canals. Materials and Methods: Sixty extracted human mandibular canine teeth were instrumented with ProTaper rotary instruments to size #40 and dressed with Ca(OH)2. The roots were randomly assigned to four groups according to irrigant agitation protocol used (n = 15). In Group 1: Conventional syringe irrigation (no activation, control); Group 2: Rotary brush agitation (CanalBrush); Group 3: Apical negative pressure irrigation (EndoVac system); and Group 4: Sonic agitation (SAF) were used. Scanning electron microscopic (SEM) evaluation was done for assessment of Ca(OH)2 removal in the coronal and apical thirds. Statistical analysis was performed by Wilcoxon and Kruskal-Wallis tests. Results: There were statistically significant differences among the groups (P = 0.218). A statistically significant difference was seen between the test groups in Ca(OH)2 removal from the apical third of the canal (P < 0.05). In the coronal third, there was no difference between the groups (P > 0.05). The most efficient Ca(OH)2 removal in apical third was recorded in Group 3 (EndoVac) and Group 4 (SAF) (P < 0.05). In Group 4 (sonic agitation), there was no significantly difference between Ca(OH)2 removal in coronal and apical thirds. Conclusions: SAF and EndoVac showed significantly better performance than CanalBrush and conventional syringe irrigation in removing Ca(OH)2 from apical third of the root canals.

Effects of irrigation solutions on the surface of protaper instruments: A microscopy study

The aim of this study was to evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), and mixture of tetracycline, citric acid, and detergent (MTAD) solutions on the surfaces of nickel titanium (NiTi) rotary files with scanning electron microscopy (SEM) and atomic force microscopy (AFM). Irrigation solutions including 2.5% NaOCl, 5% NaOCl, 2% CHX, and MTAD were used. Four new ProTaper rotary NiTi files (F3) were immersed in each four irrigation solutions for 10 min, separately. One untreated NiTi file was used as a control specimen. The surface analysis was performed with SEM and AFM. The surface analysis in AFM was performed on 12 different regions located between first and second millimeters from the tip. SEM images were taken with different magnifications. No surface alteration was recorded under SEM evaluation. AFM revealed that the root mean square (RMS) values of all treated specimens were statistically higher than the control sample (P < 0.05). The sample which was treated with CHX showed lowest RMS values in test groups. All tested solutions caused surface alterations. CHX demonstrated limited surface alterations when compared to the other tested solutions. Microsc. Res. Tech.

Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material

Aim: The aim of this study was to compare the efficacy of hand file, nickel titanium rotary instrument, and two reciprocating instruments for removing gutta-percha and sealer from the root canals. Materials and Methods: Eighty-eight mandibular premolar teeth were used. The root canals were shaped and filled with gutta-percha and a resin-based sealer. The specimens were divided into four groups according to the technique by which the root filling material was removed: Group 1 - Wave One; Group 2 - Reciproc; Group 3 - ProTaper; and Group 4 - Gates-Glidden burs and stainless steel hand file. Then teeth were split longitudinally and photographed. The images were transferred to a computer. The ratio of remaining filling material to the root canal periphery was calculated with the aid of ImageJ software. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney tests. Results: A significant difference was found among all groups (P < 0.001). The WaveOne group demonstrated significantly less remaining filling material. The greatest amount of filling material was found in specimens where gutta-percha was removed with Gates-Glidden burs and stainless steel hand file. Conclusion: The reciprocating files were found to be significantly more effective in removing the filling material from the canal walls compared to the rotational file and hand file.

Influence of Diode Laser Application on the Efficiency of QMiX and EDTA Solutions in Removing Smear Layer

OBJECTIVE The aim of this study was to compare the efficacy of QMiX and ethylenediaminetetraacetic acid (EDTA) solutions with diode laser treatment in smear layer removal. BACKGROUND DATA Removing the smear layer from the apical thirds of root canals is difficult, regardless of the solution used. Researchers have been improved some irrigation agitation methods to overcome this challenge, and agitation of irrigants with laser devices has become popular. METHODS Seventy-five extracted mandibular premolars were used. After root canals were, prepared the specimens were divided into five groups (n = 15): Group 1, no irrigation; Group 2, 17% EDTA; Group 3, QMiX solution; Group 4, 17% EDTA with diode laser; and Group 5, QMiX with diode laser. The roots were split longitudinally and prepared for scanning electron microscopic (SEM) investigation. The smear layer was evaluated under × 500, × 1000, and × 2000 magnifications. RESULTS The amount of smear layer was found significantly high in the control group (p < 0.001). In the EDTA group, the amount of smear layer was significantly high at the apical thirds, and the differences among the three regions were statistically significant (p < 0.001). In the QMiX group, no difference was found between the coronal and middle thirds; however, the amount of smear layer was significantly high at the apical thirds (p < 0.001). In the EDTA plus laser and the QMiX plus laser groups, the smear layer was found significantly high at the apical thirds (p < 0.001). However, no differences were found between the coronal and middle thirds in either group. CONCLUSIONS None of the solutions completely removed the smear layer, especially at the apical thirds. Diode laser treatment with solutions decreased the amount of smear layer, without significance.