In vitro evaluation of carrier based obturation technique: a CBCT study

AIM: The goal of the study was to compare the ability of two different carrier based obturation (CBO) techniques to reach working length and fill in three-dimensions root canal systems, by using CBCT. MATERIALS AND METHODS: Twenty-six extracted molars were scanned with CBCT and 40 curved canals were selected (between 30° and 90°) and divided in two similar groups (n=20). All canals were prepared up to size 25 taper .06 using nickel-titanium instrumentation. The canals in the Group SC were obturated using Soft-Core obturators (Kerr, Romulus, Mi, USA), while Group TH canals (n= 20) were obturated using Thermafil Endodontic Obturators (Tulsa Dental Products, Tulsa, OK, USA), strictly following manufacturers' instructions for use. The obturations were analyzed by means of CBCT to measure the distance from the apical limit of obturation to the apical foramen and the presence of voids inside root canals. RESULTS: There was no significant difference between the two groups in the mean distance of the apical extent of the obturation (t test, p>0.05). Overfilling occurred in only 3 cases (2 in Group TH and 1 in Group SC). The percentages of voids in both groups were very low with no significant difference (Z test, p>0.05). CONCLUSIONS: The two tested CBO techniques showed similar positive results in terms of performance, even if, after checking with verifiers, in most cases the size of the selected Soft-Core obturator was one size smaller than Thermafil

Detection of bone defects using CBCT exam in an Italian population

Background. The aim of this study was to evaluate the in vivo incidence and the location of fenestrations in a young Italian population by using CBCT. Materials and Methods. Fifty patients who had previously performed CBCT for planning third molar extraction or orthodontic therapy were selected for the study. No previous dental treatment had been performed on these patients. Overall, 1,395 teeth were evaluated. Root fenestrations were identified according to the definition of Davies and the American Association of Endodontists. Data was collected and statistically analyzed. Results. Fenestrations were observed in 159 teeth out of 1,395 (11% of teeth). In the lower jaw, we found 68 fenestrations (5%) and 91 in the maxilla (6,5%). Incisors were the teeth with the highest incidence of fenestrations. Conclusion.The relative common finding (11%)of fenestration supports the need for CBCT exams before any surgical/implant treatment to avoid complications related to the initial presence of fenestrations. CBCT was found to be an effective and convenient tool for diagnosing fenestration

Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

Aim. To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods. Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (P<0.05). Results. No statistically significant differences were found among groups (P<0.05). Fracture resistance of endodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions. No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations

Erratum to: Cutting efficiency of nickel–titanium rotary and reciprocating instruments after prolonged use

Abstract The aim of the present study was to compare the cutting efficiency of Twisted File instruments used in continuous rotation or TF Adaptive motion and evaluate if prolonged use significantly affected their cutting ability. 20 new NiTi instruments were used in the present study (TF tip size 35, 0.06 taper; Sybron-Endo, Orange, CA, USA), divided into 2 subgroups of 10 instruments each, depending on which movement was selected on the endodontic motor. Group 1: TF instruments were activated using the program TF continuous rotation at 500 rpm and torque set at 2 N; Group 2: TF instruments were activated using the reciprocating TF Adaptive motion. Cutting efficiency was tested in a device developed to test the cutting ability of endodontic instruments. Each instrument cut 10 plastic blocks (10 uses) and the length of the surface cut in a plastic block after 1 min was measured in a computerized program with a precision of 0.1 mm. Maximum penetration depth was calculated after 1 use and after 10 uses, and mean and standard deviation (SD) of each group was calculated. Data were statistically analyzed with a one-way ANOVA test (P.05). TF instruments used in continuous rotation (Group 1) cut a mean depth of 10.4 mm (SD = 0.6 mm) after the first use and 10.1 mm (SD 1.1 mm) after 10 uses, while TF instruments used with the Adaptive motion cut a mean depth of 9.9 mm (SD = 0.7 mm) after the first use and 9.6 mm (SD = 0.9 mm) after 10 uses. There was no statistically significant difference between the two groups investigated (P[0.05) nor between instruments after 1 or 10 uses. In conclusion, the TFA motion showed a lateral cutting ability similar to continuous rotation and all tested instruments exhibited the same cutting ability after prolonged use

In vitro Evaluation of the Cytotoxicity of Different Root Canal Filling Materials

Objective: Aim of the present study was to evaluate the cytotoxicity of Real Seal 1 compared to other commercially available endodontic filling materials: Real Seal (SybronEndo, Orange, CA, USA) and Thermafil (Tulsa Dental, Tulsa, OK, USA). Material and Methods: Periodontal ligament cells from healthy patients were cultured. The eluate of Real Seal 1TM (RS1), Real Seal (RS) and Thermafil (TF) samples was used for the cells viability tests, both diluted (50%) or undiluted (100%). Incubation of the specimens was performed in culture medium for 24 h, 48 h and 72 h at 37 °C under sterile conditions. The cellular mortality was evaluated by MTT test. Results were statistically analysed and the statistical significance was set at p&lt; 0.05. Results: None of the studied materials showed toxic effects during the period of observation (0 -72 h) when compared to the control group. Only RS induced a very modest increase in cell mortality (about 3% at both concentrations used, during the first 24 hours), when increasing the incubation time, however, only the lower concentration continued to show modest toxicity. Conclusions: Results of the present study showed that all tested materials did not exhibit cytotoxic effects when compared to the control group. © Gambarini et al

Microcomputed tomographic analysis of the furcation grooves of maxillary first premolars

Objectives. The aims of this study were to conduct a morphometric analysis on the buccal furcation grooves in freshly extracted bifurcated maxillary first premolars (MFPs) and to correlate all anatomical measurements using microcomputed tomography. Materials and Methods. Twenty-three human MFPs with bifurcated canals were selected for this study. The specimens were analyzed with microcomputed tomography.The length, the beginning, and the ending of the grooveswere measured. The minimum cross-sectional canal wallthickness in the grooves was located, and the width ofthe dentin thickness was calculated. All measurementswere recorded and statistically analyzed. Results. The concavity of the grooves begins before the bifurcation site in 9/23 samples and after the bifurcation in 56.5% of samples. The groove length varied between 1.1-9 mm; the cross-sectional area with minimum palatal dentin thickness was 0.78±0.14 mm, which was locatedat a mean distance of 7.1 mm from the cementoenamel junction (CEJ) and 1.38 mm from the furcation. Conclusions. The presence of the furcation grooves in the palatal aspects of the buccal roots of the MFPs was 100%. The length, depth, location, and width of the dentinthickness of the grooves varied in relation to tooth length, bifurcation, and CEJ. These parameters shouldbe taken into consideration before any endodontic orrestorative procedures are performed. Reducing dentin width too vigorously by intracanal instrumentation can predispose to vertical root fractures or perforations; if a post cannot be avoided, it should not extend 6.5 mmfrom the CEJ

Deformations and cyclic fatigue resistance of nickel-titanium instruments inside a sequence

To compare the effect of brushing motion on torsional and cyclic fatigue resistance of TF Adaptive instruments after clinical use. 20 packs of TFA small sequence (SybronEndo, Orange, CA, USA) were used for this study and divided into two groups. Each instrument prepared one resin tooth, consisting in 4 canals with a complex anatomy. In group A, no brushing motion was performed. In group B, after the green instrument reached the working length, brushing motion with circumferential filing was performed for 15 seconds in each canal (overall 1 minute). All the instruments were then subjected to cyclic fatigue test and mean values and standard deviation for time to fracture were evaluated. Data were subjected to one-way analysis of variance and Bonferroni t-test procedure with a significance set at P < 0.05. No instruments were broken during preparation of root canals. Two TF Adaptive green and 5 yellow showed unwinding after intra-canal clinical use. No statistically significant differences were found between green instruments of both groups (P > 0.05), while a statistically significant difference was found between the Yellow instruments (P < 0.05), with group B showing an higher resistance to cyclic fatigue. A prolonged passive brushing motion did not adversely affected mechanical resistance of the instrument used for this purpose. Resistance to both deformations and cyclic fatigue of the second instrument within the TFA small sequence was enhanced by the coronal flaring provided by the brushing action of the first instrument used

Fatigue resistance of rotary instruments manufactured using different nickel-titanium alloys: a comparative study.

The aim of this study was to investigate whether cyclic fatigue resistance is increased for Controlled Memory (CM) Nickel-Titanium (NiTi) instruments, compared to instruments produced using traditional NiTi and instruments produced using M-Wire alloy. Two groups of NiTi endodontic instruments consisting of identical instrument sizes (constant 0.06 taper and 0.25 tip diameter and constant 0.04 taper and 0.40 tip diameter) were tested: group A compared Hyflex™ CM, Vortex ™ and ProFile ™ size 25 and 0.06 taper and group B compared Hyflex™ CM, Vortex™ and ProFile™ size 40 and 0.04 taper. 10 files from each different subgroup were tested for cyclic fatigue resistance. Mean and standard deviations of the Number of Cycles to Failure (NCF) were calculated for each group and data were statistically analysed (p  0.05) was noted between Vortex™ and ProFile™ in the tested sizes. The new manufacturing process involving memory shape heat treatment produced new NiTi rotary files (Hyflex™ CM) significantly more resistant to fatigue than instruments produced with other proprietary methods of treatment (Vortex™) and with the traditional NiTi grinding process (ProFile™). © 2012 The Society of The Nippon Dental University

Cyclic Fatigue Comparison of TruNatomy, Twisted File, and ProTaper Next Rotary Systems

TruNatomy (TN; Dentsply Sirona, Maillefer, Ballaigues, Switzerland) is a newly released system that was not tested in any previous studies. The objective of this work is to evaluate cyclic fatigue resistance of the new file and compare it with the Twisted Files (TF) and ProTaper Next (PTN). Forty-five files were distributed into 3 groups: PTN X2 (size 25 and taper 0.06), TF (size 25 and taper 0.06), and TN prime file (size 26 and taper 0.04). Each group included 15 files. Lengths of all files were 25 mm. Cyclic fatigue testing was done using artificial stainless-steel canals with 60-degree curvature and 5 mm radius. Continuous rotation movement at 300 rpm was used until the file fractures. Time for file separation was recorded in seconds. The number of cycles to failure (NCF) mean and standard deviation for each group was calculated. For statistical analysis of data, ANOVA and Tukey’s multiple comparison test were used. Mean and standard deviation (SD) of NCF were 259 ± 37.2, 521.67 ± 63.07 and 846.67 ± 37.16 for PTN, TF, and TN respectively. TN on average had significantly the highest NCF compared with PTN (p<0.05) and TF (p<0.05). TruNatomy file showed superior cyclic fatigue resistance. With its potential to preserve tooth structure, this file offers a good cyclic fatigue advantage. However, future studies are required to evaluate other properties of this file and to examine its clinical performance