Endodontic Treatment of Two-Canalled Maxillary Central and Lateral Incisors: A Case Report

Familiarity with the intricacies and variations of root canal morphology is essential for successful endodontic treatment. Maxillary central and lateral incisors are known to be single-rooted with one canal, however, this case report describes endodontic treatment of maxillary central and lateral incisors with two buccopalatal root canals

Comparison of Tooth Color Change After Bleaching With Conventional and Different Light-Activated Methods

Introduction: The demand for esthetic dental treatments is increasing in recent years mainly due to improved oral hygiene and better maintenance of oral health and teeth in older individuals. Bleaching of discolored anterior teeth is the most popular among esthetic dental treatments. Even individuals with sound teeth and adequate esthetics seek to have whiter teeth in the anterior region. The aim of this study was to evaluate tooth color changes following conventional in-office bleaching techniques compared to light-activated methods using different light sources.Methods: Seventy sound anterior teeth (devoided of caries and/or fracture), extracted for periodontal and orthodontic reasons were selected and allocated to 7 groups: (A) control, (B) conventional bleaching (C) LED-activated bleaching, (D) KTP laser-activated bleaching, (E) diode laser-activated bleaching, (F) Nd:YAG laser-activated bleaching and (G) CO2 laser-activated bleaching. Colorimetric evaluation was carried out before and after treatment using a spectrophotoradiometer. Data were analyzed by one- and two-way analysis of variance (ANOVA) as well as multiple comparison methods.Results: The results showed that all bleaching procedures were effective in reducing the yellowness index. However, the KTP laser-activated bleaching was significantly more effective than the other techniques in 95% confidence level. It was also seen that CO2 laser activated method has outperformed groups E, F and G and the conventional bleaching without light activation was not effective at all and represented similar results with the control group. Furthermore, the groups E and G had almost the same results in decreasing the yellowness index.Conclusion: The results showed that all bleaching techniques were effective however, the KTP laser-activated bleaching was significantly more efficient, closely followed by the CO2 laser-activated bleaching technique

Comparison of laser and power bleaching techniques in tooth color change

Laser-assisted bleaching uses laser beam to accelerate release of free radicals within the bleaching gel to decrease time of whitening procedure. The aim of this study was to compare the efficacy of power bleaching using Opalescence Xtra Boost® and laser bleaching technique using LaserSmile gel and diode laser as an activator in their tooth whitening capacity. Student t test showed that the laser bleaching group significantly outperformed the power bleaching group in changing ?E (p=0.977). Similarly, while comparing the groups in changing ?L, the laser bleaching group indicated significantly superior results (p=0.953). Statistical data from student t test while comparing the groups in changing the parameter of yellowness indicated that samples in laser bleaching group underwent a more significant reduction than power-bleached samples (p=0.85). Correspondingly, changes in whiteness were statistically tested through student t test, showing that laser bleaching technique increased whiteness of the samples significantly more than those treated by power bleaching (p=0.965). The digital color evaluation data was in accordance with spectrophotometry and showed that laser bleaching outperformed power bleaching technique. Both techniques were able to increase whiteness and decrease yellowness ratio of the samples. ?E decrease for laser bleaching and power bleaching groups were 3.05 and 1.67, respectively. Tooth color change in laser bleaching group was 1.88 times more than that of power bleaching group (p<0.001). It could be concluded that under the conditions of this study, both laser-assisted and power bleaching techniques were capable of altering tooth color change, but laser bleaching was deemed a more efficient technique in this regard

In Vitro Comparison of the Effectiveness of Chlorhexidine and Two Calcium Hydroxide Formulations on Enterococcus Faecalis

INTRODUCTION: The aim of this in vitro study was to compare the effectiveness of three intracanal medicaments in disinfecting the root canal and dentin of experimentally infected human teeth with Enterococcus faecalis (EF). MATERIALS AND METHODS: One hundred extracted human single-rooted teeth were used. After root canal preparation, teeth were mounted in epoxy resin. Following sterilization, the teeth were infected for 28 days with EF. Then root canals were filled with one of three different disinfectants: viscous 2% Chlorhexidine (CHX), calcium hydroxide paste (CH) or a mixture of CH and CHX (n=30 in each group). Antimicrobial assessments were performed at 1, 3 and 7 days (n=10 in each time period). Microbial samples were obtained from root canals before and after the experiment. Also dentin samples were examined. The data was analyzed using Two- Way ANOVA test. RESULTS: The findings showed that there was no difference between experimental groups at different time periods. The mixture of CH/CHX in 7 days was able to eliminate EF completely from root canal system. The most elimination of EF was from dentinal tubules. CONCLUSION: According to the results of this in vitro study, viscous 2% CHX, mixture of CH with distilled water and 2% CHX are all effective disinfectants

Accuracy of CBCT, Digital Radiography and Cross-Sectioning for the Evaluation of Mandibular Incisor Root Canals

ntroduction: The aim of this study was to compare the accuracy of cone-beam computed tomography (CBCT), digital radiography and tooth sectioning in evaluating root canal morphology of mandibular incisors in an in vitro setting. Methods and Materials: A total of 76 samples were imaged using CBCT, and digital radiography in straight and angled views. The samples were then sectioned at different distances from the apex for further visualization under stereomicroscope. The agreement between the observers was statistically analyzed by kappa correlation coefficient and the chi-square test. Results: The results showed that the majority of the samples had a single canal (Vertucci’s Type I). CBCT analysis reported more frequent multi-canal roots in comparison with the other techniques. In pairwise comparisons, the highest agreement was found between digital radiographic imaging and microscopic cross-sectioning both in terms of canal configuration and the number of root canals. Conclusion: None of the used imaging techniques per se could adequately show the exact internal anatomical configuration in accordance with the gold standard.Keywords: Anatomy; Cone-Beam Computed Tomography; Digital Radiography; Incisor Teet

Comparative evaluation of the effects of three hydraulic calcium silicate cements on odontoblastic differentiation of human dental pulp stem cells: an in vitro study

Objective: The study aimed to compare the response of human dental pulp stem cells (hDPSCs) towards three hydraulic calcium silicate cements (HCSCs) by measuring cytotoxicity and expression of dentinogenic genes. Methodology: Dental pulps of five impacted mandibular third molars were extirpated as a source for hDPSCs. Next to culturing, hDPSCs were subjected to fluorescence-activated cell sorting after the third passage to validate stemness of the cells. Human DPSCs were exposed to diluted supernatants of OrthoMTA (OMTA), Biodentine (BD) and Calcium-Enriched Mixture (CEM) at concentrations 10, 25, 50 and 100% at the first, third and fifth day of culture. Then, cells were exposed to 10% concentrations supernatant of HCSCs to determine DSPP and DMP1 gene expression, using a quantitative polymerase-chain reaction. Data were analyzed using one-way and three-way ANOVA, followed by Tukey post hoc statistical tests. Results: Optimal cell proliferation was observed in all groups, regardless of concentration and time-point. HCSC supernatants were non-cytotoxic to hDPSCs at all three time-points, except for 100% Biodentine on day five. On day seven, OMTA group significantly upregulated the expression of DSPP and DMP1 genes. On day 14, expression of DMP1 and DSPP genes were significantly higher in BD and OMTA groups, respectively. Conclusion: Biodentine significantly upregulated DMP1 gene expression over 14 days, whereas CEM was associated with only minimal expression of DSPP and DMP1 . &nbsp

Comparative evaluation of the effects of three hydraulic calcium silicate cements on odontoblastic differentiation of human dental pulp stem cells: an in vitro study

Objective The study aimed to compare the response of human dental pulp stem cells (hDPSCs) towards three hydraulic calcium silicate cements (HCSCs) by measuring cytotoxicity and expression of dentinogenic genes. Methodology Dental pulps of five impacted mandibular third molars were extirpated as a source for hDPSCs. Next to culturing, hDPSCs were subjected to fluorescence-activated cell sorting after the third passage to validate stemness of the cells. Human DPSCs were exposed to diluted supernatants of OrthoMTA (OMTA), Biodentine (BD) and Calcium-Enriched Mixture (CEM) at concentrations 10, 25, 50 and 100% at the first, third and fifth day of culture. Then, cells were exposed to 10% concentrations supernatant of HCSCs to determine DSPP and DMP1 gene expression, using a quantitative polymerase-chain reaction. Data were analyzed using one-way and three-way ANOVA, followed by Tukey post hoc statistical tests. Results Optimal cell proliferation was observed in all groups, regardless of concentration and time-point. HCSC supernatants were non-cytotoxic to hDPSCs at all three time-points, except for 100% Biodentine on day five. On day seven, OMTA group significantly upregulated the expression of DSPP and DMP1 genes. On day 14, expression of DMP1 and DSPP genes were significantly higher in BD and OMTA groups, respectively. Conclusion Biodentine significantly upregulated DMP1 gene expression over 14 days, whereas CEM was associated with only minimal expression of DSPP and DMP1

Evaluation of the root canal morphology of mandibular second premolars in an Iranian population.

A detailed knowledge of root canal anatomy is a prerequisite for successful endodontic treatment. Such information is highly dependent upon the ethnicity of the population of interest. Lack of sufficient national information concerning internal anatomy can lead clinicians to increase their rate of treatment success. The aim of this study was to evaluate external root morphology and root canal anatomy of mandibular second premolars in an Iranian population.Two hundred seventeen human extracted mandibular second premolars were selected. Each tooth was radiographed both mesiodistally and buccolingually. Then, access cavities were prepared for each tooth and root canal negotiated before being immersed into 1% fuchsine solution. Teeth were de-coronated and their roots sectioned into three equal (cervical, middle and apical) parts. Cross sections were visualized under 40X magnification.Among all roots examined, 132 were straight both mesiodistally and buccolingually, 56 were mesiodistally curved, but buccolingually straight, 11 were mesiodistally straight, but buccolingually curved and 18 samples were curved in both aspects. Internal anatomical evaluation showed 198 samples (91.24%) with a single and 19 (8.75%) with more than one canal.Although straight roots are common in mandibular second premolars, curvatures in mesiodistal, buccolingual or both directions are not uncommon in the Iranian population. Single-canalled roots are also frequent in these teeth, but Vertucci's types II, III, IV, V, and C-shaped configurations are also encountered

Cytotoxicity Evaluation of ProRoot MTA, Root MTA and Portland Cement on Human Gingival Fibroblasts

INTRODUCTION: The aim of this study was to compare the cytotoxicity of ProRoot MTA (PMTA), Root MTA (RMTA) and Portland cement (PC) on human gingival fibroblasts (HGFs). MATERIALS AND METHODS: The extracts of the test materials were placed close to human gingival fibroblasts (HGFs) within 96-well plates. Cellular viability was assessed using MTT assay in different intervals (freshly mixed, 4, 24, and 168 hours after mixing). The data were analyzed using the One-way ANOVA and Tukey’s test at 95% significance level. RESULTS: It was indicated that there was not a significant difference in cytotoxicity of test materials (P&gt;0.05). In addition, there was not a statistically significant difference between different time intervals within each group (P&gt;0.05). CONCLUSION: PMTA, RMTA and PC showed comparative biocompatibility while evaluated in-vitro

Residual Antimicrobial Activity of MTAD(®) in Human Dentin After Obturation with Gutta-Percha/AH26 and Resilon/RealSeal SE at Different Time Intervals; An Ex Vivo Study.

To eliminate microorganisms that are responsible for pulpal and periapical infections and to prevent reinfection of the root canal system an effective chemomechanical preparation by irrigants with sustained antimicrobial activity is beneficial. Hereby, we evaluated the residual antibacterial activity of MTAD after canal obturation at different time intervals.A total of 120 human single-canalled anterior teeth were selected. The root canals were instrumented to a standardized apical size. Among all, 90 teeth received final irrigation with MTAD and were divided into three groups according to their obturation materials; i.e. gutta-percha/AH26, Resilon/RealSeal SE and positive controls. All these groups were divided into three 1-, 3- and 6-week time interval subgroups. Thirty teeth as negative control had no final irrigation with MTAD, but were obturated with gutta-percha/AH26 or Resilon/RealSealSE. Dentin powder was prepared after 1, 3 and 6 weeks. Dentin powder was exposed to Enterococcus faecalis for 24h and then cultured. Colony Forming Unit (CFU) was counted.Residual antimicrobial activity of MTAD in the teeth obturated with guttapercha/AH26 was significantly higher than the teeth obturated with Resilon/RealSeal SE (