Apical Microleakage in Root Canals Containing Broken Rotary Instruments

Introduction: Broken instruments in root canals complicate routine endodontic treatment. This study aimed to compare apical microleakage in root canals containing broken rotary instruments filled with mineral trioxide aggregate (MTA), calcium-enriched mixture (CEM) cement, laterally compacted gutta-percha and injected gutta-percha. Methods and Materials: In this in vitro, experimental study, 80 extracted human premolars were decoronated and then the roots were randomly divided into four groups (n=20). Root canals were instrumented with Mtwo rotary files. The files were scratched 3 mm from the tip by a high speed handpiece and they were intentionally broken in the apical third of the canals. The middle and coronal thirds of the canals were then filled with MTA, CEM cement, gutta-percha with lateral compaction technique and injected gutta-percha. Apical microleakage was measured using dye penetration method. Data were analyzed using ANOVA and Tukey’s test. Results: Root canals filled with CEM cement showed the lowest and those filled with injected gutta-percha showed the highest microleakage according to dye penetration depth. No significant difference was noted between the microleakage of CEM cement and MTA or between lateral compaction of gutta-percha and injected gutta-percha (P>0.05). However, CEM cement and MTA groups had significantly lower microleakage than laterally compacted and injected gutta-percha groups (P<0.05). Conclusion: Due to their superior sealing ability, MTA and CEM cement are suitable for filling of root canals containing a broken instrument compared to laterally compacted and injected gutta-percha.Keywords: Broken Instrument; Calcium-Enriched Mixture; Gutta-Percha; Leakage; Mineral Trioxide Aggregate; Root Canal Filling Material

Evaluation of the Quality of Four Root Canal Obturation Techniques Using Micro-Computed Tomography

Introduction: One of the key factors in successful endodontic therapy is to adequately fill the root canals. The aim of this in vitro study was to compare the quality of four different root canal obturation techniques: cold lateral condensation (CLC), warm vertical condensation (WVC), Obtura II (OII) and Gutta Flow (GF) by using micro-computed tomography (micro CT). Materials and Methods: A total of 20 extracted maxillary first molars prepared with ProTaper files, were randomly divided into four groups. Micro CT was used to measure the internal volume of root canals. Following application of AH26 sealer to canal obturation, new micro-CT images were taken and the volume percentage (VP) of voids, gutta-percha and sealer at different levels were calculated with CT software. Data was statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. Results: The highest percentage of filling material was observed in GF group followed by OII with no statistically significant difference (P>0.05). These two groups had a significantly more acceptable filling than WVC and CLC groups (P<0.05). Voids were detected in all samples. There was a significant difference between the highest and the lowest percentage of voids in CLC (19.6%) and GF groups (6.7%), respectively. In the apical third, CLC and OII showed the highest and the lowest percentage of voids (5.5% and 2.6%) and the lowest and highest percentage of gutta-percha (76.52% and 94.26%), respectively. These differences were statistically significant (P<0.05). Conclusion: None of the root canal filled teeth were gap-free. GF and CLC techniques showed the highest and lowest VP of obturation materials, respectively

Simulated Evaluation of Tooth Fracture Resistance during Instrumentation with Single-and Multi-file Rotary Systems

Introduction: Use of rotary files in root canal preparation is inevitable due to their high speed and reduced duration of treatment. However, microcracks and even root fracture may sometimes occur in teeth where canal(s) is/are prepared using these devices. The purpose of the current study was to compare NeoNiti single-file with RaCe multi-file rotary systems. Materials and Methods: An accurate scanner designed detailed three-dimensional file models, and a simulated model was developed using canal-specific features; including dentin thickness, root canal length, taper rate and root canal curvature. Cleaning and shaping conditions were simulated with appropriate speed and crack conditions for both types of files on the computer. Strain accumulation sites in the root dentin wall where microcracks was likely to occur were simulated and investigated. Abaqus and ANSYS software were used to perform finite element simulations. Results: RaCe files with 0.04 taper caused the lowest level of stress (34.33 MPa) to the simulated canal. Conversely, the highest level of stress (62.35 MPa) was applied by 8% NeoNiti file to the simulated canal. Conclusions: Based on the present experimental study, it can be concluded that RaCe multi-file rotary system may better be used in endodontic therapy, and the risk of microcracks in the tooth wall is less than that of NeoNiti single-file rotary system

Effectiveness of Two Types of Photostimulable Phosphor Plate Plastic Barrier Envelopes for Prevention of Microbiological Contamination

Objective: To compare the effectiveness of two types of commercially available photostimulable phosphor plate (PSP) protective barrier envelopes to prevent microbiological contamination. Material and Methods: In this cross-sectional study, 80 barrier envelopes were tested in 40 volunteers. The PSP plates were placed individually in Asia Teb and Soredex protective barrier envelopes and were placed in the mouth for two minutes, similar to periapical films. The protective barrier envelopes were then removed under sterile conditions, and the sensors were placed on different culture media. The number of colonies on each plate was counted. Data were analyzed using SPSS via McNemar and Wilcoxon tests. Results: Bacterial growth was noted in 17.5% of PSPs with Soredex, and 32.5% of PSPs with Asia Teb barrier envelopes. Gram- positive bacilli were the most commonly isolated bacteria. The difference between the Asia Teb and Soredex barrier envelopes for the protection of microbiological contamination was not significant (p>0.05). Conclusion: The use of different types of protective barrier envelopes was not sufficient for prevention of microbiological contamination of PSP plates, and some adjunct modalities were required to decrease microbiological contamination of PSP plates

Association between IL-8 (-251T/A) and IL-6 (-174G/C) Polymorphisms and Oral Cancer Susceptibility: A Systematic Review and Meta-Analysis

Background and objective: Inflammation and cell-mediated immunity can have significant roles in different stages of carcinogenesis. The present meta-analysis aimed to evaluate the association between the polymorphisms of IL-8 (-251T/A) and IL-6 (-174G/C) and the risk of oral cancer (OC). Methods: PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus databases were searched until December 18, 2020 without any restrictions. RevMan 5.3 software was used to calculate the results of forest plots (odds ratios (ORs) and 95% confidence intervals (CIs)); CMA 2.0 software was used to calculate funnel plots (Begg’s and Egger’s tests), and SPSS 22.0 was used for the meta-regression analysis. Moreover, trial sequential analysis was conducted to estimate the robustness of the results. Results: Eleven articles including twelve studies were selected for the meta-analysis. The pooled ORs for the association between IL-8 (-251T/A) polymorphism and the risk of OC in the models of A vs. T, AA vs. TT, TA vs. TT, AA + TA vs. TT, and AA vs. TT + TA were 0.97 (p = 0.78), 0.86 (p = 0.55), 0.78 (p = 0.37), 0.83 (p = 0.45), and 1.10 (p = 0.34), respectively. The pooled ORs IL-6 (-174G/C) polymorphism and the risk of OC in the models of C vs. G, CC vs. GG, GC vs. GG, CC + GC vs. GG, and CC vs. GG + GC were 1.07 (p = 0.87), 1.17 (p = 0.82), 1.44 (p = 0.38), 1.28 (p = 0.61), and 0.96 (p = 0.93), respectively. There was no association between IL-8 (-251T/A) polymorphism and OC susceptibility, but the C allele and GC and CC genotypes of IL-6 (-174G/C) polymorphism were associated with the risk of OC based on subgroup analyses, that is to say, the source of control and the genotyping method might bias the pattern of association. Conclusions: The meta-analysis confirmed that there was no association between the polymorphisms of IL-6 (-174G/C) and IL-8 (-251T/A) and the susceptibility of OC. However, the source of control and the genotyping method could unfavorably impact on the association between the polymorphisms of IL-6 (-174G/C) and the risk OC

In vitro evaluation of coronal discoloration following the application of calcium-enriched mixture cement, Biodentine, and mineral trioxide aggregate in endodontically treated teeth

Background: This study sought to assess and compare coronal discoloration following the application of white mineral trioxide aggregate, Biodentine, and calcium-enriched mixture cement in endodontically treated teeth. Materials and Methods: In this in vitro experimental study, 64 freshly extracted sound human premolars were selected, cleaned, and stored in saline. After cleaning, shaping, and obturation the root canal of the teeth, the teeth were randomly assigned to one control (n = 4) and three experimental (n = 20) groups. In the experimental groups, the cement were applied over the canal orifices in 3-mm thickness. All teeth were then restored with composite resin. Color parameters, according to the CIE LFNx01aFNx01bFNx01 system, were measured using Vita Easyshade spectrophotometer before application of cement and at 1 week, 1 month, 2 months, and 3 months after the application of cement. The recorded values were statistically analyzed using descriptive and analytical statistics. For analytical statistics, Kolmogorov–Smirnov test was applied to assess normal distribution of data. ANOVA was used to compare the results at baseline and repeated measures. P < 0.05 was considered statistically significant Results: Significant differences were noted in color change (ΔE) between all time points except between ΔE4 (2 months) and ΔE5 (3 months) (P < 0.01). However, tooth discoloration caused by the three cement was not significantly different (P = 0.343). Conclusion: The three tested cement were not significantly different in terms of causing coronal discoloration in endodontically treated teeth

Association between IL-8 (-251T/A) and IL-6 (-174G/C) Polymorphisms and Oral Cancer Susceptibility: A Systematic Review and Meta-Analysis

Inflammation and cell-mediated immunity can have significant roles in different stages of carcinogenesis. The present meta-analysis aimed to evaluate the association between the polymorphisms of; IL-8 (-251T/A); and; IL-6 (-174G/C); and the risk of oral cancer (OC).; PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus databases were searched until December 18, 2020 without any restrictions. RevMan 5.3 software was used to calculate the results of forest plots (odds ratios (ORs) and 95% confidence intervals (CIs)); CMA 2.0 software was used to calculate funnel plots (Begg's and Egger's tests), and SPSS 22.0 was used for the meta-regression analysis. Moreover, trial sequential analysis was conducted to estimate the robustness of the results.; Eleven articles including twelve studies were selected for the meta-analysis. The pooled ORs for the association between; IL-8 (-251T/A); polymorphism and the risk of OC in the models of A vs. T, AA vs. TT, TA vs. TT, AA + TA vs. TT, and AA vs. TT + TA were 0.97 (; p; = 0.78), 0.86 (; p; = 0.55), 0.78 (; p; = 0.37), 0.83 (; p; = 0.45), and 1.10 (; p; = 0.34), respectively. The pooled ORs; IL-6 (-174G/C); polymorphism and the risk of OC in the models of C vs. G, CC vs. GG, GC vs. GG, CC + GC vs. GG, and CC vs. GG + GC were 1.07 (; p; = 0.87), 1.17 (; p; = 0.82), 1.44 (; p; = 0.38), 1.28 (; p; = 0.61), and 0.96 (; p; = 0.93), respectively. There was no association between; IL-8 (-251T/A); polymorphism and OC susceptibility, but the C allele and GC and CC genotypes of; IL-6 (-174G/C); polymorphism were associated with the risk of OC based on subgroup analyses, that is to say, the source of control and the genotyping method might bias the pattern of association.; The meta-analysis confirmed that there was no association between the polymorphisms of; IL-6 (-174G/C); and; IL-8 (-251T/A); and the susceptibility of OC. However, the source of control and the genotyping method could unfavorably impact on the association between the polymorphisms of; IL-6 (-174G/C); and the risk OC