In vitro Evaluation of the Accuracy of the Root Zx in the Presence of Naocl 2.5% and Chlorhexidine 0.2%

Establishing the working length at the apical constriction is considered ideal for root canal therapy. Because of the limitations of radiography and complicacy of the apex of the root, electronic measurement of canal length has become valuable for endodontic treatment. This study was designed to evaluation of the accuracy of the Root zx electronic apex locator in the presence of NaOCl 2.5% and chlorhexidine 0.2%. Thirty extracted human premolars with complete root formation were enrolled. The actual length (AL) was assessed visually (under stereo microscope) and teeth mounted in the saline model. The electronic length (EL) measurements were recorded in the presence of NaOCl 2.5% and chlorhexidine 0.2% and the differences between the EL and AL were compared. By accepting the error of 0.5 and 1 mm, the accuracy of Root zx was 76.7% and 96.7% in the presence of chlorhexidine 0.2% and 90% and 100% in the presence of NaOCl 2.5%, respectively. No statistical differences was found between the measured groups (P=0.223). Our results confirmed that Root zx can accurately determine the apical constriction in presence of both NaOCl 2.5% and chlorhexidine 0.2%

Cone-Beam Computed Tomographic Evaluation of Artifact Effects of Three Different Sealers

Introduction: Cone-beam computed tomography (CBCT) is one of the most important diagnostic tools in maxillofacial imaging. Nowadays different sealers are used in root canal therapy and some of them can create artifact in CBCT images. The aim of this study was to evaluate the effect of different sealers including AH-26, Diadent, and Anyseal in creation of artifact bands in the CBCT images based on voxel size. Methods and Materials: A total of 44 single rooted extracted teeth were selected. The canals were prepared by crown-down technique. All teeth were manually filed up to master apical file (MAF) size 45 and 1 mm shorter than the apical foramen. The teeth were divided into 4 equal groups. The canals were filled with gutta-percha and either of sealers AH-26, Diadent or Anyseal by lateral condensation technique. The control group were filled just with gutta-percha without any sealer. The CBCT images were taken in voxel sizes of 0.3 and 0.15. The Fisher exact and McNemar tests were used for statistical analysis. Results: Although, the control group had the lowest ratio of presence to absence of artifact, the ratio of presence to absence of artifact in voxel size of 0.3 and 0.15 mm were significantly lower in Anyseal than AH-26 (P=0.031, P=0.020) and Diadent (P=0.001, P=0.002). No significant difference was detected between two voxel sizes (P>0.05). Conclusion: In this in vitro study, all evaluated sealers induced artifacts in the CBCT images. Anyseal sealer had the lowest artifact in both evaluated voxel sizes.Keywords: Artifacts; Canal Sealer; Cone-Beam Computed Tomography; Root Canal Filling Material; Root Fractur

Evaluation of dentin penetration of three different endodontic sealers in the presence and absence of the smear layer

Introduction: A sealer’s ability to effectively and stably penetrate the dentinal tubules is an essential factor for selecting an effective root canal obturation material. Evaluation of the sealers’ penetration into the dentinal tubules provides valuable data in the endodontic treatment outcome.Aim: To compare the dentin penetration of AH Plus, Endoseal MTA, and Syntex endodontic sealers in the presence and absence of the smear layer.Materials and methods: Thirty single-rooted teeth were selected in the present in vitro study and randomly assigned to three experimental groups (n=10). Half of the samples were prepared by removing the smear layer in each group, and the remaining samples were prepared without removing the smear layer. Root canal preparation was carried out with the Perfect Rotary system up to file T3. The root canals were obturated with gutta-percha and AH Plus, Endoseal MTA, or Syntex endodontic sealers. The samples were incubated at 100% relative humidity at 37°C for one week. Each root was sectioned at 2-, 5-, and 8-mm distances from the apex, and sealer penetration depth at each section was determined under a scanning electron microscope (SEM). ANOVA was used to compare penetration depths.Results: There were significant differences in sealer penetration between the samples with and without smear layer removal in each group. The maximum and minimum sealer penetration was at the coronal and apical sections, respectively. The maximum sealer penetration depths in descending order were observed with AH Plus, Syntex, and Endoseal MTA sealers (p<0.05).Conclusions: Elimination of smear layer increased three sealers’ dentin penetration depth, with the deepest penetration for the AH Plus sealer in the coronal section without the smear layer

Microleakage comparison of resin modified glass ionomer and OrthoMTA used as a coronal barrier in nonvital teeth bleaching

Background and Aim: Common causes of dental discoloration include trauma, drugs, genetic defects, decay, and age. In order to correct discoloration of pulpless teeth, internal bleaching is recommended. The aim of this study was to compare microleakage of resin modified glass ionomer and OrthoMTA used as an intraorifice barrier in non-vital bleaching. Methods: In this experimental study, 36 extracted mandibular premolars were selected and randomly divided into two experimental (n = 16) and two control groups (n = 2). 2mm of OrthoMTA and RMGI cements were placed as intraorifice barriers in the experimental groups. Subsequently, we placed a mixture of sodium perborate and 30% hydrogen peroxide as internal bleaching material into the canal and replaced it every three days. Leakage was measured using pH diffusion method by a digital PH meter. Data were statistically analyzed by using T- independent test and repeated measures and variance analysis (P<0.05). Results: The pH value of the negative control group was as same as the PH of normal saline while the PH value of positive control group was significantly higher than those of other groups. PH values of Ortho MTA and RMGI at the baseline and on the first, sixth and ninth day did not show significant differences with one another, while microleakage of OrthoMTA group was significantly lower on the third day. Conclusions: In general, OrthoMTA had less leakage than RMGI but both materials can be used as suitable barriers for internal tooth bleaching Keywords: Tooth bleaching, OrthoMTA, Glass ionomer, leakag

A Comparative Investigation of the Microleakage of Biodentine and Mineral Trioxide Aggregate as Coronal Barrier in Nonvital Bleaching

Background: Internal bleaching is recommended to correct the discoloration of pulpless teeth. This study aimed to compare the microleakage of biodentine and mineral trioxide aggregate (MTA) used as an intracanal barrier in non-vital bleaching. Methods: An experimental study was performed in which 36 extracted mandibular premolars were randomly divided into two experimental groups (n= 16) and two control groups (n= 2). In experimental groups, 2mm of OrthoMTA and biodentine cement were placed as intracanal barriers. The control groups were prepared similar to experimental groups, except that in positive control group the orifice barrier material was not used and in negative control group the whole root surface was covered with nail polish and orifice barrier material was not used. Subsequently a mixture containing sodium perborate and 30% hydrogen peroxide was placed into the pulp chambers and replaced every three days. Microleakage was measured using a pH diffusion method by digital pH meter. pH was checked before placement and at days 1, 3, 6, and 9 after placement. Data analysis was done in SPSS V24 Results: The pH value in negative control group was similar to that in normal saline group, while the pH value in positive control group was found to be significantly higher than other groups (P< 0.05). Nosignificant differences were seen in pH values between the experimental groups at baseline and days 1 and 6, but pH values of biodentine were significantly higher than orthoMTA at days 3 and 9 (P< 0.05). Conclusions: MTA can be used as an efficient orifice barrier during internal bleaching, specifically in cases where there is probability for cervical root resorption. Keywords: tooth bleaching, mineral trioxide aggregate, dental leakag

Accuracy of Three Types of Apex Locators versus Digital Periapical Radiography for Working Length Determination in Maxillary Premolars: An In Vitro Study

This study aimed to compare the accuracy of three types of apex locators versus digital radiography for working length (WL) determination. This experimental study was conducted on 58 extracted maxillary premolars. The teeth were decoronated, the access cavity was prepared, and WL was determined using a #15 K-file to serve as reference. The WL was then measured by Woodpex V, Woodpex III, and Root ZX apex locators in the presence of 0.9% saline, and also on a photostimulable phosphor plate (PSP) digital radiograph taken by the parallel technique. The values were compared with the actual WL using the paired t-test (alpha = 0.05). Digital radiography, Root ZX, Woodpex V, and Woodpex III determined the WL within ±0.5 mm from the actual value in 84.48%, 100%, 89.66%, and 87.93% of the cases, respectively. Woodpex V (p = 0.039), Woodpex III (p = 0.001), and Root ZX (p = 0.001) significantly over-estimated the WL. The WL measured on digital radiographs was not significantly different from the actual WL (p = 0.213). The position of the apical foramen (central/lateral) had no significant effect on the accuracy of WL determination by different techniques (p > 0.05). Within the limitations of this in vitro study, all the tested modalities showed acceptable accuracy for WL determination in maxillary premolars