Efficacy of different devices in removing calcium hydroxide from the root canal

Objectives: The aim was to compare the efficiency of removing calcium hydroxide (CH) with different devices and irrigants. Materials and Methods: Ten roots were served as positive and negative controls, the remaining roots (n=75) were assigned into 5 respect to the removal techniques: Group (G) I, Master apical file- manual needle irrigation (MNI); GII, Canal Brush (CB)-MNI; GIII, RinsEndo; GIV, Self-adjusting file(SAF)-Vatea; GV, CB+MNI, followed by SAF+Vatea. The roots were grooved longitudinally and split into halves.  Three specimens from each group were randomly selected to evaluate CH remnants under the SEM. A digital camera acquired images of each half of the canal. A scoring system was used to assess amount of residue. Data were analyzed using Kruskal–Wallis and Mann–Whitney U tests (p < 0.05). Results: Remnants of CH were found in all experimental groups. Examining the efficacy of CH removal from the each third of the canal showed that there was a statistically significant difference between the middle (p=0,003) and cervical (p=0,006) thirds. Conclusions: None of the techniques removed the CH medicament completely; the use of the RE and SAF facilitated removal of CH especially from the cervical third

Fracture load of ceramic crowns supported by some novel anchoring dental systems

Objective: This study aimed to evaluate the fracture load of endocrown restorations and fiber-reinforced composites (FRCs) fabricated through computer-aided design/computer-aided manufacturing (CAD-CAM) for post–cores of anterior teeth. Materials and Method: Forty post–core-supported crowns and endocrowns were fabricated through CAD-CAM on a canine root zirconia model (Ice Zirconia, ZirkonZahn GmBH, Bruneck, Italy). The static load-bearing capacity was measured on the following restoration groups: Group 1: zirconia crown (Prettau anterior, ZirkonZahn GmBH) retained with CAD-CAM one-piece FRC post-core crown system (experimental CAD-CAM FRC block); Group 2: zirconia crown (Prettau anterior) retained with FRC post (GC Corp., Tokyo, Japan) with discontinuous fiber composite (EverX posterior, GC Corp) core; Group 3: zirconia endocrown (Prettau anterior); and Group 4: lithium disilicate ceramic endocrown (IPS e.max CAD, Ivoclar Vivadent AG, Schaan, Liechtenstein) (n = 10/per group). After the adhesive cementation of crowns/endocrowns to the zirconia root model, a load was applied at 45° to the long axis of the teeth and measured using a universal testing machine. The fracture modes were visually examined. The statistical analyses were performed using one-way ANOVA and Tukey post-hoc tests (p < 0.05). Results: The fracture load significantly differed among the groups (p Group 4 (721 ± 96 N) ≥ Group 1 (680 ± 86 N) > Group 2 (534 ± 36 N). Conclusion: Endocrown monoblock restorations can be used as an alternative to fiber-reinforced post–core supported crown restorations

Revitalization Of Necrotic Mature Permanent Incisors With Apical Periodontitis: A Case Report

Despite considerable focus on the regenerative endodontic treatment of immature teeth with necrotic infected pulps and apical periodontitis, little data exist with regard to its possible implementation in necrotic permanent teeth with complete apical and radicular development. The present report describes the procedures and outcome of a regenerative endodontic treatment approach in 2 previously-traumatized incisors with closed apex with apical periodontitis. A 2-visit treatment procedure was employed. At initial visit, the root canals were copiously irrigated, followed by placement of a triple antibiotic paste containing ciprofloxacin, metronidazole, and clindamycin into the root canals. After 4 weeks, the antibiotic paste was removed, and apical bleeding was initiated with size 10 hand files beyond the apices. The root canals were coronally sealed with mineral trioxide aggregate, and the access cavities were restored with bonded resin composite. At post-operative 60 months, both teeth were remained asymptomatic, with the recall radiographs showing complete resolution of apical radiolucency and reestablishment of periradicular tissues. In both teeth, the dimensions of root space remained unchanged as verified by image analysis. The revitalization protocol utilizing root canal disinfection and induced apical bleeding in necrotic, closed-apex incisors may offer a clinically acceptable alternative to conventional root canal treatment.PubMe

Effect of Timing of Post Space Preparation on the Apical Seal When Using Different Sealers and Obturation Techniques

Background/purpose To prepare the post apace, some of the root-canal filling material has to be removed, which can affect the apical seal. The aim of this study was to compare the effect of immediate post space preparation to that of delayed post space preparation on apical sealing using three different endodontic sealers and obturation techniques. Materials and methods In total, 90 decrowned single-rooted human teeth were studied. After root canals were prepared with 0.06 tapered nickel–titanium rotary files to size 30, the roots were categorized randomly into three experimental groups according to the obturation material: (1) AH plus/gutta-percha; (2) Sealite Ultra/gutta-percha; and (3) Epiphany/Resilon. Furthermore in all groups, specimens were categorized randomly into three subgroups according to the obturation technique (n = 10): (1) single cone; (2) cold lateral compaction; and (3) System B + Obtura. After root-canal filling, post space preparation was immediately performed in Group 1, after 24 hours in Group 2, and after 7 days in Group 3. Apical leakage was measured using the fluid-filtration method. Statistical analysis was performed using the Kruskal–Wallis test and Wilcoxon signed ranks test at P  Sealite Ultra/gutta-percha > AH plus/gutta-percha (P < 0.001). Conclusion To reduce apical leakage, clinicians should use AH plus together with any of the obturation techniques after 7 days of obturation.PubMedWoSScopu

Bond Strength of a Calcium Silicate-Based Sealer Tested in Bulk or with Different Main Core Materials

The aim of this study was to evaluate the influence of a calcium silicate-based sealer (iRoot SP), with or without a core material, on bond strength to radicular dentin, in comparison with various contemporary root filling systems. Root canals of freshly extracted single-rooted teeth (n = 60) were instrumented using rotary instruments. The roots were randomly assigned to one of the following experimental groups: (1) a calcium silicate-based sealer without a core material (bulk-fill); (2) a calcium silicate-based sealer + gutta-percha; (3) a calcium silicate-based sealer + Resilon; (4) a methacrylate resin-based sealer (Real Seal SE) + Resilon; (5) an epoxy resin-based sealer (AH Plus) + gutta-percha, and (6) a mineral trioxide aggregate-based endodontic sealer (MTA Fillapex) + gutta-percha. Four 1-mm-thick sections were obtained from the coronal aspect of each root (n = 40 slices/group). Push-out bond strength testing was performed at a cross-head speed of 1 mm/min, and the bond strength data were analyzed statistically by one-way analysis of variance and Tukey tests (p < 0.05). The highest and lowest debonding values were obtained for the calcium silicate-based sealer bulk-fill and mineral trioxide aggregate-based endodontic sealer + gutta-percha groups, respectively (p < 0.05). It was concluded that the calcium silicate-based sealer showed higher resistance to dislocation in the bulk-filled form than in conjunction with the tested core filling materials. When the calcium silicate-based sealer was placed in bulk, its dislocation resistance was similar to that of commonly used sealer + core root filling systems. Thus, the concept of using a calcium silicate-based sealer in bulk can be more easily advocated in clinical practice.WoSWo

Effect of Endodontic Chelating Solutions on The Bond Strength of Endodontic Sealers

The purpose of this in vitro study was to evaluate the effect of various chelating solutions on the radicular push-out bond strength of calcium silicate-based and resin-based root canal sealers. Root canals of freshly-extracted single-rooted teeth (n = 80) were instrumented by using rotary instruments. The specimens were randomly divided into 4 groups according to the chelating solutions being tested: (1) 17% ethylenediaminetetraacetic acid (EDTA); (2) 9% etidronic acid; (3) 1% peracetic acid (PAA); and (4) distilled water (control). In each group, the roots were further assigned into 2 subgroups according to the sealer used: (1) an epoxy resin-based sealer (AH Plus) and (2) a calcium silicate-based sealer (iRoot SP). Four 1 mm-thick sections were obtained from the coronal aspect of each root (n = 40 slices/group). Push-out bond strength test was performed at a crosshead speed of 1 mm/min., and the bond strength data were analyzed statistically with two-way analysis of variance (ANOVA) with Bonferroni's post hoc test (p 0.05). iRoot SP showed higher resistance to dislocation than AH Plus. Final irrigation with 17% EDTA, 9% Etidronic acid, and 1% PAA did not improve the bond strength of AH Plus and iRoot SP to radicular dentin.Wo