Effect of final irrigation with sodium hypochlorite at different temperatures on postoperative pain level and antibacterial activity: a randomized controlled clinical study

Objective: To evaluate the effect of final irrigation of root canals with NaOCl solution at different temperatures on postoperative pain level and antimicrobial activity. Methodology: 45 patients were randomly divided into three groups using a web program according to the irrigation selected: NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC. First root canal samples were collected before treatment (S1). After chemo-mechanical preparation, final irrigation was performed with the selected irrigant (NaOCl 2ºC, NaOCl 25ºC and NaOCl 45ºC) and second samples were collected (S2). Samples were subjected to quantitative real-time polymerase chain reaction to evaluate the levels of total bacteria. The root canal treatments were completed and the participants were given instructions to record postoperative pain levels at 24, 48 and 72 hours, 5 days and 1 week after treatment using a visual analog scale (VAS). Results: The reduction in the number of total bacterial cell equivalents from S1 to S2 was statistically significant in all groups (p<0.001). The NaOCl 2˚C group reported significantly less postoperative pain than the NaOCl 45˚C group (p<0.05). Postoperative analgesic intake was significantly higher in the NaOCl 45˚C group than in the NaOCl 2˚C group (p<0.05). Conclusion: We conclude that final irrigation with NaOCl at different temperatures results in similar antibacterial effectiveness. Final irrigation with cold NaOCl (2˚C) is better than NaOCl 45˚C when comparing postoperative pain levels

El ve Döner Alet Kullanımı Sonrasında Apikalden Taşan Debris Miktarının ve Kalsiyum Hidroksit Uzaklaştırılmasının Değerlendirilmesi

Amaç: Bu çalışmanın amacı el ve döner alet kullanımından sonra kök kanal duvarlarında kalan kalsiyum hidroksit miktarının ve kalsiyum hidroksit uzaklaştırılması süresince apikalden taşan debris miktarının değerlendirilmesidir.Gereç ve Yöntem: Yirmi-dört çekilmiş üst çene kesici diş K-tipi eğeler ile prepare edildi ve kalsiyum hidroksit ile dolduruldu. Dört diş pozitif ve negatif kontrol olarak ayrıldı. Kalan dişler iki gruba ayrıldı: ana apikal eğe grubu ve ProTaper Universal döner alet grubu. Uzaklaştırma işlemleri boyunca yıkama solüsyonu olarak sitrik asit kullanıldı. Apikalden taşan debris toplandı ve gruplar arasında karşılaştırıldı. Daha sonra dişler dikey eksenleri boyunca ikiye ayrıldı, stereomikroskop kullanılarak fotoğrafları çekildi ve bilgisayar programı kullanılarak resimlerin analizi yapıldı. Veriler tek yönlü varyans analizi ile istatistiksel olarak analiz edildi.Bulgular: Her iki grupta kalsiyum hidroksit uzaklaştırma süresince ölçülebilir miktarda apikalden taşan debris gözlemlendi. İstatiksel analiz apikal olarak debris çıkışı ve uzaklaştırılan kalsiyum hidroksit bakımından teknikler arasında anlamlı farkın olmadığını gösterdi.Sonuçlar: Kalsiyum hidroksit uzaklaştırma süresince tekniğe bağlı olmaksızın apikal olarak debris çıkışı meydana gelmektedir. Kullanılan tekniklerden hiçbirisi kök kanal duvarlarından kalsiyum hidroksiti tamamen uzaklaştıramadı

Micro-computed Tomographic Assessment of the Residual Filling Volume, Apical Transportation, and Crack Formation after Retreatment with Reciproc and Reciproc Blue Systems in Curved Root Canals

Introduction: The purpose of the present study was to evaluate the remaining root canal filling material, apical transportation, and crack formation after retreatment with M-Wire Reciproc (VDW GmbH, Munich, Germany) and Reciproc Blue (VDW GmbH) systems in curved root canals. Methods: Twenty-six mandibular first and second molars with mesial roots that had 2 separate canals with angles between 20 degrees and 40 degrees were selected for this study. The root canals were prepared with M-Wire Reciproc size 25 instruments (VDW GmbH), and they were filled with gutta-percha and AH Plus sealer (Dentsply Sirona, Tulsa, OK). The samples were randomly divided into 2 groups (n = 13 each) according to the retreatment system used: an M-Wire Reciproc group and a Reciproc Blue group. The canals were retreated up to instrument size 25 and then to size 40 in both groups. After the retreatment procedures, the residual filling material volume, apical transportation, and crack formation were assessed using micro-computed tomographic imaging. Results: There were no significant differences between the groups in the amount of residual filling material (P> .05). The apical canal transportation values were significantly higher in the M-Wire Reciproc group than in the Reciproc Blue group at 1 mm. No significant differences were observed between the groups at any of the other levels with regard to apical transportation (P> .05) The new uncompleted and completed cracks were observed in both groups. There were no statistically significant differences between the groups in terms of crack and fracture formation (P> .05). Conclusions: The Reciproc Blue system is as effective as the M-Wire Reciproc system in terms of the retreatment of the curved mesial roots of mandibular molars. However, the formation of new uncompleted and completed cracks was found during the retreatment procedures

Effect of continuous irrigation on apical transportation, centering ability and volume of removed dentin in curved root canals: a micro computed tomography study

Aim: To assess the effect of continuous irrigation (CI) on apical transportation, centering ability and volume of removed dentin during root canal shaping with different file systems using micro-computed tomography (micro-CT)

In Vitro Fracture Resistance of Roots Obturated with Epoxy Resin-based, Mineral Trioxide Aggregate-based, and Bioceramic Root Canal Sealers

Introduction: The aim of this study was to evaluate the fracture resistance of teeth filled with 3 different endodontic sealers. Methods: Seventy-five single-rooted extracted mandibular premolars were decoronated to a length of 13 mm. The teeth were randomly divided into 5 groups (n = 15 for each group). In group 1, the teeth were left unprepared and unfilled (negative control), and in group 2, the teeth were left unobturated (positive control). The rest of the roots were prepared by using the ProTaper System up to a master apical file size of F3: group 3, bioceramic sealer (Endosequence BC sealer) + gutta-percha; group 4, mineral trioxide aggregate based sealer (Tech Biosealer Endo) + guttapercha; and group 5, epoxy resin-based sealer (AH Plus Jet) + gutta-percha. All root specimens were stored for 2 weeks at 100% humidity to allow the complete setting of the sealers. Each specimen was then subjected to fracture testing by using a universal testing machine at a crosshead speed of 1.0 mm/min(-1) until the root fractured. The force required to fracture each specimen was recorded, and the data were analyzed statistically. Results: The fracture values of groups 3 and 5 were significantly higher than those of group 4 (P .05). Conclusions: In contrast to Tech Biosealer Endo, Endosequence BC and AH Plus Jet sealer increased the force to fracture in root-filled single-rooted premolar teeth

The Effects of Mtwo, R-Endo, and D-RaCe Retreatment Instruments on the Incidence of Dentinal Defects during the Removal of Root Canal Filling Material

Introduction: The aim of this study was to compare the incidence of dentinal defects after retreatment procedures with different nickel-titanium rotary retreatment files. Methods: One hundred-eighty mandibular premolars were randomly assigned to 6 groups (n = 30 teeth per group). One group was left unprepared, and the remaining 5 groups were prepared with K-files (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and AH plus sealer (Dentsply Maillefer, Ballaigues, Switzerland). Of these 5 groups, 1 group was left filled and received no further treatments; in the other groups, removal of the filling material was performed with Mtwo R (VDW, Munich, Germany), D-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland), R-Endo instruments (Micro-Mega, Besancon, France), or Hedstrom files (Dentsply Maillefer). Roots were then sectioned 3, 6, and 9 mm from the apex and observed under a microscope. The presence of dentinal defects was noted. Chi-square tests were performed to compare the incidence of dentinal defects between the groups. A Pearson correlation test was performed to check the correlation between defects and root level or remaining dentin thickness. Results: No defects were observed in the unprepared group. Dentinal defects were detected in all retreatment groups. Retreatment, groups showed significantly more defects than the filled but no retreatment group (P .05). There was no correlation between the appearance of defects and level of the root or remaining dentin thickness. Conclusions: Under the experimental conditions, all retreatment techniques used in this' study created defects in the root dentin

Effect of Agitation of EDTA with 808-Nanometer Diode Laser on Removal of Smear Layer

Introduction: Near-infrared diode lasers can be used for several applications, which range from disinfection to smear layer removal in endodontics. This study evaluated the efficacy of agitation of 15% EDTA with an 808-nm diode laser on removal of the smear layer. Methods: Sixty extracted human maxillary central incisor teeth were instrumented up to ProTaper F4 (Dentsply Maillefer, Ballagues, Switzerland) and then randomly divided into 6 groups (n = 10 for each group) according to the different final irrigating protocols as follows: 5% sodium hypochlorite for 120 seconds performed with the NaviTip (Dentsply Maillefer, Ballaigues, Switzerland) (control group); 15% EDTA for 120 seconds performed with the NaviTip; and agitation of 15% EDTA with an 808-nm diode laser for 10, 20, 30, and 40 seconds. Specimens were observed under a scanning electron microscope, and open dentinal tubules were counted using Adobe Photoshop software (Adobe Systems, San Jose, CA). The data were analyzed with 1-way analysis of variance and Tukey post hoc tests (P = .05). Results: The number of open dentinal tubules was higher in the middle thirds than in the apical thirds. The differences between the apical and middle thirds were statistically significant < .05). Statistically significant differences were also found between the control group and the other groups in both the middle and apical thirds of the root canals (P < .05). Conclusions: The results indicated that agitation of 15% EDTA with an 808-nm diode laser for 20 seconds was effective in removing the smear layer in the apical thirds of root canals

Efficacy of different treatments of root canal walls on the pull-out bond strength of the fiber posts

The aim of this study was to evaluate the efficacy of different irrigation protocols, including laser, on the retention of the fiber-reinforced composite posts to root canal dentinal walls using pull-out tests. Root canals of 60 single-rooted human teeth were filled and post spaces were prepared. Finally, specimens were divided randomly into five groups, each consisting of 12 specimens as follows: 5 % NaOCl (control group), 17 % EDTA, ultrasonic with 17 % EDTA, single 1.5-W Er:YAG laser application, and the combined use of Er:YAG laser and 17 % EDTA. After the root canal procedures, fiber posts were cemented to the root canal. Pull-out tests were performed using a universal testing machine at a crosshead speed of 2 mm/min. The data were analyzed using a one-way ANOVA and Bonferroni post hoc test (p = 0.05). Irradiation by the Er:YAG laser with/without EDTA positively affected the pull-out bond strength (p < 0.001). The pull-out strength was significantly higher in the ultrasonic group than that of the single irrigation with NaOCl or EDTA (p < 0.001). Er:YAG laser irradiation with/without EDTA enhanced the bond strength of fiber posts to root canal dentin walls. Additionally, ultrasonic-EDTA combination increased the bond strength

The Effect of Diode Laser With Different Parameters on Root Fracture During Irrigation Procedure

The aim of this study is to compare the effect of a single diode laser application and agitation of EDTA with diode laser with different parameters at different time intervals on root fracture. Ninety mandibular incisors were instrumented except the negative control group. The specimens were divided randomly into 10 groups according to final irrigation procedure: (G1) non-instrumented; (G2) distilled water; (G3) 15% EDTA; (G4) ultrasonically agitated EDTA; (G5) single 1.5W/100Hz Diode laser; (G6) single 3W/100Hz Diode laser; (G7) 1.5W/100Hz Diode laser agitation of EDTA for 20s; (G8) 1.5W/100Hz Diode laser agitation of EDTA for 40s; (G9) 3W/100Hz Diode laser agitation of EDTA for 20s; and (G10) 3W/100Hz Diode laser agitation of EDTA for 40s. The specimens were filled, mounted in acrylic resin, and compression strength test was performed on each specimen. Statistical analysis was carried out using one way ANOVA and Tukey's post hoc tests (P=0.05). The statistical analysis revealed that there were statistically significant differences among the groups (P<0.05). Laser-agitated irrigation with a 3W/100Hz Diode laser for both 20s and 40s decreased the fracture resistance of teeth