Endodontik sebeplerle çekilmiş dişlerin mineral içeriğinin SEM-EDX yöntemi ile incelenmesi

Amaç: Bu araştırmanın amacı; endodontik tedavi sonrasında diş dokularının mineral içeriğinde meydana gelen değişikliklerin, dişin farklı bölgelerinde Taramalı Elektron Mikroskobu-Enerji Dağılımlı X Işını Analizi (SEM-EDX) yöntemi kullanılarak incelenmesidir.Gereç ve Yöntemler: Bu çalışmada başarısız olmuş kanal tedavili dişler arasından çekim endikasyonu konulan, 20 adet tek köklü insan daimi dişi ve 20 adet kök kanal tedavisi görmemiş, ortodontik veya periodontal nedenlerle çekilmiş, çürüksüz, restorasyonsuz, sağlam tek köklü insan daimi dişi olmak üzere toplam 40 adet diş kullanılmıştır. Dişler kanal tedavisi sonrasında yapılarındaki mineral miktarında olası değişikliklerin endodontik tedavide başarısızlık ile ilişkisinin araştırılması amacıyla SEM-EDX analizine gönderilmek üzere %10’luk formalin solüsyonunda bekletildi. SEM-EDX analizi sırasında, her dişin bir yarısı, apikal, orta ve koronal olmak üzere standardize edilmiş 3 ayrı noktadan, elementel içerik ve elementel dağılım açısından 300 büyütme altında analiz edildi. Dişin diğer yarısı ölçüm amacıyla kullanılmadı. Bu analiz sırasında, oksijen, karbon, kalsiyum, fosfor, magnezyum, sodyum, sülfür, çinko, alüminyum, klor ve Ca/P ile ilgili veriler değerlendirildi. SEM-EDX ile elde edilen verilerin istatistiksel analizi ise tek yönlü varyans analizi ile yapıldı.Bulgular: SEM-EDX analizinin sonuçlarına göre kök kanal tedavisi olan dişler ve kontrol grubu arasında karbon, kalsiyum, fosfor, alüminyum ve klor ile ilgili anlamlı fark bulunmuştur (p<0,01). İki grup arasında oksijen, magnezyum, sodyum, sülfür, çinko ve Ca/P miktarı ile ilgili anlamlı bir fark bulunamamıştır (p>0,05). Apikal, orta ve koronal bölgeler açısından hiçbir grupta anlamlı bir farklılık yoktur (p>0,05).Sonuç: Bu çalışmada, kök kanal tedavisi sonrasında, dişin farklı bölgelerinde bir fark gözlenmezken, diş dokusunda karbon, kalsiyum, fosfor, alüminyum ve klor mineralleri açısından anlamlı farklılıklar olduğu sonucuna varılmıştır

Clinical outcomes of non-surgical multiple-visit root canal retreatment: a retrospective cohort study

This study aimed to investigate the effects of several clinical factors on the success and survival rates of multiple-visit non-surgical root canal (NSRC) retreatment. Failed endodontically treated 236 teeth in 161 patients (18-72 years, 48% males; and 52% females) were retreated between March 2014 and December 2015 and were enrolled in this study. Two calibrated examiners evaluated the preoperative, intraoperative, and postoperative outcomes using the periapical index (PAI) scores. The teeth were classified as healed (healthy apical tissues, PAI ≤ 2, no signs or symptoms), healing (no signs and symptoms, PAI > 2 but reduced from the initial PAI score), and not-healed (presence of apical periodontitis, signs and/or symptoms, PAI > 2). The teeth scored as healed and healing was considered to be successful, while the not-healed ones were considered as failures. Of the 236 teeth, 135 (57.3%) in 103 patients (63.9%) were lost to follow-up, yielding to follow-up of 101 teeth (42.7%) in 58 patients (36%). Three teeth were extracted yielding to an overall success rate of 85.1%, at a mean observation time of 33.8 months. The teeth with periapical lesions  0.05). While, age, gender, preoperative, intraoperative, and postoperative factors did not significantly affect the outcomes (P > 0.05), tooth type significantly affected the success rate (P < 0.05). The most frequently failed teeth were the mandibular first molars (P < 0.05). Based on these results, the multiple-visit NSRC retreatment exhibited a favorable success rate and could be offered for the endodontically failed teeth

Incidence of dentinal crack formation during root canal preparation with two NiTi instruments activated by adaptive motion and continuous rotation: An in vitro study

Objectives: The aim of this study was to evaluate dentin crack incidence after root canal instrumentation usingProTaper Next (PT Next; Dentsply Maillefer, Ballaigues, Switzerland) and Twisted File Adaptive (TF Adaptive;Sybron Endo, Orange, California, USA) at different kinematics.Methods: Sixty human extracted premolar teeth were selected and divided into 4 main groups. Group 1: PTNext with continuous rotation (n = 15); Group 2: PT Next with adaptive motion (n = 15); Group 3: TF Adaptivewith continuous rotation (n = 15); Group 4: TF Adaptive with adaptive motion (n = 15). Fifteen unpreparedteeth were used as control group. Crowns of the teeth were removed and roots were sectioned at 3, 6, and 9mm from the apex using a diamond saw. Finally root dentin pieces were evaluated under stereomicroscope atx25 magnification. Digital images were evaluated by 2 researchers.Results: No cracks were observed in the control group. In groups 2 and 4 no fracture was observed at the levelof 9 mm and similarly in group 4 at 6 mm level. Group 3 showed a significantly higher dentin crack formationfollowed by Group 1, 2, 4 and control group respectively (p < 0.039). There was no significant differencebetween groups at 6 mm and 9 mm levels (p = 0.497) except for only 3 mm level (p < 0.035).Conclusions: It was concluded, both adaptive motion and continuous rotationpromoted dentinal defect.Adaptive motion produced less dentinal defects all dentin levels but there was no significant difference

Bir Türk alt popülasyonunda kalıcı üst azı dişlerinin kök kanal konfigürasyonunun değerlendirilmesi: Konik ışınlı bilgisayarlı tomografi çalışması

Objective: Maxillary molars may be challenging for root canal treatment due to their complex canal anatomy and additional root canals, especially in the mesiobuccal root. The current study aimed to investigate the prevalence of root and root canal numbers of maxillary molar in a selected Turkish population. Materials and Methods: A total of 905 first and second maxillary molars were evaluated using cone-beam computed tomography (CBCT) images. The number of roots and canals was recorded and the mesiobuccal canal was further evaluated with the Vertucci classification. Results: A total of 394 teeth had a second mesiobuccal (MB2) canal (43.5%). While 90.4% of all maxillary molars had three roots, 44% had four root canals. The most common root canal anatomy of mesiobuccal root canals was Type II (42.6%) followed by Type IV (31.5%) and Type III (22.1%). Conclusions: It is clear that the second mesial root canal in permanent maxillary molars should be carefully searched for the long-term success of root canal treatments. It is seen that CBCT sections will be beneficial in diagnosis and treatment in better understanding the anatomical structure of the teeth and determining possible anatomical deviations.Amaç: Üst çene azı dişleri, karmaşık kök kanal anatomisi ve özellikle mezial kökteki ek kök kanal sayıları nedeniyle endodontik tedaviyi zorlaştırabilir. Bu nedenle başarılı bir kanal tedavisi için üst çene azı dişlerinin anatomik özelliklerinin analiz edilmesi gerekmektedir. Bu çalışmanın amacı, seçilmiş bir Türk nüfusunda üst çene azı dişlerinin kök ve kök kanal sayılarının prevalansını araştırmaktır. Materyal ve Metot: Konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak toplam 905 birinci ve ikinci kalıcı üst azı dişi değerlendirildi. Kök ve kök kanal sayıları kaydedilerek mezyobukkal meziobukkal kök kanalı Vertucci sınıflamasına göre değerlendirildi. Bulgular: Toplam 394 üst azıda ikinci bir mezial (MB2) kök kanalı (% 43,5) vardı. Tüm üst büyük azı dişlerinin %90,4' ünde üç adet kök varken, %44'ünde ise 4 kök kanalı vardı. Mezial kök kanallarının en yaygın kök kanal anatomisi Tip II (% 42,6) iken, bunu Tip IV (% 31,5) ve Tip III (% 22,1) takip etti. Sonuç: Üst daimi azı dişlerindeki ikinci mezial kök kanalının, kanal tedavilerinin uzun dönem başarısı için dikkatlice aranmasında büyük fayda olduğu açıktır. Dişlerinin anatomik yapısının daha iyi anlaşılmasında ve olası anatomik sapmaların belirlenmesinde KIBT kesitlerinin teşhis ve tedaviye oldukça yardımcı olacağı görülmektedir

Rejeneratif endodontik tedavi sırasında kullanılan final irrigasyon solüsyonlarının endodontik simanların push-out bağlanma dayanımı üzerine etkisi: Bir in vitro çalışma

Background and Aim: Study’s aim was to compare the effect of boric acid versus ethylene-diamine-tetra-acetic acid (EDTA) in regenerative endodontic treatment on the push-out bond strength of endodontic cements. Materials and Methods: Crowns and apical parts of 72 human straight lateral teeth were removed under water cooling; length was fixed at 10 mm. Canals were prepared up to file F4, standardized using a peeso reamer 1-4 (Mani). All teeth were irrigated with 20 ml 1.5% sodium hypochlorite, divided into following groups: 1) 20 ml 17% EDTA, 2) 20 ml 5% boric acid, and 3) 20 ml saline for final irrigation. Canals were dried, filled with calcium hydroxide (CaOH2) for 3 weeks. CaOH2 was removed using 20 ml of respective final irrigation solution. Each group was divided into two subgroups: Either ProRoot MTA or Biodentine was used as the coronal barrier (h=6 mm; n=12). After 7 days, 1 mm thickness 3–4 dentin sections were taken from each sample. Push-out test was performed at a rate of 1 mm/min. Two-way ANOVA and Tukey’s post hoc tests were used for statistical analyzing.Results: Biodentine-EDTA, Biodentine-saline, and ProRoot MTA-saline groups had highest bond strength (p < 0.05). Boric acid groups showed lower bond strength (p<0.05). ProRoot MTA-EDTA group had higher bond strength than boric acid groups (p<0.05). Biodentine was found to higher than ProRoot MTA (p<0.05).Conclusion: In terms of bonding to dentin, 17% EDTA was more successful than 5% boric acid; Biodentine was more successful than ProRoot MTA.Amaç: Çalışmanın amacı, rejeneratif endodontik tedavide borik asit ile etilen-diamin-tetra-asetik asitin (EDTA) endodontik simanların push-out bağlanma dayanımı üzerindeki etkisini karşılaştırmaktı.Gereç ve Yöntem: Yetmiş iki adet sağlam, insan lateral dişinin kronları ve apikal kısımları su soğutması altında kesilerek, boyları 10 mm’ye sabitlendi. Kanallar F4 nolu eğeye kadar genişletildi; 1-4 nolu peeso reamer kullanılarak standardize edildi. Tüm dişler 20 ml %1.5 sodyum hipoklorit ile irrige edildi, şu gruplara ayrıldı: Final irrigasyon için; 1) 20 ml %17 EDTA; 2) 20 ml %5 Borik asit; 3) 20 ml Serum fizyolojik. Kanallar kurulandı, kalsiyum hidroksit (CaOH2) ile 3 hafta süresince dolduruldu. CaOH2, ait olduğu grupta kullanılan final irrigasyon solüsyonundan 20 ml kullanılarak uzaklaştırıldı. Her grup iki alt gruba ayrıldı: Koronal bariyer olarak ProRoot MTA ve Biodentine kullanıldı (h=6 mm; n=12). Yedi gün sonra, her örnekten 1 mm kalınlığında 3-4 dentin kesiti alındı. Push-out testi 1 mm/dk hızda gerçekleştirildi. İki Yönlü ANOVA testi ve Tukey’s Post Hoc testleri istatistiksel analiz için kullanıldı. Bulgular: Biodentine-EDTA, Biodentine-serum fizyolojik, ProRoot MTA-serum fizyolojik grupları en yüksek bağlanma dayanımına sahipti (p<0.05). Borik asit grupları daha düşük bağlanma dayanımı gösterdi (p<0.05). ProRoot MTA-EDTA grubu, Borik asit gruplarından daha yüksek bağlanma dayanımına sahipti (p<0.05). Biodentine, ProRoot MTA’dan daha iyi bulunmuştur (p<0.05).Sonuç: Dentine bağlanma açısından, %17 EDTA, %5 borik asitten daha başarılıdır; Biodentine ise ProRoot MTA‘dan daha başarılıdır

Evaluation of related factors in the failure of endodontically treated teeth: A cross-sectional study

WOS: 000418878600007PubMed ID: 29246376Introduction: The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth. Methods: A total of 1000 teeth treated with nonsurgical root canal therapy were analyzed, and the following information was recorded for each patient: reasons for failure and extraction, type of tooth, presence and type of coronal restoration, smoking status, age, gender, and level of education. One main reason was recorded for each failed tooth. The associations between reasons for failure, patient, and tooth were tested by using chi(2) analysis. Results: Of the 1000 endodontically failed teeth analyzed in this study, 28.1% (n = 281) were extracted, 66% (n = 660) were re-treated, and 5.9% (n = 59) were treated with apical surgery. Among the reasons for failure, restorative and endodontic reasons were seen most frequently (43.9%, n = 439), whereas orthodontic reasons were seldom seen (0.1%, n = 1). The most common reason for extraction was for prosthetic reasons (40.8%), and perforation/stripping was the least common (2.9%). The mandibular first molars were the most frequently extracted teeth (27.4%, n = 77). Conclusions: The most common reason for the extraction of endodontically treated teeth was for prosthetic reasons. Among the reasons for failure, restorative and endodontic reasons were the most frequently seen, and orthodontic reasons were the most seldom. The teeth that failed most frequently were mandibular first molars, and the teeth that failed least frequently were maxillary third molars. The most common reason for the extraction of failed endodontically treated teeth was for prosthetic reasons.Scientific Research Projects Coordination Center of Selcuk University (BAP), Konya, Turkey [11202018]The study has been supported by Scientific Research Projects Coordination Center of Selcuk University (BAP), Konya, Turkey (project number: 11202018). This study was performed in Endodontics and Oral & Maxillofacial Surgery Departments of Faculty of Dentistry, Selcuk University

Efeitos dos medicamentos intracanais e do muro de cavidade remanescente na força de fratura dos molares endodonticamente tratados

Objective: The aim of this study was to investigate the effects of the short-term intracanal application of two medicaments on the fracture strength of root-filled molar teeth with different levels of tooth structure loss. Material and Methods: Standard access cavities of totally 84 intact maxillary molar teeth were prepared in 72 teeth and were divided into 3 main groups. Standard access cavities were vkept in the first group, while mesio-occlusal-distal cavities (MOD) were prepared in the second and third groups. One-half of the palatinal walls were removed in the third group. Twelve sound teeth were used in the fourth group as control. Each group was then assigned into two subgroups according to the medicament used (n=12): 2% chlorhexidine gel and calcium hydroxide. Samples were stored at 37°C and 100% humidity for 1 week. Then the teeth were inserted into a universal testing machine and vertically loaded (5 mm/min) from the occlusal surface. The data was recorded in Newtons and statistically evaluated using a Univariate ANOVA and a Tukey as post hoc test. Results: A significant difference was found among the test groups (p0.05), however the number of remaining walls significantly affected the fracture strength (p 0,05), no entanto, o número de paredes restantes afetou significativamente a resistência à fratura (p <0,01). O primeiro grupo com cavidade de acesso apresentou fracturas principalmente reparáveis (60% -80%), enquanto as demais apresentaram padrões de fratura não reparáveis (60% -90%). Conclusão: Em conclusão, a resistência à fratura dos dentes tratados endodonticamente está relacionada à perda da estrutura em vez do medicamento intracanal utilizado

Geçici restoratif dolgu materyali olarak politetrafloroetilen bant (Ptfe): Sıvı filtrasyon çalışması

WOS: 000409813800003PubMed ID: 28955541Purpose: The purpose of this study was to compare the sealing ability of temporary restorative materials at 24 hrs and 1 week. Materials and Methods: Endodontic access cavities were prepared in 56 extracted lower incisor-teeth and divided into 5 groups (n=10). Standard 5 mm deep access preparations were completed and root canals were prepared to size ISO # 30 file. The access cavities were restored as follows: Group 1: temporary restorative material (Ceivitron); Group 2: glass ionomer cement (Fuji II); Group 3: zinc oxide-eugenol cement (IRM); Group 4: zinc phosphate cement (Adhesor); Group 5: polytetrafluoroetylene tape (PTFE). The quality of the coronal sealing of each specimen was measured (24 hrs and 1 week) using fluid transport model. The data was analysed with repeated measurements of ANO VA, Tukey, Paired samples T-Tests. Results: A significant difference was found among the groups at all time-periods (p0.05). Sealing ability of IRM and PTFE groups significantly increased by time (p0.05). IrM ve PTFE gruplarının sızıntı değeri zamanla önemli derecede azaldı (p < 0.05 ve p < 0.001 sırasıyla). Sonuç: Bu çalışmanın sınırları dâhilinde, PTFE, 1 haftalık ölçümlerde, diğer sıklıkla kullanılan geçici dolgu materyalleri ile kıyaslandığında, kabul edilebilir bir kısa-dönem sızdırmazlık kabiliyeti göstermişti

The effect of different desensitizing agents on the shear bond strength of a one-step self-etch adhesive system to dentin

Amaç: Bu çalışmanın amacı, üç farklı hassasiyet giderici uygulamasını takiben tek aşamalı self-etch adeziv siste min, dentine bağlanmada makaslama dayanımı üzerineetkisinin karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmada 40 adet çekilmiş, sağlam, insan küçük azı dişi kullanılmıştır. Dişlerin okluzal yüzeyleri dentin tamamen ortaya çıkacak şekilde uzaklaştırılmış ve her örnekten 2 mm kalınlığında okluzal kesitler elde edilmiştir. Tüm örnekler özel olarak hazırlanmış akrilik bloklara gömüldükten sonra, yüzeyleri sırasıyla 320, 600, 800, 1200 gren kalınlığında silikon karbid zımparalar ile parlatılmıştır. Örnekler rasgele 4 gruba ayrılmıştır (n=10). Kontrol grubu dışında, tüm gruplarda hassasiyet gidericiler üretici firmaların talimatları doğrultusunda uygulanmıştır. Grup 1: Bifluorid 12 (Voco GmbH, Cuxhaven, Almanya); Grup 2: Desen (Spident Co., LTD. Incheon, Kore); Grup 3: Gluma (Heraeus Kulzer GmbH, Hanau, Almanya); Grup 4: Kontrol. Kontrol grubuna herhangi bir hassasiyet giderici ajan uygulanmamıştır. Tüm gruplara adeziv ajan olarak Clearfil S3 (Kuraray Noritake Dental Inc. Okayama, Japonya) uygulanmış ve daha sonra 2 mm çap ve 3 mm yüksekliğinde polietilen tüpler yardımıyla kompozit rezin dolgu (3M ESPE FiltekTM Z250 St. Paul, MN, ABD) yapılmıştır. Örnekler 37°C’de, %100 nemlilikte, 24 saat bekletilmiştir. Makaslama dayanım testi universal test cihazı (Shimadzu Autograph, AGS-J 5kN, Shimadzu Corporation, Tokyo, Japonya) kullanılarak 1mm/dak çapraz hızda gerçekleştirilmiştir. Ġstatistiksel analizler için Tek Yönlü Varyans Analizi kullanılmıştır. Bulgular: Grup 1 ve kontrol grubu en yüksel makaslama dayanım değerleri göstermesine rağmen gruplar arasında anlamlı bir fark bulunamamıştır (p>0.05). Sonuç: Kullanılan tek aşamalı adeziv sistem göz önünde bulundurulduğunda, bu çalışmada kullanılan hassasiyet gidericilerin dentine olan bağlanmada makaslama dayanımı üzerinde negatif bir etkisinin bulunmadığı sonucuna varılabilir.Aim: The purpose of this study was to compare the effect of a one-step self-etch adhesive system on the shear bond strength of dentin following three different dentin desensitizers’ applications. Materials and Methods: Forty extracted intact human premolars were used in this study. Occlusal surfaces of the teeth were removed so that the dentin was completely exposed and 2 mm thick occlusal slices were obtained from each sample. After all specimens were embedded in specially prepared acrylic blocks, surface polishing was carried out with silicon carbide papers at 320, 600, 800, 1200 grit, respectively. Specimens were divided randomly into 4 groups (n=10). Except the control group, in all groups the desensitizers were applied in accordance with the instructions of the manufacturer instructions. Group 1: Bifluorid 12 (Voco GmbH, Cuxhaven, Germany); Group 2: Desen (Spident Co., LTD. Incheon, Korea); Group 3: Gluma (Heraeus Kulzer GmbH, Hanau, Germany); Group 4: Control. No desensitizer was applied to the control group. All groups were treated with Clearfil S3 (Kuraray Noritake Dental Inc. Okayama, Japan) as an adhesive agent and then composite resin filler (3M ESPE Filtek Z250 St. Paul, MN, USA) with the help of 2 mm diameter and 3 mm height polyethylene tubing. The samples were incubated at 37 C°, 100% humidity for 24 hours. The shear bond strength test was performed at a cross speed of 1 mm/min using a universal testing machine (Shimadzu Autograph, AGS-J 5kN, Shimadzu Corporation, Tokyo, Japan). One way ANOVA was used for statistical analysis. Results: Although Group 1 and control group showed the highest shear bond strength values, no significant difference was found between the groups (p>0.05). Conclusion: Considering the all-in-one adhesive system used in this study, it can be concluded that, the desensitizers used in this study have no negative effect on shear bonding strength to dentin

Radiographic and Clinical Findings of Single-Visit Root Canal Treatments with Apical Enlargement in Necrotic Teeth: A Retrospective Cohort Study

This study evaluated the long-term clinical outcomes of single-visit root canal treatments with apical enlargement on patients with necrotic pulp tissue retrospectively. A total of 137 teeth with necrotic pulp tissue which underwent single-visit root canal treatments were included. The root canals were shaped up until the apical constriction, which was determined by an apex locator. The outcomes were evaluated by two independent and calibrated endodontists clinically and radiographically. Teeth were dichotomized into healed (PAI ≤ 2, no signs or symptoms) and nonhealed (PAI > 2, with/without signs or symptoms) groups. Each patients' preoperative PAI and lesion size were recorded to evaluate the preoperative periapical status as well as several other prognostic factors. Statistical analyses were performed (p = 0.05) on ninety teeth. The mean observation time was 60 months. Out of ninety teeth, 87 (96.7%) were healed and 3 (3.3%) were nonhealed. No correlations were found between the prognostic factors and the outcomes (p > 0.05). Cohen's kappa and Gwet's agreement coefficient scores between the preoperative PAI scores and preoperative lesion sizes showed good agreements, with values of 0.834 and 0.898, respectively. Apical enlargement is a viable treatment option for single-visit root canal treatments