Comparison of AH26 Physicochemical Properties with Two AH26/Antibiotic Combinations

INTRODUCTION: The purpose of this study was to compare the setting time and post-setting solubility, flow, film thickness and dimensional changes of AH26 root canal sealer with AH26-Antibiotic combination. MATERIALS AND METHODS: This study was performed according to British standard BS 6876 (2001) which tests the physicochemical properties of endodontic sealers. Three samples of each of tested materials including AH26 alone, AH26/amoxicillin and AH26/doxycycline were used to test each of the properties. They were prepared according to ISO protocols. RESULTS: The setting time of studied materials was 46 hours for AH26, 29 hours for AH26/amoxicillin, 49 hours for AH26/doxycycline. Flow test results were as follows, for AH 26, 15.6 mm; AH26/amoxicillin, 14.9 mm; AH26/doxycycline, 14.2 mm. Film thickness was 0.024 mm in AH26, 0.0283 mm in AH26/amoxicillin, 0.0276 mm AH26/doxycycline. The solubility of AH26 was 0.0076%, AH26/amoxicillin, 0.0113%, and for AH26/doxycycline, 0.013 %. Dimensional changes following setting was 0.07 mm, 2.6 mm, and 1.1 mm for AH 26, AH26/amoxicillin, and AH26/doxycycline, respectively. CONCLUSION: The physico-mechanical properties of AH26 antibiotic combinations were superior compared with AH26, with the exception of flow. Also, AH26/amoxicillin had a lower setting time than AH26. However, all values were within an acceptable range which conformed to ISO

An In Vitro Study of the Number of Distal Roots and Canals in mandibular First Molars in Iranian Population

INTRODUCTION: The purpose of this study was to evaluate the number of distal roots and canals in mandibular first molars and their internal anatomy radiographically within Iranian population. MATERIALS AND METHODS: A total of 310 distal roots of mandibular first molars were incorporated in this study and evaluated in terms of number of roots and number and types of canals. Root canal systems were studied in vitro by means of radiography and based on Vertucci’s classifications. RESULTS: It was shown that 4.5% of the teeth in this study had two distal roots, of which, 100% indicated type I for both distobuccal and distolingual roots. Among all the teeth, 43.2% had two canals, 24.2% two apical foramina, and 38.7% two orifices in their distal roots. According to Vertucci’s classification 54.9% of the teeth were type I, 19% type II, 1.9% type III, 14.2% type IV, 4.2% type V, 1% type VI, 0.3% type VII and 0% type VIII. CONCLUSION: In as many as 43.2% of all teeth assessed in this study, bicanaled distal roots were observed, dentists are always recommended to search for the second canal in distal roots of mandibular first molars. In case the second canal in the distal root is missed, failure of endodontic treatment will be anticipated. A rectangular type access cavity design allows better visualization and negotiation of the probable second canals within the distal roots of mandibular first molars

Antimicrobial Effects of AH26 Sealer/Antibiotic Combinations Against Enterococcus Faecalis

INTRODUCTION: The purpose of this in vitro study was to evaluate the antimicrobial effects of two antibiotics added to AH26 sealer against Enterococcus faecalis (EF). MATERIALS AND METHODS: The antimicrobial effects of two antibiotic (amoxicillin and doxycycline) that were added separately to AH26 sealer was evaluated by using the agar diffusion test and in vitro human root inoculation method. The freshly mixed sealers were placed in prepared wells inside agar plates inoculated with EF, and were incubated at 37°C. The zones of inhibition were measured at 24, 48, 72 hours and 7 days. Root specimens were prepared and obturated with lateral condensation technique. Samples were collected from infected root canals after 2 and 7 days of incubation and the number of colony-forming units (CFU) was determined. The data were analyzed using one-way and two-way ANOVA. RESULTS: The findings of this study revealed that sealer-antibiotic combination containing amoxicillin and doxycycline had a significant difference in the mean zones of inhibition when compared to AH26 sealer alone in all of the time periods (P<0.05). The minimum effective concentration against EF was one percent of sealer powder weight for both of amoxicillin and doxycyline. The mean log10 CFU in AH26-doxycyline combination group was significantly lower than other groups at 48 h incubation period (P<0.05). AH26-doxycycline combination group and AH26-Amoxicillin combination group killed bacteria (mean CFU=0) in the dentinal tubules at 7 days incubation period. CONCLUSION: In vitro root fillings carried out with gutta-percha and AH26-antibiotic combination were effective in killing EF in dentinal tubules

The Effect of Canal Dryness on Bond Strength of Bioceramic and Epoxy-resin Sealers after Irrigation with Sodium Hypochlorite or Chlorhexidine

Introduction: The aim of this in vitro study was to evaluate the effect of canal dryness on the push-out bond strength of two resin sealers (AH-Plus and Adseal) and a bioceramic sealer (Endosequence BC sealer) after canal irrigation with sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods and Materials: A total of 18 extracted human premolars were used. Canals were prepared and were divided to two groups based on irrigation solution (either NaOCl or CHX). The samples were again divided based on pre-obturation canal condition (wet, half-wet and dry). The samples were sub-divided into 3 groups based on the sealer type; the teeth were obturated with gutta-percha and test sealers (Adseal, AH-Plus or BC sealer). A total number of 18 groups were available to be cut into dentine disks (12 disks in each group). The type of bond failure was also assessed in each group. Data were analyzed using the 3-way ANOVA, post hoc Tukey’s tests, t-test and the Fisher’s exact test. The level of significance was set at 0.05. Results: The bond strength of Adseal was not affected by the canal condition or irrigation with either NaOCl or CHX. Although the bond strength of AH-Plus was not affected by the irrigant type, the highest bond strength was seen in dry canals. For Endosequence BC sealer, the canal conditions did not affect the bond strength; however, CHX reduced the bond strength. Conclusion: Bond strength of resin sealers was not affected by irrigation solution; however, canal moisture negatively affected the bond strength of AH-Plus. CHX reduced the bond strength of BC sealer.Keywords: Bioceramic; Chlorhexidine; Epoxy Resin-Based Root Canal Sealer; Root Canal Sealer; Sodium Hypochlorite

Calcium Enriched Mixture and Mineral Trioxide Aggregate Activities against Enterococcus Faecalis in Presence of Dentin

Introduction: The purpose of this in vitro study was to compare the antibacterial activity of Calcium Enriched Mixture (CEM) with ProRoot Mineral Trioxide Aggregate (MTA) against Enterococcus faecalis (E. faecalis) in the presence/absence of dentin powder. Materials and Methods: Two series of freshly mixed (10, 50, and 100 mg), set crushed powder (10, 50, and 100 mg), and pieces of uncrushed set (50, 100 mg) of CEM and MTA were prepared (n=32 groups). All samples were suspended in normal saline for direct exposure test against E. faecalis; in the second series, 50 mg of the dentin powder was also added to the solution. Dentin powder suspension and bacterial suspension served as negative and positive control groups, respectively (n=2). The suspensions were incubated at room temperature for 1, 60, and 240 min; each group was tested five times and survival of the bacteria in test solutions was assessed by 10-fold serial dilutions and cultured on Brain Heart Infusion (BHI) plates. The plates were incubated at 37ºC. The mean values of log10 CFU were calculated and compared in all tested groups. The total number of tests added up to 510 times. Results: In presence of dentin powder, freshly mixed powder from set materials, and pieces of uncrushed set materials of both tested cements killed >95% of the bacterial cell in 1 min. Adding dentin powder caused an increase in antibacterial activity of freshly mixed powder from crushed set CEM and MTA but no acceleration in bacterial killing was observed, when dentin was mixed with set or uncrushed cements. Dentin powder alone reduced the number of viable bacteria in the 4-hour duration. There were no significant differences between different weights of freshly mixed, crushed set powder and uncrushed set of CEM cement and MTA at different times. Conclusion: Under the conditions of this in vitro study, CEM cement as well as MTA have antibacterial effects against E. faecalis. The addition of equal amounts of dentin powder to the suspension of CEM or MTA resulted in swifter elimination of bacteria

Internal Evaluation of the Endodontics Department, School of Dentistry, Tehran University of Medical Sciences

Background & Objective : Internal evaluation is a process concerning information collection and judgment in order to improve educational activities. Considering some facts related to educational measurement and collecting information will lead to a better understanding of the mentioned process. In this study, we conducted the internal evaluation of the endodontics department in Tehran University of Medical Sciences, which is responsible for training dentistry students and residents. Methods : In this descriptive study, internal evaluation was conducted using 10 steps in 9 fields including management and organization, faculty members, learners, human resources and support, educational, research, and other atmospheres, facilities regarding education, research, etc., courses, educational programs, teaching and learning process, patients and finally graduates’ satisfaction. Data was collected using observation, interview, questionnaire, and checklist. Results : According to the definition of satisfactory, results of this study were mostly qualitative and in some cases they were quantitative. The average result of the internal evaluation of the endodontics department in the school of dentistry, considering 9 fields, was 73.7% which was considered as approximately satisfactory. The results for fields like faculty members and learners were satisfactory (100% and 77.8% respectively). Atmospheres and educational facilities were unsatisfactory (both were 46%) . Conclusion : According to the results, atmospheres and educational facilities which were identified as the weakest fields need more consideration and investigation. Keywords: Internal evaluation, Department, Endodontics, School of dentistry

The Effect of Canal Dryness on Bond Strength of Bioceramic and Epoxy-resin Sealers after Irrigation with Sodium Hypochlorite or Chlorhexidine

The aim of this in vitro study was to evaluate the effect of canal dryness on the push-out bond strength of two resin sealers (AH-Plus and Adseal) and a bioceramic sealer (Endosequence BC sealer) after canal irrigation with sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods and Materials: A total of 18 extracted human premolars were used. Canals were prepared and were divided to two groups based on irrigation solution (either NaOCl or CHX). The samples were again divided based on pre-obturation canal condition (wet, half-wet and dry). The samples were sub-divided into 3 groups based on the sealer type; the teeth were obturated with gutta-percha and test sealers (Adseal, AH-Plus or BC sealer). A total number of 18 groups were available to be cut into dentine disks (12 disks in each group). The type of bond failure was also assessed in each group. Data were analyzed using the 3-way ANOVA, post hoc Tukey’s tests, t-test and the Fisher’s exact test. The level of significance was set at 0.05. Results: The bond strength of Adseal was not affected by the canal condition or irrigation with either NaOCl or CHX. Although the bond strength of AH-Plus was not affected by the irrigant type, the highest bond strength was seen in dry canals. For Endosequence BC sealer, the canal conditions did not affect the bond strength; however, CHX reduced the bond strength. Conclusion: Bond strength of resin sealers was not affected by irrigation solution; however, canal moisture negatively affected the bond strength of AH-Plus. CHX reduced the bond strength of BC sealer. m

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Anxiety-provoking factors in consecutive interpreting: a qualitative study of Iranian student interpreter trainees

Abstract Given the inherent association of interpreting with feelings of anxiousness, the subject of interpreting poses a formidable challenge for students in this field. A large number of prospective interpreters assert that they are unable to complete the assignment to a satisfactory level because they are unable to get past their fear. The harmful effect of anxiety on the interpreting performance of student trainees could result in failure and fully inhibit their accomplishment. Despite the growing recognition of anxiety as a significant challenge in interpreting education, there is a lack of comprehensive studies investigating the specific factors contributing to anxiety in consecutive interpreting and effective strategies for its reduction. To address this issue and in order to identify the factors contributing to trainees’ anxiety and those that might help to reduce consecutive interpreting (CI) anxiety, thirty students were chosen to participate in semi-structured interviews. Different factors exerting an effect on the anxiety levels of Iranian CI pupils were identified through qualitative research. These factors were categorized into six groups, i.e., individual, input (language-related factors, speaker-related factors), note- taking (inappropriate note-taking skill, lack of creativity in taking notes), environmental (noise and distraction, peer-related factors), output (meaning transfer, delivery), and teacher-related (testing, teachers’ behavior). Moreover, the study found that factors to reduce anxiety in consecutive interpreting could be classified as teacher-related and trainee-related factors each with additional sub-factors