Comparison of apical sealing ability of resected mineral trioxide aggregate, gutta-percha and a resin-based root canal filling material (resilon)

In the case of limited access in endodontic surgery, an alternative approach includes obturation of the canal with mineral trioxide aggregate (MTA) prior to surgery. Following the setting of MTA, endodontic surgery is carried out by resecting the root-end and exposing the set MTA without cavity preparation. This may also be performed with other retrofilling materials. This study was designed to compare the sealing ability of resected resilon, MTA and gutta-percha. 84 maxillary anterior teeth were instrumented and randomly assigned into three experimental groups (n = 20), each having a positive and negative control (n = 4). The canals were filled with resilon, MTA or gutta-percha. Following the root-end resection and submergence in India ink, the maximum dye penetration was measured. Welch and Brown-Forsythe test was used to analyze the data. The resected gutta-percha showed significantly more leakage than MTA (p = 0.041). The leakage in resected resilon was more than MTA and slightly lesser than gutta-percha. However, the differences were not statistically significant (p > 0.05). Based on this study, MTA is the most appropriate choice in this approach.Key words: Gutta-percha, microleakage, mineral trioxide aggregate, resilon, root-end resection

An In Vitro Comparison of the Antibacterial Efficacy of Triphala with Different Concentrations of Sodium Hypochlorite

Introduction: The antimicrobial efficacy of root canal irrigant plays an important role in increasing the success of root canal treatment (RCT). The aim of the present experimental study was to compare the antimicrobial activity of Triphala (a plant-derived solution) with 0.5, 1, 2.5 and 5% concentrations of sodium hypochlorite (NaOCl), against Enterococcus faecalis (E. faecalis). Methods and Materials: Two hundred plates of cultured E. faecalis, were divided into 5 experimental groups (n=38) and two positive and negative control groups. The antimicrobial activity of the test solutions was determined by measuring the zone of inhibition in the culture media. The mean diameter of inhibited zones between the study groups was compared using the Kruskal-Wallis test and the Mann-Whitney U test was used for the two-by-two comparison of the groups with the level of significance set at 0.05. Results: The Kruskal-Wallis test showed significant differences between the study groups (P<0.05). According to the Mann-Whitney U test the mean diameter of inhibition zones in Triphala group was significantly higher compared to 0.5 and 1% NaOCl (P<0.05). Conclusion: In this study, Triphala exhibited better antimicrobial activity against E. faecalis compared to 0.5 and 1% NaOCl (P<0.05)

Effects of Chlorhexidine and Sodium Hypochlorite on the Setting Time of Calcium-Enriched Mixture Cement

Introduction: The aim of the present study was to evaluate whether adding 2% chlorhexidine (CHX) and 2.6% sodium hypochlorite (NaOCl) to calcium-enriched mixture (CEM) cement would affect its setting time (ST), or not. Methods and Materials: In this study, the setting time of CEM cement was evaluated in three groups (n=9) as follows: group 1; CEM cement, group 2; CEM cement+2% CHX and group 3; CEM cement+2.6% NaOCl. Then the mean values of ST were calculated and the Kolmogorov-Smirnov test was used to evaluate the normal distribution of data. The Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. Statistical significance was set at 0.05. Results: The mean ST for groups 1, 2 and 3 were 105, 120 and 220 min, respectively. There was a significant increase in the duration of ST in group 3 (NaOCl) in comparison with the two other groups (P<0.05). Conclusion: NaOCl significantly increased the ST of CEM cement, whereas chlorhexidine did not alter the ST.Keywords: Calcium-Enriched Mixture; CEM Cement; Chlorhexidine; Setting Time; Sodium Hypochlorit

Comparison of apical Microleakage using Ni-Ti with stainless steel finger spreaders

INTRODUCTION: The purpose of this in vitro study was to compare apical microleakage after obturation with Nickel-Titanium (NiTi) compared to Stainless Steel (SS) finger spreaders. MATERIALS AND METHODS: Eighty straight single-rooted human teeth were instrumented using step-back technique. The specimens were randomly divided into four groups. The two experimental groups (n=30) and the negative control group (n=10) were obturated by lateral condensation technique with Ariadent gutta-percha and AH26 sealer. The roots in the positive control group (n=10) were instrumented but not obturated. In one group, SS and in another group NiTi spreaders were used. Microleakage evaluation was conducted using dye penetration method t-test was used for statistical analysis. RESULTS: The results showed statistically significant differences between NiTi and SS groups (P=0.022), with the greatest dye penetration in SS group and the least in NiTi group. CONCLUSION: According to the results of the present study using NiTi spreader decrease apical microleakage in endodontically treated teeth. [Iranian Endodontic Journal 2009;4(4):149-51

Sealing efficacy of mineral trioxide aggregate with and without nanosilver for root end filling: an in vitro bacterial leakage study

Various materials have been added to mineral trioxide aggregate to enhance its properties. This study was aimed to compare the sealing efficacy of MTA with and without nanosilver using bacterial leakage approach. Seventy canine teeth were prepared and obturated. Then, after apical resection, the root-end cavities were prepared by ultrasonic retrotips. Teeth were randomly divided into 4 groups containing two experimental groups (n=30) and two negative and positive controls (n=5). In group 1 and 2, root-end cavities were respectively filled with MTA and MTA with nanosilver (by 1% weight). Leakage assessment was carried out by bacterial leakage apparatus with Enterococcus faecalis species. Leakage comparison between experimental groups was done using Mann-Whitney test by Spss 16 software at significancy level of 0.05. The median bacterial leakages for MTA and MTA with nanosilver were 19 and 2, respectively. The mean bacterial leakages for MTA and MTA with nanosilver were 30.06±28.67 and 9.66±14.25, respectively. Mann-Whitney test indicated that there was a significant difference in bacterial leakage day between two experimental groups (P=0.002). Based on the findings of this in-vitro bacterial leakage study, adding nanosilver to MTA decreased its sealing ability

Connective Tissue Reaction to White and Gray MTA Mixed With Distilled Water or Chlorhexidine in Rats

INTRODUCTION: The purpose of this study was to compare the histocompatibility of white (WMTA) and gray (GMTA) mineral trioxide aggregate mixed with 0.12% chlorhexidine (CHX) and distilled water (DW) in subcutaneous connective tissues of rats. MATERIALS AND METHODS: The freshly mixed WMTA and GMTA with CHX or DW were inserted in polyethylene tubes and implanted into dorsal subcutaneous connective tissue of 50 Wistar Albino rats; tissue biopsies were collected and were then examined histologically 7, 15, 30, 60 and 90 days after the implantation procedure. The histology results were scored from 1-4; score 4 was considered as the worst finding. Data were analyzed using one-way ANOVA tests. RESULTS: All experimented materials were tolerated well by the connective tissues after 90-day evaluation, except for the WMTA/CHX group that had significantly more mean inflammatory scores (P<0.001). There was a statistically significant difference in the mean inflammation grades between experimental groups in each interval (P<0.001). After 90 days, GMTA/CHX group had the lowest inflammatory score. CONCLUSION: Although adding CHX to WMTA produces significantly higher inflammatory response, it seems a suitable substitute for DW in combination with GMTA. Further research is necessary to recommend this mixture for clinical use

Push-Out Bond Strength of Dorifill, Epiphany and MTA-Fillapex Sealers to Root Canal Dentin with and without Smear Layer

Introduction: The aim of the present experimental study was to evaluate the push-out bond strength of Dorifill, Epiphany and MTA-Fillapex sealers to root canal dentin in presence and absence of smear layer (SL). Methods and Materials: Sixty human single-rooted teeth were selected and divided into six groups (n=10). The canal irrigation protocol in groups 1, 3 and 5 consisted of 2.5% NaOCl during instrumentation and normal saline at the end of preparation plus a 5-min irrigation with 17% ethylenediaminetetraacetic acid (EDTA). In the remaining groups, normal saline was used for canal irrigation. The root canals were filled with Epiphany/Resilon (groups 1 and 2), Dorifill/gutta-percha (groups 3 and 4) and MTA-Fillapex/gutta-percha (groups 5 and 6). After two weeks of storage in 95% relative humidity at 37ºC, 2 mm-thick dentin disks were prepared from coronal third of each root. The push-out bond strength test was carried out using a universal testing machine. Data were analyzed with the two-way ANOVA and post hoc Tukey’s tests. Statistical significance was defined at 0.05. Results: The highest (3.06±0.38 MPa) and lowest (1.16±0.32 MPa) push-out bond strength values were recorded in Epiphany/Resilon-NaOCl/EDTA and Dorifill/gutta-percha/normal saline groups, respectively. There were significant differences in the bond strength of sealers (P<0.05). In addition, elimination of the SL significantly increased the bond strength of all sealers (P<0.05). Conclusion: The Epiphany/Resilon group exhibited the highest push-out bond strength in the presence and absence of the SL. Elimination of the SL resulted in a significant increase in the bond strength of all the sealers to dentin

Postoperative Pain after Endodontic Treatment of Asymptomatic Teeth Using Rotary Instruments: A Randomized Clinical Trial

Introduction: The aim of the present study was to compare the effect of two different rotary instruments on postoperative pain in teeth with asymptomatic irreversible pulpitis. Methods and Materials: A total of 78 mandibular first and second molars were divided into two groups (n=39) and their root canal preparation was carried out with either RaCe or ProTaper rotary instruments. All the subjects underwent one-visit root canal treatment and the severity of postoperative pain was evaluated using visual analog scale (VAS) at 4-, 12-, 24-, 48- and 72-h and 1-week intervals. In addition, the need for taking analgesics was recorded. Data were analyzed with the repeated-measures ANOVA and the Mann-Whitney U test was used for two-by-two comparison. Statistical significance was set at 0.05. Results: Comparison of mean pain severity between the two groups at various postoperative intervals did not reveal any significant differences (P=0.10). The difference in amount of analgesics taken by each groups was not statistically significant (P=0.25). Conclusion: There were no significant differences in the postoperative pain reported between the two groups; which indicates the clinical acceptability of both systems.Keywords: Irreversible Pulpitis; Flare-Up; Postoperative Pain; ProTaper; RaCe; Root Canal Treatment 

Effects of different intra canal medicaments on the push out bond strength of endodontic sealers

One of the essential properties of the root canal sealers is the adhesion to root canal dentin and their higher bond strength decreases the microleakage. The aim of the present study was to compare the effect of Different Intracanal medicaments on the push out bond strength of AH26 and MTA Fillapex sealers. A total of 104 one-rooted extracted human teeth were divided into 4 (n=26) experimental groups. After the cleaning and shaping, the root canals were filled with Ca(OH)2, triantibiotic paste (TAP), Metapex or 2% chlorhexidine gel for two weeks. Then, intracanal medicaments were rinsed away and the samples in the sub-groups were obturated with gutta-percha and AH26 or MTA Fillapex sealers. After two weeks incubation, 2-mm-thick middle section of each root was then subjected to push-out testing. Data were analyzed with two-way ANOVA and LSD test. With all the intracanal medicaments, the overall mean of bond strength values were significantly higher with AH26 compared to MTA Fillapex (p<0.05). With the use of MTA Fillapex the maximum and minimum means of bond strength values were recorded with CHX and Metapex and for AH26 were recorded with Ca(OH)2 and chlorhexidine, respectively. The bond strengths of sealers to dentin are under the influence of pre-treatment with intracanal medicaments. Under the limitations of the present study, the effect of TAP on the bond strength of endodontic sealers was not negative

Two-Rooted Maxillary First Molars with Two Canals: A Case Series

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots