Removal of calcium hydroxide pastes containing N-Methyl-2-Pyrrolidone, local anaesthesia, glycerine, and methylcellulose from artificial radicular grooves: An in-vitro study

Objective: To compare the removal of calcium hydroxide (CaOH) pastes containing N-Methyl-2-pyrrolidone (NMP), lidocaine, glycerine, methylcellulose, or water from artificially created grooves. Methods: In this study, 115 human single-rooted maxillary incisors with single and straight root canals were prepared using a rotary file up to size 40/.04 and split longitudinally. A longitudinal groove was created from 2 to 5 mm from the apex and filled with CaOH combined with different vehicles. The specimens were divided among 5 experimental groups according to the vehicle as follows: distilled water, lidocaine, glycerine, methylcellulose, and NMP. The two halves were re-attached, and the canals were flushed with 10 ml of 17% EDTA for 60 seconds. The residual amount of CaOH was scored using a stereomicroscope at 8x magnification. Statistical significance was set at P<0.05. Results: The NMP-based group exhibited significantly less residual medicament compared to the distilled water (P0.05). Conclusion: The vehicle is an important factor in the successful removal of CaOH medicament from the root canals. Within the limitations of the present study, the NMP-based CaOH medicament exhibited better removal efficacy than the distilled water. However, the cleaning success of the methylcellulose-, lidocaine-, and glycerine-based groups was similar to that of distilled water

INVESTIGATION OF PREVENTIVE MEASURES TAKEN BY FACULTY OF DENTISTRY STUDENTS IN CLINICAL PRACTICES AND PERCEIVED STRESS LEVELS DURING THE EPIDEMIC PERIOD

Objectives: This study aimed to examine the prevention measures applied by dentistry students in clinical conditions according to various variables and their perceived stress levels during the COVID-19 epidemic. Methods: The study was performed on 4th and 5th -grade students studying at RTEU Faculty of Dentistry. In the research, the whole count method was used, and data were collected from 168 students through an online questionnaire. The questionnaire consisted of demographic information, questions about prevention measures taken in clinical practice, and perceived stress scale questions. Normality test (Shapiro-Wilk) was applied to the data and T-Test and Chi-Square Analysis were used for statistical analysis. Significance was determined as p≤0.05. Results: The perceived stress levels of female students were found to be significantly higher than that of male students, and the perceived stress levels of 5th-grade students were significantly higher than that of 4th-grade students. The perceived stress levels of the students who used rubber dams were found to be significantly lower than the students who did not use rubber dams and the students who paid attention to social distance in the clinic compared to those who did not pay attention to social distance. Moreover, the perceived stress levels of students who knew which institution to contact with a suspected COVID-19 patient were found to be significantly lower than those who did not know (p&lt;0.05). Conclusion: It was determined that taking preventive measures in clinical practices was effective on students' perceived stress levels. Besides, it was observed that the perceived stress level of the students differed according to gender and grade level

Comparison of Er:YAG modalities (PIPS-SWEEPS) onEliminating of enterococcus faecalis populations

Comparison of Er:YAG Modalities (PIPS-SWEEPS) on Eliminating of Enterococcus Faecalis Populations Background: To determine the effectiveness of novel two Er:YAG lasers modalities, photon-initiated photoacoustic streaming (PIPS\SSP) and shock wave-enhanced emission photoacoustic streaming (SWEEPS\AutoSWEEPS) in terms of removal Enterococcus faecalis (E. faecalis) with or without antimicrobial agents [Sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX)]. Methods: Forty-two extracted single-rooted mandibular premolars were prepared, sterilized, and then inoculated with E. faecalis for 4 weeks, and randomly divided into to two main and three subgroups (n= 7). Group Ia ( PIPS + distilled water), Group Ib (PIPS + 5% NaOCl), Group Ic (PIPS + CHX), and Group IIa (SWEEPS + distilled water), Group IIb (SWEEPS + 5% NaOCl), and Group IIc (SWEEPS + CHX). Following incubation for 48 hours at 37°C, the colony forming units (CFU) were counted. Results: NaOCl and CHX activated with PIPS\SSP or SWEEPS\AutoSWEEPS modalities showed significantly higher reduction rates than distilled water activated with both laseractivated methods (p<0.05), but no significant differences were detected between the NaOCl and CHX groups. Besides, in all groups, no significant difference was detected between PIPS\SSP and SWEEPS\AutoSWEEPS performances in the reduction of CFU counts (p>0.05). Conclusion: Even novel laser activation methods or modalities are not sufficient alone to adequately reduce bacterial load and using antimicrobial agents with laser activation is necessary for the best reduction for microbial elimination. Novel SWEEPS\AutoSWEEPS modalıty with the conical 600μm tip showed no increased efficacy compared with PIPS\SSP mode. Besides, smaller fiber tip may increase the success of applications for minimally invasive access cavities and preparationEnterococcus Faecalis Biyofilmlerinin Ortadan Kaldırılmasında Er: YAG Yöntemlerinin (PIPS-SWEEPS) Karşılaştırılması Amaç: İki yeni Er: YAG lazer modalitesi olan foton-indüklü fotoakustik dalgalanma (PIPS \ SSP) ve şok dalgası ile geliştirilmiş emisyon fotoakustik akımının (SWEEPS \ AutoSWEEP) antimikrobiyal ajanlar (NaOCl ve klorheksidin glukonat) kullanılarak veya kullanılmadan E. faecalis uzaklaştırmadaki etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Kırk iki ekstrakte tek köklü mandibular premolar hazırlandı, sterilize edildi ve daha sonra 4 hafta boyunca E. faecalis ekimi yapıldı ve rastgele iki ana ve üç alt gruba (n = 7) ayrıldı. Grup Ia (PIPS + distile su), Grup Ib (PIPS +% 5 NaOCl), Grup Ic (PIPS + CHX) ve Grup IIa (SWEEPS +distile su), Grup IIb (SWEEPS +% 5 NaOCl) ve Grup IIc (SWEEPS + CHX). 37 ° C'de 48 saat süreyle inkübasyonun ardından, oluşan koloniler (CFU) sayıldı. Bulgular: PIPS \ SSP veya SWEEPS \ AutoSWEEPS yöntemleri ile aktive edilen NaOCl ve CHX, her iki lazer aktivasyon metodu ile aktive edilen distile sudan anlamlı şekilde daha yüksek indirgeme oranları gösterdi (p <0.05), ancak NaOCl ve CHX grupları arasında anlamlı bir fark bulunmadı. Ayrıca, tüm gruplarda, CFU sayılarının azaltılmasında PIPS \ SSP ve SWEEPS \ AutoSWEEPS performansları arasında anlamlı bir fark saptanmamıştır (p> 0.05). Sonuç: Yeni lazer aktivasyon metod veya modülleri bile bakteri yükünü yeterince azaltmak için tek başına yeterli değildir. En etkili mikrobiyal eliminasyon için lazer aktivasyonun antimikrobiyal ajanlar ile birlikte kullanılması gerekmektedir. Konik 600μm uçla uygulanan yeni SWEEPS \ AutoSWEEPS modalitesi, PIPS \ SSP’e kıyasla artan bir etkinlik göstermedi. Daha küçük fiber uç kullanımı, minimal invaziv giriş kavitesi ve preperasyonlarda uygulamaların başarısını artırabilir

Assessment of palliative approach in the pain management in endodontic emergencies during Covid-19 outbreak: Retrospective cohort study

Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material and Methods: One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen; n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Results: In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P > .05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P < .05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels

Açık apeksli dişlerde mineral trioksit agregat ile alternatif tedavi yöntemi: Olgu sunumu

The study aims to determine the efficiency and effectiveness of apexification treatment using mineral trioxide aggregate (MTA). For this purpose, two cases were taken into consideration in the examination on the basis of clinical records in the Faculty of Dentistry at Recep Tayyip Erdoğan University. These cases were a female patient at the age of 16 and a male patient at the age of 8. A treatment protocol was designed for and applied on both cases. This way, the whole treatment could be divided into three stages: preoperative, procedural and follow-up steps. The follow-up process consisted of two parts: clinical and radiographic examinations. In the procedural stage, the clinician first rinsed the root canals with 5 ml of 2.5% NaOCl and administered calcium hydroxide (CH) in the canals and allowed it to remain within a 1 -week period in order to fill the apical area (4 mm) of the immature, necrotic permanent incisors with an MTA plug. After MTA application, the clinic doctor filled the rest with gutta-percha cones. On the clinical and radiographic follow-ups performed semi-annually within one year, the lesions were dissected, and the tissues were regenerated in the periradicular area. In conclusion, use of MTA material was determined as an efficient and effective method in apexification with respect to time and quality of treatment and it is still a well-accepted technique.Bu olgu sunumunun amacı apeksi açık dişlerde Mineral Trioksit Aggregat (MTA) kullanımı sonucunda apeksifikasyon tedavisinin verimliliğinin ve etkinliğinin belirlemesidir. Bu amaçla, Recep Tayyip Erdoğan Üniversitesi Diş Hekimliği Fakültesi'nde klinik kayıtlara göre 16 yaşında bir bayan ve 8 yaşında bir erkek olmak üzere 2 vaka ele alındı. Her iki olgu için ameliyat öncesi, uygulama ve takip aşamaları olmak üzere üç aşama planlandı. Takip süreci ise klinik ve radyografik incelemeler olarak belirlendi. Uygulamanın ilk aşamasında, kök kanalları 5 ml %2.5’lik NaOCl ile yıkandı ve bir hafta süre ile kalsiyum hidroksit (CH) uygulandı. Kök kanallarının apikal 4 mm’lik kısmı MTA ile kapatıldıktan sonra kalan kısmı gütta perka konileri ile dolduruldu. Bir yıl içerisinde altı ay ara ile yapılan klinik ve radyolojik takiplerde periapikal bölgedeki dokuların yeniden yapılandığı ve lezyonların iyileştiği tespit edildi. Sonuç olarak, MTA materyali apeksifikasyon tedavisinde tedavi süresi ve kalitesi de göz önünde bulundurulduğunda hala kabul edilebilen güçlü bir alternatif yöntemdir

Comparison Of Calcium Hydroxide Removal Activities From Root Canals Of New Sonic System Vibringe And Different Irrigation Systems

Amaç: Bu çalışmanın amacı, Vibringe, EndoVac, pasif ultrasonik (PUI) ve geleneksel şırınga irrigasyonunun (GSI) kök kanallarından kalsiyum hidroksit (CH) uzaklaştırma etkinliklerinin taramalı elektron mikroskop (SEM) yardımı ile değerlendirilmesidir. Gereç ve Yöntem: Bu çalışma için 70 adet tek köklü insan mandibular premolar diş kullanıldı. Örnekler ProTaper döner sistem ile F4'e kadar prepare edildi ve kalsiyum hidroksit ile dolduruldu. Bir hafta sonra, kalsiyum hidroksit kök kanallarından GSI (Grup 1) , Vibringe (Grup 2) , EndoVac, (Grup 3) ve PUI (Grup 4) yöntemleri kullanılarak uzaklaştırıldı. ?şlemler sırasında, her örnek için toplamda altı dakika boyunca (aktif ve pasif irrigasyon) 2.5 mL % 2.5?lik NaOCI ve ardından 2.5 mL?lik % 17?lik EDTA kullanıldı. Kalan kalsiyum hidroksit miktarının değerlendirilmesi için kökler uzunlamasına ikiye ayrıldı ve x50 ve x1000 büyütme altında SEM?de incelendi. Veriler Kruskal-Wallis ve Mann-Whitney U testleri ile istatistiksel olarak analiz edildi (? = 0.05). Bulgular: Çalışmada kullanılan yöntemlerinden hiçbirisi kök kanal duvarlarından kalsiyum hidroksit medikamentini tamamen uzaklaştıramadı.. GSI sonrasında kanal duvarlarında en fazla kalsiyum hidroksit artığına rastlanırken, Vibringe, EndoVac ve PUI yöntemleri arasında anlamlı fark tespit edilmedi.(p> 0.05) Bununla birlikte GSI yönteminde apikal bölgede, koronal ve orta üçlüye göre anlamlı oranda daha fazla kalsiyum hidroksit artığına rastlanıldı. (p = 0.017) Vibringe, EndoVac ve PUI yöntemlerinin temizleme etkinliği ise kanal üçlü bölgelerine göre anlamlı farklılık göstermedi. Sonuç: Kök kanallarından kalsiyum hidroksit uzaklaştırmada Vibringe, EndoVac ve PUI yöntemleri birbirlerine benzer temizleme etkinliği göstermiş ve bu üç teknik de GSI metodundan daha başarılı bulunmuştur.Aim: The aim of this study was to evaluate the removal efficiencies of calcium hydroxide (CH) from the root canals using Vibringe, EndoVac, passive ultrasonic (PUI) and conventional needle irrigation (GSI) by means of scanning electron microscopy (SEM). Materials and Methods: Seventy single-rooted human mandibular premolar teeth were used for this study. The samples were prepared with the Protaper rotary system up to F4 and filled with calcium hydroxide. One week later, Calcium hydroxide was removed from the root canals with the several irrigation methods as follows: GSI (Group 1), Vibringe (Group 2),EndoVac (Group 3), PUI (Group 4). During the irrigation procedure, for each sample, 2.5 mL of 2.5% NaOCl followed by 2.5 mL of 17% EDTA was used for six minutes totally (active and passive irrigation). For the evaluation of remaining calcium hydroxide, the roots were split longitudinally and evaluated under SEM at x50 and x1000. Data were analyzed statistically by Kruskal-Wallis and Mann-Whitney U tests (?=0.05). Results: None of the methods used in the study could completely remove the calcium hydroxide medication from the root canal walls. Although the most residuel calcium hydroxide was observed on the canal walls after GSI irrigation, there was no significant difference between Vibringe, EndoVac and PUI methods (p> 0.05). However, GSI method showed significantly more calcium hydroxide residues in the apical region (p=0.017) than the coronal and middle area. The cleaning efficiency of the Vibringe, EndoVac and PUI methods were not significantly different in root canal areas. Conclusions: In terms of calcium hydroxide removal from root canals, Vibringe, EndoVac and PUI methods were found to be more effective than the GSI; however, there was no significant difference could be detected between each other

The Effect Of Different Retrograde Filling Materials On Periapical Tissue Healing: A Retrospective Study

Amaç: Bu çalışmanın amacı farklı retrograd dolgu materyalleri kullanılarak kök ucu rezeksiyonu uygulan- mış dişlerde doku iyileşmesinin retrospektif olarak değerlendirilmesi ve başarılı olarak gözlemlenen tedavi şeklinin rapor edilmesidir. Gereç ve Yöntem: Kök ucu rezeksiyonu endikasyonu bulunan tek köklü ve tek kanallı 330 diş, aynı hekim tarafından, 2014-2017 yılları arasında farklı retrograd dolgu materyalleri kullanılarak tedavi edilmiştir. Periapikal dokulardaki iyileşme radyografiler kullanılarak retrospektif olarak değerlendirilmiştir. Kullanılan retrograd dolgu materyaline göre 4 ana grup ve sadece rezeksiyon yapılan bir kontrol grubu oluşturuldu; Grup 1: (Trombositten Zengin Fibrin / Platelet Rich Fibrin): PRF, Grup 2: Amalgam, Grup 3: (Mineral Trioxide Aggregate) MTA ve Grup 4: PRF+MTA. Uygulanan yön- temlere göre gruplandırılmış dişler, operasyon öncesi ve sonrası radyografik incelemeler eşliğinde, önceden eğitim verilmiş, çalışma dışında bulunan 2 tarafsız hekim tarafından Rud ve ark’larının tanımladığı 4 parametreli skorlama yöntemi kullanılarak değerlen- dirildi. Elde edilen veriler SPSS 21 paket programı ile Kruskal Wallis H ve Mann-Whitney U test kullanarak istatistiksel olarak analiz edildi. Bulgular: Kontrol grubu ile çalışma grubu 1, 3 ve 4 arasında anlamlı bir fark bulunmadı. Kontrol grubu ile grup 2 arasında ise istatistiksel olarak anlamlı fark tespit edildi (p0.05). Sonuç: Bu çalışmanın sonucunda, kök ucu rezeksiyonu yapılmış dişlerde PRF, MTA veya PRF+MTA uygulamasının, retrograd dolgu uygulanmadan gerçek- leştirilen rezeksiyon vakaları ile benzer oranda iyileşme gösterdiği tespit edildi. Ancak; retrograd dolgu olarak amalgam kullanımının iyileşmeyi olumsuz etkilediği sonucuna varıldı.Aim: The aim of this study is to retrospectively assess the effects of different retrograde filling materials to periapical tissue healing, and to report the best treatment option considering the healing parameters. Materials and Methods: Apical resection cases performed by the same physician between 2014-2017 were evaluated according to the healing status of the periapical tissue retrospectively. 330 teeth with a single canal and a single root are included to the study, while teeth with multiple canals are excluded. Groups are divided into a control and four experimental groups; Group 1: (Platelet Rich Fibrin) PRF, Group 2: Amalgam, Group 3: (Mineral Trioxide Aggregate )MTA, Group 4: PRF + MTA respectively. Periapical healing of the teeth were evaluated by pre-trained 2 independent clinicians which are out-of-the study, by means of scoring the radiological findings according to Rud et al. The obtained values were statistically analyzed by Kruskal Wallis H and MannWhitney U test using SPSS 21 software. Results: No significant difference were found between control group and the experimental group 1, 3 and 4. There were a statistically significant difference between the control group and the experimental group 2 (p 0.05). Conclusion: PRF, MTA or PRF + MTA administration in apically resected teeth showed a similar improvement to resected cases without retrograde filling. The use of amalgam as a retrograde filler adversely affected recovery. The data obtained in this study are consistent with the literature in general

AÇIK APEKSLİ DİŞLERDE MİNERAL TRİOKSİT AGREGAT İLE ALTERNATİF TEDAVİ YÖNTEMİ: OLGU SUNUMU

The study aims to determine the efficiency and effectiveness of apexification treatment using mineral trioxide aggregate (MTA). For this purpose, two cases were taken into consideration in the examination on the basis of clinical records in the Faculty of Dentistry at Recep Tayyip Erdoğan University. These cases were a female patient at the age of 16 and a male patient at the age of 8. A treatment protocol was designed for and applied on both cases. This way, the whole treatment could be divided into three stages: preoperative, procedural and follow-up steps. The follow-up process consisted of two parts: clinical and radiographic examinations. In the procedural stage, the clinician first rinsed the root canals with 5 ml of 2.5% NaOCl and administered calcium hydroxide (CH) in the canals and allowed it to remain within a 1 -week period in order to fill the apical area (4 mm) of the immature, necrotic permanent incisors with an MTA plug. After MTA application, the clinic doctor filled the rest with gutta-percha cones. On the clinical and radiographic follow-ups performed semi-annually within one year, the lesions were dissected, and the tissues were regenerated in the periradicular area. In conclusion, use of MTA material was determined as an efficient and effective method in apexification with respect to time and quality of treatment and it is still a well-accepted technique.Bu olgu sunumunun amacı apeksi açık dişlerde Mineral Trioksit Aggregat (MTA) kullanımı sonucunda apeksifikasyon tedavisinin verimliliğinin ve etkinliğinin belirlemesidir. Bu amaçla, Recep Tayyip Erdoğan Üniversitesi Diş Hekimliği Fakültesi'nde klinik kayıtlara göre 16 yaşında bir bayan ve 8 yaşında bir erkek olmak üzere 2 vaka ele alındı. Her iki olgu için ameliyat öncesi, uygulama ve takip aşamaları olmak üzere üç aşama planlandı. Takip süreci ise klinik ve radyografik incelemeler olarak belirlendi. Uygulamanın ilk aşamasında, kök kanalları 5 ml %2.5’lik NaOCl ile yıkandı ve bir hafta süre ile kalsiyum hidroksit (CH) uygulandı. Kök kanallarının apikal 4 mm’lik kısmı MTA ile kapatıldıktan sonra kalan kısmı gütta perka konileri ile dolduruldu. Bir yıl içerisinde altı ay ara ile yapılan klinik ve radyolojik takiplerde periapikal bölgedeki dokuların yeniden yapılandığı ve lezyonların iyileştiği tespit edildi. Sonuç olarak, MTA materyali apeksifikasyon tedavisinde tedavi süresi ve kalitesi de göz önünde bulundurulduğunda hala kabul edilebilen güçlü bir alternatif yöntemdir

The comparison of cleaning efficacy and apical extrusion of advanced irrigation activation methods with a novel Er:YAG laser modality: sweeps

Purpose: Laser-activated irrigation (LAI) is an activation method that is based on transferring pulsed energy to the irrigation solution by using different fiber tips and generating explosive vapor bubbles with a secondary cavitation effect, causing rapid solution movement through the root canal. This study aimed to compare different types of LAI and ultrasonically activated irrigation (UAI) in terms of cleaning efficacy by using scanning electron microscopy (SEM) images. Methods: Sixty straight and single-rooted mature mandibular premolars were prepared with ProTaper Ni-Ti rotary instruments up to F4. According to the final irrigation/agitation protocols, four experimental groups (n = 15) were generated as conventional laser–activated irrigation (group 1: C.LAI), photon-induced photoacoustic streaming (group 2: PIPS), shock wave–enhanced emission photoacoustic streaming (group 3: SWEEPS), and passive ultrasonic irrigation (group 4:UAI). The irrigation protocols were performed for 60 s with 2.5% NaOCl and 17% EDTA. Debridement was evaluated using SEM with a scoring system. Apical extrusion was calculated using cube-shaped flower arrangement foam by subtracting the initial weights from the final weights. All data were statistically analyzed. Results: C.LAI and SWEEPS showed significantly lower debris scores than PIPS and UAI (p < 0.001). However, there was no significant difference between C.LAI and SWEEPS. In the PIPS group, significantly more debris residue was found compared with the other groups. Apical extrusion was significantly lower in the PUI groups than in the laser-activated groups (C.LAI, PIPS, SWEEPS). There was no significant difference between laser-activated groups. Conclusions: It can be concluded that the use of the C. LAI and novel laser-activated irrigation modality (SWEEPS) provides greater cleaning efficacy compared to UAI and PIPS. Besides, the observed results should not be generalized to teeth with shorter or longer root length and smaller or larger canal preparation with immature root development and open apices. In teeth with resorption, perforation defects or immature roots with open apex, the higher amount of apical extrusion should also be taken into account

Taurodontism and C-shaped anatomy: is there an association?

WOS: 000560603900001PubMed: 32803678Objectives To evaluate the relation between taurodontism and C-shaped configuration, as well as the prevalence and classification according to sex, left/right position, and arc length in the mandibular premolar and molar teeth using cone beam computed tomography (CBCT). Methods the presence of taurodontism and C-shaped configuration were evaluated using CBCT scans and classified by two independent radiologists. the sex, location in the jaw (left-right), and mandibular arc length measurements were recorded. the Chi-square test was used to determine the presence of taurodontism and C-shape configuration according to sex, left/right location, and independent-samplettests were used to assess the relation between the arc length. Results the prevalence of taurodontism was significantly higher in the female population, whereas the C-shaped configuration was more frequent in males (p 0.05). Conclusions A high correlation was revealed between taurodontism and complicated C-shape canal configurations. Practitioners should be very careful about the presence of C-shape morphology in taurodontism treatment, and various types of C-shaped morphology ranging from coronal to the apical direction