Sealing Ability of Mineral Trioxide Aggregate and Calcium-Enriched Mixture Cement as Apical Barriers with Different Obturation Techniques

Introduction: Endodontic treatment in pulpless immature teeth is challenging due to the lack of an apical stop. Insertion of an apical plug is an alternative to conventional long-term apexification with calcium hydroxide. The aim of this study was to compare the apical microleakage of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as apical plugs with three different obturation techniques. Methods and Materials: This experimental study was conducted on 130 single rooted human teeth with one canal. Samples were randomly divided into 2 experimental groups (n=60) and two negative and positive control groups containing 5 samples each. After cleaning and shaping, an open apex configuration was prepared in all samples. MTA or CEM cement apical plugs with 5 mm thicknesses were placed. Then, each group was divided to 4 subgroups and the remaining space of root canals were filled with either lateral compaction or thermoplasticized injectable gutta-percha or was obturated by filling the entire canal with apical plug material. In one remaining subgroup the canal space was left unfilled. Microleakage was measured by the fluid filtration method and results were analyzed by means of the two-way ANOVA test. Results: There were no significant differences between microleakage of MTA and CEM cement apical plugs (P=0.92). The difference between three obturation methods was not significant, either (P=0.39). Conclusion: MTA and CEM cement have similar sealing ability as apical plugs and no significant difference was found in microleakage of the three groups

Effect of Smear Clear and Conventional Root Canal Irrigants on Push-Out Bond Strength of Resilon/Epiphany System

Introduction: The aim of the present study is to compare the effect of SmearClear and sodiumhypochlorite (NaOCl), chlorhexidine (CHX) and normal saline (NS) on the push-out bond strength of Resilon/Epiphany system to dentine. Methods and Materials: In this in vitro study; 48 single-rooted teeth were selected and decoronated from the CEJ. Then the specimens were divided into four groups (n=12). The roots were prepared by single length technique using MTwo rotary system. The final irrigations of the canals were done using 2% CHX, normal saline, 5.25% NaOCl or SmearClear. The canals were obturated by Resilon/Epiphany system. The teeth were cut perpendicular to their longitudinal axis and four 1-mm-thick sections were obtained from coronal and mid root regions. The push-out bond strength of Resilon/Epiphany system to dentin were calculated and bond failure patterns were assessed. The data were subjected to two-way analysis of variance and Tukey’s tests. Results: The highest bond strength values were reported for SmearClear and the lowest values for the NS solutions. The effects of irrigant type (P<0.05) and canal area (P<0.0001) on the bond strength of Resilon to dentin were significant (P<0.05). Higher bond strength values were obtained in the mid root areas compared to the coronal regions. In two-by-two comparisons, significant differences in bond strength were found between SmearClear and normal saline (P<0.05) while the other irrigants showed no significant differences (P>0.05). Conclusion: SmearClear solution was able to increase the push-out bond strength of Resilon to the dentin similar to other irrigants (NaOCl and CHX). Therefore, it can be used for the root canal irrigation and smear layer removal in the clinical situations.Keywords: Push-But Bond Strength; Resilon; Root Canal Irrigation; SmearClear; Smear Laye

Management of an Endodontic-Periodontal Lesion in a Maxillary Lateral Incisor with Palatal Radicular Groove: A Case Report

The radicular groove is a developmental anomaly that predisposes the tooth to periodontal break-down. Sometimes the situation becomes more complicated by pulp necrosis and development of a combined endodontic-periodontal lesion which is a diagnostic and treatment challenge for the clinician. This report presents the successful management of an endodontic-periodontal lesion in a maxillary lateral incisor that has a developmental palatal radicular groove using a combination of nonsurgical endodontic therapy and periodontal regenerative techniques. Conclusion: The combination of nonsurgical endodontic and periodontal regenerative treatment is a predictable method in treating combined endodontic-periodontal lesions caused by palato-gingival groove.Keywords: Endodontic-Periodontal Lesion; Maxillary Lateral Incisor; Palatoradicular Groove; Periodontal Regeneratio

Antibacterial Activity of Diode Laser and Sodium Hypochlorite in Enterococcus Faecalis-Contaminated Root Canals

Introduction: The aim of the present in vitro study was to evaluate the disinfection ability of 980-nm diode laser in comparison with sodium hypochlorite (NaOCl) as a common root canal irrigant in canals infected with Enterococcus faecalis (E. faecalis). Methods and Materials: The root canals of 18 extracted single-rooted premolars were prepared by rotary system. After decoronation, the roots were autoclaved. One specimen was chosen for the negative control, and the remaining teeth were incubated with E. faecalis suspension for two weeks. Subsequently, one specimen was selected as the positive control and the remaining samples were divided into two groups (n=8). The samples of the first group were irrigated with 5.25% NaOCl and the second group were treated with a 980-nm diode laser. Microbial samples were taken from the root canals and bacterial cultivation was carried out. The average value and the standard deviation of colony-forming units (CFU) of each specimen were measured using descriptive statistics. The student’s t-test was used to compare the reduction in CFU in each group. The equality of variance of CFU was measured by the Levene’s test. Results: NaOCl resulted in 99.87% removal of the bacteria and showed significantly more antibacterial effect  compared to the 980-nm diode laser which led to 96.56% bacterial reduction (P<0.05). Conclusion: Although 5.25% NaOCl seems to reduce E. faecalis more effectively, the diode laser also reduced the bacterial count. Therefore a 980-nm diode laser could be considered as a complementary disinfection method in root canal treatment.Keywords: Diode Laser; Enterococcus faecalis; Root Canal Disinfection; Root Canal Irrigan

Evaluation of relationship between oral health-related quality of life and occlusion traits among female adolescents

Background: The aim of this study was to determine the impact of malocclusions on oral health-related quality of life (OHRQOL) among female adolescents. Materials and Methods: This is an observational cross-sectional descriptive study. A total of 129 female students with age ranges between 14 and 17 years old were randomly selected from Mashhad (Iran) high schools and were asked to fill out an OHRQOL questionnaire included in four parts: Oral symptoms, functional limitations, emotional well-being and social well-being. Each participant was clinically examined to assess her malocclusion according to the index of complexity, outcome and need (ICON) and finally the data were entered to SPSS 11.5 and the relation between these two variables was assessed with Pearson correlation test. P < 0.05 was considered as statistically significant. Results: There was statistically significant correlation between ICON scores and quality of life (P = 0.0176). Being separately assessed, among four parts of the questionnaire, only emotional well-being was significantly correlated with the ICON score (P < 0.05). Conclusion: Malocclusions play a vital role in OHRQOL. However, in female adolescents among four parts of OHRQOL, emotional well-being had significant relationship with malocclusions

Effect of Fluorohydroxyapatite on Biological and Physical Properties of MTA Angelus

Objectives. This study aimed to assess the effect of addition of fluorohydroxyapatite (FHI) on biological and physical properties of mineral trioxide aggregate (MTA) Angelus. Materials and Methods. In this in vitro, experimental study, nano-FHI powder was first synthesized, and the morphology and chemical structure of particles were evaluated by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). Three groups were evaluated in this study: MTA Angelus, MTA modified with 10% FHA, and MTA modified with 15% FHA. After mixing, the materials were applied to ring molds (10 mm diameter, 1 mm height), and the setting time of the three groups was evaluated according to ISO6876 and ASTMC266-03 with a Gillmore needle. The pH was measured using a pH meter at 24 and 48 hours and 7 days after mixing. The cytotoxicity of the materials was assessed in freshly mixed form and after 1 and 7 days using the methyl thiazolyl tetrazolium (MTT) assay according to ISO10993-5. Data were analyzed by one-way and repeated measures ANOVA and Tukey’s test (alpha = 0.05). Results. The addition of FHA to MTA significantly decreased the initial setting time (P < 0.05) and had no significant effect on cell viability (compared with pure MTA Angelus) at 1 and 7 days. However, modified MTA groups in freshly mixed form showed significantly lower cell viability (P < 0.05). The pH remained alkaline at all time points. Conclusion. Addition of 15% FHA to MTA Angelus decreased its setting time with no adverse effect on cell viability (except for fresh form) or pH