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The purpose of this study was to evaluate surface characteristics of Reciproc (R25) WaveOne (WO) &WaveOne Gold (WOG) files using SEM before and after use. Methods: fifteen primary files from each system were scanned for surface defects before instrumentation at 10x-1000x. Each file was planned to be used to instrument six root canals and then examined under SEM after preparing three and six canals at same magnifications. Data were scored and statistically analysed using CHI –SQ and Anova tests (p≤ 0.05). Results: Surface defects were detected in all study groups with higher values in WO & WOG group before use. Surface defects significantly increased in both WO and WOG groups after use as compared to R25. WO & WOG group showed significantly greater defects including metal strips, pitting, craters, micro-cracks and blunt edges (p≤ 0.05). Conclusions: Wave One Gold file has a different metallurgy due to its gold finish that does not enhance its resistance to surface defects during clinical use. Wave One and Wave One Gold showed significant increase in surface defects after six canal use which limits their usage in more than one teeth in single patient.
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Aim: Antibiotic loaded bone cement has been used extensively in orthopaedic surgery and in the treatment of osseous defects resulting from joint infection, osteomyelitis, osteitis. No endodontic investigation has used this type of material in the treatment of bony resorptive defects of the periapical lesions associated with failed endodontic therapy or periapical surgery. Therefore, this study was conducted with the use of gentamycin loaded bone cement, to assess healing ability of osseous defects in apical re-surgery cases after failed apical surgery. Methods: In all patients periapical lesions were surgically removed and gentamicin loaded bone cement was used as root end filling material and then carefully packed without pressure into the bony defect. Results: Long-term recall demonstrated clinical and radiographic healing and good tolerance of bone fill material by the periapical tissues. Conclusion: results from this study shows that gentamicin loaded bone cement is a biocompatible material and can be used effectively in apical resurgery cases for treating recalcitrant infectious osseous defects of periapical lesions associated with failed periapical surgery.
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Introduction: Long term success of any composite resinrestorative materials mainly depends on their color stability.The aim of the investigation was to examine the color stabilityof three resin-based composite materials with a high contentof inorganic filling material (Spectrum, Filtrex Z350 andTetric N Ceram).Material and Methods: Changes in color of test sampleswere determined after complete immersion in test solutionsused primarily in Kashmiri population viz. Kashmiri tea,Saffron Kehwa and a turmeric solution. Color differenceswere measured by using a spectrophotometer and CIE L*a*b*color scale and the total amount of color difference wasrepresented as ∆E.Results: For all composite resins, Turmeric solution causedthe most severe cases of discoloration (∆E > 8.25). Kashmiritea and Saffron Kehwa caused invisible (∆E <1) or visible (∆E>1) discoloration. In some samples clinically unacceptable(∆E > 3.3) discoloration was noted.Conclusion: No significant difference was found amongthe composite resins or between color values of specimensimmersed in Kashmiri tea or Saffron kehwa. Immersingspecimens in turmeric solution caused greater color changein all types of composite resins tested. It is apparent from theresults that it is essential to improve the color stability of thecomposite resin materials used in esthetic zone
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To assess calcium and phosphate loss from enamel using 37.5% hydrogen peroxide (HP) gel with additional application of light emitting diode (LED), Diode laser and Nano-Pulsed Cold laser (NPCL) light sources compared to that of 37.5% HP alone using atomic absorption spectrophotometer (AAS). Methods: Twenty teeth were sectioned to obtain mesiobuccal, distobuccal, mesiopalatal and distopalatal specimens. The specimens were randomly assigned to four equal groups. 37.5% HP of 1mm thickness was applied to the enamel surface of each specimen. Each group received three cycles of bleaching of 8 minute’s duration. Group II, III & IV received additional application of LED, Diode laser & cold laser light respectively. Results: Data was analyzed by means of descriptive statistics. Group III showed the maximum loss of ions while Group IV showed the least loss and the differences were statistically significant (P < .05). Conclusion: Teeth treated with 37.5% hydrogen peroxide with application of Nano-Pulsed Cold Laser (NPCL) light presented with significantly minimal calcium and phosphate loss
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Bleaching of vital teeth is a very common practice nowadays prompted by high esthetic demands of patients. But bleaching agents are known to cause some transient damage to enamel microstructure, so the need arises to determine the effect of bleaching agents on the mineral content of enamel. Aim: To evaluate mineral loss from enamel using in-office bleaching agent Hydrogen Peroxide and the effect of LED and Laser activated bleaching agent on mineral loss from enamel. Methods: Forty human premolar crowns were divided into buccal and lingual specimens and 80 blocks of 4x4x3mm each were obtained. Samples were randomly divided into four groups of twenty each depending upon the beaching treatment and activation method. Group I – Hydrogen Peroxide without additional activation, Group II – Hydrogen Peroxide with additional activation by Diode Laser, Group III – Hydrogen Peroxide with additional activation by LED Light and Group IV – Control group. Amount of calcium and Phosphate loss was calculated using atomic absorption spectrophotometry. Results: Results showed that bleaching with hydrogen peroxide leads to calcium and phosphate loss from enamel with additional activation resulting in higher amounts of mineral loss especially with Laser activation. Conclusion: Bleaching agents result in calcium and phosphate loss from enamel with significantly high loss of minerals due to additional activation by Laser and LED Light. Therefore bleaching procedures must be followed by remineralization treatments to prevent damage to enamel.
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Background: Aim: to evaluate the effect of bioceramic sealers on post endodontic pain following single visit endodontics. Methods: Ninety patients requiring endodontic treatment were selected for the study. Patients were treated in single visit endodontically using three different bioceramic based sealers. Results: No significant difference was found in post endodontic pain scores between the sealers groups. Conclusion: Any of the three bioceramic sealer can be used forsingle visit endodontics without fear of post operative pain.
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Background: Aim: To evaluate the effect of diode laser with maleic acid and ethylenediaminetetraacetic acid (EDTA) on the smear layer removal from root canals. Methods: A total of 160 mandibular premolars were decoronated to working the length of 12 mm and prepared with protaper gold rotary files up to size F3. Group 1 canals irrigated with 1 ml 17% EDTA followed by 3 ml of 3% NaOCl. Group 2 canals were initially irrigated with 0.8 ml of 17% EDTA the remaining 0.2 ml was used to fill the root canals, and diode laser application was done. Group 3 canals were irrigated with 1 ml of 7 % maleic acid followed by 3 ml of 3% NaOCl. Group 4 canals were irrigated with .8 ml of maleic acid and remaining .2 ml was used to fill canal and activated by diode laser followed by 3% NaOCl. Scanning electron microscope examination of canals was done for remaining smear layer at coronal middle and apical third levels. Results: Maleic acid with and without diode laser had the least smear layer scores. Conclusion: Diode laser with maleic acid performed significantly better than EDTA.
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Background: Aim: To study the outcome of single visit surgical extrusion and immediate aesthetic restoration of 15 cases of crown root fracture. Methods: Involved a conventional surgical extrusion method with elevators and stabilization with semi rigid fiber splint followed by immediate aesthetic composite buildup for restoration of aesthetics. Root canal treatment was completed after 3 weeks of Calcium hydroxide intracanal medicament. Results: Follow up examinations varying between 6 and 18 months, revealed no evident radiographic and clinical signs of root resorption, periapical disease and more important, marginal bone loss/gingival recession in any case. Conclusion: Highly favorable results of this clinical study reveal that single visit surgical extrusion with immediate aesthetics of crown root fractures may be an alternative to time consuming orthodontic extrusion which may create severe esthetic and emotional problems to patient.
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ackground: The ability of an endodontic rotary file to stay centered in the curved root canal system is one of the most important aspects of shaping of root canal as it influences the outcome of the subsequent phases of irrigation, disinfection, obturation and overall success of root canal treatment. Objectives: The purpose of this study was to evaluate root canal centering ability of four thermally treated rotary nickel titanium (NiTi) instrument systems (ProTaper NEXT, ProTaper Gold, Dia-X Files and Neoendo Flex Files) on extracted human teeth. Methods:Forty eight separate mesial root canals from extracted mature mandibular first molars identified with having apical curvature angles of 20°–35° were selected. A cone beam computed tomography (CBCT) was performed and canals were randomly divided into 4 groups of 12 teeth each. Group 1: ProTaper Gold (PTG) rotary files, Group 2: ProTaper NEXT (PTN) rotary files, Group 3: Dia-X (D-X) Rotary Files and Group 4: Neoendo Flex (NE) rotary Files. Root canal instrumentation was performed with all the four NiTi rotary files. Post instrumentation CBCT was performed. Root canal centering ratios were assessed by a standardized technique for individual groups at 9, 6 and 3mm levels of root canals. Results: ProTaper Gold files and Dia-X files resulted in significantly better canal centering ability than the Neoendo files and ProTaper NEXT files. (P<0.05). Conclusion: ProTaper Gold files and Dia-X files exhibited better centering ability than Neoendo files and ProTaper NEXT files at all levels of the root canal.
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Background: The root canal sealers form an important component of the three dimensional obturation of the root canals. Moreover, the penetration of the sealers into the dentinal tubules is a desirable phenomenon for their adequate sealing and antibacterial action. The aim of this study was to evaluate the effects of ultrasonic activation on the intratubular penetration of bioceramic root canal sealer. Methods: Eighty extracted human mandibular premolars were divided into 2 groups (n =40) according to the sealer activation method used to obturate the root canals instrumented with F3 Pro-Taper instruments .The canals were obturated using Protaper F3 guttapercha cones. Previously, the bio ceramic sealer was labeled with rhodamine B dye to allow analysis under a confocal microscope. The two groups were: UA (ultrasonically activated) and NA (no activation; control). All samples were sectioned at 3 and 8 mm from the apex. The percentages of dentinal sealer penetration segments of canal were analyzed. Results: Students T test was performed for the statistical analysis and we found that there was a significant increase in tubular penetration for the ultrasonic activation group.Conclusion: Use of ultrasonic activation of a bioceramic sealer promoted greater dentinal sealer penetration.
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Background: Cleaning and shaping is a critical aspect of endodontic treatment as it influences the outcome of the subsequent phases of canal irrigation and filling and the success of the treatment itself. The goal of instrumentation is to produce a continuously tapered preparation that maintains the canal anatomy, without any deviation from the original canal curvature, facilitating optimal irrigation, debridement, and placement of local medicaments and permanent root filling, at the same time retaining the integrity of the radicular structures. AIM: The aim of the study was to compare the shaping ability of four different Nickel-Titanium single file systems in mesial roots of mandibular first molars. Methods: Eighty freshly extracted mandibular molars, extracted for periodontal reasons were used for the study A muffle-block was constructed as given by Aviad et al.[59] After sealing the apices with wax, the canals were mounted in the muffleblock using self-cure acrylic resin. After complete polymerization of the resin, the block was removed from the model. The blocks were sectioned horizontally at three sites (coronal, middle and apical) by a thin cutting disk (0.3-mm thick) at two levels: one 3 mm from the apex and the other 6 mm from the apex. The disk was mounted on an electric saw (CIRSAW, Confident Dental Equipments Ltd, India) for cutting the blocks. Photographs were taken of all three cross-sections of each tooth using a DSLR Camera (Nikon Digital, Tokyo, Japan) at a fixed position. The sections were reassembled in the muffle. The specimens were randomly divided into the following four groups: Group l: Prepared using Reciproc rotary files. Group 2: Prepared using WaveOne rotary files. Group 3: Prepared using OneShape rotary files. Group 4: Prepared using F6 SkyTaper rotary files. Results: The results of the present study revealed that the use of Reciproc and WaveOne instruments resulted in significantly better canal centering ability than the use of OneShape instruments and F6 SkyTaper (P < 0.05) Reciproc and WaveOne exhibited less canal transportation than OneShape and F6 SkyTape There were no significant differences in the canal transportation between Reciproc and WaveOne. And also no significant difference between OneShape and F6 SkyTaper. One Shape instruments required significantly less time to prepare the root canals followed by Reciproc, WaveOne and F6 SkyTaper (P < 0.05). Conclusion: Reciproc and WaveOne instruments respected the original canal curvature better than OneShape and F6 SkyTaper files.
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Aim: The aim of this study is to evaluate the effect of low-level laser irradiation and ibuprofen in reducing the onset and severity of postoperative pain following single visit endodontics. Materials and Methods: One hundred and twenty patients were recruited for this study. Group A (n = 30) patients were administered 400 mg of ibuprofen orally 1 h before the institution of an endodontic procedure. Group B (n = 30) patients were given irradiation of a low-level laser at 50 Hz for 3 min after the standard endodontic procedure at the periapical region on both buccal and lingual aspect. Group C (n = 30) patients were given preoperative ibuprofen followed with a low-level laser at 50 Hz for 3 min after endodontic treatment. Group D (n = 30) patients were administered no preoperative ibuprofen nor low-level laser irradiation after the endodontic procedure. The patient immediately recorded his/her pain perception on the Heft Parker pain survey after completion of the appointment and at 4, 8, 12, 24, and 48 h postoperatively. Inter group analysis was carried out using the analysis of variances with “least significant difference” post hoc test. For intra group analysis, Student's t-test was used. Chi-square test was applied for nonparametric data. Results: Pain was significantly reduced in all the treatment groups postoperatively. Ibuprofen showed significant pain reduction at 4 h and 8 h period. The combination of low-level laser and ibuprofen showed the best results in terms of postoperative pain reduction. Conclusion: This study proved that low-level laser therapy can be an effective alternative for conventional use of nonsteroidal anti-inflammatory drugs in controlling postendodontic pain thereby eliminating the adverse effects of such drugs on the patients.
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Background: Sealers are universally used along with gutta-percha to obturate the root canals in three dimensions. Push-out bond strength is considered appropriate to measure the adhesion capacity of sealers. Aim: To compare the bond strength of recently introduced bioceramic sealer with commonly used sealers and to evaluate the effect of plunger: base orifice size ratio on push-out bond strength. Methods:One hundred mandibular premolars with single canals were decoronated and instrumented up to master apical file F3 Protaper. Specimens were randomly divided into four groups (n=25) based on the sealer used: Group 1-EndoSequence BC Sealer, Group 2-MTA FillApex sealer, Group3-Apexit Plus sealer & Group 4-AH Plus sealer and obturated using cold lateral compaction technique. After two weeks, 1±0.1mm thick slice of each radicular third of specimens was subjected to push-out testing with modified and standardised plunger: base orifice size ratio for each slice and bond strength calculated. Subsequently the slices were observed under stereomicroscope for failure mode analysis. Results: Results showed that AH Plus sealer had the highest overall bond strength followed by EndoSequence BC sealer and MTA FillApex while as Apexit Plus had lowest bond strength. Bond strength of all sealers reduced from coronal to apical direction except in EndoSequence BC sealer which showed better strength in critical apical third. Higher bond strength values were obtained due to modified relation of plunger with base orifice size. Conclusion: Bond strength of all sealers tested except EndoSequence BC reduces in apical direction and is impacted by plunger: base orifice size ratio.
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Aim: To evaluate the change in physical, chemical and biological properties when mineral trioxide aggregate (MTA) is mixed with a resin 4-methacryloxyethyl trimellitate anhydride (4-META)/methyl methacrylate-tri-n-butyl-borane (MMA)-TBB. Materials and Methods: For biological evaluation MTA was inoculated in Wistar rat's subcutaneous tissue and peripheral tissue response was checked after 72 h, 7 days, 15 days and 30 days. Setting time was evaluated using Gillmore needle. The Ca++ release at the end of 24 h was checked using ethylenediaminetetraacetic acid titration method. For all the trials MTA mixed with water was kept as a control and the ratio of MTA with resin was 1:1 by weight. Results: The biological reaction was verified by two observers and their readings were matched using kappa test and there was an excellent relevance. There was no significant difference in the tissue reaction at the end of 30 days where both the groups seemed to show healing. Setting time of MTA with 4-META/MMA-TBB was coming to a mean of 26 min (approx.), which is almost 6 times lesser than that of MTA with water. After applying t test, the difference in Ca++ release was found significant (P = 0.00), with mean of 0.044 and 0.031 mol/L of MTA with water and MTA with 4-META/MMA-TBB respectively. Conclusion: Under the parameters of this study, this new experimental cement has better handling, physical and chemical properties. Even its subcutaneous tissue reaction is comparable to MTA mixed with water.