Removal efficiency of a fast setting pozzalan-based bioactive cement: a micro CT study.

AIM: The aim of this study was to evaluate the removal efficiency of PRMTA and ECMPremixed applied to the coronal third according to the RET by UI and to examine the effect of different solutions on material removal. MATERIALS AND METHODS: 40 permanent upper central teeth were used to simulate immature teeth. The samples were irrigated with 1.5% NaOCl and calcium hydroxide was placed. Samples were incubated in PBS. Then irrigation was done with 17% EDTA, the samples were randomly divided into 2 groups (n = 20):Group 1: PRMTA, Group 2: ECM Premixed. The materials were placed in the samples. Then the samples were scanned with micro-CT. Materials were removed by UI. Micro-CT scan of the samples was performed. Each material group was divided into 2 subgroups (n = 10): Group1 was MTAD, group2 was irrigated with 10% CA; then micro-CT was performed. Obtained images were positioned in DataViewer and analyzed with CTAn. The obtained data were statistically analyzed in IBM SPSS 25. The significance level was determined as 5%. RESULTS: There was no significant difference between the initial volumes of the materials (p > 0.05). The amount of the remaining material after UI was significantly higher in the PRMTA (0.7471%) group compared to the ECM Premixed (0.0093%). There was no significant difference in terms of remaining material after irrigation with MTAD and CA in both groups (p > 0.05). CONCLUSION: A great deal of the materials were removed by UI under the operation microscope. ECM Premixed was removed more effectively compared to the PRMTA. And, acidic solutions did not provide any additional benefit in material removal.

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial.

OBJECTIVES: The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment. MATERIALS AND METHODS: A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone-beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven's criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05. RESULTS: In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were 'totally healed', and 39 teeth were 'reduced' on PA radiographs. No 'enlargement' was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05). CONCLUSIONS: Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems. CLINICAL RELEVANCE: In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.