Drugs in dental biofilm and enamel - A pilot study.

Objective: Enamel and dental biofilm might serve as alternative matrices for determination of illicit and medical drugs. Thus, this study aims at evaluating possible correlations between detected drug concentrations in the matrices and simulated drug use in situ. Design: Eleven subjects wore intraoral splints with embedded demineralized bovine enamel samples. Drug use was simulated by mouth rinsing with a 1.0 µg/ml drug solution three times daily for 1 min (study A) or by incubation of the splints in a 10 µg/ml drug solution once a day for 30 min (study B). Amphetamines, opiates, cocaine and benzoylecgonine were used as drugs. After 11 days, biofilm and enamel samples of the intraoral splints were analyzed by liquid chromatography mass spectrometry after drying and extraction via ultrasonication with acetonitrile (biofilm) or methanol (enamel). Results: In study A, median and mean drug concentration ± standard deviation were 1.3 pg/mg and 6.4 ± 11 pg/mg in biofilm and 0.2 pg/mg and 0.5 ± 0.9 pg/mg in enamel. In study B, median and mean drug concentration ± standard deviation were 350 pg/mg and 1100 ± 1600 pg/mg in biofilm and 5.8 pg/mg and 9.9 ± 10 pg/mg in enamel. Conclusions: Overall, there were considerable interindividual concentration differences. Correlations between concentrations in the two sample materials were shown. The results of this pilot study revealed a dependence of concentrations on intensity and duration of drug contact. Thus, important information on past drug use might be provided in forensic cases by analysis of dental biofilm and enamel.

In vitro studies on the dependence of drug deposition in dentin on drug concentration, contact time, and the physicochemical properties of the drugs.

The chemical analysis of dental hard tissues can provide information on previous drug use due to the deposition of drugs into this tissue. For the interpretation of analytical results in, e.g., postmortem toxicology or regarding archeological samples, the influence of drug dosing, consumption frequency, duration of intake and type of drug on analyte concentrations in teeth has to be characterized. To approximate these correlations, in vitro models were applied to investigate the time dependency of drug deposition via and against pulp pressure (perfusion studies) and the concentration dependency of drug deposition via oral cavity (incubation study) as well as the influence of de- and remineralization (pH cycling) on the incorporation of drugs in bovine dentin pellets. Some of the drugs of abuse most relevant in forensic case work (amphetamines, opiates, cocaine and benzoylecgonine) were applied. Concentrations in dentin samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) after pulverization and extraction via ultrasonication with methanol. The studies showed that drug deposition in dentin likely depends on the physicochemical properties of the drug molecules as well as on the duration of contact with drugs via the blood stream and on drug concentrations present in the oral cavity. Higher drug concentrations in teeth can result from a more frequent or longer drug use. In addition, intake of higher doses or oral/inhalative consumption can also be expected to lead to higher drug concentrations. These findings can be helpful for the interpretation of postmortem cases.

Dental Plaque Concentrations of Methadone, Morphine and Their Metabolites in Opioid Replacement Therapy and in Postmortem Cases.

Non-mineralized dental biofilm (plaque) has potential as a novel alternative matrix in forensic toxicology to prove drug use. The incorporation of illicit and medicinal drugs in dental plaque could take place through direct contact after oral or nasal intake, which can lead to high drug levels in the oral cavity, or indirectly via the secretion of drug-containing saliva, e.g., after intravenous application. Therefore, plaque samples from patients in opioid replacement therapy (ORT) and postmortem plaque samples were analyzed and the drug concentrations were compared. The study comprised 26 plaque samples from ORT patients with different daily doses, which were analyzed for methadone, morphine and their respective metabolites. Plaque samples were taken directly before the oral administration of the regular daily dose. Seventeen postmortem plaque samples were analyzed, either from cases of lethal drug intoxications or after pain therapy with morphine. Plaque analysis was performed using liquid chromatography--tandem mass spectrometry after liquid extraction with acetonitrile. Plaque concentrations in ORT for methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) ranged from 42 to approximately 49,000 pg/mg (median 1,300 pg/mg) and from below 10 to 610 pg/mg (median 31 pg/mg), respectively. Morphine plaque concentrations in ORT ranged from 120 to 480 pg/mg (median 400 pg/mg). In lethal intoxication cases, plaque concentrations were generally at least one order of magnitude higher than those in the study groups with therapeutic substance use. These data will help to interpret drug findings in plaque. Furthermore, the EDDP/methadone concentration ratio in plaque was lower after oral intake with contamination of the oral cavity (e.g., syrup) compared to cases with suspected intravenous application of methadone. Therefore, the EDDP/methadone concentration ratio could therefore indicate the drug administration route.

Multivariate optimization of a method for the determination of fatty acids in dental biofilm by GC-MS.

AIM: Phospholipid fatty acid methyl ester (FAME) analysis offers a simple option additionally to 16S rRNA sequencing to characterize microbial communities and to monitor changes. A method was established for the characterization of dental plaque via FAME profiles. METHODOLOGY: Fatty acids were determined as FAMEs (direct, acidic transesterification) and analyzed by GC-MS using an optimized temperature gradient. The transesterification reaction was optimized using a fractional factorial central composite face-centered design. RESULTS: Optimal conditions for the transesterification in methanol/toluene: hydrochloric acid concentration 2% (w/v), reaction time 40 min, temperature 110 °C. Method validation showed satisfactory accuracy, precision and linearity. CONCLUSION: The method provides a useful tool to characterize plaque via FAME profiles and was successfully applied to samples from ten subjects demonstrating its applicability.

Full validation of a method for the determination of drugs of abuse in non-mineralized dental biofilm using liquid chromatography-tandem mass spectrometry and application to postmortem samples.

Alternative matrices play a major role in postmortem forensic toxicology, especially if common matrices (like body fluids or hair) are not available. Incorporation of illicit and medicinal drugs into non-mineralized dental biofilm (plaque) seems likely but has not been investigated so far. Analysis of plaque could therefore extend the spectrum of potentially used matrices in postmortem toxicology. For this reason, a rapid, simple and sensitive method for the extraction, determination and quantification of ten drugs of abuse from plaque using liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed and fully validated. Amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxy-N-ethylamphetamine (MDEA), 3,4-methylenedioxyamphetamine (MDA), cocaine, benzoylecgonine, morphine, codeine and 6-acetylmorphine were extracted from 2mg of dried and powdered plaque via ultrasonication with acetonitrile. The extracts were analyzed on a triple-quadrupole linear ion trap mass spectrometer in scheduled multiple reaction monitoring mode (sMRM). The method was fully validated and proved accurate, precise, selective and specific with satisfactory linearity within the calibrated ranges. The lower limit of quantification was 10-15pgmg-1 for all compounds except for MDA (100pgmg-1) and amphetamine (200pgmg-1). The method has been successfully applied to three authentic postmortem samples with known drug history. Amphetamine, MDMA, cocaine, benzoylecgonine, morphine and codeine could be detected in these cases in concentrations ranging from 18pgmg-1 for cocaine to 1400pgmg-1 for amphetamine.

Betel Nut Chewing in Iron Age Vietnam? Detection of Areca catechu Alkaloids in Dental Enamel.

The betel quid is one of the most commonly consumed psychoactive substances in the world. By archaeological evidence like the occurrence of areca nuts in archaeological sites, the typical overall reddish-brown staining on prehistoric human teeth or specific artifacts linked with the habit, it is assumed that this tradition reaches back to prehistoric times. Since this kind of evidence is indirect, it is frequently doubted. The present study provides the earliest direct analytical indication of betel nut chewing in human history. A typical stained tooth from an Iron Age skeleton (site Gò Ô Chùa in Southern Vietnam, 400-100 BC) was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and liquid chromatography-high-resolution mass spectrometry (LC-HR-ToF-MS) and the alkaloid arecoline which is specific for Areca catechu L. (Arecaceae) was detected.

Determination of medicinal and illicit drugs in post mortem dental hard tissues and comparison with analytical results for body fluids and hair samples.

In burnt or skeletonized bodies dental hard tissue sometimes is the only remaining specimen available. Therefore, it could be used as an alternative matrix in post mortem toxicology. Additionally, analysis of dental tissues could provide a unique retrospective window of detection. For forensic interpretation, routes and rates of incorporation of different drugs as well as physicochemical differences between tooth root, tooth crown and carious material have to be taken into account. In a pilot study, one post mortem tooth each from three drug users was analyzed for medicinal and illicit drugs. The pulp was removed in two cases; in one case the tooth was root canal treated. The teeth were separated into root, crown and carious material and drugs were extracted from the powdered material with methanol under ultrasonication. The extracts were screened for drugs by LC-MS(n) (ToxTyper™) and quantitatively analyzed with LC-ESI-MS/MS in MRM mode. The findings were compared to the analytical results for cardiac blood, femoral blood, urine, stomach content and hair. In dental hard tissues, 11 drugs (amphetamine, MDMA, morphine, codeine, norcodeine, methadone, EDDP, fentanyl, tramadol, diazepam, nordazepam, and promethazine) could be detected and concentrations ranged from approximately 0.13pg/mg to 2,400pg/mg. The concentrations declined in the following order: carious material>root>crown. Only the root canal treated tooth showed higher concentrations in the crown than in the root. In post mortem toxicology, dental hard tissue could be a useful alternative matrix facilitating a more differentiated consideration of drug consumption patterns, as the window of detection seems to overlap those for body fluids and hair.

Fluoride varnishes containing calcium glycerophosphate: fluoride uptake and the effect on in vitro enamel erosion.

OBJECTIVES: Calcium glycerophosphate (CaGP) was added to fluoride varnishes to analyze their preventive effect on initial enamel erosion and fluoride uptake: potassium hydroxide (KOH)-soluble and KOH-insoluble fluoride bound to enamel. MATERIALS AND METHODS: This study was carried out in two parts. Part 1: 108 enamel samples were randomly distributed into six varnish groups: base varnish (no active ingredients); Duraphat® (2.26%NaF); Duofluorid® (5.63%NaF/CaF2); experimental varnish 1 (1%CaGP/5.63 NaF/CaF2); experimental varnish 2 (5%CaGP/5.63%NaF/CaF2); and no varnish. Cyclic demineralization (90 s; citric acid, pH = 3.6) and remineralization (4 h) was made once a day, for 3 days. Change in surface microhardness (SMH) was measured. Part 2: 60 enamel samples were cut in half and received no varnish (control) or a layer of varnish: Duraphat®, Duofluorid®, experimental varnishes 1 and 2. Then, KOH-soluble and KOH-insoluble fluoride were analyzed using an electrode. RESULTS: After cyclic demineralization, SMH decreased in all samples, but Duraphat® caused less hardness loss. No difference was observed between varnishes containing CaGP and the other varnishes. Similar amounts of KOH-soluble and insoluble fluoride was found in experimental varnish 1 and Duofluorid®, while lower values were found for experimental varnish 2 and Duraphat®. CONCLUSION: The addition of CaGP to fluoride varnishes did not increase fluoride bound to enamel and did not enhance their protection against initial enamel erosion. CLINICAL RELEVANCE: We observe that the fluoride varnishes containing CaGP do not promote greater amounts of fluoride bound to enamel and that fluoride bound to enamel may not be closely related to erosion prevention.

Effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilm in experimental primary and secondary endodontic infections.

BACKGROUND: To determine the antibacterial effect of photodynamic Therapy on Enterococcus faecalis (E. faecalis) biofilms in experimentally infected human root canals in primary infections and endodontic retreatments. METHODS: One hundred and sixty single-rooted extracted teeth with one root canal were prepared using ProTaper instruments. Seventy specimens were left without root canal filling and autoclaved. The root canals of another 70 specimens were filled with Thermafil and AH Plus and the root canal fillings were removed after 24 hours using ProTaper D files and plasma sterilized. The specimens were infected with a clinical isolate of E. faecalis for 72 hours. Samples were taken using sterile paper points to determine the presence of E. faecalis in the root canals. The specimens were randomly divided into groups according to their treatment with 20 teeth each and a control. In the PDT group the teeth were treated using PDT, consisting of the photosensitizer toluidine blue and the PDT light source at 635 nm. In the NaOCl (sodium hypochlorite) group the root canals were rinsed with 10 mL of 3% NaOCl. In the NaOCl-PDT group the root canals were rinsed with 10 mL of 3% of sodium hypochlorite and then treated with PDT. Samples were taken after treatments using sterile paper points. Additionally, remaining root canal filling material was recovered from the root canal walls. Survival fractions of the samples were calculated by counting colony-forming units. A one-way analysis of variance (ANOVA) was applied to the data to assess the effect of different treatment techniques. RESULTS: Antimicrobial treatment of root canals caused a significant reduction of bacterial load in all groups. NaOCl irrigation eliminated E. faecalis most effectively. PDT alone was less effective compared to NaOCl irrigation and the combination of NaOCl irrigation and PDT. CFU levels recovered from the filling material after NaOCl irrigation of the root canals were 10fold higher compared to PDT and the combination of NaOCl irrigation and PDT. CONCLUSIONS: Photodynamic therapy killed E. faecalis in experimental primary endodontic infections and retreated human root canals. PDT is an effective supplement in root canal disinfection, especially in endodontic retreatments.

New bacterial composition in primary and persistent/secondary endodontic infections with respect to clinical and radiographic findings.

INTRODUCTION: The aim of the present study was to analyze the microbiota of primary and secondary/persistent endodontic infections of patients undergoing endodontic treatment with respect to clinical and radiographic findings. METHODS: Samples from the root canals of 21 German patients were taken using 3 sequential sterile paper points. In the case of a root canal filling, gutta-percha was removed with sterile files, and samples were taken using sterile paper points. The samples were plated, and microorganisms were then isolated and identified morphologically by biochemical analysis and sequencing the 16S rRNA genes of isolated microorganisms. RESULTS: In 12 of 21 root canals, 33 different species could be isolated. Six (50%) of the cases with isolated microorganisms were primary, and 6 (50%) cases were endodontic infections associated with root-filled teeth. Twelve of the isolated species were facultative anaerobic and 21 obligate anaerobic. Monomicrobial infections were found for Enterococcus faecalis and Actinomyces viscosus. E. faecalis was most frequently isolated in secondary endodontic infections (33%). Moraxella osloensis was isolated from a secondary endodontic infection that had an insufficient root canal filling accompanied by a mild sensation of pain. A new bacterial composition compromising Atopobium rimae, Anaerococcus prevotii, Pseudoramibacter alactolyticus, Dialister invisus, and Fusobacterium nucleatum was recovered from teeth with chronic apical abscesses. CONCLUSIONS: New bacterial combinations were found and correlated to clinical and radiographic findings, particularly to chronic apical abscesses. M. osloensis was detected in root canals for the second time and only in German patients.

Pull-out bond strength of a fibre-reinforced composite post system luted with self-adhesive resin cements.

OBJECTIVES: Due to morphological differences along the root canal, serious structural damage, or extensive endodontic preparation, cement thickness of luted fibre-reinforced composite (FRC) post systems can largely vary. This study aimed at evaluating the effects of a self-etch (Multilink Automix, MLA) and various self-adhesive resin cements (G-Cem, GCM; Maxcem Elite, MXE; RelyX Unicem, RLX; SmartCem 2, SMC) on the pull-out bond strengths of FRC posts to root canal dentine, and to compare the effects of different cementation thicknesses. METHODS: 100 bovine incisor roots were embedded in acrylic resin and randomly assigned to two groups. Root canals of group 1 were prepared with RelyX Fiber Post drill size one (Ø 1.3mm), whereas in group 2 drill size three (Ø 1.9mm) was used to attain different cement thicknesses (thicknesses 1 and 2). Each group was then subdivided into five subgroups (n=10). RelyX Fiber Posts size one (Ø 0.70mm) were luted with the respective resin cements. All specimens were subjected to pull-out evaluation using a universal testing machine. Post surface areas covered with cement were measured by means of stereomicroscopy. RESULTS: RLX revealed the significantly highest pull-out bond strengths in both groups (p<0.05), while MXE exhibited the significantly lowest pull-out bond strengths in group 2 (p<0.05). Main failure modes were determined as adhesive at the cement-post surface for all examined groups (except for SMC, group 2). CONCLUSIONS: The different resin cements influenced the pull-out bond strengths, whereas the cement thickness itself was not responsible for any differences. CLINICAL SIGNIFICANCE: Self-adhesive resin cements can provide an acceptable retention of FRC posts even in case of use with wider post space conditions.

The influence of saliva on the dissolution of calcium fluoride after application of different fluoride gels in vitro.

OBJECTIVE: To determine the formation and dissolution of calcium fluoride on the enamel surface after application of two fluoride gel-saliva mixtures. METHOD AND MATERIALS: From each of 80 bovine incisors, two enamel specimens were prepared and subjected to two different treatment procedures. In group 1, 80 specimens were treated with a mixture of an amine fluoride gel (1.25% F-; pH 5.2; 5 minutes) and human saliva. In group 2, 80 enamel blocks were subjected to a mixture of sodium fluoride gel (1.25% F; pH 5.5; 5 minutes) and human saliva. Subsequent to fluoride treatment, 40 specimens from each group were stored in human saliva and sterile water, respectively. Ten specimens were removed after each of 1 hour, 24 hours, 2 days, and 5 days and analyzed according to potassium hydroxide-soluble fluoride. RESULTS: Application of amine fluoride gel resulted in a higher amount of potassium hydroxide-soluble fluoride than did sodium fluoride gel 1 hour after application. Saliva exerted an inhibitory effect according to the dissolution rate of calcium fluoride. However, after 5 days, more than 90% of the precipitated calcium fluoride was dissolved in the amine fluoride group, and almost all potassium hydroxide-soluble fluoride was lost in the sodium fluoride group. Calcium fluoride apparently dissolves rapidly, even at almost neutral pH. CONCLUSION: Considering the limitations of an in vitro study, it is concluded that highly concentrated fluoride gels should be applied at an adequate frequency to reestablish a calcium fluoride-like layer.

Comparison of in vitro fluoride uptake from whitening toothpastes and a conventional toothpaste in demineralised enamel.

Studies on the compatibility of abrasives and fluoride compounds deal exclusively with fluoride uptake and remineralization after storing the enamel specimens in a toothpaste-saliva mixture. The influence of brushing on the fluoride uptake when highly abrasive toothpastes are used has hardly been investigated so far. The aim of the present study was to investigate fluoride uptake in initially demineralised dental enamel after storage in, or brushing with, whitening toothpaste slurries, compared to a conventional toothpaste. For this purpose two widely available whitening toothpastes with ionically bound fluoride (sodium fluoride NaF), two with covalently-bound fluoride toothpastes (sodium monofluorophosphate, NaMFP) and a conventional amine fluoride toothpaste (AmF) were compared. The fluoride uptake after use of the AmF toothpaste was shown to be statistically significantly higher than that after application of the NaF toothpastes, which in turn was statistically significantly higher than the uptake resulting from NaMFP application. The fluoride uptake was slightly higher when the enamel samples were brushed with NaF toothpaste, rather than just stored in the respective toothpaste slurry. Brushing with highly abrasive toothpastes did not negatively influence fluoride uptake in demineralised dental enamel. The ionic form of the fluoride in toothpastes appears to be critical for increased fluoride uptake. The acidic components of the AmF toothpaste improved fluoride uptake compared to alkaline NaF toothpastes.

Effect of a 5000 ppm fluoride toothpaste and a 250 ppm fluoride mouth rinse on the demineralisation of dentin surfaces.

BACKGROUND: The purpose of this study was to test the null hypothesis that there is no difference between the effect of (1) a 5000 ppm fluoride toothpaste, and (2) a 250 ppm fluoride mouth rinse on demineralized human dentin surfaces, against the alternative hypothesis of a difference. FINDINGS: Dentin specimens were obtained from the cervical regions of 45 extracted human third molars. Half the surface of each specimen was sealed with a self-etching adhesive system and served as the reference surface. The dentin specimens were randomly assigned to one of the three groups, 5000 ppm fluoride toothpaste (Duraphat), 250 ppm fluoride mouth rinse (Meridol) and distilled water (negative control).An intraoral appliance was made for one volunteer. In each test cycle, 15 specimens were inserted in the appliance and worn for 24 hours a day, over a period of three weeks.Once daily, the appliance was immersed in the agent being tested; either toothpaste slurry, mouth rinse or distilled water for 60 seconds.Demineralization was assessed in terms of lesion depth (microm) and mineral loss (vol. % x microm) by transversal microradiography. Data analysis was accomplished using Kolmogorov-Smirnov test and ANOVA (SPSS 12.0).Statistically significant differences for mineral loss and lesion depth were found between the toothpaste and the mouth rinse as well as between the toothpaste and the control group, but not between the mouth rinse and the control group. CONCLUSION: Within the limitations of this study, the results suggest that treatment of demineralised dentin with a toothpaste containing 5000 ppm fluoride may considerably reduce mineral loss and lesion depth on exposed dentin.

In situ fluoride retention and remineralization of incipient carious lesions after the application of different concentrations of fluoride.

Limited information is available on the time-dependent or dosage-dependent cariostatic efficacy of highly concentrated fluoride compounds. This good clinical practice-conforming, double-blind, placebo-controlled, crossover in situ study tested the hypothesis that a 1.0% amine fluoride fluid is superior to a 0.5% amine fluoride fluid regarding fluoride retention and mineral change in initial caries enamel lesions over a period of 28 d. Fluoride retention was significantly higher after application of the two fluoride fluids compared with placebo but had decreased in both groups to similar levels after only 1 wk. Mineral gain was significantly higher for both verum groups compared with placebo. The use of 1% fluoride fluid resulted in significantly higher remineralization compared with the use of 0.5% fluoride fluid. For both fluoride fluids mineral gain followed a linear relationship with time during the experimental period, indicating a possible further uptake of mineral, even after 4 wk.

Shaping ability and safety of five different rotary nickel-titanium instruments compared with stainless steel hand instrumentation in simulated curved root canals.

OBJECTIVE: To compare the shaping ability and safety of engine-driven FlexMaster, GT Rotary, ProFile, ProTaper, and RaCe rotary instrumentation and Hedström hand instrumentation in simulated root canals. STUDY DESIGN: One hundred fifty simulated colored root canals with a curvature of 20 degrees and a radius of 10 mm were randomly distributed among 6 groups of 25 specimens each. After preparation to apical size 30 the area of remaining color on the canal wall indicating unprepared areas was measured in mm2 using image analyzer software. RESULTS: Specimens treated with RaCe left least areas of remaining color compared to all other groups (P < .001), followed by ProTaper. Preparation with ProFile left behind the highest amount of unprepared areas. The ProFile group revealed significantly more remaining color than ProTaper, GT Rotary, and FlexMaster (P < .05). Four FlexMaster files separated. CONCLUSION: RaCe rotary files were safe and more effective compared to the other instruments.

Efficacy of different rotary instruments for gutta-percha removal in root canal retreatment.

The purpose of this study was to evaluate the efficiency of FlexMaster, ProTaper, and RaCe rotary instruments compared with Hedström files for removal of gutta-percha during retreatment. Sixty mandibular premolars with one single straight canal were instrumented with K-type files and filled using cold lateral compaction and sealer. The teeth were randomly divided into four groups of 15 specimens each. After repreparation with Gates Glidden burs and the test instruments the specimens were cleared. The area of remaining gutta-percha/sealer on the root canal wall was measured from two directions. The RaCe group showed significantly less residual obturation material than FlexMaster and Hedström group (p < 0.05; closed test procedure). There was no difference between ProTaper and all other instruments (p > 0.05). ProTaper and RaCe instruments required significantly less time for retreatment than FlexMaster and Hedström files (p < 0.05). One RaCe file, two ProTaper, and two FlexMaster instruments separated. RaCe cleaned obturated canals more effectively than hand files and FlexMaster files.

[Bond strength of different resin composites to fiber-reinforced posts]. / Verbundfestigkeiten verschiedener Aufbaukomposite zu faserver-stärkten Wurzelkanalstiften.

Endodontically treated teeth often have little coronal tooth tissue remaining and as such require a post to retain the core and the restoration. Therefore, tooth coloured adhesive inserted fiber posts in combination with resin based core material can be used. In this study, the tensile bond strength of core materials to fiber posts was investigated. Three different core materials, Clearfil Core, CoreRestore 2 and MultiCore Flow in combination with two different fiber posts systems, ER DentinPost and DT Light Post, were tested. The posts were shortened to the lengths of 15 mm. The specimens were obtained while the upper part (3 mm) of the posts was covered with standardized cylinders of the core materials. Clearfil Core in combination with the DT Light Post (230.5 N +/- 42.2 N) and ER DentinPost (154. N +/- 33.6 N) had the highest tensile bond strengths of all groups. The tensile bond strength of CoreRestore 2 to DT Light Post (149.9 N +/- 29.5 N) was higher than the tensile bond strengths of the combinations MultiCore Flow/DT Light Post (140.9 N +/- 31.4 N) and Multi- Core Flow/ER DentinPost (122,. N +/-19,. N). The group Core-Restore 2TER DentinPost had the lowest tensile bond strengths (80,1 N ++/-19,4 N). The adhesion of the resin based core materials to the fiber posts is influenced by the post design and core materials. The combination of core materials with the type of fiber post has a great influence on the tensile bond strength.

Effectiveness of a hand file and three nickel-titanium rotary instruments for removing gutta-percha in curved root canals during retreatment.

OBJECTIVE: This study intended to compare the effectiveness of hand files and FlexMaster, ProTaper, and RaCe rotary instruments for removing gutta-percha in curved root canals during retreatment. STUDY DESIGN: Sixty curved mandibular premolars were randomly divided into 4 groups of 15 specimens each. The canals were enlarged and obturated using lateral condensation technique. After repreparation with the test instruments the specimens were cleared. The area of remaining obturation material was measured from 2 directions. Statistical analysis was performed using the Kruskal-Wallis test and a closed test procedure. RESULTS: RaCe instruments revealed significantly less residual obturation material than FlexMaster files (P < .05). No significant difference was found among the hand file, ProTaper, and FlexMaster groups (P > .05). There were 5 fractured instruments in the ProTaper group and 3 in the FlexMaster group. CONCLUSION: The RaCe system is an efficient and safe device for gutta-percha removal in curved root canals.

[Retention of fiber posts dependent on different resin cements]. / Retention glasfaserverstärkter Wurzelkanalstifte in Abhängigkeit vom Befestigungskomposit.

Tooth-coloured adhesive inserted fiber posts are used to restore endodontically treated teeth. In this investigation, the tensile bond strength of two different fiber posts systems (ER DentinPost and DT Light Post) in combination with five different resin cements was tested. The posts were inserted into artificial root canals in bovine dentin using Clearfil Core, RelyX Unicem, Panavia 21ex, Panavia F2.0 und Calibra. Titan posts (ER-Kopfstift), inserted with zincphosphate cement served as control group. ER DentinPost inserted with Clearfil Core had significantly higher tensile bond strengths than in combination with Panavia F2.0 (221.70 +/- 17.99 N) or Calibra (212.37 +/- 45.20 N). DT Light Post in combination with Calibra (338.20 +/- 46.40 N), Panavia F2.0 (321.69 +/- 40.11 N) and Panavia 21ex (290.41 +/- 55.28 N) showed significantly higher tensile bond strengths compared to adhesive cementation with RelyX Unicem (211.57 +/- 32.35 N) and Clearfil Core (131.67 +/- 51.72 N). The tensile bond strength of the control group was in the upper third of the values (315.43 +/- 51.38 N). Optical analysis of the post surface after decementation demonstrated in all cases adhesive-cohesive mixed fractures. The adhesion of resin cement to the fiber posts and resin cement to root canal dentin is influenced by different factors. The combination of fiber post systems with the type of resin cement has a great influence on the tensile bond strength.