Evaluation of filling material remnants after basic preparation, apical enlargement and final irrigation in retreatment of severely curved root canals in extracted teeth.

AIM: To compare the retreatment ability of several rotary and reciprocating file systems in curved root canals of extracted teeth and to evaluate the influence of additional apical enlargement performed after a basic retreatment on the amount of remaining filling material. METHODOLOGY: A total of 65 round curved root canals were used. The root canals were prepared with the ProTaper Next rotary system to size 25, .06 taper and filled with an epoxy resin-based sealer and gutta-percha using continuous wave vertical compaction and warm injection back-filling. The canals were randomly divided into four groups according to the retreatment system used: Group I. ProTaper Universal Retreatment system + ProTaper Gold (PTG) instrumentation system up to PTG F2; Group II. Reciproc Blue system up to the instrument RB25; Group III. Reciproc system up to the instrument R25; Group IV. Wave One Gold (WOG) system up to the instrument WOG25. After the basic retreatment, additional apical enlargement was performed in each group with an instrument that was one size larger: in Group I, II and III up to apical size 40, and in Group IV up to 35. The final irrigation protocol included the following: 15% ethylenediaminotetraacetic acid followed by NaOCl irrigation. The volume of filling material was measured using an industrial micro-CT four times: after root canal filling (Volume I), after basic retreatment with size 25 files (Volume II), after additional root canal enlargement with larger instruments (Volume III), and after the final irrigation protocol (Volume IV). The decrease in the amount of filling material after each retreatment protocol was analysed using a Kruskal-Wallis test. Intergroup analyses were performed with a Kruskal-Wallis test and between-group differences were further analysed with Mann-Whitney U test. RESULTS: There were no significant differences amongst the systems tested in the amount of remaining filling material, or the reduction rates after each phase of the retreatment procedures (P > 0.05). Intragroup analysis indicated that the use of a larger final instrument removed significantly more filling material in all groups (P < 0.001). CONCLUSION: The four tested instrumentation systems were equally effective in removing filling materials from curved root canals in extracted teeth. Additional apical enlargement with larger files improved the removal of filling remnants after basic retreatment.

Comparison of the effectiveness of various rotary and reciprocating systems with different surface treatments to remove gutta-percha and an epoxy resin-based sealer from straight root canals.

AIM: To compare the Reciproc Blue, Reciproc and ProTaper Universal Retreatment systems with regard to the effective removal of epoxy resin-based sealer and gutta-percha during the retreatment of oval, straight root canals. METHODOLOGY: Forty-five extracted, human mandibular first premolars with single straight oval canals were selected on the basis of cone beam computed tomography evaluations. The root canals were instrumented with the ProTaper Next system up to the X2 file, and filled with gutta-percha and epoxy resin-based sealer using the cold lateral condensation technique. After 1 month, the samples were randomly divided into three groups (n = 15) according to the retreatment system used: Reciproc Blue R40, Reciproc R40 and ProTaper Universal. The specimens were scanned at the resolution of 1.2 µm by a microcomputed tomography device after the root filling and retreatment procedures, and the decrease in the volume of filling material after each retreatment protocol was measured. The results were analysed using the Kruskal-Wallis test and additional box-and-whisker plots. RESULTS: Although the volume of the filling material decreased significantly in all three groups (P < 0.05), none of the systems removed the material completely. The Reciproc system removed significantly more material than the ProTaper Universal (P < 0.001) and Reciproc Blue (P = 0.005) systems, with the latter two exhibiting equal volumes of remaining material (P = 0.068). CONCLUSION: The Reciproc system was more effective than the Reciproc Blue and ProTaper Universal Retreatment systems during the removal of filling material from oval, straight canals, although none of the systems completely removed the filling material.

The efficacy of photon-initiated photoacoustic streaming and sonic-activated irrigation combined with QMiX solution or sodium hypochlorite against intracanal E. faecalis biofilm.

The aim of the study was to assess the antibacterial efficacy of photon-initiated photoacoustic streaming (PIPS) using an Er:YAG laser and sonic-activated irrigation combined with QMiX irrigant or sodium hypochlorite against Enterococcus faecalis intracanal biofilm. Root canals of 91 human extracted single-canal teeth were instrumented, sterilized, contaminated with E. faecalis and incubated for 15 days. The infected teeth were then randomly distributed into six experimental groups: G1: PIPS/Er:YAG laser (wavelength 2940 nm, pulse energy 20 mJ, 15 Hz, pulse duration 50 µs, energy density 2.06 J/cm(2), 3 × 20 s) with the QMiX irrigant; G2: PIPS/Er:YAG laser-activated 2.5 % NaOCl; G3 sonic-activated irrigation (EndoActivator system) for 60 s with the QMiX irrigant; G4 sonic-activated irrigation for 60 s with 2.5 % NaOCl; G5 30-gauge needle irrigation with the QMiX irrigant; G6 30-gauge needle irrigation with 2.5 % NaOCl. The positive control group was rinsed with sterile saline solution. The root canals were sampled by flushing with saline solution at baseline and after the treatments, serially diluted and cultured. The number of bacteria in each canal was determined by plate count. The presence and the absence of E. faecalis in root canals were demonstrated by polymerase chain reaction (PCR), and the pattern of the bacteria colonization was visualized by scanning electron microscopy. There was significant reduction in the bacterial population for all groups (p < 0.001). The best antibacterial efficacy was recorded after sonic-activated irrigation with both NaOCl (99.999 %) and QMiX (99.999 %) and after PIPS with QMiX (99.999 %), which were more effective than conventional irrigation with NaOCl (99.998 %) and the PIPS with the NaOCl (99.966 %). Also, the PIPS with QMiX solution provided the highest number of sterile samples (five). There was no difference in the bacteria reduction between the active irrigation techniques, regardless of the irrigant used. Although the laser activation did not improve the antimicrobial action of the NaOCl nor QMiX, the fact that it generated the greatest number of sterile samples warrants further investigation.

Influence of several root canal disinfection methods on pushout bond strength of self-etch post and core systems.

AIM: To determine the effect of four root canal disinfection protocols (2.5% sodium hypochlorite, 0.2% chlorhexidine gluconate, gaseous ozone and Nd : YAG laser) on the pushout bond strength of a self-etch post and core system. METHODOLOGY: Sixty anterior single-rooted permanent human teeth were used. Root canals were instrumented with ProTaper instruments (Dentsply Maillefer; Ballaigues, Switzerland). Roots were divided into four groups (n = 15 each) according to the final disinfection protocol: sodium hypochlorite, chlorhexidine gluconate, gaseous ozone and Nd:YAG laser. Fibre-reinforced composite post preparations were created in previously filled root canals, and posts cemented according to the manufacturer's instructions. Roots were then uniformly sectioned and prepared for the pushout bond strength testing in a universal testing machine. One-way anova with post hoc Scheffe test was used for statistical analysis. SEM imaging of one sample from each group was made. RESULTS: The only significant difference (P = 0.004) was observed between sodium hypochlorite irrigation, which was associated with the lowest bond strength, and Nd:YAG laser irradiation, which provided the highest bond strength. There was no difference between root canal pre-treatment with sodium hypochlorite, gaseous ozone and chlorhexidine, nor between gaseous ozone, chlorhexidine and Nd : YAG laser. CONCLUSION: Sodium hypochlorite irrigation was associated with the lowest bond strength values and Nd : YAG laser irradiation with the highest bond strength values for a self-etch post and core system bonded to root canal dentine.

Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment.

AIM: To evaluate the antimicrobial effect of a diode laser irradiation, photo-activated disinfection (PAD), conventional and sonic activated irrigation with 2.5% sodium hypochlorite (NaOCl) on Enterococcus faecalis. METHODOLOGY: Root canals of 120 human extracted teeth with single straight canals were prepared with ProTaper files, sterilized, contaminated with an E. faecalis suspension and incubated for 7 days. They were then randomly distributed into six groups: G1, diode laser irradiation (2 W, 3 × 20 s); G2, PAD (100 mW, 60 s); G3, PAD with 3D Endoprobe (100 mW, 60 s); G4, 30-gauge syringe irrigation with NaOCl (60 s); G5, sonic agitation of NaOCl with the EndoActivator system (60 s); G6, 30-gauge syringe irrigation with NaCl (60 s). The pattern of colonization was visualized by scanning electron microscopy. The root canals were sampled by flushing with saline solution at baseline and after the treatments. The number of bacteria in each canal was determined by plate count. The presence and the absence of E. faecalis in root canals were also demonstrated by polymerase chain reaction (PCR). RESULTS: There was a significant reduction in the bacterial population after all treatments (P < 0.001). The PAD, using both laser systems, and the sonic activated NaOCl irrigation were significantly more effective than diode irradiation and single NaOCl irrigation in reducing CFUs (P < 0.05). High-power diode laser and single NaOCl irrigation had an equal antibacterial effect (P > 0.05). CONCLUSIONS: The PAD and EndoActivator system were more successful in reducing the root canal infection than the diode laser and NaOCl syringe irrigation alone.

Evaluation of cytotoxic and genotoxic effects of two resin-based root-canal sealers and their components on human leucocytes in vitro.

AIM: To evaluate the in vitro genotoxicity and cytotoxicity of two resin-based root canal sealers and to determine the type of cell death they induce. METHODOLOGY: The sealers tested were Epiphany and RealSeal. Each component of the material (Epiphany Primer, Epiphany Thinning Resin, Epiphany Sealant, RealSeal Primer, RealSeal Thinning Resin and RealSeal Root Canal Sealant), components in permutual combinations and all components mixed together were tested on human peripheral blood leucocytes using ethidium bromide/acridine orange viability staining and comet assay. Simultaneously, untreated negative control cultures were analysed in the same manner. DNA damage was evaluated following 4 h of treatment and after 24 h in the absence of the components of the materials. RESULTS: After 4 h of treatment, except thinning resin, each individual component and the different combinations of components induced a significant increase in DNA migration ability (P < 0.05). After 24 h, combination of primer, thinning resin and sealant of both materials caused cell death inducing intense apoptosis. After 24 h, cells exposed to Epiphany Sealant and RealSeal Root Canal Sealant, both in polymerized and unpolymerized form, exhibited a level of DNA damage that was similar to the control. CONCLUSIONS: Primer and thinning resin of both resin-based root canal sealers and their combinations were cytotoxic and induced apoptosis. Both sealants had no significant effect on the viability of the human leucocytes.

In vitro genotoxicity of root canal sealers.

AIM: To evaluate the effect of leakage on differences in genotoxicity of root canal sealers ex vivo according to their main components using two different cytogenetic assays. METHODOLOGY: Six materials of different composition (GuttaFlow, Epiphany, Diaket, IRM, SuperEBA and Hermetic) were tested on human peripheral blood lymphocytes using the comet assay and chromosomal aberration analysis. Prepared materials were eluted in physiological solution for 1 h, 1 day, 5 and 30 days. Thereafter cultures were treated with 8 microg, 4 microg and 2 microg of each sealer. Frequencies of chromatide and chromosome breaks and accentric fragments were determined. Comet assay was used to evaluate primary DNA damage by measuring tail length and tail intensity. Chi-square, Fisher's PLSD (Protected Least Significant Difference) and Kruskall-Wallis non parametric tests were used for statistical analysis. RESULTS: After 1-h elution only the highest dose of Diaket, Hermetic and SuperEBA significantly (P = 0.035, P = 0.048, P = 0.037 respectively) affected the measured cytogenetic parameters. The migration ability of DNA was more strongly affected than induction of chromosomal aberrations. After elutions longer than 24 h none of the tested sealers exhibited a genotoxic effect. CONCLUSION: Under the conditions used in the study all sealers had acceptable biocompatibility in terms of genotoxicity.

Association between oral lichenoid reactions and amalgam restorations.

BACKGROUND: The aim of this study was to perform a clinical assessment of the association between oral lichenoid reactions (OLR) and amalgam restorations and to determine the salivary concentrations of interleukin-6 (IL-6) and IL-8 before and after replacement of the amalgam restorations. METHODS: The study included 20 patients with OLR and 20 healthy volunteers, who were examined between 2001 and 2005 at the Oral Medicine Unit of the Medical Faculty University of Rijeka. All patients were skin patch tested by an experienced physician. Saliva samples were collected, prepared and analysed for IL-6 and IL-8 concentrations using enzyme-linked immunosorbent assay. RESULTS: Sixteen out of 20 patch-tested patients showed a sensitization to inorganic mercury or amalgam. Total replacement of all amalgam fillings was carried out on 20 patients with fillings based on composite resin, gold, porcelain or a combination of these. Sixteen out of 20 patients showed complete healing of OLR; three patients had marked improvement, whereas one patient showed no improvement. Levels of IL-6 detected before replacement were significantly higher than IL-6 levels following the replacement (P = 0.003). The IL-8 levels measured before replacement procedure were significantly higher than the IL-8 levels after replacement of the fillings (P < 0.001). CONCLUSIONS: On the basis of clinical observations, restorative therapy resulted in tissue healing. Following the replacement of amalgam fillings with fillings based on other restorative materials, levels of both IL-6 and IL-8 shifted towards normal, as measured in healthy subjects.

Microleakage along Glassix glass fibre posts cemented with three different materials assessed using a fluid transport system.

AIM: To evaluate the microleakage along Glassix fibre posts cemented with three different materials. METHODOLOGY: The root canals of maxillary central incisor teeth were filled and restored with Glassix posts (Harald Nordin sa, Chailly/Montreux, Switzerland) cemented with either a zinc-phosphate Harvard cement (Richter & Hoffmann, Harvard Dental GmbH, Berlin, Germany), Fuji PLUS cement (GC Corporation, Tokyo, Japan) or Variolink II cement (Vivadent, Schaan, Lichtenstein) in three groups of 15 canals each. Twenty unrestored canals served as a control group, 10 filled with gutta-percha and sealer (negative control group), the remaining 10 with gutta-percha only (positive control group). Coronal microleakage was evaluated using a fluid transport system. The movement of an air bubble in a capillary glass tube connected to the apex of the experimental root section was measured over 5-min periods. Measurements were performed four times for each specimen and the mean values recorded. ANOVA and Duncan's test were performed. RESULTS: The positive control group had the highest values of microleakage. Amongst experimental groups, the highest values of microleakage occurred in the group with the posts cemented with Harvard cement, followed by Fuji PLUS and Variolink II cements. Groups with Fuji PLUS, Variolink II and the negative control group had significantly (P < 0.00001) less microleakage compared with the Harvard cement group and the positive control group. CONCLUSION: Canals with Glassix posts cemented with Variolink II and Fuji PLUS cement had the least leakage when assessed using a fluid transport system.

3D finite element model and cervical lesion formation in normal occlusion and in malocclusion.

The aim of this study was to develop a three-dimensional (3D) finite element model (FEM) of the first maxillary premolar in order to compare the stress profiles in the buccal and palatal cervical regions. The 3D geometry of the tooth was reconstructed, the solid model was transferred into a finite element program where a 3D mesh was created, and the stress distribution analysis was performed. Two typical cases have been considered: the tooth under normal occlusion (case I) and the tooth under malocclusion (case II). In case I, larger compressive stresses were found in the cervical enamel and dentine. Tensile stresses were found in the fissure system, adjacent area, and at the vestibular surface of the buccal cusp. The peak values for the principal stress ranged from -259 to +2.25 MPa in the cervical areas. In the case II, larger compressive stresses were found in the palato-cervical enamel and dentine. Tensile stresses were found inside the enamel in the fissure system, adjacent area, at the vestibular surface of the buccal cusp, and in the bucco-cervical enamel. The peak values for the principal stress ranged from -501.947 MPa in palatal region to +82.4 MPa in the buccal region This study implies a role of occlusal forces in development of non-carious lesions. In the case of malocclusion, tensile stresses generated on the cervical areas were higher compared with the stresses generated in the case of normal occlusion and it is probably capable of producing non-carious cervical lesion.

The prevalence of non-carious cervical lesions in permanent dentition.

A non-carious cervical lesion (NCCL) is the loss of hard dental tissue on the neck of the tooth, most frequently located on the vestibular plane. Causal agents are diverse and mutually interrelated. In the present study all vestibular NCCL were observed and recorded by the tooth wear index (TWI). The aim of the study was to determine the prevalence and severity of NCCL. For this purpose, 18555 teeth from the permanent dentition were examined in a population from the city of Rijeka, Croatia. Subjects were divided into six age groups. The teeth with most NCCL were the lower premolars, which also had the largest percentage of higher index levels, indicating the greater severity of the lesions. The most frequent index level was 1, and the prevalence and severity of the lesions increased with age.

Removal of gutta-percha from root canals using an Nd:YAG laser.

AIM: To examine the use of an Nd:YAG laser in removing gutta-percha fillings from root canals when used in conjunction with eucalyptol, dimethylformamide (DMF) or no solvent. METHODOLOGY: Root-canal fillings (sealer and gutta-percha) were removed with laser irradiation of 20 Hz/1.5 W from 30 roots randomly divided in three groups. In group 1, the solvent was eucalyptol; in group 2, the solvent was DMF; and in group 3, no solvent was used. Laser irradiation was performed until the temperature measured on the root surface increased by 4 degrees C over room temperature. The treatment was deemed complete when the apical foramen was reached with the optical fibre and a reamer. The samples were split longitudinally, and the area of remaining gutta-percha on the root-canal walls was determined with the aid of a computer program. The total number of laser pulses to achieve length and the highest temperature recorded was determined for each tooth. The results were statistically analysed using Student's t-test (P < 0.05) for independent samples. RESULTS: The average temperature increase in group 1 was 9.17 +/- 0.56 degrees C; in group 2, 9.56 +/- 0.28 degrees C; and in group 3, 8.29 +/- 0.41 degrees C. The shortest time to achieve length was in group 3 (6.4 +/- 0.49 min), then in group 1 (6.7 +/- 0.85 min) and group 2 (7.05 +/- 0.79 min). The area of remaining gutta-percha was the largest in group 2 (6.13 +/- 5.76%), whilst the smallest was for group 3 (4.69 +/- 4.03%), but the difference was not statistically significant. The number of pulses was not statistically significant between the groups. CONCLUSIONS: Use of an Nd:YAG laser alone is capable of softening gutta-percha. The addition of solvents did not improve the retreatment, either in terms of the time required for the procedure or in terms of the area of remaining gutta-percha on root-canal walls.

Examination of cytotoxicity and mutagenicity of AH26 and AH Plus sealers.

AIM: To study in vitro the cytotoxic and mutagenic effects of AH26 and AH Plus. METHODOLOGY: Cytotoxic effects on Chinese hamster V79 cells were determined by counting viable cells following incubation with eluations of AH26 and AH Plus. In one set of experiments, the materials were mixed, set for 1 h and then eluted with dimethyl sulphoxide (DMSO) for 1 h, 24 h and 7 days. In the other set, AH26 and AH Plus were mixed and set for 1 h, 24 h and 7 days in physiological saline then crushed and eluted in DMSO for 24 h. The cytotoxic effects of these eluates were evaluated. Three concentrations were chosen to examine the mutagenic effects of AH26 and AH Plus: 5.57, 16.7 and 55.7 microg mL(-1). The structural chromosomal aberration analysis and micronucleus test were performed on human lymphocytes according to standard procedures. RESULTS: Dose-response curves of cell survival were obtained. Both materials were shown to be cytotoxic in doses larger than 55.7 microg mL(-1), except for AH26, after 7 days setting time. AH Plus was also shown to be toxic in concentrations of 16.7 microg mL(-1), except after 7 days setting time. Neither AH26 nor AH Plus induced a significant increase of chromosomal aberrations or micronuclei induction at any setting time or concentration. CONCLUSION: There was no mutagenicity found for AH26 and AH Plus on human lymphocytes in highly controlled conditions in vitro.

Bacterial and fungal microleakage of AH26 and AH Plus root canal sealers.

AIM: To evaluate the penetration of Candida albicans alone and a combination of bacteria through root canals filled with gutta-percha and one or other root canal sealers, AH26 and AH Plus. METHODOLOGY: Eighty teeth were randomly divided into two groups of 40 teeth each and obturated with gutta-percha using either AH26 or AH Plus sealer. A further 10 teeth served as negative controls and 10 as positive controls. The external surface of each root, except the apical 2 mm, was covered with two layers of nail varnish. The teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile Schaedler broth. Streptococcus mutans, Streptococcus mitis, Prevotella melaninogenica and Lactobacillus acidophilus were placed in the access cavities of 20 teeth filled with AH26 and 20 with AH Plus. Candida albicans was placed in the access cavities of the other teeth. The culture medium with microorganisms was changed every 7 days. Every 72 h bacterial or fungal growth in the broth was tested up to a period of 90 days. RESULTS: Leakage in the experimental teeth occurred between 14 and 87 days. Leakage was present in 47% of all samples. From the samples with AH26, 45% leaked bacteria and 60% leaked fungi; whilst from the samples with AH Plus, 50% leaked bacteria and 55% fungi. There was no statistically significant difference in penetration of bacteria and fungi between the sealers. CONCLUSION: In this in vitro study, gutta-percha and the sealers AH26 and AH Plus allowed leakage of bacteria and fungi.

PTCH gene altered in dentigerous cysts.

Motivated by the evidence that odontogenic keratocysts are associated with genetic alterations, we examined the possibility that development of other odontogenic cysts can be attributed to gene malfunctioning, in particular to the PTCH gene. Cyst epithelium was examined for polymorphism on chromosome 9q22.3, the region that contains the PTCH gene. Loss of heterozygosity (LOH) for the D9S287 marker and/or D9S180 marker was observed in about 50% of dentigerous cysts, whereas radicular cysts gave no indication of lesions in the PTCH region. As a more direct argument for PTCH involvement in cystic growth, we report evidence of PTCH expression in dentigerous cyst lining, which indicates malfunctioning of the relevant signaling pathway. While we found no reason to believe that PTCH should be associated with radicular cysts, other genes may be implicated in their development. We performed immunohistochemical comparisons of keratocysts, dentigerous and radicular cysts for the nonmetastatic marker Nm23. A graded response placed radicular cysts in between the other two types, suggesting a similar neoplastic character for their epithelial proliferation.

Cytotoxic effect of four root filling materials.

The aim of this study was to evaluate the cytotoxic effect of four root canal sealers: AH26, AH Plus, Diaket and Apexit. In the experiment two cell lines, human cervical carcinoma (HeLa) cells and mouse skin fibroblasts (L929), were used. Under aseptic conditions, the sealers were prepared according to the manufacturers' directions, and 0.01 mL of each material was placed in a 24-well plate. The sealers were covered with cell suspension. The cytotoxicity was estimated by determining the number of viable cells by a light microscope, as well as the total number of cells 24 h, 48 h and 120 h after the treatment with mentioned materials. The results obtained in this study showed the high cytotoxcity of the new AH Plus root canal sealer, which was shown to be equally or more toxic to the standard AH26 and Diaket materials. Apexit was the least toxic sealer.

The mutagenic potential of AH+ and AH26 by Salmonella/microsome assay.

The aim of this study was to examine the mutagenic potential of canal sealers AH+ and AH26 by Salmonella/microsome assay. The materials were tested immediately after mixing, 1 hr and 1 month later, respectively. The dimethyl sulfoxide extracts of sealers in amounts of 3.0, 1.5, and 0.75 microliters/plate were used. The plated bacterial strains of Salmonella were TA 98 and TA 100. The results showed that AH+ is mutagenic toward strain TA 100 1 hr after mixing. One month after mixing, mutagenic activity was expressed only in TA 98. Paste A showed strong mutagenicity toward TA 100. AH26 was more mutagenic to the TA 100 immediately after mixing, 1 hr later, and 1 month after it was polymerized. Also it was mutagenic toward TA 98 in the polymerized condition. Further examinations should be conducted to establish a definitive conclusion about mutagenic potential for these two endodontic materials.

Leakage of five root canal sealers.

AIM: The aim of this study was to examine the apical sealing ability of five root canal sealers using a fluid transport model. METHODOLOGY: A comparison of root canal scalers AH26, AH Plus, Diaket, Apexit, and Ketac-Endo were tested on 60 single-rooted teeth. The coronal part of each tooth was removed at the amelo-cemento junction, and also 3 mm of the root tip. Root canals were instrumented using the 'step-back' technique with Gates Glidden drills and irrigated with 2.5% NaOCl. The specimens were divided into five groups of 10 samples each and filled with test materials and gutta-percha points by the cold lateral condensation technique. Ten teeth were used as a control group, out of which five served as negative and five as positive controls. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root section. RESULTS: The differences in leakage amongst Ketac-Endo (0.318 microL: SD 0.084), AH26 (0.319 microL; SD 0.075), AH Plus (0.330L; SD 0.085) Apexit (0.360 microL; SD 0.127) and Diaket (0.387 microL; SD 0.140) were not statistically significant (P > 0.05). CONCLUSIONS: Under the conditions of this study, all five sealers produced a satisfactory seal.

Scanning electron microscopic study of dentin lased with argon, CO2, and Nd:YAG laser.

The purpose of this study was to compare morphological changes on the dentin surface induced by laser light delivered perpendicular or parallel to the dentin surface. The surface of the dentin slices and the root canal walls were lased with argon, CO2, and Nd:YAG lasers. When the laser beam was parallel to the dentin, the effects of the laser energy ranged from no effect to eroding and melting of the smear layer and dentin in the samples. When the laser beam was perpendicular to the surface, all three lasers produced well-shaped craters. From this, it was concluded that the angle of the laser beam in relation to the target surface can be a deciding factor of how much energy will be absorbed by the dentin and consequently of the morphological changes induced by the laser.

Computer assisted densitometric image analysis (CADIA) of bone density in periradicular bone defects healing.

CADIA can only be performed on geometrically standardized images converted in Al equivalents. The aim of this study was to develop the ability of the new CADIA software to quantify bone density on dental radiographs without previous standardization. A total of 36 examines with periradicular lesions were treated surgically, the defects were filled with Hydroxylapatite and followed up for 1, 6, and 12 months. Before and after surgery the operated areas were clinically evaluated using intraoral radiographs, tooth mobility index and relapses. Clinical results revealed satisfactory bone healing in 27 cases and relapses in 9 cases. The radiographs were then digitized with a high resolution CCD camera. Densitometric analysis was done in 10 points at the edge of the bone defect. Correction of geometric and brightness distortions was done with mathematical manipulation from three referral points positioned at the same place on each radiograph. Density values observed no bone loss in 23 cases and loss of bone in 13 cases. The differences between clinical evaluation and CADIA were not statistically significant.