Efficacy of Endoactivator, CanalBrush, and passive ultrasonic irrigation in the removal of calcium hydroxide paste with iodoform and p-chlorophenol from root canals.

AIMS: We evaluated and compared EndoActivator, CanalBrush, and passive ultrasonic irrigation (PUI) in the removal of calcium hydroxide and calcium hydroxide with iodoform and p-chlorophenol paste (Calcipast Forte) from artificial standardized grooves in the apical third of root canals. MATERIALS AND METHODS: A total of 34 mandibular premolars were prepared and then split longitudinally. A standardized groove was prepared in the apical part of both segments. The grooves were filled with either calcium hydroxide or Calcipast Forte, and the segments were reassembled. CanalBrush, EndoActivator, or PUI were used. The amount of remaining medicament was evaluated using a four-grade scoring system. RESULTS: None of the irrigation methods could completely remove the pastes from the grooves. More Calcipast Forte paste was detected compared with calcium hydroxide (P < 0.01). PUI was the least effective method in removing Calcipast Forte. CONCLUSIONS: It was more difficult to remove Calcipast Forte than a water-based calcium hydroxide paste.

The effect of operator-induced variability on the physical properties of ProRoot MTA.

AIMS: The aim of this study was to compare the influence of operators on the microhardness and compressive strength of mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Forty dental specialists were asked to prepare a series of MTA samples. The tested material was ProRoot MTA (DentsplyMaillefer, Switzerland). Each participant prepared one sample to a consistency they considered acceptable for use in practice (improvised group) and another one according to the manufacturer's recommended water-to-powder (WP) ratio (pre-weighed group). The samples were incubated at 37°C and 95% humidity for 4 days. Parameters evaluated in this study were microhardness and compressive strength. RESULTS: Operators mixed MTA samples with varying WP ratios. However, there was no significant difference between the microhardness and compressive strength values of MTA samples between the improvised, the pre-weighed and the control groups. MTA was mixed in a thicker consistency than the manufacturers recommended ratio (0.33) by 62.5% of the operators. CONCLUSION: According to the results of this study, even though the WP ratios that were utilized in the clinical setting vary, microhardness and compressive strength values of MTA was not significantly affected.

Comparison of two different flap designs for bilateral impacted mandibular third molar surgery.

OBJECTIVE: We compared the effect of lingual-based triangular flap with buccal-based triangular flap on postoperative complications in impacted third molar surgery. MATERIAL AND METHODS: Thirty patients aged between 18 and 36 (mean age 19.65±2.14) were included. They all had bilateral impacted third molars. We used buccal-based triangular flap on a randomly selected side (Group 1) and lingual-based triangular flap on the other side (Group 2). We evaluated pain during 7 days after the surgery; swelling and trismus on postoperative 2., 7. and 14. days; wound dehiscence and alveolar osteitis incidence on postoperative 7. and 14. days. RESULTS: Pain was significantly higher in Group 2 during 7 days postoperatively (P<.05). Trismus and swelling were also more prominent in Group 2 on postoperative days 2 and 7. In Group 2, the duration of the surgery in was longer than Group 1 (P<.05). In Group 1, 17 patients (56.7%) had wound dehiscence and 6 patients (20%) in Group 2 (P<.05). No alveolar osteitis developed in either groups. CONCLUSION: The buccal-based triangular flap seems better with regard to postoperative pain, swelling and trismus. On the other hand, the lingual-based triangular flap had a lesser incidence for wound dehiscence.

X-ray diffraction analysis of MTA mixed and placed with various techniques.

OBJECTIVES: The aim of this study was to evaluate the effect of various mixing techniques as well as the effect of ultrasonic placement on hydration of mineral trioxide aggregate (MTA) using X-ray diffraction (XRD) analysis. MATERIALS AND METHODS: One gram of ProRoot MTA and MTA Angelus powder was mixed with a 0.34-g of distilled water. Specimens were mixed either by mechanical mixing of capsules for 30 s at 4500 rpm or by manual mixing followed by application of a compaction pressure of 3.22 MPa for 1 min. The mixtures were transferred into the XRD sample holder with minimum pressure. Indirect ultrasonic activation was applied to half of the specimens. All specimens were incubated at 37 °C and 100% humidity for 4 days. Samples were analyzed by XRD. Phase identification was accomplished by use of search-match software utilizing International Centre for Diffraction Data (ICDD). RESULTS: All specimens comprised tricalcium silicate, calcium carbonate, and bismuth oxide. A calcium hydroxide phase was formed in all ProRoot specimens whereas among MTA Angelus groups, it was found only in the sample mixed mechanically and placed by ultrasonication. CONCLUSIONS: Mechanical mixing followed by ultrasonication did not confer a significant disadvantage in terms of hydration characteristics of MTA. CLINICAL RELEVANCE: Clinicians vary in the way they mix and place MTA. These variations might affect their physical characteristics and clinical performance. For ProRoot MTA, the mixing and placement methods did not affect its rheological properties, whereas for MTA Angelus, mechanical mixing combined with ultrasonic placement enhanced the calcium hydroxide phase formation.

Knowledge and attitudes of Turkish endodontists towards digital radiology and cone beam computed tomography.

INTRODUCTION: The aim of this study was to assess the knowledge and attitudes of Turkish endodontists toward digital radiological imaging (DRI) and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: One hundred and fifty questionnaires were distributed. Questionnaires were given to a sample of endodontists and PhD students in endodontics who attended the 11 th International Congress of the Turkish Endodontic Society in Istanbul in 2012. Following the congress, the same questionnaires were sent electronically to endodontists who did not attend the congress. The participants were asked to answer 28 multiple-choice questions concerning their knowledge and practice regarding recent imaging techniques. The questions were subdivided into 2 main topics; general information; general approach to digital imaging. The statistical analysis was carried out by an χ2-test to compare the means at a significance level of P < 0.05. RESULTS: The response rate for this study was 74%. The mean age of the endodontists who participated in this study was 32.74 ± 10.40 (range 22-61 years). Of the endodontists, 76.6% used digital imaging techniques (DUEs) in their clinics. Statistically significant differences were found between the DUEs and endodontists not using digital imaging (NDUEs), regarding age, gender, graduation year and place of employment ( P < 0.01). Endodontists 40-years-old and above had significantly lower knowledge of CBCT compared to the younger groups ( P = 0.001). CONCLUSIONS: The number of endodontists using digital imaging has been increasing in Turkey. The findings of the present study highlighted the need for adapting to new technologies via continuing education.

An investigation of current endodontic practice in Turkey.

OBJECTIVES: The aim of this study was to gather information about the quality and quantity of root canal treatments carried out by general dental practitioners in Turkey. METHODS: Questionnaires were given to 1400 dentists who attended the 16th National Congress organized by the Turkish Dental Association. The participants were asked to answer 34 multiple-choice questions. The questions were subdivided into 3 main topics; general information; general approach to endodontic treatment; and cleaning, shaping, and obturation of root canals. The statistical analysis was carried out by an χ²-test to compare the means at a significance level of P < 0.05. RESULTS: The response rate for this study was 43%. There was a wide variation in the number of root canal treatments completed per month. Nearly 92% of practitioners stated that they never used rubber dam. The most commonly used working length determination technique was radiographic evaluation (P < 0.05). Sodium hypochlorite was the irrigant of choice with varying concentrations and AH Plus was the sealer of choice (P < 0.05). Resin composite was the most frequently used material for final restorations. CONCLUSIONS: Endodontic procedures in general practice in Turkey have differences from widely acknowledged quality guidelines. Despite the introduction of new instruments and techniques, most of the general practitioners chose conventional methods.

Microstructure and chemical analysis of blood-contaminated mineral trioxide aggregate.

AIM: To test the hypothesis that blood contamination has a detrimental effect on the chemical properties of Mineral trioxide aggregate (MTA). METHODOLOGY: The effects of whole, fresh human blood on the microstructure and elemental chemistry of MTA were evaluated using scanning electron microscopy and energy-dispersive X-ray analysis, respectively. The phase compositions of contaminated and uncontaminated MTA were also analysed using X-ray diffraction analysis. RESULTS: The hydration state of specimens partially mixed with blood were more complete than those mixed entirely with blood and less than those entirely mixed with water. Acicular crystals, characteristic of ettringite, were abundant in specimens mixed entirely with water and absent from specimens mixed partially or entirely with blood. Calcium hydroxide crystals were absent in specimens contaminated entirely with blood and the unhydrated MTA powder, but present in the other groups. CONCLUSION: Mixing MTA with blood resulted in the lack of formation of the crystalline calcium hydroxide in the early stage of the hydration process.