Crack formation on resected root surfaces subjected to conventional, ultrasonic, and laser root-end cavity preparation.

OBJECTIVE: The aim of this study was to evaluate cracks on root ends following resection and cavity preparation with a laser and two established techniques. BACKGROUND DATA: If root canal treatment of a tooth fails, an apicoectomy operation may be indicated. Three millimeters of the root tip is resected and a cavity of similar depth with parallel walls is cut to receive a root-end filling. MATERIALS AND METHODS: Sixty extracted human maxillary anterior teeth were used. Their root canals were prepared with rotary instruments, and they were filled with gutta-percha. Twenty teeth were resected with tungsten carbide fissure burs, and their root-end cavities cut with tungsten carbide round burs at a slow speed (Group 1). The other 40 teeth were resected with an Er:YAG laser, and root-end cavities were made with the same laser (Group 2), or with an ultrasonically-powered zirconium nitride coated retrotip (Group 3). The number and types of cracks on the resected surfaces were assessed using a stereomicroscope before and after cavity preparation. RESULTS: Cracking was not significantly different between the more conventional group and the laser groups after resections (p>0.05) or following cavity preparation (p>0.05). CONCLUSIONS: In this in vitro study, the laser resection and root-end preparation technique did not influence the number or type of cracks formed on the root surfaces.

Accuracy of the Dentaport ZX apex locator for working length determination when retreating molar root canals.

The aim of this study was to evaluate the accuracy of the Dentaport ZX apex locator for working length determination during root canal retreatment of mandibular molars. Fifteen extracted mandibular first molars with separate mesial canals and apical foraminae and one distal canal were selected. The mesiobuccal and distal canals were investigated; the length with the file tip at the major diameter was defined as the tooth length (TL). The canals were prepared with ProTaper files to 1 mm short of this and filled with gutta-percha and AH Plus sealer. One week later, the root fillings were removed using ProTaper retreatment files. Tooth length was remeasured and recorded as the retreatment tooth length (RTL). Then electronic measurements were taken at the major (electronic apex locator (EAL) major) and minor (EAL minor) foraminae as suggested by the instrument display. These lengths were compared with RTL and measurements 0.5 and 1 mm short of this distance. For both canals, no significant difference was found between RTL and EAL major, and 0.5 mm short of RTL and EAL minor (P > 0.05). There were significant differences found between all other readings. The Dentaport ZX could not detect the minor foramen accurately but was able to indicate the major foramen in molars undergoing a root canal retreatment procedure.

Salivary and serum B-cell activating factor (BAFF) levels after hydroxychloroquine treatment in primary Sjögren's syndrome.

PURPOSE: Some evidence implicates a role of hydroxychloroquine (HQ) in the management of Sjögren's syndrome. This study evaluated the effect of HQ on saliva B-cell activating factor (BAFF) levels as well as health related quality of life (QoL) in patients with primary Sjögren's syndrome (pSS). MATERIALS AND METHODS: Ten pSS patients who had been treated with HQ for at least 2 years and 15 healthy controls (HC) were included in the study. First, HQ was withdrawn for 12 weeks, then baseline evaluation was performed. Subsequently, HQ was restarted and further evaluations were carried out after 12 and 24 weeks of HQ treatment. Oral infection foci were eliminated by dental and periodontal treatments in both groups before enrollment. BAFF levels were evaluated with ELISA in serum and unstimulated mixed saliva. Salivary flow rates of patients and the control group were measured as well. Oral health quality of life (QoL) was evaluated by an oral health impact profile-14 (OHIP-14) questionnaire. RESULTS: Salivary BAFF levels (median: 12.39 ng/ml) were significantly decreased by using HQ both at 12 (2.78 ng/ml, P = 0.008) and 24 weeks (0.54 ng/ml, P = 0.011). Similarly, decreases in serum BAFF levels (5.23 ng/ml) were seen at 12 and 24 weeks after HQ treatment (2.18 ng/ml, P = 0.008 and 0.0 ng/ml, P = 0.012, respectively). Serum and salivary BAFF levels were significantly lower in healthy controls (0.37 ng/ml and 0.0 ng/ml, resp.) compared to those of pSS before HQ therapy (P = 0.006 and P = 0.001, resp.). Unstimulated salivary flows were similar in patients treated with HQ after 12 (0.38 ml/min) and 24 weeks (0.50 ml/min) (P = 0.51) but higher than the patients' rate at baseline (0.04 ml/min) (P = 0.008). CONCLUSION: Salivary and serum BAFF levels were lowered in patients with pSS when treated with HQ. In addition, decreased disease activity and increased salivary flows can be achieved with HQ in pSS patients.

Salivary levels of HNP 1-3 are related to oral ulcer activity in Behçet's disease.

BACKGROUND: Saliva contains antimicrobial peptides derived from oral epithelium as well as neutrophils in the innate immune response. The aim of this study was to examine the association between salivary human neutrophil peptide (HNP) 1-3 levels originating from neutrophils and oral ulcers in patients with Behçet's disease (BD). METHODS: Ninety-five patients with BD (F/M: 39/56; mean age: 38.7 ± 11.9 years) and 53 healthy controls (HC; F/M: 23/30; mean age: 35.2 ± 10.1 years) were included in the study. The disease control group (F/M: 20/33; mean age: 33.7 ± 10.7 years) was comprised of patients with oral infection regarding endodontic infection (n = 32) and pericoronitis (n = 21). Salivary HNP 1-3 levels of groups were measured in unstimulated samples by ELISA (Hycult, the Netherlands). RESULTS: A statistically significant increase was found in salivary HNP 1-3 levels of patients with BD (2268.28 ± 1216.38 µg/ml) compared with HC (1836.49 ± 857.76 µg/ml), patients with endodontic infection (849.9 ± 376.1 µg/ml), and patients with pericoronitis (824.3 ± 284.02 µg/ml; P = 0.024, 0.000 and 0.000, respectively). The ratio of active oral ulcer (100%, n = 14) was higher in low HNP 1-3 levels (≤ 1000 µg/ml) than the others (66.7%, n = 54) in active patients with BD (P = 0.008). Moreover, salivary HNP 1-3 levels were significantly lower in patients with endodontic infection and patients with pericoronitis compared with those in the HC group and patients with BD (P = 0.000). CONCLUSION: A decrease in salivary HNP 1-3 levels might be a biological factor for predisposition to oral ulcers in patients with BD and oral infection in healthy patients.

Evaluation of two different root-end cavity preparation techniques: A scanning electron microscope study.

OBJECTIVE: In this study, we aimed to evaluate and compare the dentinal walls of root-end cavities for the presence of cracks after cavity preparation using US retrotips and Er: YAG laser. MATERIALS AND METHODS: Fifty single-rooted teeth were prepared by Protaper NiTi rotary system and obturated by lateral condensation. Three milimeters of root-end was resected. Twenty teeth were prepared with US retrotip (Group 1), 20 teeth with Er: YAG laser (Group 2), and 10 teeth without retropreparation (control group). The root-end surfaces were examined under a scanning electron microscope (SEM). Then the cracks of the resected root surfaces were evaluated on microphotographs. RESULTS: No statistically significant difference was detected between US Group and Laser Group for complete, incomplete, intradentinal, and total number of cracks (P = 0.47, P = 0.80, P = 0.69, P = 0.869, respectively). CONCLUSION: Statistical analysis revealed no significant effect of retropreparation technique on the development of apical cracks (P > 0.05).

Salivary levels of antimicrobial peptides Hnp 1-3, Ll-37 and S100 in Behcet's disease.

BACKGROUND: Oral ulcer is the cardinal clinical sign and increased neutrophilic activity is a part of the pathogenesis in Behcet's disease (BD). Saliva, as a part of the innate immune response, contains antimicrobial peptides (AMPs) that are derived from both oral epithelial cells and neutrophils. The aim of this study was to investigate the associations between salivary levels of AMPs HNP 1-3, LL-37 and S100 and disease course in patients with Behcet's disease (BD). METHODS: Fifty-three patients with BD and 44 healthy controls (HC) were included in the study. Disease severity score reflecting organ involvement was calculated. Salivary HNP 1-3, LL-37 and S100 levels were measured in unstimulated saliva samples by ELISA. RESULTS: Salivary HNP 1-3 and S100 levels in BD patients (2715.2 ± 1333.4 µg/ml and 430.6 ± 203.9 ng/ml) were significantly higher compared to HC (1780.6 ± 933.2 µg/ml and 365.3 ± 84.7 ng/ml) (p = 0.000 and p = 0.004, respectively). Although LL-37 levels were also higher in BD than HC (190.9 ± 189.1 vs 143.1 ± 128.9 ng/ml), no significant difference was observed (p = 0.53). Salivary HNP 1-3 and LL-37 levels were associated with the severity of BD (mild disease: 1975.1 ± 1174.2 µg/ml and 115.9 ± 109.4 ng/ml vs severe disease: 2955.7 ± 1305.6 µg/ml and 215.3 ± 203.8 ng/ml, p=0.020 and p=0.031, respectively). Salivary LL-37 levels also correlated with the number of monthly oral ulcers (r = 0.5 p = 0.000). CONCLUSION: An increase in salivary HNP 1-3 and S100 levels might be associated with enhanced local and systemic innate responses in BD.

Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin

OBJECTIVE: The aims of this study were to evaluate the tensile bond strengths between indirect composites and dentin of 3 recently developed self-adhesive resin cements and to determine mode of failure by SEM. MATERIAL AND METHODS: Exposed dentin surfaces of 70 mandibular third molars were used. Teeth were randomly divided into 7 groups: Group 1 (control group): direct composite resin restoration (Alert) with etch-and-rinse adhesive system (Bond 1 primer/adhesive), Group 2: indirect composite restoration (Estenia) luted with a resin cement (Cement-It) combined with the same etch-and-rinse adhesive, Group 3: direct composite resin restoration with self-etch adhesive system (Nano-Bond), Group 4: indirect composite restoration luted with the resin cement combined with the same self-etch adhesive, Groups 5-7: indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem, Maxcem, and Embrace WetBond, respectively) onto the non-pretreated dentin surfaces. Tensile bond strengths of groups were tested with a universal testing machine at a constant speed of 1 mm/min using a 50 kgf load cell. Results were statistically analyzed by the Student's t-test. The failure modes of all groups were also evaluated. RESULTS: The indirect composite restorations luted with the self-adhesive resin cements (groups 5-7) showed better results compared to the other groups (p<0.05). Group 4 showed the weakest bond strength (p>0.05). The surfaces of all debonded specimens showed evidence of both adhesive and cohesive failure. CONCLUSION: The new universal self-adhesive resins may be considered an alternative for luting indirect composite restorations onto non-pretreated dentin surfaces.

Tensile bond strength of indirect composites luted with three new self-adhesive resin cements to dentin.

OBJECTIVE: The aims of this study were to evaluate the tensile bond strengths between indirect composites and dentin of 3 recently developed self-adhesive resin cements and to determine mode of failure by SEM. MATERIAL AND METHODS: Exposed dentin surfaces of 70 mandibular third molars were used. Teeth were randomly divided into 7 groups: Group 1 (control group): direct composite resin restoration (Alert) with etch-and-rinse adhesive system (Bond 1 primer/adhesive), Group 2: indirect composite restoration (Estenia) luted with a resin cement (Cement-It) combined with the same etch-and-rinse adhesive, Group 3: direct composite resin restoration with self-etch adhesive system (Nano-Bond), Group 4: indirect composite restoration luted with the resin cement combined with the same self-etch adhesive, Groups 5-7: indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem, Maxcem, and Embrace WetBond, respectively) onto the non-pretreated dentin surfaces. Tensile bond strengths of groups were tested with a universal testing machine at a constant speed of 1 mm/min using a 50 kgf load cell. Results were statistically analyzed by the Student's t-test. The failure modes of all groups were also evaluated. RESULTS: The indirect composite restorations luted with the self-adhesive resin cements (groups 5-7) showed better results compared to the other groups (p<0.05). Group 4 showed the weakest bond strength (p>0.05). The surfaces of all debonded specimens showed evidence of both adhesive and cohesive failure. CONCLUSION: The new universal self-adhesive resins may be considered an alternative for luting indirect composite restorations onto non-pretreated dentin surfaces.

Sealing efficiency of BeeFill 2in1 and System B/Obtura II versus single-cone and cold lateral compaction techniques.

OBJECTIVE: The objective of this study was to investigate the sealing properties of 2 warm vertical compaction techniques (BeeFill 2in1, System B/Obtura II) in comparison with single-cone and cold laterally compacted gutta-percha. STUDY DESIGN: The root canals of single-rooted human teeth were prepared by using Mtwo rotary files and divided into 4 groups (n = 10/group) with respect to the filling technique tested: Group 1, cold laterally compacted gutta-percha + AH-26; Group 2, single-cone tapered Mtwo gutta-percha + AH-26; Group 3, System B/ObturaII + AH-26; Group 4, BeeFill 2in1 + 2seal. The leakage of specimens was measured using a fluid-filtration method after 1 and 2 weeks. The data were analyzed statistically with 2-way repeated measures ANOVA (P = .05). RESULTS: After 1 week, the System B/Obtura II group showed the greatest amount of leakage(P < .05) compared with the other test groups that had similar levels of fluid conductance(P < .05). By the end of the second week, the BeeFill group yielded the greatest amount of leakage (P < .05). Compared with their 1-week values, the fluid conductance of all test groups decreased significantly (P < .05). CONCLUSION: The apical sealing efficiency of System B/Obtura II and BeeFill were inferior to the other obturation techniques after 2-week fluid conductance testing in vitro.

Factors affecting oral health habits among children with cerebral palsy: pilot study.

BACKGROUND: The aim of the present study was to investigate the factors affecting the oral health habits of children with spastic-type cerebral palsy (CP). METHODS: A total of 35 children with CP and their mothers were randomly selected for this cross-sectional study. Data regarding their sociodemographic characteristics and their oral health habits were collected during face-to-face interviews. RESULTS: Logistic regression analysis indicated that mothers' irregular brushing habits were a risk factor for their children's lack of regular brushing habits (odds ratio: 6.4, P = 0.048). Additionally, a significant association was observed between the mother's length of time between dental visits and the length of time between children's dental visits (R(2)= 0.11, P = 0.046). CONCLUSIONS: Mothers' oral health habits, including brushing habits and frequency of dental visits, are important factors in promoting healthy and beneficial oral health habits in children with CP in Turkey.

The correlation between root canal patterns and interorificial distance in mandibular first molars.

OBJECTIVES: The aim of this study was to investigate the relationship of the distance between mesiobuccal (MB) and mesiolingual (ML) orifices (interorificial distances) in the pulp chamber floor and the degree of canal curvature in the mandibular first molars. STUDY DESIGN: In this in vitro study, 102 extracted teeth were radiographed in both buccolingual (CV) and mesiodistal (PV) directions and then grouped according to the Vertucci classification. The interorificial distance was measured by the stereomicroscope method. RESULTS: The interorificial distance was significantly higher in type IV compared to type II (P= .016). In the logistic regression analysis, the increase in the degree of primary canal curvature of the ML in CV was a predictive factor for increase in the primary curvature of ML in PV (P = .01). CONCLUSION: The interorificial distance in the pulp chamber floor and primary curvatures in CV were found to be key factors for evaluation of root canal patterns in PV.

Endodontic treatment of unusual central incisors.

This report presents an endodontic therapy in an unusual case of a patient who had wide crowns of both permanent maxillary central incisors. The right maxillary central incisor had two separate canals on a fused root and the left had a large root canal within one root.