ABSTRACT
Background Mineral trioxide aggregate (MTA) is a biocompatible dental material used for root-end filling in endodontics. A wide variety of literature has been published on the assessment of fracture resistance of MTA. However, the results were conflicting in the reported studies, and the sample size used was insufficient to conclude the efficacy of materials such as MTA Plus and MTA Angelus. Therefore, this study was designed to compare and evaluate the effectiveness of two commercially available MTAs, namely, MTA Plus (Avalon Biomed Inc. by Prevest Denpro Ltd, Jammu, India) and MTA Angelus (Angelus Dental Solutions, Brazil) in terms of fracture resistance. Methodology To determine fracture resistance, 300 freshly extracted healthy human teeth with single roots and canals were collected by simple random sampling. Teeth were decoronated, the apical third was enlarged, and root canals were prepared to receive MTA as a 5 mm apical filling. The root segments were randomly categorized into two experimental groups of 100 samples each, namely, group A (MTA Plus) and group B (MTA Angelus), and the remaining 100 root segments were used as control (unfilled). Fracture resistance was determined using the Instron Universal testing machine. Results The results of our study showed statistically significant increased fracture resistance for MTA Plus (532.14 ± 5.19 N) than MTA Angelus (540.81 ± 3.56 N) and the control group (460.63 ± 7.91 N). Conclusions The control group showed the least fracture resistance. The composition and structure of MTA Angelus (group B) containing Portland cement, with a 4:1 addition of bismuth oxide, make it more fracture resistant than MTA Plus (group A).
ABSTRACT
BACKGROUND: The chances of extrusion of mineral trioxide aggregate (MTA) are quite high if apical barrier is not present in immature pulpless permanent teeth. Platelet-rich fibrin (PRF) enriched with platelets and growth factors serves to accelerate the wound healing of periapical lesion in immature pulpless permanent teeth and also serves as internal matrix to condense MTA. AIM: The aim of the present study was to comprehensively review the clinical success of MTA+PRF in healing of periapical lesions in immature pulpless permanent teeth. MATERIALS AND METHODS: An electronic search for systematic review was conducted in Pubmed/Medline (www.ncbi.nlm.nih.gov), Cochrane (www.cochrane.org), Scopus (www.scopus.com) databases upto 15th January 2020 related to the healing of periapical lesions in permanent teeth with immature apices when combination of MTA+PRF was used. A sample of 10 relevant studies and case reports were identified in our search out of 65. The sampling method was simple random technique. The studies and case reports with Randomised Controlled Trials(RCTs), Invitro studies, Case reports and animal studies in healing of periapical lesion were included in our comprehensive systematic review. RESULTS: The search showed that the combination of MTA+PRF showed faster and definite periapical lesion healing in immature permanent teeth. The follow-up period was also recorded in all the relevant studies and case reports. CONCLUSION: Acclerated bone filling was seen in healing of periapical leions when MTA+PRF was used.
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AIM: The aim of this study was to compare the efficacy of CanalBrush (CB), EndoActivator (EA), and Passive Ultrasonic Irrigation (PUI) on the removal of triple antibiotic paste (TAP) from root canal walls. MATERIALS AND METHODS: Thirty-six extracted human single-rooted teeth were prepared using ProTaper Universal rotary files (DentsplyMaillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with TAP, and after 21 days, roots were randomly assigned to three groups (n = 10) according to irrigation regimens used: CB, EA, and PUI. In three teeth, TAP was not removed (positive controls), and the other three teeth were not filled with TAP (negative controls). The roots were sectioned, and the amount of TAP remaining was evaluated at the mesial halves of each tooth at ×30 magnification under a stereomicroscope using a 4-grade scoring system. Data were evaluated using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS: There were significant differences among the experimental groups according to the different parts of the root canals (P < 0.05). At the apical and middle third, EA and PUI groups removed more TAP than CB group; however, there was a statistically significant difference only between CB and PUI groups (<0.01 at apical third and <0.05 at middle third). At the coronal third, there was no statistically significant difference between all the three groups (P > 0.05). CONCLUSION: PUI led to superior results compared to CB in the middle and apical thirds. There was no significant difference between EA and PUI techniques.
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BACKGROUND: Endodontic instruments including the nickel-titanium (NiTi) instruments produce debris and smear layer during instrumentation. The study was carried out to evaluate and compare the cleaning effectiveness of root canal preparation using three different rotary NiTi instrumentation systems - ProTaper Universal, K3 and Mtwo by means of scanning electron microscopy (SEM). METHODS: Thirty-six freshly extracted permanent mandibular molars were randomly divided into four groups: ProTaper Universal, K3, Mtwo system and control group. The mesiobuccal canal was cleaned and shaped with rotary instruments. The intracanal irrigant used after each instrument was 3 mL of 3% sodium hypochlorite (NaOCl). After the cleaning and shaping was completed, a 1-min 17% ethylenediaminetetraacetic acid rinse was followed by a final NaOCl rinse. All samples were decoronated. Mesial roots were sectioned buccolingually and examined under SEM at 500× magnification in three areas of root canal. Canal walls were quantitatively evaluated using a five-score evaluation scale. Statistical analysis was done using Kruskal-Wallis test, Fisher's exact test and weighted kappa. RESULTS: Completely clean canals were not found in any of the groups. The mean value of debris score for ProTaper, K3 and Mtwo was 2.35, 2.41 and 2.22 respectively. There was no statistically significant difference between the three tested groups (P = 0.237). The apical thirds of the canal was found to be significantly less clean than coronal and middle thirds irrespective of the system used. CONCLUSIONS: There was no statistically significant difference between the three tested groups - ProTaper, K3 and Mtwo in cleaning different regions of the canal - coronal, middle and apical.
Subject(s)
Root Canal Preparation , Smear Layer , Electrons , Equipment Design , Humans , Nickel , Nigeria , TitaniumABSTRACT
AIM: This prospective randomized clinical study (1) investigated the prevalence of post-obturation pain after single visit root canal treatment and (2) evaluated the influence of factors affecting the pain experience. MATERIALS AND METHODS: One thousand three hundred and twenty eight (1328) patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher's exact test. RESULTS: The prevalence of post-obturation pain (severe) within 48 h after treatment was 4% (n = 54) but less as compared to the pain experienced after 12 h (9%) and 24 h (8.6%). The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0), gender (Fishers exact test = 23.730, P = 0.0), arch (Fishers exact test = 11.710, P = 0.001), and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0). CONCLUSION: The presence of post-operative pain was low (4%). The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.
