Effect of Sodium Hypochlorite Irrigation with and Without Surfactant on Maximum Operative Torque and Vertical Force of Nickel-Titanium Endodontic Instruments.

Objectives: This study aimed to evaluate the effects of root canal irrigation on maximum operative torque and vertical force of Wave One Gold Primary (WOG), Reciproc Blue R25 (RB) and Protaper Next X2 (PTN) endodontic rotary instruments during simulated root canal preparation in the presence and absence of a surfactant "benzalkonium chloride". Material and Methods: A custom-made automated irrigation and torque/force analyzing device connected with endomotor was used for the study. Acrylic resin blocks with simulated curved root canals of 35° were randomly assigned to 6 groups for each file. The following irrigants were used during simulated root canal preparation with continuous rotation or reciprocation motion with pecking mode: 5% NaOCl and 5% NaOCl with 0.84% benzalkonium chloride. Maximum torque and vertical force values ​​of files were recorded during preparation. Results: BAC addition to NaOCl did not significantly affect maximum torque values of instruments (p>0.05). WOG generated lowest torque value compared with PTN and RCB in both groups (p<0. 05). RB generated higher vertical force compared with WOG and PTN instruments in NaOCl+BAC group. The surface modifier decreased the maximum force value of WOG instrument (p<0.05). Discussion: Surfactan addition to NaOCl had no negative effects on maximum torque and force of the instruments.

Sealer penetration: effect of separated file's cross-section, taper and motion characteristics.

OBJECTIVES: The separated root canal instruments may affect the quality of root canal filling, hence the success of endodontic treatment. The aim of this study was to evaluate the effects of separated file fragments of nickel-titanium rotary systems with different cross-section, taper and motion characteristics on the apical sealer penetration in oval-shaped root canals via confocal laser scanning microscope (CLSM). MATERIALS AND METHODS: Distal roots of 60 mandibular molars with oval-shaped root canals were randomly divided into 4 groups as follows: group 1, FlexMaster Nickel Titanium Rotary File System (NTRFS) (separated instrument: 30/.06); group 2, ProTaper Next NTRFS (X3); group 3, ProTaper Universal NTRFS (F3); group 4, Revo-S NTRFS (AS30/.06). Root canals were filled with gutta-percha and AH plus labelled with 0.1% rhodamine B using a warm vertical compaction technique. Each specimen was horizontally sectioned at 1st, 3rd and 5th mm from apical foramen. Amount of maximum and average penetration depths, penetration percentage and sealer penetrated area were measured and analysed with one-way repeated measures of ANOVA and the Bonferroni post hoc tests. p < 0.05 was considered significant. RESULTS: The penetration depth, percentage and penetrated area of the sealer increased from apical to coronal in all systems. The maximum and average penetration depths and penetration areas were higher in FlexMaster and Revo-S groups at the 3rd mm (p < 0.05). At the 5th mm, the Revo-S group had a higher penetration percentage, when compared with ProTaper Next and ProTaper Universal groups (p < 0.05). CONCLUSIONS: In the 1st mm, separated fragments of any system did not allow the penetration of the sealer, while it was observed that the files with constant taper showed more positive results in terms of sealer penetration at apical 3rd and 5th mm. CLINICAL RELEVANCE: In the presence of a separated file, the taper of the file might significantly affect the amount of penetrated sealer into the dentinal tubules as compared with the cross-section and motion characteristics of the file.

Obturation quality of calcium silicate-based cements placed with different techniques in teeth with perforating internal root resorption: a micro-computed tomographic study.

OBJECTIVES: To evaluate and compare the obturation quality of mineral trioxide aggregate (MTA) and Biodentine placed with hand condensation or indirect ultrasonic activation technique in teeth models simulating perforating internal root resorption (IRR) using micro-computed tomographic (micro-CT) imaging. MATERIALS AND METHODS: Standardized models with perforating IRR cavities were created using 40 extracted single-rooted human teeth and randomly divided into four groups (n = 10). The specimens were obturated with either MTA or Biodentine and the placement technique applied was either hand condensation or indirect ultrasonic activation. Micro-CT scans were performed for the volumetric analysis of voids and filling materials in the resorption cavities and apical portion of the specimens. Data were analyzed using one-way analysis of variance and paired t test. RESULTS: No significant difference was observed between the groups in terms of the percentage volume of filling materials (p > 0.05). The apical portion of the specimens significantly presented less percentage volume of filling materials than the resorption cavities in each group (p < 0.05). CONCLUSIONS: No placement technique produced void-free fillings in teeth with perforating IRR. There was no significant difference between the obturation quality of Biodentine and MTA. The obturation quality in the apical portion of the root canals was inferior than that in the resorption cavities. CLINICAL RELEVANCE: The obturation of the apical region of teeth with perforating IRR is challenging irrespective of the material type and placement technique.

Concentration and time-dependent effect of initial sodium hypochlorite on the ability of QMix and ethylenediaminetetraacetic acid to remove smear layer.

AIMS: The aim of this study was to compare the ability of 17% ethylenediaminetetraacetic acid (EDTA) and QMix with different concentrations and time exposures of initial sodium hypochlorite (NaOCl) to remove the smear layer from the root canals. MATERIALS AND METHODS: Eighty maxillary central incisors were used. After instrumentation, the teeth were divided into eight experimental groups according to the initial and final rinse. About 2.5% and 5% NaOCl were used during instrumentation and for 1 or 3 min was used as postinstrumentation initial irrigants, and 17% EDTA and QMix used as final irrigants. The apical and middle parts of the specimens were observed by scanning electron microscope. STATISTICAL ANALYSIS USED: Data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Friedman's test. RESULTS: Regardless of the type of final irrigant, QMix allowed more smear layer removal than EDTA after using 5% initial NaOCl for 3 min. In the apical part of the root canal walls, the smear layer was not completely removed. CONCLUSION: QMix and EDTA were similarly effective in smear layer removal at the middle parts of the root canal regardless of the concentration and time exposure of initial NaOCl, while none of the irrigation protocols was able to remove smear layer at the apical parts.

Efficacy of different irrigant protocols and application systems on sealer penetration using a stepwise CLSM analysis.

This study compared several irrigation protocols and application systems for sealer penetration into dentinal tubules. Single-rooted-human teeth were divided into 5 experimental groups (n = 15) and a control group (n = 5), according to final irrigation protocols: standard needle irrigation (SNI); Vibringe; Vibringe + NaviTip FX (Vibringe NFX); Endo Spray (ES); and passive-ultrasonic-irrigation (PUI). Following obturation of the root canals, the percentage of the sealer penetration was measured at different depths using stepwise CLSM analysis. The sealer penetration in the experimental groups was significantly higher than the control group at all levels (p < .05). No significant differences were observed between Vibringe and SNI or Vibringe NFX, ES, and PUI at all depths (p > .05). The Vibringe NFX, ES, and PUI groups allowed deeper sealer penetration than SNI at 100, 250, and 500 µm levels (p < .05). The irrigant activation, the needle design, and the application form (syringe or spray) may impact the quality of the seal that is achieved with root canal filling.

Effect of Instrumentation Techniques and Preparation Taper on Apical Extrusion of Bacteria.

INTRODUCTION: The aim of this in vitro study was to evaluate the effects of different root canal instrumentation techniques and preparation tapers on the amount of apically extruded bacteria. METHODS: The root canals of 98 extracted human mandibular incisors were contaminated with Enterococcus faecalis suspension. After incubation at 37°C for 24 hours, the root canals were instrumented with K3 rotary files in a crown-down (CD) or full-length linear instrumentation technique (FL) by using 3 different root canal tapers (0.02, 0.04, and 0.06). During instrumentation, apically extruded bacteria were collected into vials containing saline solution. The microbiological samples were taken from the vials and incubated in brain-heart agar medium for 24 hours, and the numbers of colony-forming units (CFUs) were determined. The obtained results were analyzed with t test and one-way analysis of variance for the comparisons between the instrumentation techniques (CD and FL) and the preparation tapers (0.02, 0.04, and 0.06), respectively. Tukey honestly significant difference test was used for pairwise comparisons. RESULTS: The preparation taper had no effect on the number of CFUs when a FL instrumentation technique was used (P > .05). There was a statistically significant difference in the CFUs between FL and CD techniques when the preparation taper was 0.02 (P < .05). There was no statistically significant difference between the 0.04 and 0.06 preparation tapers in any of the instrumentation techniques (P > .05). CONCLUSIONS: Using a 0.02 taper in a CD manner results in the least amount of bacterial extrusion. The instrumentation technique did not seem to affect the amount of bacterial extrusion when 0.04 and 0.06 taper instruments were used for cleaning and shaping the root canal space.

Comparison of triple antibiotic paste removal by different irrigation techniques.

This study compared different irrigation techniques in triple antibiotic paste (TAP) removal from root canals. Fifty-six maxillaryanterior-teeth were filled with TAP for 28 days, and assigned into 5 experimental groups (n=10): Syringe irrigation (SI), NaviTip FX (NFX), Vibringe-Syringe irrigation (V-SI), NaviTip FX-Vibringe (V-NFX), passive ultrasonic irrigation (PUI) and positive and negative control groups (n=3 for each). Following the removal of the medicament, the remaining medicament was evaluated using 4-grade scoring-system. V-NFX and NFX showed similar performances (p>0.05) while V-NFX was significantly more efficient than SI and PUI (p<0.05) at all parts of root canals. VSI was less efficient at apical part when compared to NFX and V-NFX (p<0.05) while not significantly different from PUI and SI at all parts of the root canals (p>0.05). Regarding different parts of the root canals, V-SI and PUI were significantly less efficient at the apical part (p<0.05). In conclusion, the brush form of irrigation delivery with and without sonic activation improved the removal of TAP from the root canals when compared to ultrasonic activation, syringe irrigation or sonic activation alone.

Effects of QMix and ethylenediaminetetraacetic acid on decalcification and erosion of root canal dentin.

The aim of this study was to evaluate the effect of initial NaOCl on the decalcification and erosion ability of EDTA and QMix. Sixty-maxillary-incisors were bisected longitudinally and the tooth-halves were used. The experiment was conducted in two-sets. In set-I, 80-tooth halves were treated in the presence or absence of initial NaOCl and EDTA. In set-II, 40-tooth halves were immersed in NaOCl and QMix. After each treatment, calcium-ion release was determined with flame photometry. The erosion was imaged using SEM. Initial NaOCl led to concentration- and time-dependent increase in calcium removal effect of 17% EDTA (p < .05). The rate of calcium removal and root canal wall erosion was considerably more severe with the use of 5% NaOCl for 3 min (p < .05). QMix as a final solution showed less decalcification and erosion than 17% EDTA when used 5% NaOCl as an initial irrigant (p < .05). Optimizing the concentration and application time of NaOCl can decrease the decalcification effect of chelating agents.

Effect of placement technique on the push-out bond strength of calcium-silicate based cements.

The purpose of this study was to evaluate the effects of ultrasonic and manual placement techniques on the push-out bond strength of Biodentine and MTA with and without calcium chloride. One hundred and twenty mid-root slices from forty freshly extracted single-rooted human mandibular premolar teeth were instrumented and randomly divided into six groups (n=20) according to the filling material and placement technique applied, as follows: G1: MTA-manual compaction, G2: Biodentine-manual compaction, G3: MTA+5% CaCl2-manual compaction, G4: MTA-ultrasonic activation, G5: Biodentine-ultrasonic activation, G6: MTA+5% CaCl2-ultrasonic activation. The push-out bond strengths were measured using an Instron testing machine. Data were analyzed using twoway analysis of variance (ANOVA) with Bonferroni correction. The ultrasonic activation significantly enhanced the bond strength values of the materials. Biodentine presented higher bond strength values than that of MTA groups. The addition of CaCl2 to MTA did not improve the bond strength of the material.

Neurotoxicity of various root canal sealers on rat sciatic nerve: an electrophysiologic and histopathologic study.

OBJECTIVES: The aim of this study was to compare the neurotoxicity of various root canal sealers on rat sciatic nerve by electrophysiologic and histopathologic analyses. MATERIALS AND METHODS: A total of 40 male rats were randomly divided into five groups: Control, AH Plus, GuttaFlow, Sealapex and Smartpastebio. Sciatic nerves of the rats were uncovered using the surgical procedures, and the prepared sealers were then applied on nerves with a polyethylene tube vehicle for 15 days. Nerve potentials were recorded at initial exposure, 5, 30 and 120 min (early phase), and 15 days (late phase) by an electrophysiologic analysis system for all groups. The obtained measurements were then used to calculate the nerve conduction velocities (NCV). Subsequently, all rats were sacrificed, and their sciatic nerves were removed for histopathologic analysis. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests for intergroup variables and the Friedman and Wilcoxon test for intragroup variables. Statistical significance was set at P < 0.05. RESULTS: There was no significant difference between early and late phase results in the control group. This group showed little or no lasting damage to nerve tissue. All sealers decreased the NCV in the early phase time periods, but this decrease was only statistically significant in the AH Plus group at 120-min time period (P < 0.0125). During the late phase, the AH Plus and GuttaFlow groups almost reached initial NCV values, and it was lower than the initial values in the Sealapex and Smartpastebio groups. However, this decrease was not statistically significant. When intergroup comparisons were performed, statistically significant differences occurred at 30 min in the Sealapex group and 120 min in the AH Plus group compared with the control group (P < 0.0125). All sealers induced neurotoxicity as a result of degenerative and inflammatory responses of nerve tissue in histologic analysis. Histologic analysis revealed Sealapex and GuttaFlow to be the most and least neurotoxic, respectively. CONCLUSIONS: All tested root canal sealers exhibited a variable degree of neurotoxicity depending on their chemical compositions. CLINICAL RELEVANCE: Apical extrusion of endodontic filling materials may cause undesired consequences, such as inflammation and severe neurotoxic damage; therefore, extrusion factor plays an important role during the root canal treatment.

Effect of needle insertion depth and apical diameter on irrigant extrusion in simulated immature permanent teeth.

The aim of this study was to compare the amount of irrigant extrusion in simulated immature permanent teeth when the apical diameter and needle insertion depth were varied. Thirty single-rooted maxillary incisors with straight root canals were selected. The root length was standardized to a length of 9 mm. The teeth were divided into two experimental groups according to the degree of apical enlargement (n = 15). The apices were enlarged to a diameter of 1.10 mm or 1.70 mm by using a #3 or #6 peeso reamer, respectively, to simulate immature teeth. The irrigation solution was applied 2 or 4 mm short of the working length (WL) in each experimental group. The glass vial model was used for the collection of extruded irrigant beyond the root apex. A two-way repeated measures analysis of variance test showed that there was no significant difference between different needle insertion depths (2 and 4 mm short of the WL) in the group with an apical diameter of 1.70 mm (p > 0.05). In the group with an apical diameter of 1.10 mm, a 32% increase in irrigant extrusion was observed when the needle was positioned at 2 mm (p < 0.05). Regarding the effect of apical diameter, the group with a diameter of 1.70 mm showed more apical extrusion of the irrigant (34% increase for the needle positioned at 2 mm and 68% increase for the needle positioned at 4 mm). It was observed that the needle insertion depth and apical diameter have a significant effect on irrigant extrusion in immature permanent teeth.

Bond strength of calcium silicate-based sealers to dentine dried with different techniques.

OBJECTIVE: To assess the influence of various canal-drying techniques on the push-out bond strength between radicular dentine and both MTA Fillapex and iRoot SP sealers. MATERIALS AND METHODS: Eighty extracted single-root teeth were instrumented with ProTaper Universal rotary instruments to a size F4. The teeth were randomly assigned to 1 of 4 groups as follows: group 1, excess fluid in the canals was removed using a Luer vacuum adapter; group 2, the canals were dried with a single paper point; group 3, the canals were dried with 3-5 paper points, and group 4, the canals were rinsed with 95% ethanol and then dried with 3-5 paper points. In each group, the specimens were subgrouped according to root canal sealer into either subgroup A (MTA Fillapex) or subgroup B (iRoot SP sealer). Horizontal sections (thickness 1 ± 0.1 mm) were obtained from each specimen and a push-out test was performed using a universal testing machine at a crosshead speed of 1 mm/min on root slices. Statistical analysis was done using the Kruskal-Wallis test and Dunn's test for pair-wise comparisons. p < 0.05 was considered statistically significant. RESULTS: Canals dried with only 1 paper point and obturated with the iRoot SP sealer (subgroup 2B) showed significantly higher bond strengths to the root canal wall compared to all other subgroups (p < 0.05), except for subgroup 1B (p > 0.05). CONCLUSIONS: The canal-drying technique influenced the adhesive bond strength between calcium silicate-based root canal sealers and the root canal wall.

Effect of EDTA, sodium hypochlorite, and chlorhexidine gluconate with or without surface modifiers on dentin microhardness.

INTRODUCTION: This study aimed to evaluate the effects of root canal irrigants on the microhardness of root canal dentin in the presence and absence of surface-modifying agents. METHODS: Forty-eight root halves were prepared by longitudinal splitting of the distal roots of 24 freshly extracted mandibular human third molars and embedded in autopolymerizing acrylic resin, leaving the dentin surface exposed. After polishing, the microhardness values of the untreated dentin surfaces were recorded by using Vickers tester at the mid-root level. The root halves were randomly assigned to 6 groups composed of 8 samples each and treated for 5 minutes with one of the following irrigants: 17% EDTA, REDTA, 2% chlorhexidine gluconate (CHX), 2% CHX with surface modifiers (CHX-Plus), 6% NaOCl, or 6% NaOCl with surface modifiers (Chlor-XTRA). After surface treatment, dentin microhardness values were recorded at close proximity to the initial indentation areas. Experimental data were statistically analyzed by using the t test and one-way analysis of variance, followed by Tukey honestly significant difference test at α = 0.05. RESULTS: EDTA, REDTA, NaOCl, and Chlor-XTRA significantly decreased the microhardness of root dentin compared with intact controls (P < .05). CONCLUSIONS: The addition of surface modifiers to the irrigants did not affect the microhardness of the samples.

A case series associated with different kinds of endo-perio lesions.

Pulpal and periodontal problems are responsible for more than half of the tooth mortality. There are some articles published in the literature about this issue. Many of them are quite old. There has been also lack of knowledge about the effect of endodontic treatment on the periodontal tissue healing and suitable treatment interval between endodontic and periodontal treatments. In this case report, different kinds of endo-perio lesion were treated with sequential endodontic and periodontal treatment. The follow-up radiographs showed complete healing of the hard and soft tissue lesions. The tooth with endo-perio lesions should be evaluated thoroughly in terms of any cracks and fracture, especially furcation areas for a long term prognosis. In this case report, it was showed that 3 months treatment intervals between endodontic treatment and periodontal surgery has no harmful effect on periodontal tissue healing. Key words:Endo-perio lesion, furcation, mandibular molar, bone graft, crack line, treatment interval.

Push-out bond strength of three calcium silicate cements to root canal dentine after two different irrigation regimes.

OBJECTIVES: The aim of this study was to compare the push-out bond strength of three calcium silicate cements to dentine after two different irrigation regimes. MATERIALS AND METHODS: One hundred eighty 2-mm-thick root sections were prepared. The sections were divided into three main groups (n = 60). In group A, the sections were immersed in 1 % NaOCl for 3 min. In group B, the sections were immersed in 17 % EDTA for 3 min followed by 1 % NaOCl for the same period of time. In group C (control group), no irrigation was applied to the sections. The samples from each group were divided into four subgroups (n = 15). In subgroups A1, B1 and C1, DiaRoot BioAggregate; in subgroups A2, B2 and C2, MTA-Angelus and in subgroups A3, B3 and C3, MM-MTA were mixed with hand-mixing. In subgroups A4, B4 and C4, MM-MTA was mixed with auto-mixing. The mixed cements were then placed into cavities with a carrier. The samples were submitted to the push-out test and were loaded. All the data were analysed with one-way analysis of variance and the Tukey HSD multiple comparisons (p < 0.05). RESULTS: There were no statistically significant differences between the irrigation regimes regardless of the used materials. The resistance to displacement in subgroup B4 was significantly greater than that presented by subgroups A3, B3 and C3 (p < 0.05) while not different than all other groups. CONCLUSIONS: Irrigation regimes had not affected the push-out bond strength of the calcium silicate cements. Also, strength of auto-mixed MM-MTA was similar to the other cements. CLINICAL RELEVANCE: The novel calcium silicate cements would be a potentially useful material in endodontic procedures with favourable properties.

Evaluation of the cytotoxicity of different root canal sealers on L929 cell line by MTT assay.

The purpose of this study was to evaluate the cytotoxic effects of commercially available root canal sealers [Sealite Ultra (SU), Tubli-Seal (TS), Tubli-Seal EWT (TS-EWT), Pulp Canal Sealer (PCS), Pulp Canal Sealer EWT (PCS-EWT), Endomethasone N (En N), and Apexit Plus (AP)] on L929 cells by using MTT assay. After incubation with each sealer's extract at 37°C in a humidified air atmosphere containing 5% CO(2 )for 24 h, MTT (5 mg/mL) in saline was added into each well and further incubated at 37°C for 4 h. Formazan precipitate was dissolved in a buffer containing 23% sodium dodecyl sulfate and 50% N, N-dimethylformamide (pH 4.7). Optical densities of dissolved formazan were read using a microplate spectrophotometer. AP, TS, and TS-EWT showed no cytotoxicity at any dilution tested. Other sealers exhibited some degree of cytotoxicity at the 1/4 and 1/2 dilutions. PCS-EWT and SU exerted more potent cytotoxicity at 1/2 dilution than the other sealers.

Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles.

The purpose of this study was to compare the amount of apically extruded irrigant using 2 Ni-Ti rotary systems. Forty mandibular premolars with single canals were randomly assigned into 4 groups. Flower arrangement foam cubes were weighed with a precision balance before being attached to the apical portions of all teeth. In group 1, preparation was completed with ProTaper files. In group 2 canals were prepared with RaCe files. In groups 1 and 2, the irrigant was delivered with a 30-gauge conventional dental needle. In groups 3 and 4, teeth were prepared as in groups 1 and 2 with the exception that the irrigant was delivered with a side-vented irrigation needle. The weight of the extruded material (irrigant and debris) for each group was calculated by comparing the pre- and postinstrumentation weights of the foams used for periapical modeling. Obtained data were analyzed by Kruskal-Wallis and Mann-Whitney U tests, with P equals .05 as the level for statistical significance. ProTaper files used with regular needle irrigation had the highest fluid extrusion. The lowest irrigant extrusion was observed with the RaCe system combined with a side-vented irrigation needle. Within the limitations of this study, it can be concluded that irrigation needle and rotary instruments have an effect on the amount of extruded root canal irrigant.

Effect of smear layer and root-end cavity thickness on apical sealing ability of MTA as a root-end filling material: a bacterial leakage study.

OBJECTIVE: The aim of this study was to investigate the effect of the cavity thickness and smear layer on apical sealing ability of mineral trioxide aggregate (MTA) as a root-end filling material. STUDY DESIGN: Seventy single-rooted maxillary central teeth were used in this study. All teeth were instrumented to size 50 using a step-back technique. The selected teeth were randomly divided into 4 groups, each containing 15 experimental samples and 5 positive and 5 negative control samples. In the first and second groups (smear+), the teeth were irrigated with only 5.25% NaOCl. In the third and fourth groups (smear-), the teeth were irrigated with 17% EDTA and 5.25% NaOCl to remove the smear layer. Also, in the first and third groups, cavities were prepared as 3 mm. In the second and fourth groups, cavities were prepared as 5 mm. All the root-end cavities were then filled with MTA. Nail varnish was applied to all external root surfaces to the level of the resected root-ends to prevent lateral microleakage. Samples were sterilized in an ethylene oxide sterilizer for 12 hours. The apical 3-4 mm of the roots were immersed in brain heart infusion culture medium with phenol red indicator within culture chambers. The coronal access of each specimen was inoculated every 48 hours with a suspension of Enterococcus faecalis. Bacterial leakage was monitored every 24 hours for 4 weeks. The data obtained were analyzed using a chi-squared test, with alpha = .05 as the level for statistical significance. RESULTS: There were no statistically significant differences in rate of bacterial leakage among the experimental groups at 1-4 weeks (P > .05). Also, there was no difference between the groups when the 2 thickness groups were combined (P > .05). However, there was statistically significant differences when the 2 smear groups were combined for 4-week observation periods (P < .05). Removal of the smear layer caused significantly more apical microleakage than when the smear layer was left intact for 4 weeks. CONCLUSION: The thickness of root-end cavity (3 or 5 mm) had no influence in the bacterial leakage of the root end filled with MTA. Removing the smear layer may not be necessary in root-end cavities filled with MTA.

Comparison of the sealing ability of three filling techniques in canals shaped with two different rotary systems: a bacterial leakage study.

OBJECTIVE: This study compared the sealing ability of 3 current filling techniques in root canals shaped with 2 different rotary systems. STUDY DESIGN: Eighty human extracted mandibular premolars were divided randomly into 2 similar groups of 40 each and instrumented with either ProTaper (Dentsply Maillefer, Tulsa, OK; group A) or Mtwo (VDW; Antaeos, Munich, Germany; group B) rotary systems. Each group was divided into 3 subgroups (n = 10) and 2 control groups (n = 5). Canals were filled either with the tapered single-cone technique (SC; subgroups A1 and B1), with lateral condensation (LC; subgroups A2 and B2), or warm vertical compaction (WVC; subgroups A3 and B3). AH Plus was used as a root canal sealer in all groups. Samples were sterilized in an ethylene oxide sterilizer for 12 hours. The apical 3-4 mm of the roots were immersed in brain-heart infusion culture medium with phenol red indicator within culture chambers. The coronal access of each specimen was inoculated every 48 hours with a suspension of Enterococcus faecalis. Bacterial leakage was monitored every 24 hours for 8 weeks. The data obtained were analyzed using a chi-squared test, and P was set at .05. RESULTS: In group A, 70% of the specimens filled with SC (subgroup A1), 50% of the specimens filled with LC (subgroup A2), and 20% of the specimens filled with WVC (subgroup A3) leaked. There was no statistically significant difference between the subgroups (P > .05). In group B, bacterial leakage was observed in 50% of SC samples (subgroup B1), 40% of LC samples (subgroup B2), and 50% of WVC samples (subgroup B3). There was no statistically significant difference between subgroups B1, B2, and B3 (P > .05). There was also no statistically significant difference between group A and group B (P > .05). CONCLUSION: Filling with SC, LC, and WVC techniques in canals treated with ProTaper or Mtwo rotary instruments showed similar levels of sealing efficacy.

Microleakage evaluation of roots filled with different obturation techniques and sealers.

OBJECTIVE: The aim of this study was to compare the apical seal of the Single-cone ProTaper gutta-percha technique and the lateral compaction technique in combination with 3 sealers (AH-26, Apexit, and Sealite-Ultra). STUDY DESIGN: Seventy extracted single-root teeth were used. Root canals were prepared with ProTaper rotary instruments. Six groups were formed: (I) Single-cone ProTaper gutta-percha with AH-26; (II) lateral compaction technique with AH-26; (III) Single-cone ProTaper gutta-percha with Apexit; (IV) lateral compaction technique with Apexit; (V) Single-cone ProTaper gutta-percha with Sealite-Ultra; and (VI) lateral compaction technique with Sealite-Ultra. The fluid conductance of each specimen was measured after the 7th and 30th days using a fluid filtration method. RESULTS: When lateral compaction was performed, all sealers showed similar levels of leakage (P > .05). Using the single-cone technique, Sealite-Ultra showed more leakage than the others (P < .05). Comparing filling techniques, there was a significant difference only in the Sealite-Ultra groups (P < .05). CONCLUSION: Single-cone ProTaper gutta-percha and lateral compaction techniques showed similar sealing effect.