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Introduction: Apical surgery aims to eradicate the apical part of the root and the lesion to enhance the healing. The sealing ability of retrograde filling material is an essential factor affecting the success rate of the surgery. Mineral trioxide aggregate (MTA) is the gold standard of retrograde filling materials, with approved sealing capability and biocompatibility. Newly introduced root repair material with an approved antibacterial effect similar to MTA is Nano-fast cement (NFC) which should be investigated for its sealing ability. This study aimed to evaluate the sealing ability of NFC vs. MTA. Materials and Methods: Root apices of 48 single-rooted teeth were resected at 90 degrees and were prepared at 3 mm depth. The teeth were randomly divided into 2 experimental groups (n=21), negative control group (n=3), and positive control group (n= 3). MTA and NFC plugs were condensed as retrograde filling material. The samples were evaluated by a modified fluid filtration device for 1 hour. The measurement was conducted at 24 h, 1, and 3 months. Data were analyzed by Friedman Test and Kruskal-Wallis test. Results: According to the results, NFC at 3-months interval showed the least microleakage, and MTA had the highest at the baseline. However, the results between the two groups were not statistically significant in all intervals. NFC reached the ideal sealing ability within 1 month, which was reached for MTA after 3 months. Conclusions: The results of this in vitro study showed that the microleakage value of NFC is comparable to MTA. In light of current findings, NFC shows characteristics of a suitable calcium silicate-based cement. Further clinical researches are needed to introduce the NFC as retrograde apical plug or for other endodontic applications.
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STATEMENT OF THE PROBLEM: The extrusion of intracanal debris is one of the challenging problems related to almost all root canal preparation systems, which may cause flare-ups and impairment in the healing process. PURPOSE: This study was conducted to evaluate the amount of apically-extruded debris during root canal preparation using Medin (MEDIN Co., Czech Republic) rotary system compared with two common rotary systems, including ProTaper (Dentsply Maillefer., Switzerland) and RaCe (FKG Dentaire, Switzerland). MATERIALS AND METHOD: In this in vitro study, Sixty mandibular premolars with single canal were randomly assigned to three groups (n=20). The root canals were prepared with Medin, ProTaper, and RaCe rotary instruments based on their manufacturers' instructions. The debris were collected into pre-weighted Eppendorf tubes. The weight of the extruded debris was calculated by subtracting the pretreatment weight of the vials. Data were analyzed using the Kruskal-Wallis test at a 5% significance level. RESULTS: Medin instrument caused significantly less debris extrusion in comparison with ProTaper and RaCe (p< 0.05). The differences between the ProTaper and RaCe rotary systems were not statistically significant (p= 0.752). CONCLUSION: Within the limitations of this in vitro study, Medin rotary system produced less apical extrusion than ProTaper and RaCe.
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Dens invagination is a developmental anomaly that requires specific treatment approaches. The invagination is enamel-lined in the crown of the tooth truly negligible, and usually there is no extension on the level of the external amelocemental junction. A well ending surgical root canal treatment of an invaginated tooth with a retrograde filling is presented in this case report. Periapical radiographic examination, after 3 months and 6 years of follow-up, showed periapical healing with osseous formation .
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BACKGROUND: The purpose of this study was to evaluate the effect of calcium hydroxide (Ca[OH] 2) residues on the accuracy of two electronic apex locators (EALs) (Root ZX and Raypex 6) in the presence of different irrigants. MATERIALS AND METHODS: In this an in vitro study Eighty single-rooted human mandibular premolars were selected. The crowns of the teeth were removed to standardize the working lengths (WLs). Actual WLs (AWLs) were recorded, and the root canals were shaped using protaper rotary instruments up to size F3. Then, the root canals were dried and filled with injectable Ca (OH) 2 paste and the access cavities were temporarily sealed. Teeth were put into four alginate boxes, including two experimental groups (n = 30) and two control groups (n = 10). The pools of alginate were wrapped in wet gazes and stored at 37°C and 100% humidity for 7 days. Then, the root canals were exposed and Ca (OH) 2 paste was removed by normal saline or 5.25% sodium hypochlorite irrigation followed by 17% ethylenediaminetetraacetic acid (EDTA), and the electronic WL (EWL) was measured by Root ZX and Raypex 6. Differences of EWL from AWL were calculated. Furthermore, the percentage of acceptable measurements (tolerance limit of ± 0.5 and ± 1 mm) was calculated for each apex locator. One-way ANOVA test with post hoc paired t-test and Chi-square test was used to analyze the data (P < 0.05). RESULTS: The results showed that there was no significant difference between the accuracy of two EALs and irrigants (P > 0.05). CONCLUSION: The present study revealed that no statistically significant differences were observed between the two apex locators after Ca(OH)2 paste removal with different irrigants.
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STATEMENT OF THE PROBLEM: The complete removal of filling material is an important step to regain access to the entire canal and facilitate the disinfection of the root canal system. Rotary nickel-titanium (NiTi) instruments systems have been proposed as an effective removal technique for root canal retreatment. PURPOSE: The aim of this study was to evaluate the efficacy of Neolix rotary system and ProTaper Universal retreatment system in the removal of gutta-percha combined with two different sealers. MATERIALS AND METHOD: In vivo study, eighty extracted human permanent mandibular premolars were prepared using the ProTaper Universal rotary system to an apical size 30 (F3/0.06). The specimens were randomly divided into 4 groups (n=20) and subsequently filled with lateral condensation of gutta-percha and two sealers: AH-26 and Sure-Seal Root. The teeth were stored for 4 weeks at 37°C and 100% humidity and then retreated by one of the following rotary systems: Neolix or ProTaper Universal retreatment system. Teeth were then grooved and monitored under a stereomicroscope with 8× magnification. The images were transferred to the computer and the amount of filling material that remained on the root canal walls was scored using AutoCAD 2017 version 1.1software. Results were analyzed using one-way analysis of variance test and post hoc Tukey-HSD test (p< 0.05). RESULTS: The mean percentage of remaining gutta-percha and sealer was significantly higher in apical third in all groups (p< 0.01). Post hoc Tukey test showed that there is significantly higher residual filling material in the group filled with gutta-percha and Sure-Seal Root sealer and retreated by Neoniti rotary system compared with other groups in both coronal and middle third of the canal. CONCLUSION: The Neoniti rotary system was as effective as ProTaper Universal retreatment system in retreatment of gutta-percha and AH-26 sealer but was significantly less effective in groups obturated with Sure-Seal Root sealer.
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STATEMENT OF THE PROBLEM: Nonsuicidal self-inflicted injuries are socially unacceptable and may cause mild to severe damages. PURPOSE: This study aimed to evaluate the demographic features of the subjects with orodental self-injuries referred to a forensic medicine center in Shiraz, Iran. MATERIALS AND METHOD: This cross-sectional study evaluated 51 participants (49 men and 2 women) with orodental injuries referred to forensic medicine administration. Orodental self-injury was detected in the subjects, based on the last forensic criterion of self-injuries, considering their history, clinical examinations, and panoramic radiographs. RESULTS: The findings of this study revealed that dental self-injuries were more prevalent among married men from urban areas with secondary education levels. Most of the cases were due to the monetary compensation received. In the majority of cases, a hard object was used for this self-injury. Moreover, no statistical association was observed between the economic status and orodental self-injury. CONCLUSION: This study concluded that dental self-injury could be regarded as an unplanned incident because no significant correlation was observed between the participants, their economic status, and the type of dental trauma. Furthermore, detailed investigations on the latent variables are required.
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INTRODUCTION: This in vitro study investigated the effect of adding 10% calcium chloride (CaCl2) on push out bond strength of calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) to root canal dentin. METHODS AND MATERIALS: A total of 120 root dentin slices with 2 mm thickness were prepared from sixty single-rooted human teeth. Dentinal discs were enlarged to achieve 1.3 mm diameter. The specimens were randomly allocated into eight groups (n=15). Dentin discs were filled with either CEM cement or MTA with or without CaCl2 and the push out test was performed after 3 and 21 days. Data were analyzed with two-way ANOVA test. The level of significance was set at 0.05. RESULTS: There was an interaction effect amongst all groups (P=0.028). After 3 days, CEM cement showed a significantly lower bond strength than other groups (P<0.05) while MTA demonstrated significantly higher bond strength than CEM cement with or without CaCl2 (P=0.001). After 21 days, CEM cement with or without CaCl2 had no significant difference with other groups (P>0.05). However, the bond strength of MTA decreased when CaCl2 was added (P=0.011). CONCLUSION: The addition of 10% CaCl2 increased the push out bond strength of CEM cement and improved it over time; while, this substance aggravated this property for MTA.
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INTRODUCTION: In this experimental study, the amount of smear layer (SL) remnants in curved root canals after chemomechanical instrumentation with two engine-driven systems or hand instrumentation was evaluated. METHODS AND MATERIALS: Forty-eight mesiobuccal roots of mandibular first molars with curvatures ranging between 25 and 35 degrees (according to Schneider's method) were divided into three groups (n=16) which were prepared by either the ProTaper Universal file series, Reciproc single file system or hand instrumentation. The canals were intermittently irrigated with 5.25% NaOCl and 17% (ethylenediaminetetraacetic acid) EDTA, followed by distilled water as the final rinse. The roots were split longitudinally and the apical third of the specimens were evaluated under 2500× magnification with a scanning electron microscope (SEM). The mean scores of the SL were calculated and analyzed using the non-parametric Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The mean scores of the SL were 2.00±0.73, 1.94±0.68 and 1.44±0.63 µm for the ProTaper Universal, Reciproc and hand instrumentation, respectively. Mean score of SL was significantly less in the hand instrumentation group than the ProTaper (P=0.027) and Reciproc (P=0.035) groups. The difference between the two engine-driven systems, however, was not significant (P=0.803). CONCLUSION: The amount of smear layer in the apical third of curved root canals prepared with both engine-driven systems was similar and greater than the hand instrumentation technique. Complete cleanliness was not attained.
