Effect of different irrigation methods in the presence of a separated instrument: an in vitro study.

Objective: The aim of this study was to evaluate the effect of different irrigation methods on sodium hypochlorite (NaOCl)/debris extrusion and dentinal tubule penetration of 2.5% NaOCl in the presence of an apically separated instrument.Materials and methods: Sixty root canals of freshly extracted mandibular single-rooted premolars were chemomechanically prepared up to ProTaper F2. Manual needle irrigation (30-gauge/side-vented) with 2.5% NaOCl was performed between files and a smear layer was removed with 17% ethylenediaminetetraacetic acid. Three mm of notched ProTaper F3 files were separated in the apical third of the roots. Samples were then randomly divided according to the final irrigation systems as follows: EndoActivator, EndoVac, manual needle irrigation, passive ultrasonic activation, and RinsEndo. Samples were mounted to Eppendorf tubes and root canals were irrigated with 3-mL Rhodamine B-labelled 2.5% NaOCl, which was applied using one of the above-mentioned methods. The extruded NaOCl/debris weight was calculated by extracting pre-irrigation weights of tubes from post-irrigation ones. Samples embedded in acrylic resin were sectioned transversely in 1-mm thicknesses at apical 1- and 3-mm levels. NaOCl's penetration depth and percentage into the dentinal tubules were evaluated with the aid of a confocal laser scanning microscope. Data were analysed statistically with Kruskal-Wallis and post hoc Siegel-Castellan tests (p < .05).Results: EndoVac significantly decreased the extruded NaOCl/debris compared to RinsEndo, passive ultrasonic activation, and EndoActivator in the presence of a separated instrument (p < .05). The penetrability of NaOCl significantly increased with the use of RinsEndo and EndoVac compared to the remaining groups (p < .05).Conclusion: In the presence of an irretrievable separated instrument, it could be suggested that devices with apical negative pressure such as EndoVac may improve the penetrability of irrigation solutions to the apical part of the root while preserving periapical tissues from NaOCl/debris extrusion.

Comparison of Preoperative Administration of Pregabalin and Duloxetine on Cognitive Functions and Pain Management After Spinal Surgery: A Randomized, Double-blind, Placebo-controlled Study.

STUDY OBJECTIVE: Surgical trauma is known to induce hyperalgesia, and if pain management is insufficient, it contributes to persistent pain in the postoperative period.In this study, our primary aims were to compare the effect of pregabalin and duloxetine on postoperative pain scores and cognitive functions. Our secondary aim was to determine drug-related side effects. DESIGN: This was a prospective, randomized, double-blind, placebo-controlled study. SETTINGS: The study was carried out in the setting of the operating room and the surgical ward. PATIENTS: Ninety-four patients, 18 to 65 years of age, ASA status I-II, scheduled for elective repair of lumbar disc herniation were enrolled in the study. INTERVENTIONS: The patients were randomly divided into 3 groups: the first group received pregabalin 75 mg orally 1 hour before the surgery and at the postoperative 12th and 24th hours. The second group received duloxetine 60 mg orally 1 hour before the surgery. At the postoperative 12th hour, they received a placebo capsule, and, at the 24th hour, they received duloxetine 60 mg again. The third group received placebo capsules orally at all timepoints. MEASUREMENTS: Postoperative pain evaluation was conducted using a Visual Analogue Scale at the postoperative first minute, 30th minute, first hour, and the 12th, 24th, and 48th hours. The preoperative and postoperative sixth hour cognitive functions were evaluated with Montreal Cognitive Assessment (MoCA) test. MAIN RESULTS: There was a significant reduction in mean MoCA scores postoperatively in all groups (P<0.01). The highest MoCA score reduction was in the pregabalin group (1.83±1.31 point), then in the duloxetine group (1.16±0.82), and the least decrease was in the control group (0.49±0.61). At all timepoints, the mean Visual Analogue Scale scores of the pregabalin and duloxetine groups were similar to each other, and they were lower than that of the control group (P<0.05). CONCLUSIONS: Preoperative use of duloxetine 60 mg can be an useful alternative to pregabalin 75 mg, as it has a similar analgesic effect on postoperative pain, with fewer incidences of drug-related negative effects on cognitive function.

Effect of Low-surface Tension EDTA Solutions on the Bond Strength of Resin-based Sealer to Young and Old Root Canal Dentin.

INTRODUCTION: The purpose of this study was to evaluate the effect of low-surface tension EDTA solutions on the push-out bond strength of resin-based sealer to young and old root canal dentin. METHODS: Root canals from 64 (n = 32 age <30 years old and n = 32 >60 years old) extracted, decoronized, single-rooted human teeth were prepared with ProTaper rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland) up to size F4 using 3 mL 2.5% sodium hypochlorite (NaOCl) between each file. Each group was divided into 4 subgroups as follows: 3 mL EDTA, REDTA (17% EDTA + 0.84 g cetyltrimethylammonium bromide; Sigma-Aldrich, St Louis, MO), EDTA-T (17% EDTA + 1.25% sodium lauryl ether sulfate, Sigma-Aldrich), and saline as the control (n = 8). The final irrigation was completed with 3 mL saline after 3 mL NaOCl in the experimental groups and 3 mL saline in the control group. After root canal filling with gutta-percha (GP) cones/AH Plus sealer (Dentsply, Petropolis, RJ, Brazil), samples were stored at 37°C and 100% humidity for 2 weeks. One-millimeter-thick horizontal sections from the coronal and midthirds of each root were sliced, and push-out bond strength values were measured using a universal testing machine. Data were analyzed using 2-way analysis of variance followed by the Bonferroni test (P < .05). RESULTS: EDTA-T, REDTA, and EDTA significantly increased the bond strength values of GP/AH Plus to the root canal dentin compared with saline in both young and old groups (P < .05). EDTA-T treatment provided higher bond strength values in young dentin compared with EDTA and EDTA-T-treated old dentin (P < .05). CONCLUSIONS: The bond strength values of GP/AH Plus could be altered depending on age and the type of EDTA compounds.

Evaluating the impact of climate change on groundwater resources in a small Mediterranean watershed.

Western Mediterranean Region of Turkey is subject to considerable impacts of climate change that may adversely affect the water resources. Decrease in annual precipitation and winter precipitation as well as increase in temperatures are observed since 1960s. In this study, the impact of climate change on groundwater resources in part of Köycegiz-Dalyan Watershed was evaluated. Evaluation was done by quantifying the impacts of climate change on the water budget components. Hydrological modeling was conducted with SWAT model which was calibrated and validated successfully. Climate change and land use scenarios were used to calculate the present and future climate change impacts on water budgets. According to the simulation results, almost all water budget components have decreased. SWAT was able to allocate less irrigation water because of the decrease of overall water due to the climate change. This resulted in an increase of water stressed days and temperature stressed days whereas crop yields have decreased according to the simulation results. The results indicated that lack of water is expected to be a problem in the future. In this manner, investigations on switching to more efficient irrigation methods and to crops with less water consumption are recommended as adaptation measures to climate change impacts.