• Restorative Dentistry and Endodontics
• /
• v.48 no.1
• /
• pp.10.1-10.9
• /
• 2023

Objectives: This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. Materials and Methods: The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. Results: The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). Conclusions: NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

• Restorative Dentistry and Endodontics
• /
• v.25 no.1
• /
• pp.63-70
• /
• 2000

The properties of ideal retrograde filling materials include the ability to seal the root canal system in three dimensions and well tolerated by periradicular tissues. Biocompatibility testing has been done mainly with cytotoxicity tests using cell culture. Little attention has been paid to the potential adverse influence on the inflammatory and immune reaction in the periapical tissue. The purpose of this study was to investigate the effects of retrograde filling materials on human mononuclear cells in vitro. Freshly mixed and set specimens from six materials (Z100, Tetric Ceram, Fuji II, Fuji II LC, F2000, Compoglass Flow, and ZOE) were eluated with cell culture medium for 24 hours. Cytotoxic effects of these extracts were evaluated by determining cell viability and enzyme activity using MTT and lactate dehydrogenase (LD). The production of inflammatoy bone resorptive cytokine, TNF-${\alpha}$ was measured from human peripheral blood mononuclear cells (PBMC) exposed to the extracts by means of Endogen Human TNF-${\alpha}$ ELISA kit (Wobrun, MA, U.S.A.). Eluates and diluted (1 : 10) eluates with cell culture medium from freshly mixed Fuji IT had cytotoxic effects on mononuclear cells using MTT and LD. However, eluates from set Fuji II were not cytotoxic. Eluates form set ZOE exhibited cytotoxicity with LD test. TNF-${\alpha}$ levels were high in eluates from freshly mixed Fuji II and Z100. Diluted eluates from freshly mixed Z100 and F2000 stimulated the production of TNF-${\alpha}$. However, there were no significant difference in TNF-${\alpha}$ levels compared to controls. These results indicate that some materials could possibly stimulate bone resorption in the periapical tissue by means of the production of bone resorptive cytokine.

• Imaging Science in Dentistry
• /
• v.51 no.1
• /
• pp.55-62
• /
• 2021

Purpose: This study evaluated the influence of a metal artifact reduction (MAR) tool in a cone-beam computed tomography (CBCT) device on the diagnosis of vertical root fractures (VRFs) in teeth with different root filling materials. Materials and Methods: Forty-five extracted human premolars were classified into three subgroups; 1) no filling; 2) gutta-percha; and 3) metallic post. CBCT images were acquired using an Orthopantomograph 300 unit with and without a MAR tool. Subsequently, the same teeth were fractured, and new CBCT scans were obtained with and without MAR. Two oral radiologists evaluated the images regarding the presence or absence of VRF. Receiver operating characteristic (ROC) curves and diagnostic tests were performed. Results: The overall area under the curve values were 0.695 for CBCT with MAR and 0.789 for CBCT without MAR. The MAR tool negatively influenced the overall diagnosis of VRFs in all tested subgroups, with lower accuracy (0.45-0.72), sensitivity (0.6-0.67), and specificity (0.23-0.8) than were found for the images without MAR. In the latter group, the accuracy, sensitivity, and specificity values were 0.68-0.77, 0.67-083, and 0.53-087, respectively. However, no significant difference was found between images with and without MAR for the no filling and gutta-percha subgroups (P>0.05). In the metallic post subgroup, CBCT showed a significant difference according to MAR use (P<0.05). Conclusion: The OP 300 MAR tool negatively influenced the detection of VRFs in teeth with no root canal filling, gutta-percha, or metallic posts. Teeth with metallic posts suffered the most from the negative impact of MAR.

• Restorative Dentistry and Endodontics
• /
• v.48 no.2
• /
• pp.15.1-15.7
• /
• 2023

Objectives: This study evaluated the efficiency of WaveOne Primary files (Dentsply Sirona) for removing root canal fillings with 2 types of movement: reciprocating (RCP) and continuous counterclockwise rotation (CCR). Materials and Methods: Twenty mandibular incisors were prepared with a RCP instrument (25.08) and filled using the Tagger hybrid obturation technique. The teeth were retreated with a WaveOne Primary file and randomly allocated to 2 experimental retreatment groups (n = 10) according to movement type: RCP and CCR. The root canals were emptied of filling material in the first 3 steps of insertion, until reaching the working length. The timing of retreatment and procedure errors were recorded for all samples. The specimens were scanned before and after the retreatment procedure with micro-computed tomography to calculate the percentage and volume (mm³) of the residual filling material. The results were statistically evaluated using paired and independent t-tests, with a significance level set at 5%. Results: No significant difference was found in the timing of filling removal between the groups, with a mean of 322 seconds (RCP) and 327 seconds (CCR) (p < 0.05). There were 6 instrument fractures: 1 in a RCP motion file and 5 in continuous rotation files. The volumes of residual filling material were similar (9.94% for RCP and 15.94% for CCR; p > 0.05). Conclusions: The WaveOne Primary files used in retreatment performed similarly in both RCP and CCR movements. Neither movement type completely removed the obturation material, but the RCP movement provided greater safety.

• Journal of Chest Surgery
• /
• v.18 no.2
• /
• pp.299-304
• /
• 1985

The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

• Restorative Dentistry and Endodontics
• /
• v.41 no.1
• /
• pp.63-67
• /
• 2016

During clinical endodontic treatment, we often find radiopaque filling material beyond the root apex. Accidental extrusion of calcium hydroxide could cause the injury of inferior alveolar nerve, such as paresthesia or continuous inflammatory response. This case report presents the extrusion of calcium hydroxide and treatment procedures including surgical intervention. A 48 yr old female patient experienced Calcipex II extrusion in to the inferior alveolar canal on left mandibular area during endodontic treatment. After completion of endodontic treatment on left mandibular first molar, surgical intervention was planned under general anesthesia. After cortical bone osteotomy and debridement, neuroma resection and neurorrhaphy was performed, and prognosis was observed. But no improvement in sensory nerve was seen following surgical intervention after 20 mon. A clinician should be aware of extrusion of intracanal medicaments and the possibility of damage on inferior alveolar canal. Injectable type of calcium hydroxide should be applied with care for preventing nerve injury. The alternative delivery method such as lentulo spiral was suggested on the posterior mandibular molar.

• Restorative Dentistry and Endodontics
• /
• v.24 no.3
• /
• pp.490-494
• /
• 1999

The aim of this in vitro study was to investigate the coronal leakage of obligate anaerobes into root canals obturated with two different techniques. 48 extracted human teeth with straight, single root canals were prepared with crown-down technique with Profile under copious irrigation until the master apical file was size 40. The teeth were divided randomly into experimental groups (40 teeth) and control groups (8 teeth). In the experimental groups, 20 teeth were obturated with lateral condensation and other 20 teeth were obturated with continuous wave technique with System B. Coronal leakage of two root canal filing technique was evaluated using anaerobic bacterial leakage model with Fusobacterium nucleatum(ATCC 25586) for 60 days. The results were as follows 1. The incidence of bacterial leakage of experimental groups was 65% in group 1 (lateral condensation) and 60% in group 2 (continuous wave technique with System B). This difference was not statistically significant (P>0.05). 2. There was no statistically significant difference(P>0.05) in leakage score between group 1 (lateral condensation) and group2 (continuous wave technique with System B).

• Restorative Dentistry and Endodontics
• /
• v.46 no.3
• /
• pp.38.1-38.13
• /
• 2021

The elimination of endodontic biofilms and the maintenance of a leak-proof canal filling are key aspects of successful root canal treatment. Several materials have been introduced to treat endodontic disease, although treatment success is limited by the features of the biomaterials used. Silver nanoparticles (AgNPs) have been increasingly considered in dental applications, especially endodontics, due to their high antimicrobial activity. For the present study, an electronic search was conducted using MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and EMBASE. This review provides insights into the unique characteristics of AgNPs, including their chemical, physical, and antimicrobial properties; limitations; and potential uses. Various studies involving different application methods of AgNPs were carefully examined. Based on previous clinical studies, the synthesis, means of obtaining, usage conditions, and potential cytotoxicity of AgNPs were evaluated. The findings indicate that AgNPs are effective antimicrobial agents for the elimination of endodontic biofilms.

• Restorative Dentistry and Endodontics
• /
• v.30 no.5
• /
• pp.385-392
• /
• 2005

The purpose of this study was to observe the effect of canal filling on the bacteria left in the dentinal tubules and to compare the sealing ability between Gutta-percha and Resilon. The bovine dentin block models were prepared E. faecalis was inoculated to dentin blocks and incubated. The dentin blocks were divided into 5 groups. Group 1 was the negative control. Group 2 was the positive control. Group 3 was filled with ZOE based sealer and Gutta-percha, Group 4 with resin based sealer and Gutta-percha, and Group 5 with resin based sealer and Resilon. After 24 hour, the blocks were incubated at $37^{\circ}C$ for 1, 2, 3 and 4 weeks on BHI agar plates. The internal dentin portion of the blocks was removed using ISO 027, 029, 031, 035 round burs and the dentin chips were incubated at $37^{\circ}C$ for 24 hour Following incubation, the optical density of the medium was measured. The data were statistically analysed using repeated measures ANOVA and one-way ANOVA. The results were as follows, 1. There. was statistically significant reduction in the number of E. faecalis of the group where dentinal tubules were completely sealed with nail varnish in comparison with the groups obturated with gutta-percha or resilon (p < 0.05). 2. In group 5, the number of E. faecalis in the dentinal tubules decreased significantly with time (p < 0.05). whereas in Group 3 and 4, there was no reduction in its number (p > 0.05). 3. Under the conditions of this experiment, E. faecalis survived up to 4 weeks after obturation with gutta-percha or resilon (p > 0.05).

• Restorative Dentistry and Endodontics
• /
• v.23 no.2
• /
• pp.682-689
• /
• 1998

The purpose of this study was to evaluate the sealing ability of the Microseal$^{(R)}$, which was new obturation system made by Tycom company, U.S.A. Forty-five extracted single-rooted human teeth were resected at cemento-enamel junction and divided three groups. All canals were prepared using Profile system, and then each group was obturated by lateral condensation technique (group 1), vertical condensation technique (group 2) and Microseal$^{(R)}$ condensation technique (group 3) with root canal sealer. Teeth were immersed in resorcinol-formaldehyde resin for 5 days at $4^{\circ}C$ and the resin was allowed to polymerize completely for 4 days at room temperature. Teeth were resected horizontally at 1 mm (level I), 2 mm (level II), 3 mm (level III) from the anatomical root apex using low speed microtome and examined with Image analyzer (IBASR, Zeiss co., Germany.) at ${\times}25$ magnification. The gab between the canal wall and the filling material, which was filled with the resin, was measured at each of the three levels. Each ratio of leakage was expressed percentage by calculating the ratio of the area of the resin to the total area of the canal and was analyzed statistically (one-way ANOVA). The results were as follows; 1. The mean ratio of leakage (%) was 6.46% at group 1, 3.06% at group 2, 11.27% at group 3. 2. When evaluating the ratio of leakage at the three levels, there was level I> level II> level III in all groups. Especially, the difference between level I and level III was statistically significant (p<0.05). 3. When evaluating the ratio of leakage at the three groups, there was group 3> group 1> group 2 at all levels. Especially the difference between group 2 and group 3 was statistically significant (p<0.05).