• Restorative Dentistry and Endodontics
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• v.48 no.2
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• pp.21.1-21.15
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• 2023

Objectives: This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods: Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey's test (α = 0.05). Results: No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions: The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.359-365
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• 2013

The aim of this study was to evaluate the effect of temporary restorative and filling material on bonding strength between lithium disilicate glass-ceramic and dentin. 60 extracted human molars were cross-sectioned at occlusal third and were embedded into self-cure acrylic resin. Then the teeth were randomly divided into four groups of 15 each. Lithium disilicate glass-ceramic is cemented to dentin as follows: after no any application of the provisional materials (Group A), after application of ALIKETM (GC America Inc.)(Group B), after application of Luxatemp$^{(R)}$ Automix plus (DMG, Germany)(Group C), after application of Fermit$^{(R)}$ (Ivoclar Vivadent, Leichtenstein)(Group D). After the specimens were stored in distilled water for 24 hours, the shear bond strength of the specimens were measured using UTM (Zwick 1456 41, Zwick, Germany) at a crosshead speed of 1mm/min. The data were analysed by one-way ANOVA and Tukey HSD tests. There were no statistically significant differences of bond strength among the groups. Fracture type was showed mixed type of adhesive and cohesive fracture in most of specimens. Within the limitation of this study, bond strength of adhesive resin cement between lithium disilicate glass-ceramic and dentin was not affected by provisional restorative and filling materials.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.13.1-13.9
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• 2021

Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37℃. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.

• Restorative Dentistry and Endodontics
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• v.47 no.2
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• pp.22.1-22.18
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• 2022

Objectives: This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and Methods: Only in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. Results: The search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. Conclusions: This review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.213-221
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• 2022

Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.

• Restorative Dentistry and Endodontics
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• v.35 no.3
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• pp.222-228
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• 2010

The purpose of this study was to compare mineral trioxide aggregate (MTA; Dentsply, Tulsa Dental, Tulsa, OK, USA), which is widely used as root-end filling material, with DiaRoot BioAggregate (DB; Innovative BioCaramix Inc, Vancouver, BC, Canada), newly developed product, by using MG63 osteoblast-like cells. MTA, DB, and Intermediate Restorative Material (IRM; Dentsply Caulk, Milford, DE, USA) were used for root-end filling material while tissue culture plastic was used for control group. Each material was mixed and, the mixtures were left to set for 24 hours. MG63 cells were seeded to each group and then they were cultured for attachment for 4 hours. Following the attachment of cells to the root-end filling material, early cellular response was observed. After another 12 hours'culture, the level of attachment between cells and material was observed and in order to identify the effect of each material to bone formation, transforming growth factor beta1 ($TGF{\beta}1$) and osteocalin (OC) were estimated by using enzyme-linked immunosorbent assay (ELISA), and the amount of alkaline phosphatase (ALP) was also measured. The data were analyzed using one-way ANOVA. As a result, only at OC and the number of cells which were attached to materials, there was no statistical difference between MTA and DB. At other items, there was statistically significant difference in all groups. Although DB has not shown exactly the same cellular response like that of MTA, the number of attached cells shows that biocompatibility of the material and OC indicates bone formation rate. Therefore, if DB is used for root end filling material, it is expected to lead to similar results to MTA.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.457-464
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• 2016

PURPOSE. The aim of this study was to determine whether two methods of documentation, print and electronic forms, for the assessment of patient-reported outcomes (PRO) in complete denture wearers provide comparable results. The study also quantified the time needed for filling the forms by each method. MATERIALS AND METHODS. Thirty participants enrolled in a university clinic answered two forms (a questionnaire for denture satisfaction and OHIP-EDENT). They provided answers with two application methods in a random order, with a one-month interval between them: (1) electronic forms on a tablet computer; and (2) print forms. The methods were compared in terms of mean results, correlation/agreement, internal consistency, and spent time. RESULTS. Mean results for both methods were similar for each denture satisfaction item (100-mm VAS) and OHIP-EDENT summary score. Both questionnaires presented good internal consistency regardless of the application method (Cronbach's ${\alpha}=0.86$ or higher). Correlation and agreement between the methods regarding specific items was at least moderate for the majority of cases. Mean time for the electronic and print forms were 9.2 and 8.5 minutes, respectively (paired t test, P=.06, non-significant). CONCLUSION. The electronic method is comparable to print forms for the assessment of important PRO of prosthetic treatment for edentulism, considering the results and time needed. Findings suggest the viability of replacing print forms with a tablet for applying the tested inventories in clinical trials.

• Restorative Dentistry and Endodontics
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• v.49 no.3
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• pp.26.1-26.14
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• 2024

Objectives: This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis. Materials and Methods: The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling. Results: The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction. Conclusions: CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.

• Restorative Dentistry and Endodontics
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• v.21 no.1
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• pp.403-424
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• 1996

Cell culture methods have been used to assess the cytotoxicity of dental materials. Different paramaters are used to monitor cytotoxic effects. But it is difficult to compare each investigator's results with different methods. The objective of this study was to investigate cytotoxic effect of several retrograde filling materials according to cell lines and assay methods. Cytotoxicity of Bestalloy (Dogmyung, Korea), Prisma APH(Densply International Inc., U.S.A.), Clearfil FII (Kuraray Co., Japan), Fuji II (GC Co., Japan), Fuji II LC (GC Co., Japan) and IRM (Densply Co., U.S.A.) on L929, 3T3 and KB permanent cell lines was measured. Radiochromium, Lactate dehydrogenase (LDH) release method and colorimetric assays, namely neutral red (NR) and MTT were used. Each material was mixed according to the manufacturer's instruction. They were tested as solid and extracted state. Cell culture media were added to each mixed or solid materials then the solution was collected and used as extract solutions. Solid Fuji II showed mild cytotoxicity on three cell lines using radiochromium release method. There was no difference in cytotoxicity of extract solution group using radiochromium release method. In colorimetric assay immediate Fuji II group and all the IRM groups showed severe cytotoxic effect. Difference in cyctotoxicity was due to rather kinds of cell lines than assay methods. Solid Fuji II and IRM showed mild cytotoxicity on three cell lines. But extract solutions had different cytotoxic effect according to cell lines using LDH release assay. Light-cured glass ionomer had mild to moderate degree of cytotoxicity on three cell lines. Cytotoxicity was affected by specimen prepaton. Susceptibility of each cell ines were also affected by assay emthods. It was suggested that cytotoxicity study using only one cell line and/or assay method might not accurately reflect the real toxic nature of dental biomaterials.

• Restorative Dentistry and Endodontics
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• v.36 no.5
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• pp.377-384
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• 2011

Objectives: The purpose of this study was to observe the change in the viscoelastic properties of thermoplasticized injectable root canal filling materials as a function of temperature and to compare the handling characteristics of these materials. Materials and Methods: Three commercial gutta perchas and Resilon (Pentron Clinical Technologies) in a pellet form were heated in the Obtura-II system (Obtura Spartan) at $140^{\circ}C$ and $200^{\circ}C$, and the extrusion temperature of the thermoplasticized materials was measured. The viscoelastic properties of the materials as a function of temperature were evaluated using a rheometer. The elastic modulus G', viscous modulus G", loss tangent tan${\delta}$, and complex viscosity ${\eta}^*$ were determined. The phase transition temperature was determined by both the rheometer and a differential scanning calorimeter (DSC). The consistency of the materials was compared under compacting pressure at $60^{\circ}C$ and $40^{\circ}C$ by a squeeze test. Results: The three gutta perchas had dissimilar profiles in viscoelastic properties with varying temperature. The phase transition of softened materials into solidification occurred at $40^{\circ}C$ to $50^{\circ}C$, and the onset temperatures obtained by a rheometer and a DSC were similar to each other. The onset temperature of phase transition and the consistency upon compaction pressure were different among the materials (p < 0.05). Resilon had a rheologically similar pattern to the gutta perchas, and was featured between high and low-flow gutta perchas. Conclusions: The rheological characteristics of the thermoplasticized root canal filling materials changed under a cooling process. The dissimilar viscoelastic properties among the materials require different handling characteristics during an injecting and compacting procedure.