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"nBackground and Aim: One of the unique properties of MTA is its setting ability in presence of moisture. The sealing ability of MTA used as a root-end filling was shown to be unaffected by the presence of blood, in vitro. It has been recommended that, because of MTA ability to set in the presence of blood, there is no need to dry the perforation site before MTA placement. On the other hand, based on an in vitro study, it is recommended that hemorrhage be controlled at the perforation site and blood be removed from the perforation walls before placement of tooth-colored MTA. Blood contamination may also affect the crystalline structure of MTA. The microhardness of a material is influenced substantially by some fundamental properties of the material such as crystal structure stability. Thus, it can be used as an indicator of the setting process. It can also indicate the effect of various setting conditions on the overall strength of a material. The aim of this study was to evaluate the effect of blood contamination on microhardness of white and gray MTA as an indicator of their setting process. "nMaterials and Methods: In groups 1 and 2 each material has been mixed with distilled water according to manufacturer,s instruction (No contamination groups). In groups 3 and 4 samples were prepared like groups 1 and 2 but the surface of material placed in contact with blood (Surface blood contamination groups). Samples of groups 5 and 6 were mixed with blood instead of distilled water and also the surfaces of the materials were placed in contact with blood (Mixed with blood groups). All samples were stored in 370C and 100% humidity for 96 hours. The microhardness of the samples was measured with Vickers test. "nResults: White MTA samples which have not contaminated with blood had the highest microharness (59.9±11.4 N/mm2) while gray MTA mixed with blood had the lowest hardness (18.45±7.8 N/mm2). One-way ANOVA test showed that contamination with blood significantly reduces the microhardness of both white and gray MTA (p

Statement of Problem: Radiography is the most common technique in working length determination, however, because of its limitations is not considered as an ideal technique. Its application, particularly for children due to radiation hazards, technical problems in young and unco-operative children and the superimposition of permanent teeth bud on primary teeth root, lead to numerous problems."nPurpose: The goal of this study was to evaluate the accuracy of an electronic apex locator (EAL) in working length determination of primary teeth."nMaterials and Methods: In this in-vitro study 96 canals of the extracted primary teeth, with at least 2/3 of the root length remained, were investigated. There were no obstructed canal, previous root canal therapy and perforation of pulp chamber floor. All working lengths were also measured by radiography. The results of Raypex 4 and radiography were compared with actual root canal lengths determined by direct observation. The applied EAL, in this study was called Raypex 4, a new device belonged to the fourth generation (Ratio Type). The results were analyzed by Chi-Square and Pearson correlation statistical tests."nResults: The accuracy of Raypex and radiography were 61.5% and 63.5%, respectively. The differences between Reypex 4 root canal length measurements and those of direct observation were not significant (P=0.08), but such difference between radiography and direct observation was statistically significant (P=0.01). The diameter of the apical foramen (the site of canal opening) did not affect on Raypex 4 accuray (P>0.05)."nConclusion: Considering the acceptable safetyness, Painlessness, simple and rapid application and an accuracy comparable to that of radiography, the use of Raypex4 EAL for the measurement of primary teeth length is suggested.

Background: Human dental pulp-derived mesenchymal stem cells (hDP-MSCs), which include human dental pulp stem cells (hDPSCs) and stem cells from human exfoliated deciduous teeth (SHEDs), are promising cell sources for regenerative therapies. Nevertheless, a lack of knowledge relating to the mechanisms regulating their differentiation has limited their clinical application. microRNAs (miRNAs) are important regulatory molecules in cellular processes including cell differentiation. This systematic review aims to provide a panel of miRNAs that regulate the differentiation of hDP-MSCs including hDPSCs and SHEDs. Additionally, bioinformatic analyses were conducted to discover target genes, signaling pathways and gene ontologies associated with the identified miRNAs., Methods: A literature search was performed in MEDLINE (via PubMed), Web of Science, Scopus, Embase and Cochrane Library. Experimental studies assessing the promotive/suppressive effect of miRNAs on the differentiation of hDP-MSCs and studies evaluating changes to the expression of miRNAs during the differentiation of hDP-MSCs were included. miRNAs involved in odontogenic/osteogenic differentiation were then included in a bioinformatic analysis. A miRNA-mRNA network was constructed, and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. A protein-protein interaction (PPI) network was also constructed., Results: Of 766 initially identified records through database searching, 42 and 36 studies were included in qualitative synthesis and bioinformatic analyses, respectively. Thirteen miRNAs promoted and 17 suppressed odontogenic/osteogenic differentiation of hDP-MSCs. hsa-miR-140-5p, hsa-miR-218 and hsa-miR-143 were more frequently reported suppressing the odontogenic/osteogenic differentiation of hDP-MSCs. hsa-miR-221 and hsa-miR-124 promoted and hsa-miR-140-5p inhibited neuronal differentiation, hsa-miR-26a-5p promoted and hsa-miR-424 suppressed angiogenic differentiation, and hsa-miR-135 and hsa-miR-143 inhibited differentiation within myogenic lineages. A miRNA-mRNA network including 1890 nodes and 2171 edges was constructed. KEGG pathway analysis revealed MAPK, PI3K-Akt and FoxO as key signaling pathways involved in the odontogenic/osteogenic differentiation of hDP-MSCs., Conclusions: The findings of this systematic review support the potential application of the specific miRNAs to regulate the directed differentiation of hDP-MSCs in the field of regenerative therapies., (© 2023. The Author(s).)

Introduction: Human endometrial mesenchymal stem cells (hEnMSCs) are a rich source of mesenchymal stem cells (MSCs) with multi-lineage differentiation potential, making them an intriguing tool in regenerative medicine, particularly for the treatment of reproductive and infertility issues. The specific process of germline cell-derived stem cell differentiation remains unknown, the aim is to study novel ways to achieve an effective differentiation method that produces adequate and functioning human gamete cells., Methods: We adjusted the optimum retinoic acid (RA) concentration for enhancement of germ cell-derived hEnSCs generation in 2D cell culture after 7 days in this study. Subsequently, we developed a suitable oocyte-like cell induction media including RA and bone morphogenetic protein 4 (BMP4), and studied their effects on oocyte-like cell differentiation in 2D and 3D cell culture media utilizing cells encapsulated in alginate hydrogel., Results: Our results from microscopy analysis, real-time PCR, and immunofluorescence tests revealed that 10 µM RA concentration was the optimal dose for inducing germ-like cells after 7 days. We examined the alginate hydrogel structural characteristics and integrity by rheology analysis and SEM microscope. We also demonstrated encapsulated cell viability and adhesion in the manufactured hydrogel. We propose that in 3D cell cultures in alginate hydrogel, an induction medium containing 10 µM RA and 50 ng/mL BMP4 can enhance hEnSC differentiation into oocyte-like cells., Conclusion: The production of oocyte-like cells using 3D alginate hydrogel may be viable in vitro approach for replacing gonad tissues and cells., Competing Interests: The authors declare no conflict of interest., (© 2023 The Author(s).)

Objective: The study aimed to compare the response of human dental pulp stem cells (hDPSCs) towards three hydraulic calcium silicate cements (HCSCs) by measuring cytotoxicity and expression of dentinogenic genes., Methodology: Dental pulps of five impacted mandibular third molars were extirpated as a source for hDPSCs. Next to culturing, hDPSCs were subjected to fluorescence-activated cell sorting after the third passage to validate stemness of the cells. Human DPSCs were exposed to diluted supernatants of OrthoMTA (OMTA), Biodentine (BD) and Calcium-Enriched Mixture (CEM) at concentrations 10, 25, 50 and 100% at the first, third and fifth day of culture. Then, cells were exposed to 10% concentrations supernatant of HCSCs to determine DSPP and DMP1 gene expression, using a quantitative polymerase-chain reaction. Data were analyzed using one-way and three-way ANOVA, followed by Tukey post hoc statistical tests., Results: Optimal cell proliferation was observed in all groups, regardless of concentration and time-point. HCSC supernatants were non-cytotoxic to hDPSCs at all three time-points, except for 100% Biodentine on day five. On day seven, OMTA group significantly upregulated the expression of DSPP and DMP1 genes. On day 14, expression of DMP1 and DSPP genes were significantly higher in BD and OMTA groups, respectively., Conclusion: Biodentine significantly upregulated DMP1 gene expression over 14 days, whereas CEM was associated with only minimal expression of DSPP and DMP1 .

Background: Conflicting findings on the potency of antibiotic pastes versus calcium hydroxide (CH) have been evident in the literature., Aims: To compare the antibacterial efficacy of single antibiotic paste (SAP), double antibiotic paste (DAP), triple antibiotic paste (TAP), and modified TAP (mTAP) with CH on bacterial biofilms., Methods: PubMed, Scopus, and Embase were comprehensively searched until August 23, 2021. The study protocol was registered in the PROSPERO. Ex vivo studies performed on Enterococcus faecalis or polymicrobial biofilms incubated on human/bovine dentin were selected. The quality of the studies was assessed using a customized quality assessment tool. Standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated for the meta-analysis. Meta-regression models were used to identify the sources of heterogeneity and to compare the efficacy of pastes., Results: The qualitative and quantitative synthesis included 40 and 23 papers, respectively, out of 1421 search results. TAP (SMD = -3.82; CI, -5.44 to -2.21; P < 0.001) and SAPs (SMD = -2.38; CI, -2.81 to - 1.94; P < 0.001) had significantly higher antibacterial efficacy compared to the CH on E. faecalis biofilm. However, no significant difference was found between the efficacy of DAP (SMD = -2.74; CI, -5.56-0.07; P = 0.06) or mTAP (SMD = -0.28; CI, -0.82-0.26; P = 0.31) and CH. Meta-regression model on E. faecalis showed that SAPs have similar efficacy compared to TAP and significantly better efficacy than DAP. On dual-species (SMD = 0.15; CI, -1.00-1.29; P = 0.80) or multi-species (SMD = 0.23; CI, -0.08-0.55; P = 0.15) biofilms, DAP and CH had similar efficacy., Conclusions: Ex vivo evidence showed that antibiotic pastes were either superior or equal to CH. The studied SAPs had considerably higher or similar antibacterial effectiveness compared to DAP, CH, and TAP. Hence, combined antibiotic therapy was not necessarily required for root canal disinfection ex vivo ., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Background: One problem encountered in vital pulp therapy is the dislodgment of biomaterial as the result of the application of mechanical condensation forces for the final restoration of the cavity or occlusal loads., Material and Methods: In this in vitro , experimental study, 90 dentin discs were prepared with Gates Glidden drills to have a 1.3 mm canal diameter. The specimens were divided into nine groups (n=10). ProRoot MTA, Biodentine, and TheraCal were applied in groups 1-3, 4-6, and 7-9, respectively. The PBS was measured after 15 minutes, four hours, and three days and mode of failure was determined., Results: The interaction effect of time and material on PBS was statistically significant ( P <0.003). The PBS of Biodentine and ProRoot MTA significantly increased over time ( P =0.000). At 15 minutes and four hours, the PBS of TheraCal was higher than that of Biodentine and ProRoot MTA ( P =0.000). Our results showed the predominant type of bond failures in Biodentine and Theracal groups was cohesive, whereas it was adhesive for ProRootMTA., Conclusions: Theracal showed higher values of bond strength than Biodentine and ProRootMTA at 15 minutes & four hours and may thus be better options for single session of VPT. Key words: Biodentine, Mineral Trioxide Aggregate, Pushout Bond Strength, TheraCal., Competing Interests: Conflicts of interest No potential conflict of interest relevant to this article was reported., (Copyright: © 2021 Medicina Oral S.L.)

Objective: The aim of present study was to isolate and differentiate human adipose-derived stem cells (ASCs) into odontoblast-like cells., Materials and Methods: In this experimental study, human adipose tissues were taken from the buccal fat pad of three individuals (mean age: 24.6 ± 2.1 years). The tissues were transferred to a laboratory in a sterile culture medium, divided into small pieces and digested by collagenase I (2 mg/mL, 60-90 minutes). ASCs were isolated by passing the cell suspension through cell strainers (70 and 40 μm), followed by incubation at 37ºC and 5% CO 2 in Dulbecco's modified eagle medium (DMEM) supplemented with fetal bovine serum (FBS 5%) and penicillin/streptomycin (P/S). After three passages, the ASCs were harvested. Subsequently, flow cytometry and reverse transcriptase polymerase chain reaction (RT-PCR) were used to detect expression levels of NANOG and OCT4 to evaluate stemness. Then, a differentiation medium that included high-glucose DMEM supplemented with 10% FBS, dexamethasone (10 nM), sodium β-glycerophosphate (5 mM) and ascorbic acid (100 μM) was added. The cells were cultivated for four weeks, and the odontogenic medium was changed every two days. Cell differentiation was evaluated with Alizarin red staining and expressions of collagen I (COL1A1), dentin sialophosphoprotein (DSPP) and dentin matrix protein-1 (DMP1)., Results: The ASCs were effectively and easily isolated. They were negative for CD45 and positive for the CD105 and CD73 markers. The ASCs expressed OCT4 and NANOG. Differentiated cells highly expressed DSPP, COL1A1 and DMP1. Alizarin red staining revealed a positive reaction for calcium deposition., Conclusion: ASCs were isolated successfully in high numbers from the buccal fat pad of human volunteers and were differentiated into odontoblast-like cells. These ASCs could be considered a new source of cells for use in regenerative endodontic treatments., Competing Interests: There is no conflict of interest in this study., (Copyright© by Royan Institute. All rights reserved.)

Objective: The aim of this study was to compare the fracture resistance of immature bovine roots when using ProRoot MTA, CEM Cement, and Biodentine as root filling materials., Materials and Methods: An immature bovine tooth model was developed by removing the coronal and apical portions of 70 bovine incisors 8 mm above and 12 mm below the cementoenamel junction (CEJ). The specimens were then divided into five groups: ProRoot MTA, CEM Cement, Biodentine, gutta-percha/AH26 sealer, and control. All groups received a 5-mm apical plug with a temporary restorative material. Then, the remaining root canal space was filled with one of the afore-mentioned materials. After setting, the specimens were mounted in acrylic resin. Then, 3 mm coronal to the CEJ from the buccal side of the teeth and at a 135°angle to the long axis, the specimens were loaded until fracture., Results: The specimens in the Biodentine (2196 N) and ProRoot MTA (2103 N) groups had significantly greater fracture resistance in comparison to the control group ( p = 0.01). No significant difference was found between CEM Cement, gutta-percha and sealer AH26, and control groups. No significant differences occurred between the four experimental groups ( p = 0.45)., Conclusion: Filling the root canal space with ProRoot MTA and Biodentine contributed to higher fracture resistance values., Competing Interests: None declared., (Dental Investigation Society.)

Infection of the dental pulp will result in inflammation and eventually tissue necrosis which is treated conventionally by pulpectomy and root canal treatment. Advances in regenerative medicine and tissue engineering along with the introduction of new sources of stem cells have led to the possibility of pulp tissue regeneration. This systematic review analyzes animal studies published since 2010 to determine the ability of stem cell therapy to regenerate the dentine-pulp complex (DPC) and the success of clinical protocols. In vitro and human clinical studies are excluded and only the experimental studies on animal models were included. Dental pulp stem cells constitute the most commonly used cell type. The majority of stem cells are incorporated into various types of scaffold and implanted into root canals. Some of the studies combine growth factors with stem cells in an attempt to improve the outcome. Studies of ectopic transplantation using small animal models are simple and non-systematic evaluation techniques. Stem cell concentrations have not been so far reported; therefore, the translational value of such animal studies remains questionable. Though all types of stem cells appear capable of regenerating a dentine-pulp complex, still several factors have been considered in selecting the cell type. Co-administrative factors are essential for inducing the systemic migration of stem cells, and their vascularization and differentiation into odontoblast-like cells. Scaffolds provide a biodegradable structure able to control the release of growth factors. To identify problems and reduce costs, novel strategies should be initially tested in subcutaneous or renal capsule implantation followed by root canal models to confirm results.

Introduction: The type of materials and application time of veneering restorations on calcium silicate cements are important factors which influence the interfacial properties. The aim of this study was to measure the micro-shear bond strength of a resin composite (RC) using several adhesive systems and a resin-modified glass ionomer cement (RM-GIC) to different aged Biodentine specimens., Methods and Materials: A total of 15 Biodentine blocks were prepared and assigned to three aging periods: 12 min, one week and one month. Then they were subdivided into five sub-groups to receive cylinders of resinous materials. RC was applied using different adhesive systems: A) no adhesive B) etch and rinse C) two-step self-etch and D) universal adhesive in self-etch mode and E) RM-GIC applied directly over Biodentine. Micro-shear bond strength was measured and the data were analyzed using one-way and two-way ANOVA. The level of significance was set at 0.05., Result: There was significant interaction between Biodentine aging periods and resinous materials ( P< 0.05). The highest value was obtained in group D bonded to the recently set Biodentine. Increasing the aging period to one week resulted in increased micro-shear bond strength in all groups expect for group D. One-month incubation time led to reduced shear bond strength in group A, C and D. Micro-shear bond strength values of group E increased to the longer aged Biodentine., Conclusion: Group D showed the highest bond strength to freshly mixed Biodentine., Competing Interests: ‘None declared’.

Objectives: This study aimed to compare the surface microhardness of mineral trioxide aggregate (MTA) samples having different thicknesses and exposed to human blood from one side and with or without a moist cotton pellet on the other side., Materials and Methods: Ninety cylindrical molds with three heights of 2, 4, and 6 mm were fabricated. In group 1 (dry condition), molds with heights of 2, 4, and 6 mm (10 molds of each) were filled with ProRoot MTA (Dentsply Tulsa Dental), and the upper surface of the material was not exposed to any additional moisture. In groups 2 and 3, a distilled water- or phosphate-buffered saline (PBS)-moistened cotton pellet was placed on the upper side of MTA, respectively. The lower side of the molds in all the groups was in contact with human blood-wetted foams. After 4 day, the Vickers microhardness of the upper surface of MTA was measured., Results: In the dry condition, the 4 and 6 mm-thick MTA samples showed significantly lower microhardness than the 2 mm-thick samples (p = 0.003 and p = 0.001, respectively). However, when a distilled water- or PBS-moistened cotton pellet was placed over the MTA, no significant difference was found between the surface microhardness of samples having the abovementioned three thicknesses of the material (p = 0.210 and p = 0.112, respectively)., Conclusions: It could be concluded that a moist cotton pellet must be placed over the 4 to 6 mm-thick MTA for better hydration of the material. However, this might not be necessary when 2 mm-thick MTA is used.

Objectives: This study was performed to evaluate the cytotoxicity of four calcium silicate-based endodontic cements at different storage times after mixing., Materials and Methods: Capillary tubes were filled with Biodentine (Septodont), Calcium Enriched Mixture (CEM cement, BioniqueDent), Tech Biosealer Endo (Tech Biosealer) and ProRoot MTA (Dentsply Tulsa Dental). Empty tubes and tubes containing Dycal were used as negative and positive control groups respectively. Filled capillary tubes were kept in 0.2 mL microtubes and incubated at 37℃. Each material was divided into 3 groups for testing at intervals of 24 hr, 7 day and 28 day after mixing. Human monocytes were isolated from peripheral blood mononuclear cells and cocultered with 24 hr, 7 day and 28 day samples of different materials for 24 and 48 hr. Cell viability was evaluated using an MTT assay., Results: In all groups, the viability of monocytes significantly improved with increasing storage time regardless of the incubation time (p < 0.001). After 24 hr of incubation, there was no significant difference between the materials regarding monocyte viability. However, at 48 hr of incubation, ProRoot MTA and Biodentine were less cytotoxic than CEM cement and Biosealer (p < 0.01)., Conclusions: Biodentine and ProRoot MTA had similar biocompatibility. Mixing ProRoot MTA with PBS in place of distilled water had no effect on its biocompatibility. Biosealer and CEM cement after 48 hr of incubation were significantly more cytotoxic to on monocyte cells compared to ProRoot MTA and Biodentine.

Introduction: This study aimed to compare the marginal adaptation of new bioceramic materials, EndoSequence Root Repair Material (ERRM putty and ERRM paste), to that of mineral trioxide aggregate (MTA) as root-end filling materials., Materials and Methods: Thirty-six extracted human single-rooted teeth were prepared and obturated with gutta-percha and AH-26 sealer. The roots were resected 3 mm from the apex. Root-end cavities were then prepared with an ultrasonic retrotip. The specimens were divided into three groups (n=12) and filled with MTA, ERRM putty or ERRM paste. Epoxy resin replicas from the resected root-end surfaces and longitudinally sectioned roots were fabricated. The gaps at the material/dentin interface were measured using scanning electron microscope (SEM). Transversal, longitudinal, and overall gap sizes were measured for each specimen. The data were analyzed using the Kruskal-Wallis test., Results: In transversal sections, no significant difference was found between MTA, ERRM putty and ERRM paste (P=0.31). However, in longitudinal sections, larger gaps were evident between ERRM paste and dentinal walls compared to MTA and ERRM putty (P=0.002 and P=0.033, respectively). Considering the overall gap size values, the difference between three tested materials was not statistically significant (P=0.17)., Conclusion: Within the limits of this study, the marginal adaptation of ERRM paste and putty was comparable to that of MTA. However, ERRM putty might be more suitable for filling the root-end cavities because of its superior adaptation compared to ERRM paste in longitudinal sections.

Objective: The aim of this study was to compare the effect of an acidic environment on dislocation resistance (push-out bond strength) of EndoSequence Root Repair Material (ERRM putty and ERRM paste), a new bioceramic-based material, to that of mineral tri-oxide aggregate (MTA)., Materials and Methods: One-hundred twenty root dentin slices with standardized canal spaces were divided into 6 groups (n = 20 each) and filled with tooth-colored ProRoot MTA (groups 1 and 2), ERRM putty (groups 3 and 4), or ERRM paste (groups 5 and 6). The specimens of groups 1, 3, and 5 were exposed to phosphate buffered saline (PBS) solution (pH=7.4) and those of groups 2, 4, and 6 were exposed to butyric acid (pH= 4.4). The specimens were then incubated for 4 days at 37°C. The push-out bond strength was then measured using a universal testing machine. Failure modes after the push-out test were examined under a light microscope at ×40 magnification. The data for dislocation resistance were analyzed using the t-test and one-way analysis of variance., Results: In PBS environment (pH=7.4), there were no significant differences among materials (P=0.30); but the mean push-out bond strength of ERRM putty was significantly higher than that of other materials in an acidic environment (P<0.001). Push-out bond strength of MTA and ERRM paste decreased after exposure to an acidic environment; whereas ERRM putty was not affected by acidic pH. The bond failure mode was predominantly cohesive for all groups except for MTA in an acidic environment; which showed mixed bond failure in most of the specimens., Conclusion: The force needed for dislocation of MTA and ERRM paste was significantly lower in samples stored in acidic pH; however, push-out bond strength of ERRM putty was not influenced by acidity.

Objective: This study compared the push-out bond strength of EndoSequence Root Repair Material (ERRM) and Bioaggregate (BA), new bioceramic materials, to that of mineral trioxide aggregate (MTA) after incubation in phosphate-buffered saline (PBS), a synthetic tissue fluid, for either 1 week or 2 months., Materials and Methods: One-hundred and twenty root sections were filled with ProRoot MTA, BA, or ERRM. Each tested material was then randomly divided into two subgroups (n = 20): root sections were immersed in PBS for 1 week or 2 months. The bond strengths were measured using a universal testing machine. After that, the failure modes were examined with stereomicroscopy and scanning electron microscopy (SEM). The push-out data and failure mode categories were analyzed by two-way ANOVA and chi-square tests, respectively., Results: The bond strength of ERRM was significantly higher than that of BA and MTA at both incubation periods. No significant difference was found between the bond strength of MTA and BA at either 1 week or 2 months. Increasing the incubation time to 2 months resulted in a significant increase in bond strength of all the materials. The failure mode was mainly mixed for MTA and BA, but cohesive for ERRM at both incubation periods., Conclusion: ERRM had significantly higher bond strength to root canal walls compared to MTA and BA. Increasing the incubation time significantly improved the bond strength and bioactive reaction products of all materials.

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time., Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with CaCl2 (RMTA-C); Group 3, RMTA modified with Na2HPO4 (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr., Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3 hr, the CS of specimens in the RMTA groups (with and without blood contamination) was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups, the CS of specimens significantly increased over time (p < 0.05)., Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.

Background: Root surface debridement (RSD) is necessary to create an environment suitable for reattachment of the periodontium. Root surface conditioning may aid the formation of a biocompatible surface suitable for cell reattachment. BioPure™ MTAD (mixture of Doxycycline, citric acid and a detergent) is an endodontic irrigant with antibacterial properties and the ability to remove smear layer. It was hypothesized that MTAD may be useful for root surface conditioning. The efficacy of MTAD as a conditioner was measured by examining fibroblast attachment to root surfaces., Materials and Methods: Thirty-two specimens of human teeth with advanced periodontal disease were used. The surfaces were root planed until smooth. Half of the specimens were treated with 0.9% saline and the other samples with Biopure MTAD. As a negative control group, five further samples were left unscaled with surface calculus. Human gingival fibroblast cells HGF1-PI1 were cultured and poured over the tooth specimens and incubated. After fixation, the samples were sputter-coated with gold and examined with a SEM. The morphology and number of attached, fixed viable cells were examined. The data was analysed using the Mann-Whitney-U statistical test., Results: There was no significant difference between the numbers of attached cells in the experimental group treated with MTAD and the control group treated with saline. Little or no attached cells were seen in the negative control group., Conclusion: RSD created an environment suitable for cell growth and attachment in a laboratory setting. The use of MTAD did not promote the attachment and growth of cells on the surface of human roots following RSD.

Objective: Biopure® MTAD (Dentsply Tulsa Dental, USA) has been developed as a final irrigant following root canal shaping to remove intracanal smear layer. Many of the unique properties of MTAD potentially transfer to the conditioning process of tooth roots during periodontal therapy. The aim of this ex vivo study was to evaluate the effect of MTAD on the removal of smear layer from root surfaces., Materials and Methods: Thirty two longitudinally sectioned specimens from 16 freshly extracted teeth diagnosed with advanced periodontal disease were divided into four groups. In group 1 and 2, the root surfaces were scaled using Gracey curettes. In group 3 and 4, 0.5 mm of the root surface was removed using a fissure bur. The specimens in group 1 and 3 were then irrigated by normal saline. The specimens in groups 2 and 4 were irrigated with Biopure MTAD. All specimens were prepared for SEM and scored according to the presence of smear layer., Results: MTAD significantly increased (P=0.001) the smear layer removal in both groups 2 and 4 compared to the associated control groups, in which only saline was used., Conclusion: MTAD increased the removal of the smear layer from periodontally affected root surfaces. Use of MTAD as a periodontal conditioner may be suggested.

The purpose of this study was to compare the precision of one of the new generation of root canal measuring devices, Neosono Ultima EZ, while using files manufactured of different alloys. Fifty-four root canals of extracted teeth were chosen. They were placed in special tubes with roots immersed in 2 percent agar with phosphate buffered saline. The device was used to locate the apex of each canal in wet conditions at the zero digital reading, first using a stainless steel file and then using a nickel-titanium file. These values were compared to the actual lengths obtained by measuring the distance of the coronal reference point to the apical opening with a size 10 file minus 0.5 mm. The accuracy of the device was 94 percent with nickel-titanium files and 91 percent with stainless steel. No significant difference was noted between the results for either file. The accuracy of the Neosono Ultima EZ in wet conditions exceeded 90 percent regardless of the alloy used.