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Objective: The aim of this study was to compare the incidence of root cracks after root canal instrumentation with thermomechanically processed nickel-titanium (Ni-Ti) files with different instrumentation kinematics., Materials and Methods: A total of 150 extracted mandibular premolars with mature apices and straight root canals were divided into five groups and used in this study. In Group 1, 30 teeth were prepared using hand K-files and assigned to control group, Group 2 was instrumented using K3XF Rotary files (SybronEndo, Glendora, CA, USA) with continuous rotary motion. The teeth in Group 3 were instrumented by ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) rotary files which make asymmetric rotary motion, In Group 4, teeth were instrumented by RECIPROC (VDW, Munich, Germany) with reciprocation motion and in Group 5, teeth were instrumented by Twisted File (TF) Adaptive (SybronEndo, Orange, CA, USA) files that use combination of continuous rotation and reciprocation motion ( n = 30/per group). All the roots were horizontally sectioned 3, 6, and 9 mm from the apex with a low speed saw under water cooling. Then, the slices were examined through a stereomicroscope to determine the presence of dentinal microcracks., Results: For the apical (3-mm) and coronal (9-mm) sections, the ProTaper Next and TF Adaptive produced significantly more cracks than the hand files, RECIPROC, and K3XF ( P < 0.05). There was no significant difference between the experimental groups and control group at the 6-mm level ( P > 0.05)., Conclusions: Within the limitations of this in vitro study, all thermal-treated Ni-Ti instruments and hand files caused microcracks in root canal dentin., Competing Interests: There are no conflicts of interest.

Objective: The aim of this study was to evaluate the efficiencies of different irrigation protocols and solutions in the removal of calcium hydroxide (Ca[OH]2)., Materials and Methods: Sixty-eight maxillary incisors were used. Root canals were prepared and filled with Ca(OH)2. Two control (n = 4) and six experimental groups (n = 10) were adjusted: Group 1:1% peracetic acid (PAA) + master apical file (MAF); Group 2: 17% ethylenediaminetetraacetic acid (EDTA) + MAF; Group 3: 9% 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) + MAF; Group 4: 1% PAA + ultrasonic activation (UA); Group 5: 17% EDTA + UA; Group 6: 9% HEBP + UA. The cleanliness of root canal thirds were evaluated with scanning electron microscopy. Statistical analysis were performed (α = 0.05)., Results: At coronal thirds; PAA + UA was superior to EDTA + MAF, HEBP + MAF; and PAA + MAF was superior to EDTA + MAF, HEBP + MAF (P < 0.05). At middle thirds; PAA + MAF and PAA + UA were superior to EDTA + MAF and EDTA + UA; and, PAA + UA was superior to HEBP + MAF (P < 0.05). There were no significant differences among the rest of the experimental groups (P > 0.05)., Conclusion: Complete removal of Ca(OH)2could not be achieved by none of the irrigants at all root thirds.

The aim of this study was to evaluate the effect of MTAD (a mixture of tetracycline isomer, an acid, and a detergent) and conventional irrigation agents on the apical leakage and push-out bond strength of root canal filling and to correlate the apical leakage and push-out bond strength. Root canals of 120 maxillary central incisors were prepared with a ProTaper file up to F3 and distributed to six groups. Saline, 1% NaOCl, 17% EDTA, 17% EDTA/1% NaOCl, and 2% chlorhexidine (CHX) solutions were used between each file change, and 5 mL of the same irrigating solution was used for the final flush. In the MTAD group, the root canals were irrigated with 1.3% NaOCl between each file and 5 mL of MTAD for the final flush. All the root canals were filled with AH Plus sealer and gutta-percha cones. Apical leakage was evaluated using a fluid transport system. After the apical leakage test, each tooth was prepared for the push-out assessment. The statistical analysis revealed that the irrigation solutions had no effect on the apical leakage of the root canal fillings (p = 0.258). The root fillings of the groups irrigated with MTAD showed significantly lower push-out bond strength values than the other groups (p < 0.001). These commonly used irrigating solutions did not affect the apical leakage of the root canal sealer. MTAD reduced the bond strength of the root canal sealer to the root canal dentin., (© Wiley Periodicals, Inc.)

Objective: The aim of the present study was to investigate the incidence of dentinal microcracks caused by different preparation techniques., Materials and Methods: 120 extracted human mandibular incisor teeth were divided into five experimental groups and one control group (n = 20): Group 1: Hand preparation with balanced force technique up to #25 K-file. Group 2: Preparation with only ProTaper F2 instrument in a reciprocating movement. Group 3: Preparation with Reciproc R25 instrument in a reciprocating movement. Group 4: Preparation with ProTaper instruments up to F2 instrument. Group 5: Preparation with ProTaper Next instruments up to X2 instrument. No procedure was applied to control group. The roots were sectioned horizontally at 3, 6 and 9 mm from the apex and examined. Absence or presence of dentinal microcracks was noted., Results: The Chi-square test was performed to compare the appearance of cracked roots between all groups. There were no significant differences among the groups (P > 0.05)., Conclusions: In conclusion, except the hand file and control group, all experimental groups showed microcrack formations.

Objective: The aim of this study was to determine how physical and morphological properties affect the fracture resistance of roots, and which criteria are important for root specimen standardization in fracture resistance studies., Materials and Methods: Seventy-five freshly extracted human canine teeth were selected. Crowns were sectioned from the cement-enamel junction and the root lengths were set at 16 mm. Then they were prepared up to ProTaper F3 file. Each root was numbered and data were obtained by measuring mesiodistal and buccolingual dimensions, volume, weight, and density. Tests for fracture strength were performed using an Instron Testing Machine (Instron Corp. MA, USA). The force was applied axially, angled at 45 degrees with a constant speed of 1 mm/min. For each sample, the force at the time of fracture was recorded in Newtons. Results were evaluated statistically using linear regression analysis., Results: Volume and weight of the roots had more effect than mesiodistal or buccolingual dimensions on root fracture resistance., Conclusions: In root fracture resistance studies, volume or weight of the roots must be standardized when distributing roots to groups.

Aim: This study aimed to compare the fracture resistance of roots filled with a bonded material, fiber posts, or titanium post systems., Methods: Canals in the first group were filled with AH Plus and gutta-percha cones, and roots in the second group were filled with Epiphany sealer and Resilon cones. The root fillings (60 roots) were removed up to 4 mm from the canal apex to obtain 10-mm-deep post spaces, and posts were cemented. The groups were as follows: AH Plus control group, Epiphany control group, AH Plus fiber post group, AH Plus titanium post group, Epiphany fiber post group, and Epiphany titanium post group. Fracture tests were performed by using an Instron testing machine. The force was applied at a 45° axial angle with a constant speed of 1 mm/min. For each sample, the force at which fracture occurred was recorded in units of newtons. Statistical analysis was carried out by using analysis of variance test., Results: There was no statistically significant difference between all groups (P > .05)., Conclusions: Titanium posts, fiber posts, and Epiphany root canal filling systems were found to have no reinforcing effect on endodontically treated roots., (Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to evaluate by means of radiographs the technical quality of root fillings performed by dental practitioners., Methods and Material: Standardized periapical radiographs were made on 484 patients who received endodontic treatment in private practice. A total of 831 endodontically treated teeth with 1448 roots were evaluated for technical quality of the root canal filling and the periapical status of the teeth. Also, the apical status of each root-filled tooth was assessed according to the length, density, and taper of root fillings, and the presence of apical transportation, broken root instruments, and overfilled sealer or gutta-percha material was recorded for each root canal., Results: Of the endodontically treated teeth 26.6% had healthy periapical tissues, while technically good endodontic treatment constituted 12.8%. Based on the treatment success, there was no significant difference between the tooth groups. Statistical analysis of the data did not demonstrate statistically significant differences between the various parameters that were evaluated (P < 0.05)., Conclusions: Technical quality of root fillings in a population who received treatment in private practice was poor and was consistent with a low prevalence of apical health. The probable reasons for this failure are multifactorial and may be improved if the operators improve their skills with continuing postgraduate education programs.

The aim of this study was to compare the effects of antioxidant treatment and delayed bonding, following intra-coronal bleaching, on the shear bond strength (SBS) and bond failure site of brackets bonded to enamel. Eighty mandibular incisors were divided into four equal groups. After root canal filling, specimens in Group 1 were used as control and not bleached. For experimental groups 2 to 4, bleaching agent was placed into the rest of the cavity for a four-day period and this bleaching treatment was performed two times. In Group 2, specimens were bonded immediately after bleaching; in Group 3, specimens were bleached and then immersed in artificial saliva for 30 days before bonding; in Group 4, specimens were bleached, treated with an antioxidant agent, and then bonded. The SBS values of bonded brackets were measured in megapascal (MPa), while adhesive remnant index (ARI) scores were determined after the brackets failed. The SBS values of Group 1 (mean: 20.3+/-7.1 MPa) and Group 4 (mean: 18.2+/-6.1 MPa) were significantly higher (p>0.001) than those of Group 2 (mean: 4.9+/-3.2 MPa) and Group 3 (mean: 8.7+/-4.9 MPa). No significant differences in SBS were found between Groups 1 and 4, and between Groups 2 and 3.

Introduction: Our objective was to determine the effects of intracoronal bleaching on the shear bond strength and failure side location of metallic brackets at 2 times (bleaching immediately before bonding and 30 days before bonding)., Methods: Sixty freshly extracted mandibular incisors were randomly divided into 3 groups; each group contained 20 teeth. After finishing canal preparation and root canal filling, the root fillings were removed to a level 2 mm apical to the cementoenamel junction. Glass ionomer base (Vitrabond, 3 M Dental Products, St Paul, Minn) was placed approximately 2-mm thick. Bleaching agent (Whiteness Perfect, FGM Dental Products, Joinville, Brazil) was placed into the rest of the cavity for 4 days at 2 times. Shear bond strength of these brackets was measured in megapascals. The adhesive remnant index (ARI) scores were determined after the brackets failed. Data were analyzed with analysis of variance (ANOVA), Tukey, and chi-square tests., Results: The bond strengths of the group with no bleaching (mean, 20.25 +/- 7.06 MPa) were significantly higher (P >0.001) than those of the group that had bleaching immediately before bonding (mean, 4.85 +/- 3.22 MPa) and the group that had bleaching 30 days before bonding (mean, 8.70 +/- 4.93 MPa). The results of the chi-square comparisons indicated significant differences among the 3 groups. In the group with no bleaching, there was a higher frequency of ARI scores of 2 to 4, indicating cohesive failures in the resin. In the other 2 groups, the failures were mostly adhesive at the resin-enamel interface (ARI scores of 4 and 5)., Conclusions: Intracoronal bleaching with carbamide peroxide adversely affected the shear bond strength and changed the site of failure during debonding when bonding was done immediately or 30 days after bleaching.

Aim: The aim of this study was to evaluate the antimicrobial efficiency of different root canal sealers on Enterococcus faecalis (E. Faecalis) at different time intervals., Methods and Materials: All sealers used were mixed according to the manufacturers' instructions then 75 mg of each sealer was added to different sterile tubes and evaluated at 20 minutes, 24 hours, 7 days, and 30 days. A time-kill assay (TKA) was used to determine the antimicrobial efficiency of the sealers., Results: AH Plus and MCS were found to be bactericidal at 20 minutes and 24 hours, but only MCS was bactericidal at the seventh and thirtieth days. Epiphany and Sealapex were found to be bacteriostatic at the seventh and thirtieth days but indifferent at 20 minutes and 24-hours. MCS and AH Plus were both found to be bactericidal in freshly mixed samples, but only MCS was bactericidal at longer time periods. Epiphany Sealer and Sealapex were found to be bacteriostatic at longer time periods but indifferent at 20 minutes and 24 hours., Conclusion: The antibacterial effect of MCS was greater than the other sealers evaluated., Clinical Significance: Sealers containing eugenol and epoxy resin might be preferable due to their antibacterial effect.