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Aim: To evaluate the effectiveness of various chelates used alone or in combination with sodium hypochlorite (NaOCl) in the removal of calcium hydroxide (Ca(OH)2 ) from root canals. Materials and Methods: The root canals of 72 mandibular incisors were prepared up to the ProTaper F2 file. Among these, six randomly selected teeth were used as negative and positive controls, while the root canals of the remaining 66 were filled with Ca(OH)2 paste for 1 week. Then, the experimental group specimens were divided into six groups (n = 11). The access cavities were reopened and the Ca(OH)2 paste in each group was removed using the following solutions: 2.5 mL ethylenediaminetetraacetic acid (EDTA; Group 1), 2.5 mL peracetic acid (PAA; Group 2), 2.5 mL QMix (Group 3), 2.5 mL NaOCl/2.5 mL EDTA (Group 4), 2.5 mL NaOCl/2.5 mL PAA (Group 5), and 2.5 mL NaOCl/2.5 mL QMix (Group 6). Digital photographs of longitudinally split specimens were imported into image analyzer software, and the amount of residual Ca (OH) 2 was recorded as a percentage of the overall canal surface area. The results were analyzed using Kruskal–Wallis and Conover–Dunn tests. Results: The canal walls in the positive control group were completely covered with Ca(OH) 2 compared with those in the negative control group. The lowest Ca(OH)2 removal efficiency was observed for Group 4 (P < 0.001), while Group 6 showed favorable results (P < 0.05). Conclusions: QMix combined with NaOCl can remove Ca(OH)2 from root canals as effectively as 17% EDTA and 1% PAA. The type and sequence of irrigants are more important than the total irrigant volume for effective Ca(OH) 2 removal.

Background: Bond strength of root canal sealers is mainly influenced by the surface tension of the root canal wall. Heat, or the use of a surfactant might reduce surface tension and it is known that surface tension of an EDTA solution significantly affected from temperature rise. QMix is a novel endodontic irrigant for smear layer removal containing EDTA, chlorhexidine and a detergent. There is no data regarding the influence of the temperature of the EDTA and QMix on the push-out bond strength of root canal sealers. Aim: To evaluate effect of temperatures of QMix and EDTA on the bond-strength of AH Plus. Materials and Methods: Sixty premolars were prepared with ProTaper F4. During preparation 3% NaOCl was performed. Specimens were divided into 4 groups as follows: 5-mL 17% EDTA at 22°C and 37°C; 5-mL QMix at 22°C and 37°C. Three specimens from each group were prepared for observation using SEM. Remaining roots were obturated and prepared for a push-out test. Data was analysed using Anova and Bonferroni tests (p

Background. Regenerative endodontic treatment (RET) is a clinically advanced procedure for necrotic immature teeth. However, root canal walls of these teeth are brittle especially in the cervical region and need reinforcement. This in vitro study is conducted to evaluate the effect of intra-orifice barrier materials on the fracture resistance of immature teeth treated with regenerative procedure. Methods. Forty-eight maxillary central incisors were used. Twelve intact teeth were selected for the control group. Remained teeth were prepared using peeso drills to simulate immature teeth and assigned into three groups according to the intra-orifice barrier material placed over MTA (n=12); Composite resin (CR), ProRoot MTA and Resin-modified glass ionomer cement (RMGIC). Fracture strength test was applied using a universal testing machine. One-way ANOVA and Tukey post hoc tests were used at P=0.05. Results. A significant difference was obtained among groups (P0.05). Conclusion. Intra-orifice restorative materials have reinforcement affect in immature teeth treated with regenerative endodontic procedure. RMGIC or CR can be regarded as a viable choice to reduce the occurrence of cervical root fracture of immature teeth treated with a regenerative therapy.

Introduction: Biomechanical shaping and hermetic obturation play an important role in the success of root canal treatment. Aims and Objectives: This study aimed to examine the bonding strength of the bioceramics sealer to the dentin surface with or without core when irrigated with conventional NaOCl, modified NaOCl, EDTA, MTAD and distilled water. Materials and Methods: 120 single-root teeth dissected at the level of enamel-cement junction were grouped according to different irrigation and filling techniques; each group consisted 12 teeth. After final irrigation with NaOCl, modified NaOCl, EDTA, MTAD or distilled water, the samples were filled with bioceramic sealer. Samples with or without core were obtained; then 2 mm-thickness horizontal sections were made in the middle coronal and the middle third of the dentin and subjected to a push-out test. Results: Although bonding strength was the lowest when modified NaOCl was used, the highest bonding strength was reported with NaOCl in the present study. Bond strength values determined in the coronal third were found to be high compared to the middle third, although the difference was not statistically significant. In the groups without core, the resistance of the connection was found to be higher than in the core with a filled root canal (P < 0.05). Conclusion: Because the connection value of the bioceramic root canal sealer to the dentin using modified NaOCl was lower,it is recommended not to use the monoblock effect in canal filling in cases anticipated to be problematic. It would be more appropriate to use bioceramic paste without core in cases where a high attachment to dentin is desired

PurposeThe reinforcement effect of 3 various root canal sealers (AH 26, MTA Plus sealer andBioRoot RCS) and gutta-percha at different time periods (1 week and 1 month) wereevaluated in the present study.Materials and MethodsSingle-rooted, single-canalled, cracks-free 80 mandibular premolars weredecoronated to a length of 13mm. Group PC (positive control, n=10): samples wereleft unprepared and unfilled. Seventy samples were prepared by using the ProTaperRotary System up to F4. Group NC (negative control, n=10): samples were leftunfilled. Remaining 60 samples were assigned into 3 groups; Group 1: AH 26 + F4gutta-percha (GP); Group 2: MTA Plus sealer + F4 GP and Group 3: BioRoot RCS + F4GP. Filled samples were divided into subgroups according to storage time: Samplesin Groups 1A, 2A, and 3A were stored for 1 week; while Groups 1B, 2B and 3B werestored for 1 month at 100% humidity to allow the complete setting of the sealers(n=10, for each). A universal testing machine at a crosshead speed of 1.0 mm/minwas used for fracture testing. For each specimen, the force at the time of fracturewas recorded and the data were analyzed statistically.ResultsThe highest fracture resistance values were obtained in Group PC, while the lowestvalues were obtained in Group NC. Groups PC and NC were statistically differentfrom each other and from other groups, regardless of time (p

Purpose The reinforcement effect of 3 various root canal sealers (AH 26, MTA Plus sealer and BioRoot RCS) and gutta-percha at different time periods (1 week and 1 month) were evaluated in the present study. Materials and Methods Single-rooted, single-canalled, cracks-free 80 mandibular premolars were decoronated to a length of 13mm. Group PC (positive control, n=10): samples were left unprepared and unfilled. Seventy samples were prepared by using the ProTaper Rotary System up to F4. Group NC (negative control, n=10): samples were left unfilled. Remaining 60 samples were assigned into 3 groups; Group 1: AH 26 + F4 gutta-percha (GP); Group 2: MTA Plus sealer + F4 GP and Group 3: BioRoot RCS + F4 GP. Filled samples were divided into subgroups according to storage time: Samples in Groups 1A, 2A, and 3A were stored for 1 week; while Groups 1B, 2B and 3B were stored for 1 month at 100% humidity to allow the complete setting of the sealers (n=10, for each). A universal testing machine at a crosshead speed of 1.0 mm/min was used for fracture testing. For each specimen, the force at the time of fracture was recorded and the data were analyzed statistically. Results The highest fracture resistance values were obtained in Group PC, while the lowest values were obtained in Group NC. Groups PC and NC were statistically different from each other and from other groups, regardless of time (p

Background.This study compared the effect of smear layer on the penetration depth and push-out bond strength of various root canal sealers. Methods.A total of 90 extracted human mandibular premolars were assigned into 2 groups: smear layer preserved and smear layer removed. Then the roots were further divided into 3 subgroups according to the sealer tested: AH 26, BioRoot RCS and MTA Plus. Obturation was performed with gutta-percha and the relevant sealer was mixed with 0.1% rhodamine B. Three 1-mm-thick slices were obtained from the mid-third area of each root. Two slices were selected for the push-out test and the remaining slice was used to calculate the dentinal tubule penetration depth and percentage. Results.The retention of MTA Plus and BioRoot RCS was higher than that of AH 26 when the smear layer was preserved (P

Objectives The aim was to evaluate dentinal crack formation after root canal preparation with ProTaper Next system (PTN) with and without a glide path. Materials and Methods Forty-five mesial roots of mandibular first molars were selected. Fifteen teeth were left unprepared and served as controls. The experimental groups consist of mesiobuccal and mesiolingual root canals of remaining 30 teeth, which were divided into 2 groups (n = 15): Group PG/PTN, glide path was created with ProGlider (PG) and then canals were shaped with PTN system; Group PTN, glide path was not prepared and canals were shaped with PTN system only. All roots were sectioned perpendicular to the long axis at 1, 2, 3, 4, 6, and 8 mm from the apex, and the sections were observed under a stereomicroscope. The presence/absence of cracks was recorded. Data were analyzed with chi-square tests with Yates correction. Results There were no significant differences in crack formation between the PTN with and without glide path preparation. The incidence of cracks observed in PG/PTN and PTN groups was 17.8% and 28.9%, respectively. Conclusions The creation of a glide path with ProGlider before ProTaper Next rotary system did not influence dentinal crack formation in root canals.

Objective To assess the effect of glide path on the amount of apically extruded debris after instrumentation with WaveOne and OneShape.Methods. Forty-eight extracted human mandibular incisorswere assigned to 4 groups. In groups 1 and 2, preparation was completed with WaveOne In groups 3 and 4, canals were prepared with OneShape. Before instrumentation, in groups 1 and 3, glide path was created with PathFile 1, 2, and 3 at working length, whereas in groups 2 and 4, glide path was not performed. The weight of the extruded debris for each group was calculated by comparing the pre- and post-instrumentation weights of the eppendorf tubes. The time required for reaching full WL was also recorded. Data were analyzed by Kruskal–Wallis and Mann–Whitney U tests. Results. There was no difference in the amount of debris extruded between the single file systems (P=0.234). Time required to reach full WL was significantly decreased by creating a glide path (P< 0.05).Conclusion. Creation of a glide path does not significantly affect the apically extruded debris.

Purpose: To evaluate the alterations on the surface of gutta-percha cones (GPCs) on exposure to the different irrigation solutions and their possible antibacterial effect against Enterococcus faecalis. (E. faecalis) Materials and Methods: Disinfection ability of different solutions (5.25% sodium hypochlorite, 2% chlorhexidine, 1% peracetic acid, and QMix) were tested with 96 GPCs and the time of exposure to each solution was 5 and10 minutes, respectively. GPCs used in this study were contaminated with E.faecalis. After disinfection, GPCs were placed in tubes containing the medium and incubated at 37˚C for 7 days. All tubes were visually checked for turbidity at 24-hour intervals. About 92 new GPCs were analyzed by means of SEM/EDS to assess the topography and chemical elements present on their surface. The data generated was analyzed using Pearson chi-square test, p0.05). SEM/EDS analyses showed no alteration in the superficial features of GPCs after treating with various irrigation solutions. Conclusion: QMix was found to be an effective agent for rapid disinfection of GPCs as well-known irrigation solutions. Irrigation solutions were found to have sterilized the GPCs after both 5 and 10 minutes of exposure.

Abstract Postoperative pain is a frequent complication associated with root canal treatment, especially during apical instrumentation of tooth with preexisting periradicular inflammation Objectives The aim of this clinical study was to evaluate the influence of the instrumentation techniques on the incidence and intensity of postoperative pain in single-visit root canal treatment. Material and Methods Ninety patients with single root/canal and non-vital pulps were included. The patients were assigned into 3 groups according to root canal instrumentation technique used; modified step-back, reciprocal, and rotational techniques. Root canal treatment was carried out in a single visit and the severity of postoperative pain was assessed via 4-point pain intensity scale. All the participants were called through the phone at 12, 24 and 48 h to obtain the pain scores. Data were analyzed through the Kruskal–Wallis test. Results There was significant difference between all groups (p

Background: Bond strength of root canal sealers is mainly influenced by the surface tension of the root canal wall. Heat, or the use of a surfactant might reduce surface tension and it is known that surface tension of an EDTA solution significantly affected from temperature rise. QMix is a novel endodontic irrigant for smear layer removal containing EDTA, chlorhexidine and a detergent. There is no data regarding the influence of the temperature of the EDTA and QMix on the push-out bond strength of root canal sealers., Aim: To evaluate effect of temperatures of QMix and EDTA on the bond-strength of AH Plus., Materials and Methods: Sixty premolars were prepared with ProTaper F4. During preparation 3% NaOCl was performed. Specimens were divided into 4 groups as follows: 5-mL 17% EDTA at 22°C and 37°C; 5-mL QMix at 22°C and 37°C. Three specimens from each group were prepared for observation using SEM. Remaining roots were obturated and prepared for a push-out test. Data was analysed using Anova and Bonferroni tests (p<0.05)., Results: Samples irrigated with QMix had higher push-out bond strength values than those irrigated with EDTA (p=0.01), regardless of temperature. Samples irrigated with 37°C EDTA resulted in higher bond-strength values than those irrigated with 22°C EDTA (p<0.001)., Conclusion: Temperature of the final irrigant does affect the bond strength values of AH plus to root dentin irrigated with EDTA. Bond strength of AH Plus sealer to root canal dentin may improve with QMix.

Aim: One Shape Apical 1 (OSA 1) is a new file for preparing the apical aspect of the root canal after One Shape (OS, Micro Mega, Besançon, France). This study compared apical transportation and centering ratios in curved root canals, which were instrumented with ProTaper Next (PTN, Dentsply Tulsa Dental Specialties, Tulsa, OK) up to size X3 and with OS up to OSA 1., Materials and Methods: Forty-eight mesial canals of mandibular molars were assigned into two groups (n = 24) with respect to canal length and curvature. Root canals were accessed conventionally and preperation was completed with PTN files up to X3 or with OS up to OSA 1 according to the manufacturer's protocols. Apical transportation was assessed pre- and postinstrumentation using cone-beam computed tomographic (CBCT) scans of 1, 2, 3, 4, and 5 mm sections. A Friedman test was performed to assess the significance between file systems., Results: No significant difference was found between the file systems regarding apical transportation and centering ratio values (p > 0.05). Transportation in the mesial direction was greater than the distal transportation for both file systems., Conclusion: Considering apical transportation and centering ratio in curved canals, two systems provided similar results., Clinical Significance: Preparation up to One Shape Apical 1 or ProTaper Next X3 was shown similar results regarding apical transportation and centering ratio. Both systems were safe to use in curved molar root canals.