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Aim: To clinically evaluate the effect of different irrigation activation techniques (needle irrigation, passive ultrasonic irrigation (PUI) and EndoVac) on post-operative pain after single-visit endodontic treatment. Materials and methods: Thirty patients aged between 16 and 40 years requiring endodontic therapy of asymptomatic vital/non vital maxillary central or canine teeth were selected for this study. In all cases, root canal treatment was done is single-visit in which root canals were prepared using nickel-titanium ProTaper Universal rotary system in crown down manner up to master apical file size F4 or F5 according to the initial apical canal size. Irrigation was done using 2.5% NaOCl. Patients were randomly assigned into three groups according to the final irrigation activation method, group 1 (control group) needle irrigation, group 2 PUI and group 3 EndoVac system. Obturation was done using cold lateral compaction technique. Post-operative pain was assessed after 6, 12, 24, 48 hours, one week and two weeks respectively. Post-operative pain evaluation was done using Visual Analogue Scale (VAS). Results: EndoVac group showed the least post-operative pain values while needle irrigation group showed the highest values. This was statistically significant at 6 and 48 hours time intervals. PUI group showed lower pain values than needle group and this was significant at 48 hours time interval. In all groups the intensity of post-operative pain decreased over time. Conclusion: EndoVac system and PUI reduce post-operative pain after single-visit endodontic treatment than needle irrigation in the first 48 hours.

The aim of this study is to evaluate the bond strength of AH Plus sealer after irrigation of the root canals using of Nano-Silver and Sodium hypochlorite. Sixty, freshly extracted, sound maxillary anterior teeth with completely formed apices and straight roots were used in this study. Each tooth was decoronated to provide approximately 16 mm± 1 of root, root canals with initial apical file size #20 were selected to approximately standardize the canal diameter. The samples were divided into two groups 30 root each according to the irrigation protocol used through instrumentation: Group A: root canal preparation was performed using the Protaper Next system during instrumentation the root canals were irrigated using Nano-Silver irrigant 0.02mol/L = 2000ppm. Group B: root canal preparation was also performed using the Protaper Next system but during instrumentation the root canals were irrigated using Sodium Hypochlorite (NaOCl) irrigant 5.25%. Root canals of each group were then obturated using master cones of #40/06 and AH Plus sealer in lateral condensation technique. 2mm thick slices of apical, middle and coronal root portion for all samples were prepared for assessment of push out bond strength for the two groups.Results showed that AH plus sealer had a lower value of push out bond strength ( 1.223± 0.533) in the group irrigated using nano silver than the second group irrigated with sodium hypochlorite (2.321 ± 0.650) at the coronal third with statistically significant difference( P= 0.004), also at the middle third it showed a lower value (1.732 ± 0.899) than the sodium hypochlorite but with no statistically significant difference, and finally at the apical third it also a lower value of push out bond strength (2.103 ± 1.319) than the other group irrigated with NaOCl (5.045 ± 1.397) with statistically significant difference (0.001)

Aim The aim was to clinically and radiographically evaluate mineral trioxide aggregate (MTA) and TheraCal LC as direct pulp capping (DPC) materials. Materials and methods Twenty male patients aged 17–35 years with immediate mechanical pulp exposure in lower molars were randomly divided into two equal groups (n = 10). Group 1: pulp exposures were capped using MTA. Group 2: pulp exposures were capped using TheraCal LC. Immediately after DPC, a base-line digital bitewing and periapical radiographs were taken. Clinical evaluation was performed at 1, 4, 12, and 24 weeks after DPC for presence/absence of spontaneous pain, tenderness to percussion, draining sinuses and pulp response to thermal pulp vitality test. At 24 weeks after DPC, digital periapical, and bitewing radiographs were taken. Digitalized bitewing radiographs were submitted to image analysis software to measure dentin bridge thickness in comparison to the base-line bitewing radiographic image. Digitalized preoperative and postoperative periapical radiographs were submitted to the same software to evaluate changes in the width of periodontal ligament space. Results Clinically, all cases showed criteria of successful treatment except 3, four cases in groups 1 and 2, respectively. Statistical analysis revealed no statistically significant difference between both groups (P > 0.05). All of the thirteen cases that were available for evaluation after 6 months showed dentin bridge formation. In MTA group, the mean value of dentin bridge formed was higher than in TheraCal LC group with no statistically significant difference (P = 0.710). Changes in the width of periodontal ligament space were not significantly different between both groups recording (P > 0.05). Conclusion Clinically and radiographically, MTA and TheraCal LC are favorable materials for DPC inducing adequate dentin bridge formation and minimal widening of periodontal ligament space.

Aim To evaluate centering ability, amount of removed dentin of hand NiTi Flex K-files, ProTaper Universal system, OneShape, and WaveOne system in curved root canals. Materials and methods Forty extracted human premolars with a range of canal curvature (21–39°) were used. Samples were randomly divided into four groups (n = 10). Group 1: NiTi Flex (control group), group 2: ProTaper, group 3: OneShape, and group 4: WaveOne Primary. Centering ability of each instrument was evaluated using superimposed standardized preinstrumentation and postinstrumentation cone-beam computed tomography images recorded at three root canal levels (3, 6, and 9 mm from the apex). Amount of removed dentin was calculated by differences between preinstrumentation and postinstrumentation root canal volumes. Results WaveOne system showed the highest mean centering ratios at all tested canal levels in both directions. Apical thirds of all groups showed the highest centering ratios while the coronal showed the lowest. ProTaper system group recorded significantly highest amount of root dentin removal compared to other groups. Conclusion Reciprocating WaveOne files had more centering ability than other tested instruments. ProTaper Universal system removed significantly high amount of dentin in comparison to other systems.

Aim The aim of this study was to investigate the effect of heat treatment on the centering ability and amount of dentin removal of OneShape single file rotary system (OS) by cone beam computed tomography. Materials and methods Twenty human premolars with single root canals were allocated into two equal groups (n = 10) according to the used rotary system: group 1: OS system, group 2: One Curve which is heat-treated OS single file rotary system. Preinstrumentation and postinstrumentation images were obtained at 3, 6, and 9 mm from the apex and assessed to determine canal centering ability. Amount of removed dentin was estimated by difference between preinstrumentation and postinstrumentation root canal volumes. Data were analyzed using t-test and significance level was set at P value less than or equal to 0.05. Results The results showed that One Curve file has higher mean centering ratio and more dentin removal than OS file with no statistically significant difference between them (P > 0.05). Conclusion It was concluded that heat treatment did not have significant effect as both files could maintain the original canal path without significant differences in centering ability and amount of removed dentin.

Aim To evaluate the efficacy of trisodium phosphate (Na3PO4) and sodium bicarbonate (NaHCO3) irrigations against Enterococcus faecalis in differently prepared root canals. Materials and methods Ninety laboratory-infected root canals were endodontically prepared using K-file (group 1), Mtwo rotary (group 2) and OneShape rotary (group 3) file systems. Canals in each group were irrigated with the minimum bactericidal concentrations of sodium hypochlorite (subgroup 1), Na3PO4(subgroup 2) and NaHCO3(subgroup 3) solutions. Another 10 infected unprepared canals served as control group. Samples obtained from lumens and dentin linings of root canals were used to count the residual bacteria in each subgroup. Both two-way analysis of variance and Mann–Whitney comparisons at P value less than or equal to 0.05 were used to statistically analyze the results. Results All tested subgroups showed lower no of colony-forming units than the control (P 0.05). Conclusion Although none of the tested irrigation solutions are capable of completely eradicating E. faecalis, both Na3PO4 and NaHCO3 seem effective when used together with the nominated file systems.

Introduction Primary teeth are considered natural space maintainers and should be maintained till their exfoliation is chronologically appropriate. The success of endodontic treatment is directly related to the microbial reduction in the root canal system as a result of chemomechanical preparation. Objective This study was carried out to evaluate and compare cleaning efficacy of rotary and manual systems for root canal preparation in primary teeth. Materials and methods Thirty extracted single-rooted human primary teeth were selected. In group I the root canals were instrumented manually with Ni-Ti Flex K-file. Revo-S rotary instruments were used for canal preparation in group II. Irrigation with 1% sodium hypochlorite was done at each file change. Roots were split longitudinally and processed for scanning electron microscope examination. For evaluation of cleaning efficiency two separate scores were used for evaluation of debris and smear layer at three root canal thirds. Results However, both techniques did not achieve complete clean walls, Revo-S rotary system achieved better cleanliness than that obtained by manual instrumentation at all root canal levels. Conclusion Revo-S rotary system might be an alternative method for preparing root canal in primary teeth with better cleaning efficiency.

Introduction The purpose of this study was to evaluate push-out bond strength of two endodontic sealers (MetaSeal, Endosequence BC) to radicular dentin following different disinfection protocols [sodium hypochlorite (NaOCl), photoactivated disinfection, and ozonated olive oil]. Materials and methods A total of 60 freshly extracted human single rooted premolars with single root canals were selected. The crowns were removed to obtain a standardized root length of 15 mm and working length was determined. Root canals were prepared using ProTaper Universal rotary instruments up to F4 and irrigation throughout instrumentation was performed using 3 ml of 0.9% sodium chloride. Roots were randomly divided into six groups (n=10). In groups 1 and 2, root canals were finally irrigated with 3 ml of 2.5% NaOCl (as control groups), in groups 3 and 4, final disinfection protocol was performed with photoactivated disinfection, but in groups 5 and 6, root canals were finally disinfected by coating ProTaper F4 file with ozonated olive oil. In groups 1, 3, and 5, root canals were obturated with gutta-percha/MetaSeal sealer while in groups 2, 4, and 6, obturation was performed using gutta-percha/Endosequence BC sealer. Three horizontal sections were prepared in a thickness of 2 mm each corresponding to apical, middle, and coronal parts of the root. Each section was subjected to a compressive load to evaluate push-out bond strength and the data were statistically analyzed using two-way analysis of variance and post-hoc Tukey test. Results PAD groups recorded the highest values while ozonated olive oil groups recorded the lowest values. Bond strength of Endosequence BC was significantly higher than MetaSeal (P ≤ 0.05). The bond strength in the coronal sections was higher than that in the middle and apical sections. Conclusion PDA final disinfection protocol performed similarly to NaOCl and does not negatively affect bond strength as ozonated olive oil. Endosequence BC was better than MetaSeal in terms of bond strength.

Purpose To compare the cleaning efficacy of root canal walls after using two Nickel–Titanium (Ni–Ti) rotary files (Flexmaster and Mtwo) and one hand Ni–Ti file (Ni–Ti flex-K) when associated with different final irrigation regimens (SmearClear, 17% ethylene diamine tetra acetic acid (EDTA) and sodium hypochlorite). Materials and methods Ninety extracted human premolars with similar range of canal curvature (21–39°) were selected. After crown removal and working length determination, roots were divided into three equal groups according to root canal instrumentation: Group I and Group II were prepared using Flexmaster, Mtwo Ni–Ti rotary systems respectively where Group III was prepared using hand NiTi flex-K files. Each group was further subdivided into three equal subgroups according to root canal final irrigation; subgroup A: SmearClear, subgroup B: 17% EDTA and subgroup C: NaOCl. Roots were then splitted longitudinally and processed for scanning electron microscopic (SEM) examination to evaluate and score the root canal cleanliness. Results Final root canal irrigation using either SmearClear or 17% EDTA had significantly better cleaning efficiency than that of NaOCl in all tested groups. Ni–Ti hand files had significantly less cleaning efficacy than that of rotary systems except in subgroup C using NaOCl.