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Objective: The aim of this study is to measure the knowledge level of materials and equipment for endodontics and pedodontics, as well as sterilization and disinfection procedures, of dental assistants in dental institutions and intern oral and dental health technician students studying at college. Methods: Four hundred ninety-eight people, including dental assistants working in public, private and university institutions, between the ages of 18-65, and students of the Oral and Dental Health Technician School of Universities, participated in the study. A questionnaire was applied to the participants. With the help of the survey consisting of different questions, the participants' knowledge levels about pedodontic and endodontic materials and sterilization procedures were measured. Results: The knowledge level of dental assistants about dental materials was found to be low in 5.2% of the participants, medium in 32.5% of the participants, and high in 62.3% of the participants. There isn't any significant difference between the assistants' knowledge level and their gender (p=0.23), age group (p=0.09), educational status (p=0.41), professional experience (p=0.51), certification (p=0.39), and the institution that they work for (p=0.24). Conclusion: It was found that dental assistants have a lack of knowledge in this subject. It is thought that planning and perform regular training education programmes in terms of both acquiring new information and repeating existing information can be effective for eliminating the deficiencies of dental assistants. Keywords: Dental assistant, Endodontic material, Pedodontics material, Sterilization, Disinfection. [ABSTRACT FROM AUTHOR]

Ntroduction Good physicochemical properties of endodontic materials are one of the main preconditions for successful endodontic treatment. Modern endodontic materials are expected to have good adhesiveness, stability and low solubility in order to enable high-quality and permanent obturation of the root canal. The aim of this study was to test in vitro the stability and degree of solubility of two endodontic materials: Mineral Trioxide Aggregate (MTA) and Gutta Flow. Materials and methods The solubility of endodontic materials Mineral Trioxide Aggregate - MTA (Angelus) and Gutta Flow (Colthane) was tested by the aging method using artificial saliva according to the prescription of Ira and Shannon. Twelve samples of single-rooted teeth (6 MTA, 6 Gutta Flow) were used. The samples were analyzed after 7, 14, 21, 28 and 35 days. After obturation, the samples were longitudinally cut and filled with auto-polymerizing acrylate and stored in artificial saliva at a temperature of 37° ± 2° C. Results The results of the analysis of the longitudinal sections of the roots through MTA and Gutta Flow showed the absence of damage to both endodontic materials after 14 days of exposure to the artificial saliva. The appearance of the first morphological damage, as well as the weakening of the bonding with dentin wall, were observed on the 21st day with Gutta Flow, and on the 28th day with MTA from the beginning of the experiment. After a period of 35 days, both materials showed increased porosity, solubility and breaking of the bond with dentin wall of the root canal. Conclusion Based on the obtained results, it can be concluded that MTA showed lower solubility and better adhesive ness with dentin wall of the tooth root canal than Gutta Flow.

Featured Application: Bioceramic materials have been recently proposed for several applications in endodontic practice. The impact of their setting time and chemical composition on biocompatibility is still controversial. This in vitro study evaluated the osteogenic potential of different bioceramic formulations. Recently, pre-mixed bioceramics in fast set formulations have been increasingly utilized in clinical practice as an alternative to mineral trioxide aggregate (MTA) for their shorter setting time and better handling properties. However, the impact on their osteogenic potential, due to modifications in chemical composition to promote a fast setting, is still unclear. This molecular and in vitro study compared the osteogenic potential of root repairing material putty fast set (FSP) with root-repairing material putty (RRMPU), root-repairing material paste (RRMPA), Biodentine™ and MTA. The null hypothesis tested was that there are no differences among the tricalcium silicate materials in terms of osteogenic potential. Standardized discs were cultured with MG-63 human osteoblastic-like cells to assess biocompatibility, the activity of alkaline phosphatase (ALP) and osteogenic potential. Biocompatibility was evaluated at baseline and after 24 and 48 h. Osteogenic differentiation was assessed after 15 days. Data were analyzed with one-way ANOVAs and Tukey's post-hoc test (p < 0.05). All materials showed biocompatibility and bioactivity. ALP activity, which induces mineral nodule deposition, increased in all the cements tested, with a significant increase in RRMPU (p < 0.001) and FSP (p < 0.001) samples versus MTA. In vitro mineralization was significantly increased for RRMPU (p < 0.0001), FSP (p = 0.00012) and Biodentine™ (p < 0.0001) versus MTA. The bioceramics tested showed higher levels of biocompatibility and bioactivity than MTA; a higher capacity for mineralization was observed with RRMPU and FSP versus MTA. [ABSTRACT FROM AUTHOR]

Recently, pre-mixed bioceramics in fast set formulations have been increasingly utilized in clinical practice as an alternative to mineral trioxide aggregate (MTA) for their shorter setting time and better handling properties. However, the impact on their osteogenic potential, due to modifications in chemical composition to promote a fast setting, is still unclear. This molecular and in vitro study compared the osteogenic potential of root repairing material putty fast set (FSP) with root-repairing material putty (RRMPU), root-repairing material paste (RRMPA), Biodentine™ and MTA. The null hypothesis tested was that there are no differences among the tricalcium silicate materials in terms of osteogenic potential. Standardized discs were cultured with MG-63 human osteoblastic-like cells to assess biocompatibility, the activity of alkaline phosphatase (ALP) and osteogenic potential. Biocompatibility was evaluated at baseline and after 24 and 48 h. Osteogenic differentiation was assessed after 15 days. Data were analyzed with one-way ANOVAs and Tukey’s post-hoc test (p < 0.05). All materials showed biocompatibility and bioactivity. ALP activity, which induces mineral nodule deposition, increased in all the cements tested, with a significant increase in RRMPU (p < 0.001) and FSP (p < 0.001) samples versus MTA. In vitro mineralization was significantly increased for RRMPU (p < 0.0001), FSP (p = 0.00012) and Biodentine™ (p < 0.0001) versus MTA. The bioceramics tested showed higher levels of biocompatibility and bioactivity than MTA; a higher capacity for mineralization was observed with RRMPU and FSP versus MTA.

Background/purpose: To examine the effects of fibroblast growth factor-2 (FGF-2)/calcium silicate (CS) cement on material characters and in vitro primary human dental pulp cell (hDPC) behavior. Materials and methods: Setting time and diametral tensile strength (DTS) of CS and CS/FGF-2 composite were measured. PrestoBlue assay was used for evaluating primary hDPC proliferation. Alkaline phosphatase and osteocalcin expression in HDPCs cultured on the specimens were determined by enzyme-linked immunosorbent assay. One-way analysis of variance was used to evaluate the significance of the differences between the mean values. Results: Setting time and DTS of CS were not significantly different (P > 0.05) between CS hydration with H2O or FGF-2. Cell proliferation and osteogenic properties increased significantly (P

Background/purpose: The use of root-end filling materials designed to stimulate tissue repair in periradicular tissues is highly recommended. These materials should be proved good tissue compatibility. The aim of this study was to estimate the responses of Intermediate restorative material (IRM), mineral trioxide aggregate (MTA), and calcium silicate (CS) cement after implantation into a rat subcutaneous, including the immune response, and materials degradation. Materials and methods: Materials with the same chemical component were inserted into the bilateral pockets in each rat. Hematoxylin and eosin (H&E) staining was used to evaluate the immune response of tissue after implantation. Western blot was employed to quantify the COX-2 expression of tissue. Results: After implantation for 6 weeks, H&E staining showed that the inflamed fibrous capsule surrounding MTA and CS was thicker and looser. At 12 weeks, the tissue responses became very uniform for MTA and CS. The capsule was almost free of inflammatory cells and filled with fibroblasts. A significant increase in the thickness of fibrous tissue was observed after 3 weeks, 6 weeks, and 12 weeks for IRM at the respective time points (P

Aims and Objectives: Nowadays, the material that offers the best sealing characteristic in the field of endodontic treatment is the mineral trioxide aggregate (MTA), nevertheless, this material necessities an adhesive bonding agent to perfectly join to the dental surface. The aim of this study was to analyze using a scanning electron microscope (SEM) the possible microgap between the adhesive, MTA, and the dental surface. Material and Methods: Fourteen extracted molars were divided into two groups - group A was prepared with MTA-component adhesive and group B was prepared with MTA and composite dual etching. The observations were carried out with a SEM Phenom G2 Pro mode S.E.I. JMP® software was used for statistical analysis, and a t-test was used for evaluating the difference between the two groups. Results: The gap of the areas at higher magnification (1000×) with a size greater than 5 microns in width and 20 microns in length were considered significant, and only group A recorded significant data. Conclusions: The SEM analysis performed in the group A with interposition of adhesive and flow between the dental pulp chamber and MTA demonstrates the presence of a marginal gap of considerable amplitude in the all of the samples investigated. [ABSTRACT FROM AUTHOR]

Introduction. Due to the inability to sterilize infected root canals during cleaning and shaping, contemporary endodontic materials are expected to possess certain antibacterial effect. Aim. The aim of this study was to evaluate antibacterial effect of four contemporary endodontic materials: Acroseal, AH-Plus, Gutta Flow and Mineral Trioxide Aggregate (MTA) in vitro. Materials and Methods. Antibacterial effect of tested materials was evaluated against bacterial species Enterococcus faecalis ATCC 29212 using the agar diffusion test. Results. Based on the obtained results, it can be concluded that freshly mixed Acroseal and AH-Plus exhibited significant antibacterial effect while Gutta Flow and MTA did not present any antimicrobial potential in this study. Conclusion. Endodontic sealers tested in this study, freshly mixed Acroseal and AH-Plus, possess certain antibacterial effect whereas in solid state this effect is not present. .

Shie MY, Chang HC, Ding SJ. Effects of altering the Si/Ca molar ratio of a calcium silicate cement on in vitro cell attachment. International Endodontic Journal, 45, 337-345, 2012. Abstract Aim To examine the effects of altering the Si/Ca molar ratio (6 : 4, 5 : 5, and 4 : 6) of a quick-setting calcium silicate cement on in vitro cell attachment. Methodology Working time and setting time of three different calcium silicate cements were measured. Alamar Blue was used for real-time and repeated monitoring of cell attachment and proliferation. The Si and Ca ion concentrations of the cell culture medium in the presence of three different calcium silicate cements seeded with MG63 cells were measured. Kinetic immunofluorescent staining of MG63 cells was performed during cell attachment and spreading. Reverse transcription-polymerase chain reaction was employed to determine gene expression in MG63 cells cultured on the cements. One-way analysis of variance was used to evaluate the significance of the differences between the mean values. Results The working time (4-7 min) and setting time (17-24 min) of the cements were shortened with an increase in the Ca content of the calcium silicate powders after mixing the powder with water. In contrast, the higher the Si content in the cement, the more the MG63 cells attached to the cement at all culture time-points, accompanying by the formation of more obvious actin stress fibres. Cell proliferation and differentiation increased significantly ( P < 0.05) with an increase in the Si content of the calcium silicate cements. Si ion concentration of the culture medium increased significantly ( P < 0.05) with increasing cement Si content and culture time-points. Conclusions The higher Si content cement enhanced the higher expression of cell attachment, proliferation and differentiation as compared to the lower Si content cement. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate a prototype surface reaction-type pre-reacted glass-ionomer (S-PRG) filler-containing endodontic sealer (S-PRG sealer) in terms of its ion-releasing ability and the incorporation of the released ions by root canal dentin. Materials and Methods: The concentration of ions in the set S-PRG sealer was measured by ICPS and with a fluoride ion electrode. Element mapping and chemical component bulk analysis of the outermost dentin of the S-PRG sealer-dentin interface were performed by SEM-EPMA. The incorporation depth of the elements in dentin was measured by element line scanning. Results and Discussion: Ions released from the S-PRG sealer (Al, B, F, Na, Si, Sr, and Zn) were detected over time. The incorporation of fluoride (F), strontium (Sr), silicon (Si), and boron (B) was observed along the outermost dentin of the S-PRG sealer-dentin interface by EPMA analysis, and the incorporation depth increased with prolonged immersion. Conclusion: The continuous release of ions from the S-PRG sealer and their subsequent incorporation by root canal dentin were confirmed. [ABSTRACT FROM AUTHOR]

Aim To determine the types of periapical lesions associated with root filled teeth with persistent periapical pathosis that required surgical treatment based on specific inclusion and exclusion criteria. Methodology Periapical lesions from a consecutive clinical sample of 100 patients were examined histopathologically to determine a definitive diagnosis. Results Females were more represented ( n = 56), the average age was 46.5 years and there were no age differences between gender or lesion type. A diagnosis of periapical granuloma was the most common finding with a similar number present in females ( n = 40) and males ( n = 37). A cyst was present in 18% of the cases with a majority of females ( n = 12) represented in the sample. Evidence of foreign material, with an appearance consistent with endodontic sealer materials, was seen in 25 periapical granulomas, two cysts and one scar. Two periapical scars were seen, one had a history of apicectomy and amalgam root-end filling while the other was associated with extruded root filling material. Conclusions By using defined clinical inclusion and exclusion criteria a predictable clinical diagnosis of a persistent periapical lesion due to endodontic origin can be reliably made. Periapical granulomas and cysts were the most common periapical lesions of endodontic origin associated with persistent periapical pathosis with the overall incidence of periapical cysts similar to previous studies. The presence of endodontic material in a high proportion of periapical lesions suggests a cause-effect association with the inference that clinicians should employ canal preparation techniques that limit apical extrusion of material. [ABSTRACT FROM AUTHOR]

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Silicone tubes containing a freshly mixed experimental Sealapex, in which titanium dioxide was removed from the original formula, were implanted in the dorsal subcutaneous connective tissue of the rat. Solid silicone rods of the same size as the tubes were also implanted and used as inert controls. The tissue reaction to both these materials was histometrically and quantitatively studied under light microscopy and by elemental electron microprobe analysis. After 7, 30 and 90 d of implantation, different grades of tissue reaction to the tested materials were recorded. A granulomatous tissue containing numerous foreign-body giant cells and macrophages with engulfed particles in their cytoplasms was initially detected in contact with the test material. In addition, many fibroblasts and newly formed vessels were also observed at these areas. The results of this study revealed that these reactions increased progressively at the 30- and 90-d observations. The electron microprobe analysis of the granulomatous tissues showed the presence of heavy components of the experimental material. [ABSTRACT FROM AUTHOR]

The design and preparation of clinically relevant endodontic obturating material for root canal therapy is a great challenge. For the first time, we report a new polymer nanocomposite which was prepared by using reversible addition-fragmentation chain-transfer (RAFT) polymerization of methacrylic acid and methylene glycol dimethacrylate. The polymer was embedded with reduced graphene oxide nanoplatelets (rGO). These graphene nanoplatelets were embedded in the polymers (GNPs) have shown the tensile strength (27‐–36%) and the elongation at break 2.1 – 3.1% is quite similar to the commercial gutta percha (GP-C). Atomic force micrograph provided interesting information related to scattering of rGO flakes in GNPs and the surface of GNP contains crystalline spikes of height varied between 0.95 and 1.26 μm. These spikes improved the adhesion of GNPs to bio-interface. The GNPs were 95% more effective in inhibiting bacterial colonization without disturbing the nearby cell integrity compared to commercial GP. It was found that the GNPs after incubation of 24 h at 37 °C, the radius of the inhibition zone was 6.8 mm and 4.3 mm for E.coli and S. aureus , respectively indicating better effective antibacterial activity than the GP-C. This work offers biocompatible, better adhesive and antibacterial endodontic obturating material for future root canal therapy. • Polymer nanocomposites were developed as an endodontic obturation material. • Graphene nanoplatelets in the endodontic material improved antimicrobial activity. • Polymer nanocomposite reported as non-toxic to nearby cells. • Better mechanical and antibacterial compared to commercial gutta-percha. [ABSTRACT FROM AUTHOR]

Objectives: This study reports the efficacy of two solvent mixtures on the dissolution of gutta-percha and AH Plus sealer, together with the cytotoxicity. Methods: Methyl ethyl ketone (MEK), orange oil, tetrachloroethylene, MEK/tetrachloroethylene (1:1), MEK/orange oil (1:1), and chloroform (control) were tested. Twelve groups (n = 15) of standardized stainless-steel molds filled with softened gutta-percha cones and twelve (n = 15) filled with AH Plus were immersed in the corresponding mixture or individual solvent, in an ultrasonic bath, for either 2 or 5 min. The effect of the solvents was assessed qualitatively by a topographical analysis (scanning electron microscopy) and chemical analysis (Fourier transform infrared spectroscopy), and quantitatively by a weight loss and viscoelastic property (dynamic mechanical analysis) evaluation. The cytotoxicity was assessed on MG63 human osteoblastic cells. Results: The mixtures did not show the formation of new compounds. Both presented significantly higher efficacies compared to their individual solvents, suggesting a synergistic effect. Their dissolution efficacy was similar to that of chloroform, showing high cytocompatibility. Conclusions: The proposed strategy, incorporating ultrasound agitation and profiting from the synergy of adequate solvents, might enhance root canal cleanliness allowing a single-step procedure to dissolve gutta-percha and the sealer remnants, while assuring cytocompatibility with the periapical tissues. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Oral bacteria have evolved to form biofilms on hard tooth surfaces and dental materials. The antibiofilm effect of materials used for the restoration of oral function affects oral health. In this review we describe the features involved in the formation of oral biofilms on different surfaces in the oral cavity and the antibiofilm properties of dental materials. Methods: An electronic search of scientific papers from 1987 to 2013 was performed with PubMed, ScienceDirect and Google search engines using the following search terms: antibiofilm, dental material, dental hard tissue, endodontic material, implant material, oral biofilm, and restorative material. Results: Selected inclusion criteria resulted in 179 citations from the scientific, peer-reviewed literature. Oral biofilms form not only on dental hard tissue, but also on a wide range of dental materials used in cariology, endodontics, restorative dentistry and periodontology, resulting in destruction of dental hard tissue and even infection. Therefore, there has been a continuous effort to develop the antibiofilm properties of dental materials used for different purposes. Specific antimicrobial design in the composition and application of new materials (e.g. bioceramic sealer, resin composite, implant coating) demonstrates an improvement of the antibiofilm properties of these materials compared to earlier generations. Significance: A significant number of dental materials have been shown to affect biofilm growth by inhibiting the adhesion of bacteria, limiting their growth or killing microbes in the biofilms formed in vitro. Incorporation of an appropriate amount of antibacterial agent could provide dental materials with antibiofilm activity without significantly influencing their mechanical properties. However, more randomized and double-blind clinical studies of sufficient length with these materials are needed to confirm long term success following their use in the dental clinic. [Copyright &y& Elsevier]