No abstract available.
Dental Pulp Cavity* ; Root Canal Preparation*

No abstract available.

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.
Cone-Beam Computed Tomography* ; Dental Pulp Cavity* ; Molar*

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.
Ankylosis ; Autografts* ; Bicuspid ; Dental Pulp Cavity ; Esthetics ; Follow-Up Studies ; Humans ; Incisor* ; Necrosis ; Replantation ; Root Resorption* ; Tissue Donors ; Tooth ; Tooth Extraction

OBJECTIVES: To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. MATERIALS AND METHODS: Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1), fiber-reinforced composite (FRC) post and composite core (group 2), composite post and core (group 3), and controls (group 4). Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4). Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at 135degrees vertical angle, subjected to thermomechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. RESULTS: Fracture resistance of the groups was as follows: Control (group 4) > cast post and core (group 1) > fiber post and composite core (group 2) > composite post and core (group 3). All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58%) in group 1 were non-restorable. CONCLUSIONS: Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors.
Aging ; Cementation ; Crowns ; Glass Ionomer Cements ; Incisor* ; Tooth

OBJECTIVES: The aim of this study was to investigate the expression of 7 different sirtuin genes (SIRT1-SIRT7) in human dental pulp cells (HDPCs), and to determine the role of SIRTs in the odontoblastic differentiation potential of HDPCs. MATERIALS AND METHODS: HDPCs were isolated from freshly extracted third molar teeth of healthy patients and cultulred in odontoblastic differentiation inducing media. Osteocalcin (OCN) and dentin sialophosphoprotein (DSPP) expression was analyzed to evaluate the odontoblastic differentiation of HDPCs by reverse transcription-polymerase chain reaction (RT-PCR), while alizarin red staining was used for the mineralization assay. To investigate the expression of SIRTs during odontoblastic differentiation of HDPCs, real time PCR was also performed with RT-PCR. RESULTS: During the culture of HDPCs in the differentiation inducing media, OCN, and DSPP mRNA expressions were increased. Mineralized nodule formation was also increased in the 14 days culture. All seven SIRT genes were expressed during the odontogenic induction period. SIRT4 expression was increased in a time-dependent manner. CONCLUSIONS: Our study identified the expression of seven different SIRT genes in HDPCs, and revealed that SIRT4 could exert an influence on the odontoblast differentiation process. Further studies are needed to determine the effects of other SIRTs on the odontogenic potential of HDPCs.
Dental Pulp* ; Dentin ; Gene Expression* ; Humans* ; Molar, Third ; Odontoblasts* ; Osteocalcin ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Tooth

OBJECTIVES: To evaluate the effects of copolymer of acrylic acid and maleic acid (Poly[AA-co-MA]) and calcium hypochlorite (Ca(OCl)2) on root canal dentin using scanning electron microscope (SEM). MATERIALS AND METHODS: Twenty-four single-rooted teeth were instrumented and the apical and coronal thirds of each root were removed, leaving the 5 mm middle thirds, which were then separated into two pieces longitudinally. The specimens were randomly divided into six groups and subjected to each irrigant for 5 min as follows: G1, Ca(OCl)2; G2, Poly(AA-co-MA); G3, Ca(OCl)2 + Poly(AA-co-MA); G4, sodium hypochlorite (NaOCl); G5, ethylenediaminetetraacetic acid (EDTA); G6, NaOCl+EDTA. The specimens were prepared for SEM evaluation. Smear layer, debris and erosion scores were recorded by two blinded examiners. One image from G3 was analyzed with energy dispersive spectroscopy (EDS) on suspicion of precipitate formation. Data were analyzed using the Kruskal-Wallis and Dunn tests. RESULTS: G1 and G4 showed the presence of debris and smear layer and they were statistically different from G2, G3, G5 and G6 where debris and smear layer were totally removed (p < 0.05). In G1 and G4, erosion evaluation could not be done because of debris and smear layer. G2, G3 and G5 showed no erosion, and there was no significant difference between them. G6 showed severe erosion and was statistically different from G2, G3 and G5 (p < 0.05). EDS microanalysis showed the presence of Na, P, and Ca elements on the surface. CONCLUSIONS: Poly(AA-co-MA) is effective in removing the smear layer and debris without causing erosion either alone or with Ca(OCl)2.
Calcium ; Dental Pulp Cavity ; Dentin* ; Edetic Acid ; Hypochlorous Acid ; Smear Layer* ; Sodium Hypochlorite ; Spectrum Analysis ; Tooth

OBJECTIVES: The aim of this study was to evaluate the fluoride release of conventional glass ionomer cements (GICs) and resin-modified GICs. MATERIALS AND METHODS: The cements were grouped as follows: G1 (Vidrion R, SS White), G2 (Vitro Fil, DFL), G3 (Vitro Molar, DFL), G4 (Bioglass R, Biodinamica), and G5 (Ketac Fil, 3M ESPE), as conventional GICs, and G6 (Vitremer, 3M ESPE), G7 (Vitro Fil LC, DFL), and G8 (Resiglass, Biodinamica) as resin-modified GICs. Six specimens (8.60 mm in diameter; 1.65 mm in thickness) of each material were prepared using a stainless steel mold. The specimens were immersed in a demineralizing solution (pH 4.3) for 6 hr and a remineralizing solution (pH 7.0) for 18 hr a day. The fluoride ions were measured for 15 days. Analysis of variance (ANOVA) and Tukey's test with 5% significance were applied. RESULTS: The highest amounts of fluoride release were found during the first 24 hr for all cements, decreasing abruptly on day 2, and reaching gradually decreasing levels on day 7. Based on these results, the decreasing scale of fluoride release was as follows: G2 > G3 > G8 = G4 = G7 > G6 = G1 > G5 (p < 0.05). CONCLUSIONS: There were wide variations among the materials in terms of the cumulative amount of fluoride ion released, and the amount of fluoride release could not be attributed to the category of cement, that is, conventional GICs or resin-modified GICs.
Dental Materials ; Fluorides* ; Fungi ; Glass Ionomer Cements* ; Glass* ; Ions ; Molar ; Stainless Steel

OBJECTIVES: This study determined the effect of the air-stream application time and the bonding technique on the dentin bond strength of adhesives with different solvents. Furthermore, the content and volatilization rate of the solvents contained in the adhesives were also evaluated. MATERIALS AND METHODS: Three adhesive systems with different solvents (Stae, SDI, acetone; XP Bond, Dentsply De Trey, butanol; Ambar, FGM, ethanol) were evaluated. The concentrations and evaporation rates of each adhesive were measured using an analytical balance. After acid-etching and rinsing, medium occlusal dentin surfaces of human molars were kept moist (conventional) or were treated with 10% sodium hypochlorite for deproteinization. After applying adhesives over the dentin, slight air-stream was applied for 10, 30 or 60 sec. Composite cylinders were built up and submitted to shear testing. The data were submitted to ANOVA and Tukey's test (alpha = 0.05). RESULTS: Stae showed the highest solvent content and Ambar the lowest. Acetone presented the highest evaporation rate, followed by butanol. Shear bond strengths were significantly affected only by the factors of 'adhesive' and 'bonding technique' (p < 0.05), while the factor 'duration of air-stream' was not significant. Deproteinization of dentin increased the bond strength (p < 0.05). Stae showed the lowest bond strength values (p < 0.05), while no significant difference was observed between XP Bond and Ambar. CONCLUSIONS: Despite the differences in content and evaporation rate of the solvents, the duration of air-stream application did not affect the bond strength to dentin irrespective of the bonding technique.
Acetone ; Adhesives* ; Dental Bonding ; Dentin* ; Dentin-Bonding Agents ; Humans ; Molar ; Sodium Hypochlorite ; Solvents ; Volatilization*

OBJECTIVES: The use of chitosan nanoparticles (CNPs) in endodontics is of interest due to their antibiofilm properties. This study was to investigate the ability of bioactive CNPs to remove the smear layer and inhibit bacterial recolonization on dentin. MATERIALS AND METHODS: One hundred bovine dentin sections were divided into five groups (n = 20 per group) according to the treatment. The irrigating solutions used were 2.5% sodium hypochlorite (NaOCl) for 20 min, 17% ethylenediaminetetraacetic acid (EDTA) for 3 min and 1.29 mg/mL CNPs for 3 min. The samples were irrigated with either distilled water (control), NaOCl, NaOCl-EDTA, NaOCl-EDTA-CNPs or NaOCl-CNPs. After the treatment, half of the samples (n = 50) were used to assess the chelating effect of the solutions using portable scanning electronic microscopy, while the other half (n = 50) were infected intra-orally to examine the post-treatment bacterial biofilm forming capacity. The biovolume and cellular viability of the biofilms were analysed under confocal laser scanning microscopy. The Kappa test was performed for examiner calibration, and the non-parametric Kruskal-Wallis and Dunn tests (p < 0.05) were used for comparisons among the groups. RESULTS: The smear layer was significantly reduced in all of the groups except the control and NaOCl groups (p < 0.05). The CNPs-treated samples were able to resist biofilm formation significantly better than other treatment groups (p < 0.05). CONCLUSIONS: CNPs could be used as a final irrigant during root canal treatment with the dual benefit of removing the smear layer and inhibiting bacterial recolonization on root dentin.
Biofilms ; Calibration ; Chitosan* ; Dental Pulp Cavity ; Dentin* ; Edetic Acid ; Endodontics ; Microscopy ; Microscopy, Confocal ; Nanoparticles* ; Smear Layer ; Sodium Hypochlorite ; Water