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Statistical notes for clinical researchers: logistic regression.

Hae Young KIM

Restorative Dentistry & Endodontics.2017;42(4):342-348. doi:10.5395/rde.2017.42.4.342

No abstract available.
Logistic Models*

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Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments.

Taha ÖZYÜREK ; Vildan TEK ; Koray YILMAZ ; Gülşah USLU

Restorative Dentistry & Endodontics.2017;42(4):332-341. doi:10.5395/rde.2017.42.4.332

OBJECTIVES: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. MATERIALS AND METHODS: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with χ2 tests using SPSS 21.0 software. RESULTS: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. CONCLUSIONS: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.
Bicuspid ; Dental Pulp Cavity* ; Dentin ; Endodontics ; Hand ; Incidence* ; Retreatment ; Root Canal Filling Materials* ; Root Canal Preparation ; Tooth

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Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation.

Daniel POLETTO ; Ana Claudia POLETTO ; Andressa CAVALARO ; Ricardo MACHADO ; Leopoldo COSME-SILVA ; Cássia Cilene Dezan GARBELINI ; Márcio Grama HOEPPNER

Restorative Dentistry & Endodontics.2017;42(4):324-331. doi:10.5395/rde.2017.42.4.324

OBJECTIVES: This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. MATERIALS AND METHODS: Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope. RESULTS: EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05). CONCLUSIONS: Ultrasonic activation did not significantly influence smear layer removal.
Bicuspid ; Chlorhexidine ; Edetic Acid ; Humans ; Methods ; Microscopy ; Post and Core Technique ; Smear Layer* ; Sodium Chloride ; Sodium Hypochlorite ; Ultrasonics*

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Comparison of apical extrusion of intracanal bacteria by various glide-path establishing systems: an in vitro study.

Alberto DAGNA ; Rashid EL ABED ; Sameeha HUSSAIN ; Ibrahim H ABU-TAHUN ; Livia VISAI ; Federico BERTOGLIO ; Floriana BOSCO ; Riccardo BELTRAMI ; Claudio POGGIO ; Hyeon Cheol KIM

Restorative Dentistry & Endodontics.2017;42(4):316-323. doi:10.5395/rde.2017.42.4.316

OBJECTIVES: This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems. MATERIALS AND METHODS: Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU). RESULTS: The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria. CONCLUSIONS: All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.
Agar ; Bacteria* ; Brain ; Enterococcus faecalis ; Ethylene Oxide ; Glass ; Heart ; In Vitro Techniques* ; Molar ; Stem Cells ; Tooth

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Effect of water storage on flexural strength of silorane and methacrylate-based composite resins.

Narges PANAHANDEH ; Hassan TORABZADEH ; Hani NADERI ; Seyedeh Mahsa SHEIKH-AL-ESLAMIAN

Restorative Dentistry & Endodontics.2017;42(4):309-315. doi:10.5395/rde.2017.42.4.309

OBJECTIVES: This study assessed the effect of water storage on the flexural strength (FS) of low shrinkage composites. MATERIALS AND METHODS: A total of 165 bar-shaped specimens (2 × 2 × 25 mm) were fabricated of 2 low shrinkage composites (Filtek P90 [3M ESPE], GC Kalore [GC International]) and a conventional methacrylate-based composite (Filtek Z250 [3M ESPE]). The specimens were subjected to 3-point bending test at 6 time intervals, namely: immediately after curing, at 24 hours, 1 week, 1 month, 6 months, and 1 year following storage in wet and dry conditions. The FS of the specimens were measured by applying compressive load at a crosshead speed of 1.0 mm/min. Data was analyzed using 3-way analysis of variance (ANOVA) and Tukey's test. RESULTS: Three-way ANOVA revealed significant interactions between time, type of composite, and storage condition (p = 0.001). Tukey's multiple comparison test revealed significant reductions in FS of all composites after 6 months and 1 year of storage in distilled water compared to dry condition. CONCLUSIONS: Filtek P90 showed the highest and GC Kalore showed the lowest FS after 1 year storage in distilled water. The immediate high strength of Filtek Z250 significantly decreased at 1 year and its final value was lower than that of Filtek P90.
Composite Resins* ; Polymers ; Silorane Resins* ; Water*

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The effects of autoclave sterilization on the cyclic fatigue resistance of ProTaper Universal, ProTaper Next, and ProTaper Gold nickel-titanium instruments.

Taha ÖZYÜREK ; Koray YILMAZ ; Gülşah USLU

Restorative Dentistry & Endodontics.2017;42(4):301-308. doi:10.5395/rde.2017.42.4.301

OBJECTIVES: It was aimed to compare the cyclic fatigue resistances of ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG) and the effects of sterilization by autoclave on the cyclic fatigue life of nickel-titanium (NiTi) instruments. MATERIALS AND METHODS: Eighty PTU, 80 PTN, and 80 PTG were included to the present study. Files were tested in a simulated canal. Each brand of the NiTi files were divided into 4 subgroups: group 1, as received condition; group 2, pre-sterilized instruments exposed to 10 times sterilization by autoclave; group 3, instruments tested were sterilized after being exposed to 25%, 50%, and 75% of the mean cycles to failure, then cycled fatigue test was performed; group 4, instruments exposed to the same experiment with group 3 without sterilization. The number of cycles to failure (NCF) was calculated. The data was statistically analyzed by using one-way analysis of variance and post hoc Tukey tests. RESULTS: PTG showed significantly higher NCF than PTU and PTN in group 1 (p < 0.05). Sterilization significantly increased the NCF of PTN and PTG (p < 0.05) in group 2. PTN in group 3 had significantly higher cyclic fatigue resistance than PTN group 4 (p < 0.05). Also, significantly higher NCF was observed for PTG in group 2 than in groups 3 and 4 (p < 0.05). CONCLUSIONS: PTG instrument made of new gold alloy was more resistant to fatigue failure than PTN and PTU. Autoclaving increased the cyclic fatigue resistances of PTN and PTG.
Alloys ; Endodontics ; Fatigue* ; Sterilization*

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Removal efficacy and cytotoxicity of a calcium hydroxide paste using N-2-methyl-pyrrolidone as a vehicle.

Myung Jin LIM ; Hyun Jin JANG ; Mi Kyung YU ; Kwang Won LEE ; Kyung San MIN

Restorative Dentistry & Endodontics.2017;42(4):290-300. doi:10.5395/rde.2017.42.4.290

OBJECTIVES: This study investigated the removal efficacy and cytotoxicity of a newly developed calcium hydroxide paste (cleaniCal, Maruchi) using N-2-methyl-pyrrolidone (NMP) as a vehicle in comparison with ApexCal (Ivoclar Vivadent) and Calcipex II (Nishika), which use different vehicles such as polyethylene glycol and propylene glycol, respectively. MATERIALS AND METHODS: Thirty maxillary premolars with oval-shaped canals were divided into 3 groups and the teeth were filled with one of the pastes. After removal of the paste, micro-computed tomographic (μ-CT) imaging was obtained to assess the volume of residual paste in the root canal of each tooth. The teeth were then split longitudinally and the area of the paste-coated surface was evaluated by stereomicroscopy. The cytotoxicity of each product was assessed using an agar overlay assay. The effect of each vehicle on cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The data were analyzed using one-way analysis of variance and Tukey's tests to detect any significance (p < 0.05). RESULTS: In the μ-CT and stereomicroscopic analysis, cleaniCal exhibited less remnants of medicament than ApexCal and Calcipex. cleaniCal showed a higher cytotoxicity than the other pastes in the agar overlay assay. Furthermore, NMP exhibited lower cell viability compared to the other vehicles. CONCLUSIONS: cleaniCal showed better removal efficacy compared to the other products. However, clinicians should be aware of the higher cytotoxicity of the NMP-based material and consider its possible adverse effects on periradicular tissue when it is overfilled.
Agar ; Bicuspid ; Calcium Hydroxide* ; Calcium* ; Cell Survival ; Dental Pulp Cavity ; Ointments ; Polyethylene Glycols ; Propylene Glycol ; Tooth

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In vitro comparison of the cyclic fatigue resistance of HyFlex EDM, One G, and ProGlider nickel titanium glide path instruments in single and double curvature canals.

Koray YILMAZ ; Gülşah USLU ; Taha ÖZYÜREK

Restorative Dentistry & Endodontics.2017;42(4):282-289. doi:10.5395/rde.2017.42.4.282

OBJECTIVES: It was aimed to compare the cyclic fatigue resistances of ProGlider (PG), One G (OG), and HyFlex EDM (HEDM) nickel titanium glide path files in single- and double-curved artificial canals. MATERIALS AND METHODS: 40 PG (16/0.02), 40 OG (14/0.03), and 40 HEDM (10/0.05) single-file glide path files were used in the present study. Sixty files were subjected to cyclic fatigue test by using double-curved canals and 60 files by using single-curved canal (n = 20). The number of cycles to fracture (NCF) was calculated and the length of the fractured fragment (FL) was determined by a digital micro-caliper. Twelve pieces of fractured files were examined with scanning electron microscope to determine fracture types of the files (n = 2). The NCF and the FL data were analyzed using one-way analysis of variance and post hoc Tukey test using SPSS 21 software (p < 0.05). RESULTS: In all of the groups, NCF values were significantly lower in double-curved canals when compared to single-curved canals (p < 0.05). For both of single- and double-curved canals, NCF values of HEDM group in apical and coronal curvatures were found to be significantly higher than NCF values of PG and OG groups (p < 0.05). In both of single- and double-curved canals, NCF value of PG group was found significantly higher than OG group (p < 0.05). CONCLUSIONS: Within the limitations of this study, HEDM glide path files were found to have the highest cyclic fatigue resistance in both of single- and double-curved canals.
Fatigue* ; In Vitro Techniques* ; Nickel* ; Titanium*

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Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation.

Su Jin JEON ; Young Mi MOON ; Min Seock SEO

Restorative Dentistry & Endodontics.2017;42(4):273-281. doi:10.5395/rde.2017.42.4.273

OBJECTIVES: The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (µCT). MATERIALS AND METHODS: Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using µCT. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test. RESULTS: Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15–1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score (p < 0.05). CONCLUSIONS: The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.
Dental Pulp Cavity ; Gutta-Percha ; Humans ; In Vitro Techniques ; Methods ; Root Canal Obturation ; Tooth ; X-Ray Microtomography

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Evaluation of antimicrobial activity and efficacy of herbal oils and extracts in disinfection of gutta percha cones before obturation.

Chetana S MAKADE ; Pratima R SHENOI ; Elakshi MOREY ; Ameya V PARALIKAR

Restorative Dentistry & Endodontics.2017;42(4):264-272. doi:10.5395/rde.2017.42.4.264

OBJECTIVES: Literature has shown that micro-organisms contaminate gutta percha (GP) during storage and manipulation. Till date herbal extracts are not explored as an alternative medicament for pre-operative chairside disinfection of GP cones. The purpose of our study was to evaluate the antimicrobial activity and efficacy of lemon grass oil (LG), basil oil (BO), and obicure tea extract (OT) in disinfecting GP cones before obturation. MATERIALS AND METHODS: Agar diffusion method was used to evaluate the antimicrobial efficacy of LG, BO, OT, and sodium hypochlorite (control) against common contaminants, namely, Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. One hundred and twenty GP cones were contaminated and cut into 2. First half was placed in the broth and incubated; whereas the second was treated with herbal extracts for 1 minute and then incubated for 24 hours in the broth. Any inhibition in bacterial growth was noted with presence/absence of turbidity. Two-way analysis of variance and χ² test were used to assess the effectiveness of herbal extracts to decontaminate GP. RESULTS: LG showed the highest inhibition zones (29.9 ± 6.9 mm) for all tested organisms, followed by OT extract (16.3 ± 1.8 mm), sodium hypochlorite (16.0 ± 1.6 mm), and BO (14.5 ± 5.3 mm). Statistically significant difference was observed between LG and other herbal extracts (p < 0.05). CONCLUSIONS: All extracts proved to be potential rapid chairside disinfectants of GP cones with LG showing the highest antimicrobial activity.
Agar ; Candida albicans ; Cymbopogon ; Diffusion ; Disinfectants ; Disinfection* ; Enterococcus faecalis ; Gutta-Percha* ; Methods ; Ocimum basilicum ; Oils* ; Sodium Hypochlorite ; Staphylococcus aureus ; Tea

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