OBJECTIVE: To compare the effects of autoclave on surface microstructure and cyclic fatigue resistance of K3XF and K3. METHODS: Forty-eight size 25, 0.06 taper 25 mm-long K3XF or K3 were randomly divided into 4 groups (n=12). The instruments from group 1 were not autoclaved, and the groups 2 to 4 underwent autoclave for 10 cycles, 20 cycles, and 30 cycles, respectively. The surface microstructure of two instruments randomly selected from each group was observed using scanning electron microscope (SEM). The remaining 10 instruments were submitted to the cyclic fatigue test by using a simulated metal root canal with curvature of 60° and radius 3.5 mm. The time till fracture was recorded, the number of cyclic fatigue (NCF) calculated, the fragment length evaluated, and the topographic features were analyzed using SEM. The data were analyzed using the two-way ANOVA analysis by SAS 9.3 software at a significance level of P<0.05. RESULTS: SEM observation identified rough features on the surface of K3XF with micropores existing evenly. K3 was characterized by machining grooves, which located specifically in the flute, leaving a smooth cutting edge. After autoclave, SEM observation indicated that the micropores in the surface of K3XF became larger and more, whereas the machining grooves in the surface of K3 were squeezed, out of shape and flaking. As far as the NCF was concerned, new K3XF was 210±59, and no significant difference was found after 10, 20, and 30 cycles of autoclave for K3XF, values being 178±37, 208±48, and 227±43, respectively (P>0.05). For K3, the new one was 145±38, and no significant difference in NCF was demonstrated after 10 and 20 cycles of autoclave, with the values of 128±43 and 124±46, respectively (P>0.05). However, after 30 cycles of autoclave of K3, significant increase to 216±38 was identified (P<0.05). Topographic features demonstrated typical cyclic fatigue for all the groups. CONCLUSION The surface roughness of K3XF was increased after autoclave, while the cyclic resistance remained stable after up to 30 cycles.
Dental Alloys ; Dental Instruments ; Disinfection ; Equipment Failure ; Hot Temperature ; Materials Testing ; Nickel ; Root Canal Preparation/instrumentation* ; Titanium

Developments in science and technology include the use of laser as an auxiliary device in treating oral diseases. Nd:YAG laser is convenient and safe to use. Nd:YAG laser irradiation leaves no scabby area on the wound surface, causes a mild reaction postoperation, and promotes high comfort. Therefore, this treatment has attracted increasing attention in the clinical setting. This review enumerates the applications of water-cooled pulsed Nd:YAG laser in hard and soft tissues in oral medicine. Nd:YAG laser in hard tissues can be applied in cavity preparation, acid etching, root canal preparation and sterilization, and dentin desensitization therapy. Meanwhile, the applications of this laser in soft tissues include adjunctive therapy in basic periodontitis treatment, gingival aesthetic treatment, and resection. This review suggests the importance of Nd:YAG laser as an auxiliary device in the clinical diagnosis and treatment of oral diseases.
Dental Cavity Preparation ; Dentin ; Humans ; Lasers, Solid-State ; Oral Medicine ; instrumentation ; methods ; Root Canal Preparation

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA-PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
Aluminum Compounds ; therapeutic use ; Calcification, Physiologic ; physiology ; Calcium Compounds ; therapeutic use ; Crystallization ; Dental Pulp Cavity ; microbiology ; Dentin ; microbiology ; Drug Combinations ; Enterococcus faecalis ; ultrastructure ; Humans ; Methylmethacrylates ; therapeutic use ; Microscopy, Electron, Scanning ; Oxides ; therapeutic use ; Root Canal Filling Materials ; therapeutic use ; Root Canal Obturation ; methods ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Time Factors ; Zinc Oxide-Eugenol Cement ; therapeutic use

Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
Calcium Compounds ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Microsurgery ; instrumentation ; Middle Aged ; Periapical Diseases ; therapy ; Periapical Tissue ; diagnostic imaging ; physiology ; Radiography, Bitewing ; Regeneration ; physiology ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Ultrasonic Surgical Procedures ; instrumentation ; Wound Healing ; physiology

In this study, we evaluate the influence of post surface pre-treatments on the bond strength of four different cements to glass fiber posts. Eighty extracted human maxillary central incisors and canines were endodontically treated and standardized post spaces were prepared. Four post pre-treatments were tested: (i) no pre-treatment (NS, control), (ii) sandblasting (SA), (iii) silanization (SI) and (iv) sandblasting followed by silanization (SS). Per pre-treatment, four dual-cure resin cements were used for luting posts: DMG LUXACORE Smartmix Dual, Multilink Automix, RelyX Unicem and Panavia F2.0. All the specimens were subjected to micro push-out test. Two-way analysis of variance and Tukey post hoc tests were performed (α=0.05) to analyze the data. Bond strength was significantly affected by the type of resin cement, and bond strengths of RelyX Unicem and Panavia F2.0 to the fiber posts were significantly higher than the other cement groups. Sandblasting significantly increased the bond strength of DMG group to the fiber posts.
Aluminum Oxide ; chemistry ; Composite Resins ; chemistry ; Curing Lights, Dental ; classification ; Cuspid ; pathology ; Dental Bonding ; Dental Etching ; methods ; Dental Materials ; chemistry ; Dental Stress Analysis ; instrumentation ; Glass ; chemistry ; Humans ; Incisor ; pathology ; Materials Testing ; Microscopy, Electron, Scanning ; Polymerization ; Post and Core Technique ; instrumentation ; Resin Cements ; chemistry ; Root Canal Preparation ; methods ; Self-Curing of Dental Resins ; methods ; Silanes ; chemistry ; Stress, Mechanical ; Surface Properties ; Tooth, Nonvital ; therapy

Calcium hydroxide (CH) dressing residues can compromise endodontic sealing. This study aimed to evaluate the amount of remaining CH in root canals after mechanical removal by four groups of irrigation techniques including needle irrigation only, ProTaper file, EndoActivator, and ultrasonic file. Fifteen extracted single-rooted teeth were collected and used for all four groups. The samples were firstly prepared by ProTaper rotary instruments, and then sectioned longitudinally through the long axis of the root canals, followed by final reassembling by wires. CH was kept in the canals for 7 days setting. The removal procedure began with 5 mL of 2.5% sodium hypochlorite (NaOCl) followed by 1 mL of 17% ethylenediaminetetraacetic acid and a final irrigation with 5 mL of 2.5% NaOCl solution for all groups. No additional agitation of the irrigant was performed in group 1, while agitation for 20 s between irrigants was done with F2 ProTaper rotary file in group 2, EndoActivator with tip size 25/.04 in group 3 and by an ultrasonic file 25/.02 in group 4. The total activation time was 60 s. The roots were then disassembled and captured by digital camera. The ratio of CH coated surface area to the surface area of the whole canal as well as each third of the canal was calculated. The data were statistically analyzed by one-way ANOVA using post hoc Tukey test. Results showed that none of the four techniques could remove all CH. No significant difference was found between EndoActivator and ultrasonic techniques. However, they both removed significantly more CH than ProTaper and needle irrigation (P=0.0001). In conclusion, the sonic and ultrasonic agitation techniques were more effective in removing intracanal medicaments than the ProTaper rotary file and needle irrigation in all thirds of the canal.
Calcium Hydroxide ; isolation & purification ; Dental Instruments ; Dental Pulp Cavity ; chemistry ; Equipment Design ; Equipment Failure Analysis ; Humans ; In Vitro Techniques ; Root Canal Irrigants ; isolation & purification ; Root Canal Preparation ; instrumentation ; methods ; Sonication ; instrumentation ; methods ; Therapeutic Irrigation ; instrumentation

The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate (MTA) to apical dentin using microcomputed tomography (micro-CT) and scanning electron microscopy (SEM). Sixty-four extracted single-rooted human maxillary teeth were used. Following root-end resection and apical preparation, the teeth were equally divided into four groups according to the following root end filling materials: (i) white-colored MTA (WMTA), (ii) etched WMTA (EWMTA), (iii) gray-colored MTA (GMTA) and (iv) etched GMTA (EGMTA). After 48 h, the interface between root-end filling materials and the dentinal walls was assessed using micro-CT and SEM. Data were statistically analyzed using the Kruskal-Wallis and Dunn tests. Micro-CT analysis revealed gap volumes between the apical cavity dentin walls and EGMTA, GMTA, EWMTA and WMTA of (0.007 1±0.004) mm(3), (0.053±0.002) mm(3), (0.003 6±0.001) mm(3) and (0.005 9±0.002) mm(3) respectively. SEM analysis revealed gap sizes for EGMTA, WMTA, EWMTA and GMTA to be (492.3±13.8) µm, (594.5±17.12) µm, (543.1±15.33) µm and (910.7±26.2) µm respectively. A significant difference in gap size between root end preparations filled with GMTA and EGMTA was found (P<0.05). No significance difference in gap size between WMTA and EWMTA were found in either SEM or micro-CT analysis. In conclusion, pre-etching of apical dentin can provide a better seal for GMTA but not for WMTA.
Acid Etching, Dental ; methods ; Aluminum Compounds ; chemistry ; Apicoectomy ; methods ; Calcium Compounds ; chemistry ; Dental Bonding ; Dental Marginal Adaptation ; Dental Pulp Cavity ; ultrastructure ; Dentin ; ultrastructure ; Drug Combinations ; Humans ; Materials Testing ; Microscopy, Electron, Scanning ; Oxides ; chemistry ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; chemistry ; Root Canal Preparation ; instrumentation ; methods ; Silicates ; chemistry ; Surface Properties ; Time Factors ; Tooth Apex ; ultrastructure ; X-Ray Microtomography

OBJECTIVETo evaluate the microleakage of fiber post and core systems after high-speed handpiece preparation at different time points.

METHODSThe crowns of forty-five extracted human premolar were removed and the roots were endodontically treated. The samples were devided into five groups. Root canal preparation was performed on each premolar followed by fiber post cementation and core build up. Tooth preparation was applied at 5 min in group 1, at 15 min in group 2 and at 30 min in group 3 after post cementation. Five teeth with only 5 mm apical sealing were served as a positive control group, and ten with fiber post and core build-up but no coronal preparation were taken as a negative control group. Microleakage was evaluated using a fluid filtration system. The bonding interface was observed by scanning electronic microscope (SEM).

RESULTSThe microleakage was significantly increased after coronal preparation with high-speed handpiece. The negative control group has less leakage [(1.50 × 10(-6) ± 0.37 × 10(-6)) µl×min(-1)×Pa(-1)] than the groups with coronal preparation (P < 0.05); Group 1 leaked significantly more [(6.02 × 10(-5) ± 1.02 × 10(-5)) µl×min(-1)×Pa(-1)] than group 2 [(1.50 × 10(-5) ± 0.26 × 10(-5)) µl·min(-1)×Pa(-1)] and group 3 [(1.50 × 10(-5) ± 0.39 × 10(-5)) µl×min(-1)×Pa(-1)] did (P < 0.05). Corresponding to microleakage, the micro gaps between the resin cement and dentine in group 1 were wider than those in the other groups. The coronal section was wider than the apical part.

CONCLUSIONSHigh-speed handpiece had negative effects on microleakage of fiber post and core systems. Coronal preparation should be performed 15 min or more after post cementation.

Cementation ; Dental Bonding ; Dental Leakage ; Dentin-Bonding Agents ; Humans ; Microscopy, Electron, Scanning ; Post and Core Technique ; instrumentation ; Resin Cements ; Root Canal Preparation ; Time Factors

Chlorhexidine ; Citric Acid ; Dental Pulp Cavity ; Disinfectants ; Disinfection ; Doxycycline ; Edetic Acid ; Humans ; Hydrogen Peroxide ; Needles ; Polysorbates ; Root Canal Irrigants ; Root Canal Preparation ; instrumentation ; methods ; Sodium Hypochlorite ; Ultrasonics

The aim of this study was to analyze the specific influence of root canal anatomy on the accessibility of working length during root canal therapy. Four hundred seventy-six root canal therapy cases (amounting to a total of 1 005 root canals) were examined. The anatomy risk factors assessed in each case included: tooth type (tooth location), root canal curvature, and root canal calcification, as well as endodontic retreatment. The investigation examined the correlation between each of these anatomic factors and the working length, with statistical analysis consisting of Chi-square tests and multiple logistic regression analysis. In an independent factor analysis, tooth type (tooth location), root canal curvature, canal calcification, and endodontic retreatment were determined to be the primary risk factors. In a multiple-factor regression model, root curvature and canal calcification were found to most significantly influence root canal working length accessibility (P<0.05). Root canal anatomy increases the difficulty of root canal preparation. Appropriate consideration of tooth anatomy will assist in accurate determination of preparation difficulty before instrumentation. This study alerts clinical therapists to anatomical factors influencing the working length accessibility, and allows for a direct estimate of success rate given in situ measurements of tooth factors during the root canal treatment procedure.
Chi-Square Distribution ; Dental Pulp Calcification ; pathology ; Dental Pulp Cavity ; anatomy & histology ; diagnostic imaging ; Humans ; Logistic Models ; Odontometry ; Radiography ; Retreatment ; Risk Factors ; Root Canal Preparation ; instrumentation ; Tooth Apex ; Tooth Root ; anatomy & histology