Effect of Er,Cr: YSGG Laser on the Microtensile Bond Strength of Two Different Adhesives to the Sound and Caries-affected Dentin

The microtensile bond strength of a three-step etch-and-rinse and a two-step self-etch adhesive is not negatively affected by Er,Cr:YSGG laser irradiation in sound and caries-affected dentin.

Oxygen release of tetra acetyl ethylene diamine (TAED) and sodium perborate combination

AIM

To evaluate the effect of tetra acetyl ethylene diamine (TAED) on oxygen release from sodium perborate and to compare it with sodium perborate-hydrogen peroxide (H(2)O(2)) and sodium perborate-distilled water mixtures.

METHODOLOGY

Six groups were evaluated: control groups (groups I-III), sodium perborate was mixed with distilled water or 3% or 30% H(2)O(2); experimental groups (groups IV-VI), sodium perborate was mixed with TAED in different ratios and then distilled water was added to these mixtures. The amount of oxygen released from the samples was measured with a digital oxygen meter at room temperature (25 degrees C) and body temperature (37 degrees C) after 1 min, 1-6 h and 12 h and on each day up to 1 week. The results were statistically evaluated by one-way analysis of variance and post hoc Tukey's tests.

RESULTS

The TAED groups demonstrated significantly higher amounts of released oxygen after 1 min and 1 h at 25 degrees C and 1 min at 37 degrees C (P < 0.05). At all other measurement times, the amount of TAED in each mixture did not alter the amount or speed of oxygen release (P > 0.05).

CONCLUSIONS

Tetra acetyl ethylene diamine groups achieved their maximum oxygen release 2 h earlier at 25 degrees C and 1 h earlier at 37 degrees C than the other groups. Thus, TAED accelerated oxygen release from sodium perborate-distilled water mixtures regardless of its proportions up to 24 h.

Effect of 10% sodium ascorbate on the shear bond strength of composite resin to bleached bovine enamel

The purpose of this study was to comparatively investigate the effect of antioxidant treatment and delayed bonding after bleaching with three different concentrations of carbamide peroxide (CP) on the shear bond strength of composite resin to enamel. One hundred flat buccal enamel surfaces obtained from bovine incisors were divided into three bleaching groups of 10, 16 and 22% CP (n = 30) and a control group. Each bleaching group was then divided into three subgroups (n = 10). Group 1 consisted of specimens bonded immediately after bleaching. Group 2 specimens were treated with antioxidant agent, 10% sodium ascorbate, while Group 3 specimens were immersed in artificial saliva for 1 week after bleaching. Specimens in the control group were not bleached. After the specimens were bonded with Clearfil SE Bond and Clearfil AP-X, they were thermocycled and tested in shear until failure. Fracture analysis of the bonded enamel surface was performed using scanning electron microscope. The shear bond strength data was subjected to one-way analysis of variance followed by Duncan's multiple range test at a significance level of P < 0.05. Shear bond strength of composite resin to enamel that was bonded immediately after bleaching with 10, 16 and 22% CP was significantly lower than that of unbleached enamel (P < 0.05). For all three bleaching groups, when the antioxidant-treated and delayed bonding (1 week) subgroups were compared with the control group, no statistically significant differences in shear bond strength were noted (P < 0.05).

The effect of one-step polishing system on the surface roughness of three esthetic resin composite materials

Proper finishing of restorations is desirable not only for aesthetic considerations but also for oral health. The primary goal of finishing is to obtain a restoration that has good contour, occlusion, healthy embrasure forms and a smooth surface. This study investigated: 1) analyzing the surface roughness of three resin composites finished and polished with a new one-step and two conventional multi-step polishing systems and 2) evaluating the effectiveness of one-step polishing system and surface morphology using scanning electron microscope analysis (SEM). Specimens (N = 72) measuring 8-mm in diameter x 2-mm in thickness were fabricated in a plexiglass mold covered with a Mylar strip using three esthetic resin composites. After polymerization six specimens per resin composite received no finishing treatment and served as a control. Fifty-four specimens were randomly polished with Sof-Lex discs, Enhance disc with polishing paste or PoGo for 30 seconds after being ground wet with a 1200 grit silicon carbide paper. The average surface roughness of each polished specimen was determined with a profilometer (Surtronic 4). The data were analyzed using repeated measures ANOVA and Scheffe's post-hoc test of multiple comparisons (p < or = 0.01). Representative samples of the mentioned finishing procedures were selected and examined using a scanning electron microscope (SEM). There was no surface roughness in all resin composites tested against Mylar strip. The results showed no difference between the surfaces of Clearfil ST and Esthet-X polished with PoGo and the Mylar group (p > or = 0.01). Among all the polishing systems tested, PoGo exhibited the smoothest finish for all resin composites. The combination of Enhance and Prisma Gloss polishing paste exhibited the highest roughness values for Filtek A110 and Clearfil ST; however, it gave the same Ra values as PoGo for Esthet-X (p < or = 0.01). SEM analysis of Esthet-X samples confirmed the profilometer's results. The surfaces of the Clearfil ST discs polished with PoGo resemble that of Mylar, while Enhance and Sof-Lex exposed and dislodged the filler particles. PoGo scratched in some places Filtek A110's surface, while Enhance produced mostly a Mylar-like surface with dislodged fillers in some places.

Effect of nonvital bleaching with 10% carbamide peroxide on sealing ability of resin composite restorations

AIM

To (i) determine the effect of nonvital bleaching with 10% carbamide peroxide on the sealing ability of resin composite restorations bonded with a self-etching adhesive system; and (ii) compare the effects of antioxidant treatment and delayed restoration after bleaching on marginal seal.

METHODOLOGY

Forty-eight noncarious maxillary incisors were divided into four groups (n=12) after conventional root canal treatment was completed. In group 1, access cavities were restored with a self-etching adhesive system and resin composite. In the remaining three groups, 10% carbamide peroxide bleaching gel was placed into the access cavities for periods of 8 h per day for 1 week. They were then restored in the same manner as group 1. Group 2 consisted of specimens restored immediately after bleaching. Group 3 specimens were treated with the antioxidant, 10% sodium ascorbate, whereas group 4 specimens were immersed in artificial saliva for 1 week before restoration. Ten specimens in each group were then subjected to dye leakage; the remaining 2 specimens were examined in a SEM (Jeol/JSM 5200, Tokyo, Japan). The dye penetration was assessed with the standard scoring system. Statistical analysis was carried out using the Kruskal-Wallis and the Mann-Whitney tests.

RESULTS

Groups 1, 3 and 4 exhibited similar leakage patterns and significantly less leakage than group 2 (P<0.0083). SEM examination of groups 1, 3 and 4 specimens demonstrated close adaptation of resin composite to cavity walls, whereas group 2 specimens did not.

CONCLUSION

Nonvital bleaching with 10% carbamide peroxide adversely affected the immediate sealing ability of resin composite restoration; both 10% sodium ascorbate treatment and a 1-week delay in restoration following bleaching improved the reduced sealing ability of resin composite.

Delayed replantation of avulsed mature teeth with calcium hydroxide treatment

Three avulsed teeth that were replanted and splinted after approximately a 200-min dry extraoral period in two patients are presented. In case 1 calcium hydroxide treatment was performed 1 month after replantation, because the patient did not come for endodontic treatment on the day after replantation as requested. In case 2, calcium hydroxide treatment was initiated on the day after replantation. Calcium hydroxide treatment was used to prevent or treat inflammatory root resorption. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position and did not reveal clinical ankylosis or replacement resorption.

Surgical extrusion of crown-root-fractured teeth: a clinical review

AIM

In this clinical study combined surgical and endodontic treatment was performed in 20 cases of crown-root fracture and the outcomes reviewed.

METHODOLOGY

Surgical treatment involved a conventional extraction and stabilization technique. Root canal treatment using calcium hydroxide was performed. Before root canal obturation, a calcium hydroxide dressing was maintained for 3 months.

RESULTS

Follow-up examinations, which varied between 6 and 36 (mean 14.5) months, showed that there were no radiographic and clinical signs of progressive root resorption, marginal bone loss or periapical disease in all except one case.

CONCLUSIONS

The favourable results of this study demonstrate that surgical extrusion in teeth with crown-root fractures may be an alternative treatment to orthodontic extrusion.

Surgical extrusion of intruded immature permanent incisors: case report and review of the literature

This report presents a case of intrusive luxation of immature maxillary central incisors with concomitant uncomplicated crown fractures in an 8-year-old boy. The intruded teeth with open apices were repositioned with surgical extrusion and endodontically treated through use of calcium hydroxide paste. Six months after initiation of apexification, definitive apical stops had formed. The canals were then permanently obturated, and the crowns were restored with composite resin. Clinical and radiographic examination 24 months after the surgical extrusion revealed satisfactory apical healing and healthy supporting tissues.

Effect of calcium hydroxide as an intracanal dressing on apical leakage

In this in vitro study, we investigated the effects of the use of two different calcium hydroxide (Ca(OH)2) preparations as an intracanal dressing on the sealing ability of two different sealers were investigated. Eighty-eight freshly extracted, single-rooted maxillary anterior teeth were used. After the root canals were hand-instrumented, they were divided into six groups of 10 each. The root canals were dressed with Ca(OH)2 paste, either mixed with sterile water (in groups 1 and 2) or with glycerine (in groups 3 and 4). The dressed root canals were incubated in 100% humidity at 37 degrees C for 7 days. In groups 5 and 6, the root canals were not dressed. After the root canal dressings were removed by irrigation with 5.25% NaOCl and reaming with a K-type file, all canals of the experimental groups were obturated with sealer and gutta-percha using a cold lateral condensation technique. Calciobiotric Root Canal Sealer, (CRCS), (in groups 1, 3 and 5) and Diaket (in groups 2, 4 and 6) were used as sealers. All specimens were placed in India ink for 7 days, and the amount of apical leakage was scored. Eight further prepared specimens were dressed with Ca(OH)2 plus water or Ca(OH)2 plus glycerine and examined with scanning electron microscopy (SEM) following the removal of dressings. There was a statistical difference in the leakage patterns amongst the 6 experimental groups (P < 0.05). Specimens in group 2 exhibited less leakage than the other experimental groups, except group 4 (P < 0.05). There were no other significant interactions. SEM examination revealed that Ca(OH)2 crystals were present on the surface of smear layer in both groups where Ca(OH)2 paste had been placed, but they did not penetrate into the dentinal tubules.

Delayed endodontic and orthodontic treatment of cross-bite occurring after luxation injury in permanent incisor teeth

A case is presented in which combined endodontic and orthodontic therapy was performed in traumatically injured teeth 12 months after an accident. Calcium hydroxide treatment was used to halt any possible resorption during orthodontic treatment. The teeth were repositioned in a desirable manner without any complication by orthodontic treatment. Root canal obturation was accomplished after the completion of active orthodontic treatment. Recall examination 12 months after completion of root canal treatment showed clinical and radiographic evidence of healing.

Periapical repair and apical closure of a pulpless tooth using calcium hydroxide

A case with a wide-open apex and a large cystlike periapical lesion in an adult is presented. The lesion formed as a result of necrosis from trauma to a maxillary central incisor 12 years ago. After nonsurgical endodontic treatment with calcium hydroxide paste and a calcium hydroxide-containing root canal sealer, apical closure and significant healing of the periapical lesion within 15 months were observed. This report suggests that even large periapical lesions (likely cystic) could respond favorably to nonsurgical treatment.

The effects of sodium hypochlorite and calcium hydroxide on tissue dissolution and root canal cleanliness

In this in vitro study, we investigated the efficacy of sodium hypochlorite (NaOCl) and calcium hydroxide (Ca(OH)2) in dissolving necrotic tissue and cleaning root canals. In the first part of the study, 0.5% NaOCl solution and Ca(OH)2 paste and solution were tested with samples of necrotic bovine muscle in different treatment modes and for different periods. The necrotic tissue was weighed before and after the test and the percentage of weight change calculated. In the second part of the study, 40 extracted single-rooted human teeth were hand instrumented and then subjected to different irrigation regimens. The cleansing efficacy in root canals of 0.5% NaOCl with Ca(OH)2 pretreatments and ultrasonics was examined using scanning electron microscopy. A solution of 5% NaOCl was significantly more effective than 0.5% NaOCl as a solvent of necrotic tissue. Calcium hydroxide was an effective solvent for necrotic tissue as a paste but not as a solution. Pretreatment of necrotic tissue with Ca(OH)2 increased its solubility in 0.5% NaOCl. While 5% NaOCl plus ultrasonic irrigation produced cleaner root-canal walls at the middle and apical thirds, 0.5% NaOCl used with the same technique achieved no root-canal cleaning. However, pretreatment of root canals with Ca(OH)2 paste increased the effectiveness of 0.5% NaOCl plus ultrasonic irrigation, except in the coronal third of the root canal.

Prognosis of permanent teeth with internal resorption: a clinical review

This study was performed in order to report the clinical features of internal resorption cases and evaluate their prognosis after endodontic treatment. Twenty-seven patients with 28 teeth with internal resorption were referred to our clinic and 20 teeth were treated endodontically. Sixteen teeth had non-perforating internal resorption and were treated by conventional root canal therapy. The remaining 4 teeth had perforating internal resorption and were initially treated by remineralization therapy with calcium hydroxide. The teeth treated by conventional root canal therapy showed clinical and radiographic evidence of healing. However, the remineralization therapy was successful in only one case. The three failed cases were subsequently treated by endodontic surgery. The surgical therapy was unsuccessful in one case due to extensive loss of marginal alveolar bone and increased tooth mobility.

Root canal treatment of a root-fractured incisor tooth with internal resorption: a case report

A case is described in which root canal treatment with calcium hydroxide was used successfully to repair a fracture site with internal resorption of the tooth.

Clinical investigation of traumatic injuries of permanent incisors in Izmir, Turkey

470 injured teeth of 370 patients who consulted the Dental Clinic of Ege University, Izmir, Turkey for examination or treatment between 1981-1993 were evaluated. Information concerning sex, age of patients at the time of injury, cause of trauma, number of injured teeth, type of tooth and type of trauma were recorded. More boys suffered traumatic injuries (64.8%) than girls (35.2%). Patients aged 11-15 years old exhibited the highest number of injuries (34.4%) followed by the 6-10 years old group (24.5%). Most injuries involved one tooth (60%) and maxillary central incisors were the most often affected teeth (66.2%). The leading cause of injury was undefined falls (45.1%). At the initial examination, cases seen after a long posttraumatic period showed more complications than those presented within a short time period. Educational programs about the importance of dental trauma, the benefits of immediate attendance and conservation of avulsed and fractured teeth would be very helpful for patients. Additionally improving the knowledge of the dental practitioner about trauma would be another important point in solving the problem.

Stability of various sodium hypochlorite solutions

Although the manufacturers use at least a 2-yr expiration date for sealed undiluted NaOCl solutions, chemical stability of NaOCl may be adversely affected by many factors. The purpose of this study was to investigate the effects of storage temperature, concentration, and time on the stability on three different brands of commercial household bleaching agents as a source of NaOCl, and to compare the stability of these brands. All solutions showed degradation versus time; however, this degradation occurred very slowly except for the group of solutions containing 5% available chlorine stored at 24 degrees C. Solutions containing 0.5% available chlorine stored at 4 degrees C and 24 degrees C and 5% solutions stored at 4 degrees C showed satisfactory stability at 200 days. No significant difference was found among three brands in respect to their chemical stability.

The smear layer: a phenomenon in root canal therapy

When the root canals are instrumented during endodontic therapy, a layer of material composed of dentine, remnants of pulp tissue and odontoblastic processes, and sometimes bacteria, is always formed on the canal walls. This layer has been called the smear layer. It has an amorphous, irregular and granular appearance under the scanning electron microscope. The advantages and disadvantages of the presence of smear layer, and whether it should be removed or not from the instrumented root canals, are still controversial. It has been shown that this layer is not a complete barrier to bacteria and it delays but does not abolish the action of endodontic disinfectants. Endodontic smear layer also acts as a physical barrier interfering with adhesion and penetration of sealers into dentinal tubules. In turn, it may affect the sealing efficiency of root canal obturation. When it is not removed, the durability of the apical and coronal seal should be evaluated over a long period. If smear layer is to be removed, EDTA and NaOCl solutions have been shown to be effective, among various irrigation solutions and techniques, including ultrasonics, that have been tested. Once this layer is removed, it should be borne in mind that there is a risk of reinfecting dentinal tubules if the seal fails. Further studies are needed to establish the clinical importance of the absence or presence of smear layer.

Root canal morphology of human permanent teeth in a Turkish population

An in vitro study was performed to determine the number and the type of root canals, their ramifications, transverse anastomoses, apical foramina locations, and frequency of apical deltas in a Turkish population. One thousand four hundred human permanent teeth were injected with India ink, decalcified, and cleared after the length of each was measured. The examination of root canal systems of the teeth was based on Vertucci's classification. The findings were used to classify the teeth into four groups. Variable root canal configurations were found in the second premolar and the mesiobuccal roots of first and second molars among the maxillary teeth and in all of the mandibular teeth, except the mandibular second premolar.

Allergy to sodium hypochlorite during root canal therapy: a case report

Sodium hypochlorite (NaOCl), is the most popular irrigation solution used in root canal treatment but it is known to be an irritant to vital tissues. There have been many case reports dealing with toxic effects of this material. Although the allergic potential of NaOCl has been described in the medical literature, only one case of known hypersensitivity to NaOCl has been reported in the dental literature. In this paper a case is presented, describing both local and systemic adverse tissue reactions, caused by an allergic response, after NaOCl irrigation.

Permeability of protective gloves used in dental practice

Two brands of latex rubber gloves and one brand of polyvinyl chloride glove were examined for their permeability. New and used gloves were included. All of the gloves were examined visually and then subjected to an air leakage test, an electrical test, and a microbiologic test. Permeability was evaluated independently by two researchers in a blind manner. Statistical analysis showed that there were no significant differences among the three brands of gloves or with respect to the usage periods, according to visual inspection and the air leakage test. Conversely, there were significant differences among each of the three brands of gloves and with respect to usage periods, according to the electrical and microbiologic tests.