Effect of Hydrothermal, Chemical, and Mechanical Degradation on Flexural Strength and Phase Transformation of Ground, Glazed, and Polished Zirconia.

Objectives: Evaluation of the effect of grinding on flexural strength of zirconia after low temperature degradation (LTD) and pH-cycling. Materials and Methods: Sixty-four bar-shaped specimens of yttria-stabilized tetragonal polycrystalline zirconia were milled, sintered, wet-polished, and divided into 8 groups (N=8). The four control groups were not aged while artificial aging was performed in the 4 experimental groups in three steps including LTD in steam for 40h, pH-cycling, and tooth brushing for artificial aging. All groups underwent surface preparations as follows: standard polishing without surface treatment (Sp), grinding with a blue-yellow band diamond instrument (Gr); grinding with a diamond rotary instrument (DRI) and then over-glazing (Gl); grinding with a DRI followed by two-step intraoral polishing (Po); standard polishing and aging (Sp-Ag); grinding and aging (Gr-Ag), grinding, over-glazing and aging (Gl-Ag); and grinding, polishing and aging (Po-Ag). Monoclinic content was assessed in one specimen of each group by X-ray diffraction (XRD). The 3-point flexural strength test was performed in a universal testing machine. The results were analyzed with two-way ANOVA and Tukey's test (α=0.05). Results: Mean flexural strength (Mpa) was significantly higher in groups Gr and Po compared to group Sp (both, P<0.0001) and group Gl (both, P<0.0001). In XRD analyses, the highest monoclinic phase before aging was observed in group Gr (12.6%), and after aging in group Gr-Ag (51.2%). Conclusion: Grinding and polishing increased the flexural strength, while glazing did not exhibit any significant effect on this parameter. Furthermore, aging did not adversely affect flexural strength.

Effect of Low-Temperature Degradation, Ph-Cycling and Simulated Tooth Brushing on Surface Roughness, Topography, and Polish Retention of Yttrium-Stabilized Tetragonal Zirconia.

Statement of the Problem: Surface roughness of zirconia is an important parameter that determines the success of zirconia restorations. When zirconia surfaces are left rough, higher susceptibility to hydrothermal aging, plaque accumulation and color changes would occur. Therefore, polish retention of these restorations is considered as a challenge. Purpose: The purpose of this in vitro study was to determine the effect of hydrothermal degradation, pH- cycling, and simulated tooth brushing on surface roughness, topography, and polish retention of an yttrium-stabilized monolithic zirconia. Materials and Method: In this experimental study, 64 specimens of yttria-stabilized tetragonal zirconium oxide (20×4×2mm) were prepared (ZirKonzahn, Steger, Ahrntal). The specimens were wet- polished (standard polishing), and divided into 8 groups (n=8). Four control groups were assessed in non-aged condition while in 4 experimental groups the artificially ageing was done. Different finishing and polishing procedures were performed in 8 groups. The surface roughness values including mean surface roughness (Ra) and mean height of surface roughness (Rz) was measured by a profilometer. The results were analyzed using two-way ANOVA and Tukey's HSD test (α=0.05). One representative specimen of each group was inspected under a scanning electron microscope (SEM) for assessment of surface topography. Results: The effects of surface treatments on Ra (p<.001) and Rz (p<.001) parameters were significant. Ageing had no significant effect on Ra (p=.086) and Rz (p=.067) values. Maximum Ra and Rz parameters were recorded following grinding (p<.001) and minimum values were recorded after glazing, which were significantly lower than the values in grinding group (p<.001). Polishing and glazing diminished the surface roughness (Ra) of ground zirconia similarly (p=.995). Conclusion: Aging had no significant effect on surface roughness of zirconia, irrespective of surface treatment type. Grinding yielded maximum surface roughness. Intra oral polishing yielded a surface roughness comparable to standard polishing and glazing.

Endodontic management of a tooth with apical overfilling and perforating external root resorption: A case report.

Successful non-surgical orthograde retreatment of a tooth with external root resorption in apical third of root and overfilling material beyond the apical barrier which was diagnosed with the help of cone beam computed tomography (CBCT), was reported. Biodentine was used as the treatment of choice for obturation of resorption area.

Canal Transportation and Centering after Using PathFile and R-Pilot in Mesiobuccal Canals of Maxillary Molars Using Cone-Beam Computed Tomography.

Introduction: This study aimed to compare the changes in root canal anatomy following the use of PathFile and R-Pilot using cone-beam computed tomography (CBCT). Methods and Materials: In this in vitro, experimental study, 60 extracted maxillary first and second molars with 20 to 40° mesiobuccal root curvature, minimum of 19 mm of root length, no calcified root canals and no history of previous treatment were divided into two groups (n=30). CBCT scans were taken before and after the treatment, and sections at 1, 2 and 3 mm from the apex were compared. Pairwise comparisons were carried out using the Mann Whitney-U test. The centering ratio data were analyzed using the Chi-square test and Fisher's exact test. All statistical analyses were carried out using Sigma Stat 4 software. Results: The difference between PathFile and R-Pilot in canal transportation in mesiodistal direction was significant at 1 and 2 mm from the apex (P<0.01). The R-Pilot file was significantly superior to PathFile in centering ability in mesiodistal direction at 1 mm from the apex (P<0.05). Canal transportation direction was towards the mesiolingual and distobuccal in R-Pilot and PathFile groups, respectively. Conclusion: Within the limitations of this study, the results showed that R-Pilot with reciprocal movement is a safe and easy to use instrument for creating a glide path.

Negotiation, Centering Ability and Transportation of Three Glide Path Files in Second Mesiobuccal Canals of Maxillary Molars: A CBCT Assessment.

Introduction: The aim of this study was to compare negotiation, centering ability and transportation of three path finder rotary instruments (ProGlider, ScoutRace and M3 Pro-Gold Path File) to create glide path in second mesiobuccal (MB2) canals of maxillary molars with cone-beam computed tomography (CBCT). Methods and Materials: In this in vitro study, 66 maxillary molars with separate second MB2 canals were selected with the following criteria: having 18-21 mm root length, without any resorption or calcification in radiography, without previous treatment and 20-40º curve according to Schneider's method. Then MB2 canals were randomly divided into three groups (n=22). CBCT scan before and after root canal negotiation was taken. A #10 K-file for determination of working length was inserted into all canals. In group1; ProGlider file, group2; ScoutRace file and in group 3; M3 Pro-Gold Path file was implemented. The calculated data from CBCT based on reaching full working length (RFWL) or not (NRFWL) were analyzed using the Pearson Chi-square test. Centering ability was calculated by Fisher's exact test and amount of transportation was determined with the Pearson Chi-square test in SPSS software. Results: ProGlider file had the least RFWL and ScoutRace was the best, but the results were not statistically significant (P>0.05). Regarding the centering ability and transportation, all 3 groups showed no significant differences (P>0.05), except at level of 2 mm from the apex in buccopalatal direction for ProGlider and ScoutRace files (P<0.05). Conclusion: In spite of insignificantly different results, ScoutRace file was better than other groups in negotiating and centering ability in mesiodistal direction of the MB2 canal in maxillary molars. Also, ProGlider file was significantly better than ScoutRace regarding transportation at level of 2 mm from apex in buccopalatal direction.

An In vitro Comparison of Apically Extruded Debris Using Reciproc, ProTaper Universal, Neolix and Hyflex in Curved Canals.

INTRODUCTION: As a consequence of root canal preparation, dentinal chips, irrigants and pulp remnants are extruded into preradicular space. This phenomenon may lead to post endodontic flare-ups. The purpose of this study was to compare the amount of extruded debris with four endodontic NiTi engine-driven systems. METHODS AND MATERIALS: Sixty mesiobuccal roots of maxillary molars with 15-30˚ curvature were divided randomly into four groups (n=15). Each group was instrumented up to apical size of 25 using Reciproc, ProTaper Universal, Neolix and Hyflex. Bidistilled water was used as irrigant and extruded debris was collected in pre-weighted Eppendorf tubes. Tubes were stored in incubator for drying the debris. Extruded debris were weighted in electronic microbalance with accuracy of 0.0001 g. The raw data was analyzed with one way analysis of variance (ANOVA) and Tukey's HSD post hoc test. Level of significance was set at 0.05. RESULTS: The debris extrusion with Reciproc files was significantly higher than the other groups (P<0.05). Hyflex significantly extruded less debris than other files (P<0.05). There was no significant difference between ProTaper Universal and Neolix regarding the amount of extruded debris (P=0.98). CONCLUSION: All systems extruded debris during the instrumentation. Reciproc system significantly extruded more debris. Caution should be taken when interpreting the results of this study and applying it to the real clinical situation.

Biocompatibility of Portland Cement Modified with Titanium Oxide and Calcium Chloride in a Rat Model.

INTRODUCTION: The aim of the present study was to evaluate the biocompatibility of two modified formulations of Portland cement (PC) mixed with either titanium oxide or both titanium oxide and calcium chloride. METHODS AND MATERIALS: Polyethylene tubes were filled with modified PCs or Angelus MTA as the control; the tubes were then implanted in 28 Wistar rats subcutaneously. One tube was left empty as a negative control in each rat. Histologic samples were taken after 7, 15, 30 and 60 days. Sections were assessed histologically for inflammatory responses and presence of fibrous capsule and granulation tissue formation. Data were analyzed using the Fisher's exact and Kruskal-Wallis tests. RESULT: PC mixed with titanium oxide showed the highest mean scores of inflammation compared with others. There was no statistically significant difference in the mean inflammatory grades between all groups in each of the understudy time intervals. CONCLUSION: The results showed favorable biocompatibility of these modified PC mixed with calcium chloride and titanium oxide.

Apical Extrusion of Debris after Canal Preparation with Hand-Files Used Manually or Installed on Reciprocating Air-Driven Handpiece in Straight and Curved Canals.

INTRODUCTION: Apical debris extrusion (DE) subsequent to root canal instrumentation, is one of the most important causes of endodontic flare-ups. The aim of this study was to compare the amount of DE after root canal instrumentation using nickel-titanium (NiTi) hand files with step-back manual technique or installed on reciprocating handpiece. METHODS AND MATERIALS: This study was conducted on mesiobuccal (MB) roots of extracted maxillary first molars (n=20) and roots of mandibular premolars (n=20) that were randomly divided into two groups (n=20) according to the armamentarium used for canal preparation (air-driven reciprocating handpiece or hand instrumentation). In each group, the MB and premolar roots were prepared with the main apical sizes of 35 and 40, respectively. The extruded debris were collected and weighed. Finally, the mean dry weights were compared using ANOVA and t-test, and Tukey's Multiple Comparisons Procedures were used to determine the significant differences in amounts of DE. The level of significance was set at 0.05. RESULTS: Regardless of the type of teeth, the mean values of DE, were significantly lower in the handpiece group (P<0.0001). In addition, significantly lower amounts of DE was observed in premolars in similar group (P<0.001). However, this difference was not significant in MB roots of molars (P=0.20). CONCLUSION: Root canal preparation with reciprocating handpiece can lead to significantly lower debris extrusion than the manual step-back technique. In handpiece-prepared canals, the amount of extruded debris was significantly lower in premolar teeth.

Cone-beam Computed Tomographic Assessment of Canal Centering Ability and Transportation after Preparation with Twisted File and Bio RaCe Instrumentation.

OBJECTIVE: Use of rotary Nickel-Titanium (NiTi) instruments for endodontic preparation has introduced a new era in endodontic practice, but this issue has undergone dramatic modifications in order to achieve improved shaping abilities. Cone-beam computed tomography (CBCT) has made it possible to accurately evaluate geometrical changes following canal preparation. This study was carried out to compare canal centering ability and transportation of Twisted File and BioRaCe rotary systems by means of cone-beam computed tomography. MATERIALS AND METHODS: Thirty root canals from freshly extracted mandibular and maxillary teeth were selected. Teeth were mounted and scanned before and after preparation by CBCT at different apical levels. Specimens were divided into 2 groups of 15. In the first group Twisted File and in the second, BioRaCe was used for canal preparation. Canal transportation and centering ability after preparation were assessed by NNT Viewer and Photoshop CS4 software. Statistical analysis was performed using t-test and two-way ANOVA. RESULTS: All samples showed deviations from the original axes of the canals. No significant differences were detected between the two rotary NiTi instruments for canal centering ability in all sections. Regarding canal transportation however, a significant difference was seen in the BioRaCe group at 7.5mm from the apex. CONCLUSION: Under the conditions of this in vitro study, Twisted File and BioRaCe rotary NiTi files retained original canal geometry.