Effect of low uterine segment involvement on prognosis of early stage endometrial cancer.

AIM: Our aim is to investigate the effect of uterine lower segment involvement on prognosis of early-stage endometrial cancer cases diagnosed and treated in our clinic. MATERIALS AND METHODS: The file records of 316 cases reviewed retrospectively.Only stage I (a and b, n=209) cases were investigated, because they were more homogeneous group. RESULTS: The lymphovascular invasion rate was found to be higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Adjuvant treatment requirement was higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Among stage Ia cases, the recurrence rate between 1 and 3 years was found to be higher in cases with uterine lower segment involvement (p = 0.001). Among the stage Ib cases, lymphovascular invasion was found to be higher in cases with uterine lower segment involvement (p < 0.001). The recurrence rate between 1 and 3 years was found to be higher in stage Ib compared to Ia (p = 0.01). Uterine lower segment involvement was found to be associated with high lymphovascular invasion rate in all stage I cases (p < 0.001). It was determined that the need for adjuvant treatment was higher in cases with uterine lower segment involvement (p < 0.001). It was determined that the probability of recurrence between 1 and 3 years was higher in cases with uterine lower segment involvement (p = 0.007). CONCLUSION: Uterine lower segment involvement is associated with increased lymphovascular invasion even in the early stages. It is an important risk factor for systemic spread such as lymphovascular invasion, myometrial invasion, and lymph node involvement.

The micro CT evaluation of crown and root pulp volume versus dentin thickness in teeth in postmortem interval (PMI).

Determining the postmortem interval (PMI) is one of the main study subjects of forensic sciences. The main purpose of this prospective in vitro study that was the Micro-CT evaluation of teeth crown and root pulp volume versus dentin thickness in terms of PMI determination. The study involved 60 female Wistar rats, with weights ranging from 270 to 320 g. These rats were grouped into six different post-mortem period categories. Following the animals' sacrifice, they were subjected to a natural putrefaction period, with a control group, in the grounds of a sheltered garden. Hemi-mandible samples were then extracted and placed in glass tubes for Micro-CT evaluations, following the progression of putrefaction processes. The pulp volume and dentin thickness were assessed using Micro-CT, and the gathered data underwent statistical analysis. Micro-CT was employed to analyze sixty right mandibular second molar teeth in the hemi-mandible. The crown pulp volume exhibited a reduction in group 6, with a value of 0.239 mm3 after a three-month period of natural putrefaction (p < 0.001). There is statistically differences among groups in case of pairwise comparison (p < 0.05). However, the root pulp volume and dentin thickness variables did not display any statistically significant changes. Despite certain limitations associated with this study, the Micro-CT findings concerning teeth pulp volume can serve as an objective parameter, especially for late postmortem investigations and the estimation of time of death.

Micro-computed Tomographic Evaluation of Dentinal Microcrack Formation after Using New Heat-treated Nickel-titanium Systems.

INTRODUCTION: The aim of the present study was to evaluate the frequency of dentinal microcracks observed after root canal preparation with HyFlex CM (Coltène/Whaledent, Altstätten, Switzerland), HyFlex EDM (Coltène/Whaledent), Vortex Blue (Dentsply Tulsa Dental Specialties, Tulsa, OK), and TRUShape (Dentsply Tulsa Dental Specialties) systems using micro-computed tomographic (micro-CT) analysis. METHODS: Forty human mandibular incisors with 1 and straight root canals were randomly assigned to 4 experimental groups (n = 10) and 1 control group for root canal preparation: group 1, HyFlex CM; group 2, HyFlex EDM; group 3, Vortex Blue; and group 4, TRUShape. The specimens were scanned using high-resolution micro-CT imaging before and after root canal preparation. Afterward, preoperative and postoperative cross-sectional images of the teeth were screened to identify the presence of dentinal defects. The number of microcracks was determined as a percentage for each group. RESULTS: Before and after canal preparation, 36,152 cross-sectional images were examined. Four thousand four hundred fifty-two (12.31%) dentinal defects were observed. No new microcracks were observed after root canal instrumentation with the tested systems. CONCLUSIONS: Root canal preparation with the HyFlex CM, HyFlex EDM, Vortex Blue, and TRUShape systems did not induce the formation of new dentinal microcracks on straight root canals of mandibular incisors.

Effect of ProTaper Gold, Self-Adjusting File, and XP-endo Shaper Instruments on Dentinal Microcrack Formation: A Micro-computed Tomographic Study.

INTRODUCTION: The aim of the present study was to evaluate the frequency of dentinal microcracks observed after root canal preparation with ProTaper Universal (PTU; Dentsply Tulsa Dental Specialties, Tulsa, OK), ProTaper Gold (PTG; Dentsply Tulsa Dental Specialties), Self-Adjusting File (SAF; ReDent Nova, Ra'anana, Israel), and XP-endo Shaper (XP; FKG Dentaire, La Chaux-de-Fonds, Switzerland) instruments using micro-computed tomographic (CT) analysis. METHODS: Forty extracted human mandibular premolars having single-canal and straight root were randomly assigned to 4 experimental groups (n = 10) according to the different nickel-titanium systems used for root canal preparation: PTU, PTG, SAF, and XP. In the SAF and XP groups, the canals were first prepared with a K-file until #25 at the working length, and then the SAF or XP files were used. The specimens were scanned using high-resolution micro-computed tomographic imaging before and after root canal preparation. Afterward, preoperative and postoperative cross-sectional images of the teeth were screened to identify the presence of dentinal defects. For each group, the number of microcracks was determined as a percentage rate. The McNemar test was used to determine significant differences before and after instrumentation. The level of significance was set at P ≤ .05. RESULTS: The PTU system significantly increased the percentage rate of microcracks compared with preoperative specimens (P < .05). No new dentinal microcracks were observed in the PTG, SAF, or XP groups. CONCLUSIONS: Root canal preparations with the PTG, SAF, and XP systems did not induce the formation of new dentinal microcracks on straight root canals of mandibular premolars.

Effect of double antibiotic and calcium hydroxide pastes on dislodgement resistance of an epoxy resin-based and two calcium silicate-based root canal sealers.

OBJECTIVES: The purpose of the present study was to determine the dislodgement resistance of AH Plus, MTA Fillapex, and Total Fill BC sealer to root canal dentin walls following placement of calcium hydroxide (CH) or double antibiotic paste (DAP) medicaments. MATERIALS AND METHODS: Root canals of 90 single-rooted human mandibular premolar teeth were instrumented with Reciproc rotary instruments to a size R50. The teeth were randomly divided into two experimental groups: those receiving an intracanal medicament with either CH or DAP and a control group (n = 30). After 3 weeks, the medicaments were removed by irrigation with 5 mL of 2.5 % NaOCl, 5 mL 17 % EDTA, and 5 mL distilled water under sonic agitation. Each group was then subdivided into three subgroups (n = 10), and the canals were filled with either AH Plus, MTA Fillapex, or Total Fill BC sealer. After 1 week, a push-out test was applied to the specimens and the results were analyzed using one-way analysis of variance (ANOVA) and post hoc Tamhane's tests. RESULTS: Regardless of the type of intracanal medicament used, Total Fill BC Sealer and MTA Fillapex showed the highest and lowest bond strength, respectively (P < 0.05). The use or absence of medicaments did not significantly affect the dislodgment resistance of root canal fillings (P > 0.05). Prior CH placement improved dislodgement resistance of all sealers without statistical difference (P > 0.05). Adhesive failure between core and sealer was the most frequent failure mode. CONCLUSIONS: Prior application of CH or DAP did not significantly affect the adhesion of the AH Plus, MTA Fillapex, and Total Fill BC Sealers. CLINICAL RELEVANCE: There is a little information about the influence of antibiotic medicaments on the bond strength of root canal sealer. These findings suggest that the use of DAP does not affect the adhesion strength of AH Plus, MTA Fillapex, and Total Fill BC Sealers.

Fracture resistance of immature teeth filled with mineral trioxide aggregate, bioaggregate, and biodentine.

OBJECTIVE: The purpose of this study was to evaluate fracture resistance of teeth with immature apices treated with coronal placement of mineral trioxide aggregate (MTA), bioaggregate (BA), and Biodentine. MATERIALS AND METHODS: Forty-one freshly extracted, single-rooted human premolar teeth were used for the study. At first, the root length was standardized to 9 mm. The crown-down technique was used for the preparation of the root canals using the rotary ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland) of F3 (30). Peeso reamer no. 6 was stepped out from the apex to simulate an incompletely formed root. The prepared roots were randomly assigned to one control (n = 5) and three experimental (n = 12) groups, as described below. Group 1: White MTA (Angelus, Londrina, Brazil) was prepared as per the manufacturer's instructions and compacted into the root canal using MAP system (Dentsply Maillefer, Ballaigues, Switzerland) and condensed by pluggers (Angelus, Londrina, Brazil). Group 2: The canals were filled with DiaRoot-BA (DiaDent Group International, Canada). Group 3: Biodentine (Septodont, Saint Maur des Fosses, France) solution was mixed with the capsule powder and condensed using pluggers. Instron was used to determine the maximum horizontal load to fracture the tooth, placing the tip 3 mm incisal to the cementoenamel junction. Mean values of the fracture strength were compared by ANOVA followed by a post hoc test. P < 0.05 was considered statistically significant. RESULTS: No significant difference was observed among the MTA, BA, and biodentine experimental groups. CONCLUSION: All the three materials tested, may be used as effective strengthening agents for immature teeth.

Determination of the Apical Sealing Abilities of Mineral Trioxide Aggregate, Portland Cement, and Bioaggregate After Irrigation with Different Solutions.

OBJECTIVES: The purpose of this study was to investigate the sealing ability of root-end filling materials such as mineral trioxide aggregate (MTA), Portland cement, and bioaggregate (BA) after irrigation with different solutions. MATERIALS AND METHODS: We examined 130 human maxillar central teeth. After cutting the teeth at the cementoenamel junction, the root canals were expanded using nickel-titanium rotary instruments. Root canals were filled with AH-plus and gutta-percha. Then, the roots were cut apically, and 3 mm deep retrograde cavities were prepared. The roots were divided 12 experimental groups, consisting 10 teeth each; the positive and negative control groups contained five teeth each. The retrograde cavities were rinsed using ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX), BioPure(™) mixture of a tetracycline isomer, an acid, and a detergent (MTAD), or distilled water. Next, groups 1, 2, 3, and 4 were sealed with MTA; groups 5, 6, 7, and 8 were sealed with Portland cement; and groups 9, 10, 11, and 12 were sealed with BA. Then, apical microleakage was evaluated by using a computerized fluid filtration method. The results of the leakage test were statistically evaluated by the post-hoc Tukey's test. RESULTS: MTA, Portland cement, and BA root-end filling materials showed the least leakage in the CHX and distilled water groups. The highest leakage was observed in the EDTA and MTAD groups. CONCLUSIONS: The sealing ability of BA was as good as that of MTA. EDTA and MTAD increased the apical leakage and CHX and distilled water decreased the leakage of the root-end filling materials examined in this study.

Solubility evaluation of different root canal sealing materials.

AIM: To evaluate the solubility of five different root canal sealers (AH Plus Jet, RealSeal SE, MTA Fillapex, Tubli-Seal, and Acroseal) in chloroform, eucalyptol and Endosolv-E solvents. MATERIALS AND METHODS: Ninety root canal sealer samples were prepared and then divided into three groups for immersion in a solvent for 2, 5 or 10 minutes. The mean values of the root canal sealers' dissolution in the solvents were obtained by the difference between the preimmersion original weight and the post-immersion weight on a digital analytical scale. Data were statistically analyzed by a Kruskal-Wallis test with a Bonferroni correction. RESULTS: Chloroform was a more effective solvent than eucaly-ptol or Endosolv E for all root canal sealers, except for RealSeal SE, at all time points (p < 0.003). RealSeal SE was the least soluble sealer in all solvents at all time points. CONCLUSION: Chloroform demonstrated a superior ability over other solvents in dissolving canal sealing materials, and eucaly-ptol was found to be the least effective solvent in this study. CLINICAL SIGNIFICANCE: This study can help to the clinicians about which solvent should be preferred for solving the filling materials in retreatment cases.

Fluid flow evaluation of coronal microleakage intraorifice barrier materials in endodontically treated teeth.

OBJECTIVE: The objective of this study was to compare the coronal microleakage intraorifice barrier materials, called CoroSeal (CS), fissur sealant (FS), flowable composite FC, and policarboksilate cement (PC), by using the computerized fluid filtration method. MATERIALS AND METHODS: Fifty freshly extracted, single-canal human maxillary central teeth were used in this study. The teeth were decoronated to a standardized root length of 15 mm. After preparation and irrigation, all the teeth were obturated with gutta-percha and AH-Plus. In all teeth, the coronal 2 mm of root filling was removed and replaced with one of the intraorifice barriers. According to intraorifice barriers, teeth were divided randomly into 4 experimental groups (n = 10) and 2 control groups (n = 5). Group 1: CS; Group 2: FS; Group 3: FC; and Group 4: PC. POSITIVE CONTROL GROUP: No barrier material was used. NEGATIVE CONTROL GROUP: Roots were completely coated with the nail polish, including the orifice. Leakage was evaluated by using a computerized fluid filtration model. Differences in fluid filtration among groups were subjected to statistical analysis using the Kruskal-Wallis Test and multiple comparisons test. RESULTS: A value of P < 0.05 was statistically significant. Statistical analysis has indicated that the CS leaked significantly less than other groups (P < 0.05). There was a significant difference between FS and PC (P < 0.05), in contrast there was no significant difference between FS and FC (P > 0.05). CONCLUSIONS: Using the CS material as an intraorrifice barrier material reduced amount of microleakage as compared with FS, FC, and PC.