Calcium silicate cement interface with restorative materials through layering after different time intervals.

The aim was to evaluate the interfacial characteristics of Biodentine, CEM Cement, and ProRoot MTA when restored with different final restorative materials after different time intervals. Biodentine, CEM Cement and ProRoot MTA were layered with amalgam, composite resin or light cure glass ionomer cement. Layering was done either immediately, 24 or 72 h after cement placement. The interface of cements with restorative materials was characterized using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) after separation. Vickers surface microhardness test was also performed on the interface. Statistical analysis included two-way Anova, Dunnett T3, and Tukey HSD. The significance level was set at P < 0.05. The highest microhardness values were seen when restorative materials were layered after 24 h in the case of Biodentine, and after 72 h in the case of CEM Cement and ProRoot MTA. In ProRoot MTA no significant difference was seen in the microhardness when layered with different restorative materials regardless of the time of layering. In immediate layering, Biodentine exhibited the highest microhardness values. Both immediate and delayed layering resulted in element transfer between calcium silicate cements (CSCs) and restorative materials. Deposition and depletion of element occurs subsequent to layering of restorative materials on CSCs. When immediate layering is necessary, Biodentine may be a better option compared to other CSCs evaluated.

Effect of SWEEPS and PIPS techniques on dye extrusion in photodynamic therapy procedure after root canal preparation.

AIM: The aim of this study is to measure and compare the amount of apical extrusion of the methylene blue as photosensitizer using Laser-activated irrigation(LAI) techniques (SWEEPS, PIPS) and photodynamic therapy (PDT). MATERIALS AND METHODS: 40 single-rooted premolar teeth were selected and their root canals were cleaned and prepared. The photosensitizer, Methylene blue (MB), was used as dye which applied inside the root canals and the access cavities. Then the teeth were randomly allocated to 4 groups. Different techniques (SWEEPS, PIPS, PDT) were used in 3 groups. One group received no activation. Data related to the concentration of the extruded methylene blue was measured using ultraviolet and visible (UV-Vis) absorption spectroscopy. Absorption peak intensity of MB in the wavelength of 668 nm was considered as the concentration index according to Beer Lambert law. Taking into account the normal distribution of this data, one-way ANOVA analysis was used to evaluate the effects of the independent variables on the amount of apical extrusion of the irrigant. RESULTS: Based on the results of ANOVA analysis, there was no significant difference between the amounts of apical extrusion of MB between different groups (p = 0.628) CONCLUSION: Using SWEEPS and PIPS techniques, despite diffusion of the photosensitizer, didn't lead to any difference in the amount of apical extrusion. Therefore, these LAI techniques can be used safely for root canal irrigation.

Bacterial microleakage in endodontically treated teeth following two methods of postspace preparation at two-time intervals: An in vitro study.

Aims: The goal of this study was to analyze the bacterial microleakage following two methods (heat vs. rotary) of postspace preparation after two-time intervals (immediate vs. 1 week later). Setting and Design: In vitro-comparative study. Materials and Methods: Eighty-two single-rooted teeth were decoronated at the cementoenamel junction. Root canals were prepared using rotary files. After root canal obturation, specimens were randomly allocated to 4 experimental groups based on the method of postspace preparation (heat or peeso reamer) and time interval (immediate or 1 week later) (n = 18). Group 1: Peeso reamer-immediate, Group 2: Heat-immediate, Group 3: Peeso reamer-1 week later, Group 4: Heat-1 week later. 10 specimens were considered as positive and negative controls (n = 5 each). Custom-made dual-chamber devices were used to appraise the bacterial microleakage for 60 days. Statistical Analysis Used: Data were analyzed with Chi-Square and Log-Rank tests and Cox regression. Results: All through the experimental period, there was no significant difference (P = 0.41) between the studied groups. Groups 2 and 4 had the highest microleakage and the lowest survival rate (55.56% ± 11.71%). Group 1 showed the lowest microleakage and the highest survival rate (77.8% ± 9.80%). Conclusions: The applied techniques for postspace preparation and the time intervals (neither independently nor simultaneously) showed no significant difference in the field of bacterial leakage.

Cyclic Fatigue Resistance of Five Different Glidepath Files in a Double Curved Artificial Canal.

Introduction: The aim of this study was to examine the cyclic fatigue resistances #16 ProGlider, #15.02 Scout RaCe, #15.03 NeoNiTi GPS, One G and Path-File NiTi glide path files in S-shaped artificial canals. Materials and Methods: Twenty files from each group were tested. An artificial groove simulating double (S-shaped) curved canal measuring 1.5 mm in width at the top level decreasing towards the apical reaching 0.3 mm at the tip having a 0.06 taper, 18 mm in length, and 1.5 in depth machined in a stainless steel block was used in this study. Resistance to cyclic fatigue was determined by counting the numbers of cycles to failure (NCF). Furthermore, the fragment length of the fractured tips and angle and radius of curvature formed by each file in each trajectory were evaluated. The data were analyzed using the one-way analysis of variance and Tukey's HSD test and the level of significance was set at 5%. Results: NeoNiti GPS and Scout RaCe glide path files showed significantly higher NCF values compared to other evaluated glide path files (P<0.001) but no significant difference when compared with each other (P=0.67). Conclusion: Based on this in vitro study NeoNiti GPS and Scout RaCe glide path files had the highest cyclic fatigue resistance in simulated double (S-shaped) curved artificial canals among the evaluated path finding files. Therefore, it seems that they can be used with more confidence in endodontic treatment of S-shaped canals clinically.

Management of a Large Periapical Lesion Using Decompression: A Case Report with Three-year Follow-up.

Large radicular lesions should be treated initially by orthograde root canal therapy. When the signs and symptoms of the infection (e.g. persistent purulent drainage) do not resolve after this treatment, then surgical approaches should be considered. In the cases of large radicular cysts, total enucleation of the cyst can endanger adjacent structures and teeth. Therefore, decompression or marsupialization techniques are recommended in order to decrease the size of the lesion. In this case report, a 55-year-old woman with previously initiated therapy was referred to endodontic department for management of a sinus tract associated with tooth #7. Root canal treatment was performed and intracanal irrigant (5.25% sodium hypochlorite) activated using passive ultrasonic application, various intracanal medicament (calcium hydroxide, double antibiotic paste) was used in multiple sessions, but intracanal purulent drainage was not resolved. After this, decompression was performed using needle cap to maintain the opening of the cyst and remained for three months. During this period the cavity was kept clean and rinsed by the patient with 0.2% chlorhexidine mouthwash. After three-year follow-up, radiographic examination revealed substantial osseous repair of the defect and clinical signs and symptoms were absent.

Colorimetric Comparison of Internal Bleaching with and without Removing Mineral Trioxide Aggregate (MTA) on Induced Coronal Tooth Discoloration by MTA.

Objective. This study aimed to colorimetric comparison of internal bleaching with and without removing mineral trioxide aggregate (MTA) on induced coronal tooth discoloration by MTA cement. In this experimental study, twenty human teeth were prepared. An OrthoMTA barrier was placed 1 mm below the CEJ. The teeth were restored with composite resin and were placed in the aging accelerator machine. Then, the specimens were divided into two groups (n = 10); in group A, part of the OrthoMTA was removed and the glass ionomer was placed on the OrthoMTA, and in group B, the OrthoMTA remained intact. Internal bleaching was performed 5 times in 6-day intervals using 37% carbamide peroxide gel. Color determination was performed in 5 stages: baseline, after OrthoMTA discoloration, before OrthoMTA removal, after OrthoMTA removal, and after bleaching treatment sessions. In group A, 8 specimens reached to ∆E < 3.3 after 2 times internal bleaching treatment, and in group B, 5 specimens reached to ∆E < 3.3 with almost 3 bleaching sessions (p > 0.05). Additionally, 5 specimens reached to the initial color (baseline) after bleaching treatment, 4 specimens in group A and 1 specimen in group B. After OrthoMTA removal, 2 specimens in group A reached to ∆E < 3.3. There was no significant difference between groups with or without OrthoMTA removal (p=0.06). Although, the specimens with OrthoMTA removal required fewer bleaching treatment sessions, and the mean value of ∆E was lower in this group.

Effect of Root Dentin Pretreatment on Micro-Push-Out Bond Strength of Fiber Posts to Root Canal Dentin: Cold Atmospheric Argon Plasma (CAAP) and Ethylenediaminetetraacetic Acid (EDTA).

PURPOSE: Debonding from the root canal dentin is the most common failure mode of fiber posts. This study aimed to assess the effects of cold atmospheric argon plasma (CAAP) and ethylenediaminetetraacetic acid (EDTA) on micro-push-out bond strength of fiber posts to root canal dentin. MATERIALS AND METHODS: Forty maxillary canine teeth were decoronated, underwent endodontic treatment, and were stored in an incubator for 7 days. After post space preparation, the teeth were randomly divided into four groups for different surface treatments: (I) saline, (II) 17% EDTA, (III) CAAP, and (IV) 17% EDTA + CAAP. Fiber posts (Whitepost no. 2, FGM) were cemented into the root canals using Panavia F2.0 resin cement, and 1 mm-thick sections were made at the coronal, middle, and apical thirds of the roots. The samples underwent micro-push-out bond strength test. The mode of failure was also determined under a stereomicroscope. Data were analyzed using three-way ANOVA and Tukey's post hoc test (α = 0.05). The mode of failure data were analyzed using the chi-square test. RESULTS: The mean micro-push-out bond strength of fiber posts was not significantly different in the four groups (P > 0.05). However, the bond strength values in the coronal third were significantly higher than the corresponding values in the apical third (P=0.01). There was no significant difference in the modes of failure between the groups (P > 0.05). CONCLUSION: Application of CAAP alone or in combination with 17% EDTA could not successfully increase the bond strength of fiber posts to root canal dentin.

The Effect of Bleaching Agents on the Microstructure and Surface Microhardness of Three Calcium Silicate-Based Barrier Materials.

Introduction: The aim of this study was to evaluate the effects of exposure to sodium perborate and H2O2 on the surface characteristics of MTA Angelus, Biodentine and MTA Repair HP after 1 and 6 month time intervals. Methods and Materials: Three calcium silicate-based cements were evaluated: MTA Angelus, Biodentine, MTA Repair HP. A total of 234 specimens were stored in Hank's balanced salt solution (HBSS) for 1 month or 6 months in which afterwards were divided into 3 groups according to bleaching agent applied: control, sodium perborate, 35% hydrogen peroxide. The microstructural changes were evaluated by scanning electron microscopy and energy-dispersive X-ray spectroscopy. The surface microhardness was also evaluated. Data were analyzed by one-way analysis of variance and Games-Howell post-hoc tests for the effect bleaching agents and hydraulic calcium silicate-based cements and t-test was for the effect of time. Results: Distinctive alterations with uneven depression areas, woodpecker defects and cracks were seen due to exposure to perborate and H2O2 on all evaluated cements. Exposure to H2O2 caused a decrease in Ca/Si ratio in all experimental cements. Both H2O2 and perborate significantly decreased the microhardness of all cement (P<0.05) with H2O2 having a more profound effect (P<0.01). A 6-month delay in exposure to bleaching agents significantly increased the microhardness of Biodentine compared to 1 month (P<0.001 for both bleaching agents). Conclusion: Based on this in vitro study, H2O2 had more detrimental effects on MTA Angelus, Biodentine and MTA Repair HP. Sodium perborate may be a more conservative selection when considering effects on barrier materials.

A comparison of the efficacy of potassium nitrate and Gluma desensitizer in the reduction of hypersensitivity in teeth with full-crown preparations.

AIM: The aim of this clinical investigation was to compare the efficacy of Gluma Desensitizer and potassium nitrate desensitizing agents on the reduction of hypersensitivity of teeth prepared for full coverage crowns. METHODS AND MATERIALS: This study included 75 vital teeth in 25 patients in need of fixed prosthesis treatment. After completing routine examinations, hypersensitivity of the teeth was measured using an air sensitivity test. The measurement of sensitivity was using a Visual Analog Scale (VAS) before preparation, after preparation, before using desensitizers, after using desensitizers, and before cementation. Each tooth was randomly put into one of the three groups of 25 teeth according to the desensitizing agent used (potassium nitrate, Gluma, and the control). In each patient potassium nitrate was used on one of the abutments and Gluma was used on the other abutment and on the third abutment (the control) no substance was used. RESULTS: Both desensitizers decreased dentinal hypersensitivity in vital teeth prepared for full-coverage crowns, but potassium nitrate was more effective when applied before cementation. In 88% of the teeth to which Gluma was applied a vascular pain (with pulse) was present. CONCLUSION: The results of this investigation suggest the application of potassium nitrate to dentin in full crown preparations prior to cementation reduces post-operative sensitivity. CLINICAL SIGNIFICANCE: Clinical experiments show the preparation of vital teeth for full coverage crowns can cause sharp, transient pain as a result of dentinal hypersensitivity in the majority of cases. Several different substances and methods have been suggested for reducing such hypersensitivity including costly laser treatments. However, the findings of this study indicate the use of desensitizer substances such as potassium nitrate can reduce tooth hypersensitivity efficiently with less expense.

The effect of ketorolac buccal infiltration on postoperative endodontic pain: a prospective, double-blind, randomized, controlled clinical trial.

OBJECTIVES: The aim of the present double-blind, randomized, controlled clinical trial was to evaluate the effect of ketorolac buccal infiltration of on postendodontic pain of patients with symptomatic irreversible pulpitis in mandibular first/second molars. METHOD AND MATERIALS: Sixty patients meeting the inclusion criteria were evaluated. After receiving a standard inferior alveolar nerve block (IANB) followed by a buccal infiltration injection with lidocaine, half of the participants randomly received a supplemental buccal infiltration of 30 mg/mL ketorolac tromethamine and the other half received a buccal infiltration of normal saline adjacent to the periapical region of the tooth being treated. Afterwards, all participants received a single-visit root canal treatment. Pre- and postoperative (immediately after treatment, and at 2, 4, 6, and 24 hours) pain levels were evaluated via Heft-Parker visual analog scale (HP-VAS). Analgesic consumption was also recorded. The data were statistically analyzed using repeated-measures ANOVA and Friedman tests. The significance level was set at P < .05. RESULTS: There was a significant difference in postoperative pain between the two groups in overall evaluations and in each time interval (P < .001 and P = .043 respectively). Of those patients receiving ketorolac, 60% (18/30) did not require any analgesic consumption up to 24 hours postoperatively, whereas this number was 43% (13/30) for the placebo group. CONCLUSION: Ketorolac buccal infiltration could reduce the postoperative pain experienced by patients requiring endodontic treatment diagnosed with symptomatic irreversible pulpitis.

Crystalline phases involved in the hydration of calcium silicate-based cements: Semi-quantitative Rietveld X-ray diffraction analysis.

Chemical comparisons of powder and hydrated forms of calcium silicate cements (CSCs) and calculation of alterations in tricalcium silicate (Ca3 SiO5 ) calcium hydroxide (Ca(OH)2 ) are essential for understanding their hydration processes. This study aimed to evaluate and compare these changes in ProRoot MTA, Biodentine and CEM cement. Powder and hydrated forms of tooth coloured ProRoot MTA, Biodentine and CEM cement were subjected to X-ray diffraction (XRD) analysis with Rietveld refinement to semi-quantitatively identify and quantify the main phases involved in their hydration process. Data were reported descriptively. Reduction in Ca3 SiO5 and formation of Ca(OH)2 were seen after the hydration of ProRoot MTA and Biodentine; however, in the case of CEM cement, no reduction of Ca3 SiO5 and no formation of Ca(OH)2 were detected. The highest percentages of amorphous phases were seen in Biodentine samples. Ettringite was detected in the hydrated forms of ProRoot MTA and CEM cement but not in Biodentine.

Incidence of Dentinal Crack Formation Using ProTaper Universal and WaveOne Systems in Straight and Curved Root Canals.

Introduction: This study aimed to compare dentinal micro crack formation following root canal instrumentation with ProTaper Universal (PTU) and WaveOne (WO) rotary systems in straight and curved root canals. Methods and Materials: One hundred mesiobuccal (MB) straight and curved canals of mandibular molars meeting inclusion criteria were divided into two control (n=10) and four experimental groups (n=20). After mounting the teeth and simulating the periodontal ligament, all the MB canals were coronally flared using Gates-Glidden drills #3 and 2 respectively. Then, in the experimental groups, the canals were instrumented with either PTU files (Sx, S1, S2, F1, F2), or Primary WO (25/0.08). Afterwards, roots were horizontally sectioned at 2, 4, and 6 mm from the apices, and evaluated under a microscope under 20× magnification. Data were analyzed with the Chi-Square and Kruskal-Wallis tests. The significance level was set at 0.05. Results: The control groups showed no cracks. There was no significant difference between the two systems in the straight root canals (P>0.05). But in the curved root canals, PTU produced significantly more cracks (P<0.05) with the complete crack type which was dominant (P=0.013) compared to WO. Conclusions: This in vitro study showed that in curved root canals, instrumentation with reciprocal WO system may be safer than full rotational PTU instruments regarding crack formation.

Effect of blood contamination on the compressive strength of three calcium silicate-based cements.

The aim of this study was to investigate the effect of human blood exposure on the compressive strength of various calcium silicate-based cements. Two hundred and eighty-eight customised cylindrical moulds were randomly divided into three groups according to material used: ProRoot MTA, Biodentine or CEM cement (n = 96). Each group was divided into two subgroups according to exposure conditions: PBS or blood. Then, the compressive strength of the specimens was measured after 6 h, 24 h, 72 h and 7 days. The compressive strength of CEM cement could not be measured after 6 and 24  h regardless of the exposure conditions nor could the compressive strength of 6 h blood-exposed ProRoot MTA. The compressive strength of blood-exposed ProRoot MTA was only significantly lower after 6 h, but no difference was seen at other time intervals. Blood exposed did adversely affected the compressive strength of Biodentine. The compressive strength of all groups significantly increased over time (P < 0.005).

Bonding to caries affected dentine.

OBJECTIVES: Dentine replacement materials are often placed over caries affected dentine (CAD). The aim of this study was to compare the bonding characteristics and interactions of selected hydraulic calcium silicate-based dentine replacement materials to CAD and sound dentine. METHODS: Three hydraulic calcium silicate-based dentine replacement materials were assessed: Retro MTA, Biodentine and Theracal LC. Material characterization was done by scanning electron microscopy and X-ray diffraction analyses. Blocks of sound and CAD were prepared and standardized by Vickers microhardness testing. Half of the affected and sound dentine blocks were pretreated with 5.25% NaOCl prior to material placement. The materials were stored either for 1 week or 24 weeks in 37°C in fully saturated conditions. Shear bond strength was assessed at both time periods. Radiopacity of the interfacial dentine was also evaluated to assess the remineralization potential of the dentine replacement materials. RESULTS: The reaction of Theracal was slower than that of the water-based materials. The bond strengths of different materials did not differ after 1 week (P>0.05). The bond strength of Biodentine and Retro MTA increased over time but no change was observed for Theracal. NaOCl pre-treatment deteriorated the bond strength to sound dentine but improvement was observed in affected dentine. Radiopacity changes were observed after 24 weeks. SIGNIFICANCE: Biodentine and Retro MTA showed better bonding to CAD. Pretreatment with NaOCl improved the bond strength of dentine replacement materials to CAD.

Bonding over Dentin Replacement Materials.

INTRODUCTION: Dentin replacement materials are necessary in large cavities to protect the pulp and reduce the bulk of filling material. These materials are layered with a composite resin restorative material. Microleakage caused by poor bonding of composite resin to underlying dentin replacement material will result in pulp damage. The aim of this study was to characterize the interface between dentin replacement materials and composite resin and to measure the shear bond strength after dynamic aging. METHODS: Biodentine (Septodont, Saint Maur-des-Fosses, France), Theracal LC (Bisco, Schaumburg, IL), and Fuji IX (GC, Tokyo, Japan) were used as dentin replacement materials. They were then overlaid with a total-etch and bonding agent or a self-etch primer and composite resin or a glass ionomer cement. All combinations were thermocycled for 3000 cycles. The interface was characterized using scanning electron microscopy and elemental mapping. Furthermore, the shear bond strength was assessed. RESULTS: The Biodentine surface was modified by etching. The Theracal LC and Fuji IX microstructure was unchanged upon the application of acid etch. The Biodentine and glass ionomer interface showed an evident wide open space, and glass particles from the glass ionomer adhered to the Biodentine surface. Elemental migration was shown with aluminum, barium, fluorine, and ytterbium present in Biodentine from the overlying composite resin. Calcium was more stable. The bond strength between Theracal LC and composite using a total-etch technique followed by self-etch primer achieved the best bond strength values. Biodentine exhibited the weakest bond with complete failure of bonding shown after demolding and thermocycling. CONCLUSIONS: Dynamic aging is necessary to have clinically valid data. Bonding composite resin to water-based dentin replacement materials is still challenging, and further alternatives for restoration of teeth using such materials need to be developed.

Effect of Intra-Canal Calcium Hydroxide Remnants on the Push-Out Bond Strength of Two Endodontic Sealers.

INTRODUCTION: The aim of this study was to evaluate the effect of intra-canal calcium hydroxide (CH) remnants after ultrasonic irrigation and hand file removal on the push out bond strength of AH-26 and EndoSequence Bioceramic sealer (BC Sealer). METHODS AND MATERIALS: A total of 102 single-rooted extracted human teeth were used in this study. After root canal preparation up to 35/0.04 Mtwo rotary file, all the specimens received CH dressing except for 34 specimens in the control group. After 1 week, the specimens with CH were divided into 2 groups (n=34) based on the CH removal technique; i.e. either with ultrasonic or with #35 hand file. Then specimens were divided into two subgroups according to the sealer used for root canal obturation: AH-26 or BC Sealer. After 7 days, 1 mm-thick disks were prepared from the middle portion of the specimens. The push out bond strength and failure mode were evaluated. Data were analyzed by the two-way ANOVA and Tukey's post hoc tests. RESULTS: The push out bond strength of both sealers was lower in specimens receiving CH. These values were significantly higher when CH was removed by ultrasonic (P<0.05). The dominant mode of failure in all subgroups was of mixed type except for the BC Sealer specimens undergoing CH removal with hand file which dominantly exhibited adhesive mode of failure. CONCLUSION: CH remnants had a negative effect on the push out bond strength of AH-26 and BC Sealer. Ultrasonic irrigation was more effective in removing CH.

The Effect of Root Canal Preparation Using Single Versus Multiple Endodontic Rotary Files on Post-operative Pain, a Randomised Clinical Trial.

OBJECTIVE: The purpose of this randomised clinical trial study was to compare the incidence and intensity of post-operative pain following the use of single-file and multi-file rotary instruments with continuous rotational motion for root canal preparation in asymptomatic permanent human teeth. METHODS: A total of 105 healthy consenting patients who fulfilled specific inclusion criteria and had premolar or molar teeth diagnosed with asymptomatic irreversible pulpitis without periapical pathosis requiring endodontic treatment participated in this study. The patients were randomly allocated by stratification into five groups of 21 according to the instruments and systems used for root canal preparation: (a) Neoniti A1 (#25) single file, (b) RaCe #25/.06 single file, (c) Mtwo #25/.06 single file, (d) Easy RaCe, (e) and Mtwo multifile. Endodontic treatment was carried out in a single appointment. The severity of post-operative pain was assessed by numerical rating scale scores until complete pain relief was achieved. Analgesic consumption and the incidence of pain were also evaluated. Data were analysed by one-way ANOVA and Tukey HSD tests. RESULTS: When comparing different instruments and systems for canal preparation, the analgesic consumption, incidence and intensity of post-operative pain did not differ (p>0.05). The highest levels of post-operative pain were experienced after 6 h in all groups. CONCLUSION: The post-operative pain did not differ between the single and multi-file root canal preparation techniques evaluated in this study.

Effect of Blood Exposure on Push-Out Bond Strength of Four Calcium Silicate Based Cements.

INTRODUCTION: The purpose of this study was to compare the push-out bond strength of white ProRoot Mineral Trioxide Aggregate (MTA), Biodentine, calcium-enriched mixture (CEM) cement and Endosequence Root Repair Material (ERRM) putty after exposure to blood. METHODS AND MATERIALS: A total of 96 root dentin slices with a standardized thickness of 1.00±0.05 mm and standardized canal spaces were randomly divided into 4 main experimental groups (n=24) according to the calcium silicate based cement (CSC) used: white ProRoot MTA, CEM Cement, ERRM Putty and Biodentine. Specimens were exposed to whole fresh human blood and then subdivided into two subgroups depending on the exposure time (24 or 72 h). Push-out bond strength was measured using a universal testing machine. Failure modes were examined under a light microscope under ×10 magnification. Data were analyzed using the two-way ANOVA test. RESULTS: Biodentine exhibited the highest values regardless of the exposure time. The lowest push-out strength values were seen in white ProRoot MTA and CEM cement in both post exposure times. After exposure to blood, the push-out bond strength of all materials increased over time. This increase was only statistically significant in white ProRoot MTA and ERRM specimens. The dominant failure mode in all CSCs was the adhesive mode. CONCLUSION: Biodentine showed the highest values of push-out bond strength and may be better options for situations encountering higher dislocation forces in a short time after cement application.

Evaluation of the Fractured Surface of Five Endodontic Rotary Instruments: A Metallurgical Study.

INTRODUCTION: The aim of this study was to compare several metallurgic properties of Neoniti instrument with four other commonly used endodontic rotary files. METHODS AND MATERIALS: Neoniti A1 (25/0.08), RaCe (25/0.06), Mtwo (25/0.06), Twisted file (25/0.06) and ProTaper Next X2 (25/0.06) were examined by differential scanning calorimetry (DSC) before and after heat treatment at 500°C. X-ray diffraction (XRD) was also performed on the specimens. Furthermore, scanning electron microscopy (SEM) and x-ray energy-dispersive spectrometric (EDS) analyses were carried out on randomly selected fractured files. RESULTS: In SEM tests, dimpled ruptures, characteristic of ductile fracture, were seen in all evaluated cross sections of all files. The SEM results of all evaluated files were alike. EDS results revealed higher proportions of Nickel (Ni) rich intermetallic compounds in Neoniti; whereas, in all the other files the proportion of Titanium (Ti) rich precipitates was higher. DSC results indicated that the temperature present in the oral environment, the austenite phase existed in all files. Mtwo and RaCe files did not show austenite transformation in the temperature range evaluated in this study. Only Neoniti revealed rhombohedal phase (R-phase) transformation. After heat treatment. No significant difference was seen in the transformation temperatures of all evaluated files. XRD evaluations revealed that Neoniti contained both Ni-rich and Ti-rich precipitates. The amount of the martensite phase was higher in ProTaper Next. CONCLUSION: The metallurgic properties of Neoniti files were different from other evaluated rotary files. This file contained higher proportions of Ni-rich precipitates.

A Case of Successful Retreatment of a Maxillary Lateral Incisor with a Supernumerary Root.

Knowledge about the morphology of the root canal system is a pre-requisite for achieving a successful outcome in root canal treatment. In this report, a patient with a maxillary lateral incisor which had previously undergone orthograde endodontic retreatment for two times is discussed. The tooth had been misdiagnosed with a palatal groove or a root fracture, its prognosis had been determined to be poor and extraction was advised by a practitioner. During our evaluation, an unrecognized supernumerary root and root canal were detected and the tooth was maintained successfully with orthograde endodontic retreatment. The use of cone beam computed tomography (CBCT) and magnification were of significance in the treatment process of this case.