Exploring the impact of type II diabetes mellitus on voice quality.

PURPOSE: This cross-sectional study aimed to investigate the potential of voice analysis as a prescreening tool for type II diabetes mellitus (T2DM) by examining the differences in voice recordings between non-diabetic and T2DM participants. METHODS: 60 participants diagnosed as non-diabetic (n = 30) or T2DM (n = 30) were recruited on the basis of specific inclusion and exclusion criteria in Iran between February 2020 and September 2023. Participants were matched according to their year of birth and then placed into six age categories. Using the WhatsApp application, participants recorded the translated versions of speech elicitation tasks. Seven acoustic features [fundamental frequency, jitter, shimmer, harmonic-to-noise ratio (HNR), cepstral peak prominence (CPP), voice onset time (VOT), and formant (F1-F2)] were extracted from each recording and analyzed using Praat software. Data was analyzed with Kolmogorov-Smirnov, two-way ANOVA, post hoc Tukey, binary logistic regression, and student t tests. RESULTS: The comparison between groups showed significant differences in fundamental frequency, jitter, shimmer, CPP, and HNR (p < 0.05), while there were no significant differences in formant and VOT (p > 0.05). Binary logistic regression showed that shimmer was the most significant predictor of the disease group. There was also a significant difference between diabetes status and age, in the case of CPP. CONCLUSIONS: Participants with type II diabetes exhibited significant vocal variations compared to non-diabetic controls.

The effect of diabetes on Fracture Resistance of Teeth: An in vitro study.

The root fracture resistance (RFR) of premolars extracted from diabetic patients and the effect of biomaterials: white mineral trioxide aggregate (WMTA) and WMTA+Na2 HPO4 as an additive, on enhancing RFR were evaluated. Diabetic and non-diabetic teeth were divided into 4 subgroups (n = 5): root canals were obturated with WMTA, WMTA+Na2 HPO4 , gutta-percha and one unfilled (control). A plunger (1 mm diameter) applied a downward compressive load with crosshead speed of 1 mm min-1 on the specimens mounted on resin blocks, and the ultimate force to fracture was measured. The mean RFR values of diabetic specimens were significantly lower. The lowest and highest means of RFR were recorded in the control and WMTA, in normal group and the control and WMTA+Na2 HPO4 in the diabetic group, respectively. The RFR in diabetic patients was significantly lower, indicating their higher susceptibility to fracture under vertical forces. The use of WMTA (with or without Na2 HPO4 ) for obturation enhances the RFR.

Retromolar canal infiltration as a supplement to the inferior alveolar nerve block injection: an uncontrolled clinical trial.

OBJECTIVES: This study aimed to determine the success rate of retromolar canal (RMC) infiltration following the failure of inferior alveolar nerve block (IANB) injections for the anesthesia of mandibular first molars with acute irreversible pulpitis. MATERIALS AND METHODS: An IANB injection was administered for 50 patients with acute irreversible pulpitis. Lip numbness was set as the sign of anesthesia and further evaluated and confirmed with pulp sensibility tests after 10-15 min. Access cavity preparation was commenced unless the patient felt any pain; in this case, an RMC infiltration injection was given. The success rate was determined through the patients' recording of the presence, absence, or reduction of pain severity during access cavity preparation using the Heft-Parker visual analog scale. RESULTS: Seven patients (14%) did not experience any pain by pulp sensibility tests and during access cavity preparation after IANB injection. Twenty-five (58.1%) of the remaining 43 patients who had the RMC infiltration injection had reduced pain, and four patients (9.3%) experienced no pain after the RMC infiltration. Fourteen patients (32.5%) experienced no change in pain. Chi-squared test results revealed that the percentage of patients with reduced pain was higher than that of other patients (P < 0.001). CONCLUSIONS: RMC infiltration, along with IANB, significantly reduced the pain felt by patients and increased the success of the anesthetic technique for root canal treatment of mandibular first molars with acute irreversible pulpitis. CLINICAL RELEVANCE: The administration of RMC infiltration can enhance the success of the IANB technique for anesthetizing mandibular first molars exhibiting acute irreversible pulpitis.

A Novel Polyurethane Expandable Root Canal Sealer.

INTRODUCTION: Endodontic sealers play a vital role in the obturation of root canal space. The aim of this study was to evaluate the utility of a recently developed polyurethane expandable sealer (PES), along with its cytotoxicity and dimensional changes. METHODS: L929 fibroblasts and an cell viability assay (MTS assay) were used to determine the cytotoxicity of dental sealers (AH Plus [Dentsply Maillefer, Ballaigues, Switzerland], Sure-Seal Root [Sure Dent Corporation, Gyeonggi-do, South Korea], and the PES) at 24, 48, 72, and 96 hours. An advanced choroidal neovascularization model was used to assess the effect of these sealers on angiogenesis. Thirty-six extracted single-rooted human teeth were prepared and randomly divided into 3 groups (n = 12). Obturation was performed with gutta-percha and a sealer using lateral compaction as follows: group 1, AH Plus; group 2, Sure-Seal; and group 3, PES. The average depth of sealer penetration into dentinal tubules was measured with a scanning electron microscope. Data were analyzed using 1-way analysis of variance and post hoc Tukey tests (level of significance, P < .05). RESULTS: The values of MTS, choroidal neovascularization, and the penetration depth of PES were significantly higher than in other experimental groups (P < .05). The lowest values were noted in specimens of AH Plus, whereas the highest were detected in the PES group. CONCLUSIONS: PES showed promising results in terms of biocompatibility and dentinal tubule adaptation and penetration.

A Maxillary Second Premolar with Four Canals: A Case Report.

Profound knowledge of the internal anatomy and configuration of the teeth plays a pivotal role in the success of standard root canal treatment. The presence of unexpected extra root canals has been reported in all the teeth, making root canal treatment a challenge for every clinician. Although the maxillary second premolar is no exception to this rule, the presence of a variety of multiple canals is relatively rare. In fact, the presence of three separate root canals has been reported in only 1-6% of cases. A 33-year-old male was referred for root canal retreatment of his left maxillary second premolar. An intraoral periapical radiograph revealed previous substandard endodontic treatment. Retreatment was performed under an operating microscope, and four root canals were found, which is, in fact, very rare. This case highlights another variation in the morphology of such teeth and it does highlight the importance of using magnification, especially an operating microscope in endodontic treatment.

Endodontic Periapical Lesion: An Overview on the Etiology, Diagnosis and Current Treatment Modalities.

Nonsurgical and surgical endodontic treatments have a high success rate in the treatment and prevention of apical periodontitis when carried out according to standard and accepted clinical principles. Nevertheless, endodontic periapical lesions remain in some cases, and further treatment should be considered when apical periodontitis persists. Although several treatment modalities have been proposed for endodontically treated teeth with persistent apical periodontitis, there is a need for less invasive methods with more predictable outcomes. The advantages and shortcomings of existing approaches for the diagnosis and treatment of endodontic periradicular lesions are discussed in this review.

Effect of Diabetes on Tubular Density and Push-out Bond Strength of Mineral Trioxide Aggregate to Dentin.

INTRODUCTION: This study compared the tubular density and push-out bond strength of mineral trioxide aggregate (MTA) to dentin in diabetic and nondiabetic patients. METHODS: Ten extracted single-rooted human teeth from diabetic and nondiabetic patients (n = 5 in each group) were decoronated, prepared up to a #5 Gates-Glidden drill, and sectioned horizontally at the midroot area to prepare 3 dentin slices, each measuring 2 mm in thickness (1 slice for the push-out test and 2 slices for the tubular density test). MTA was prepared and packed into the root canal space followed by incubation for 3 days. The push-out bond strength values were determined using a universal testing machine. Specimens were viewed under a stereomicroscope and a scanning electron microscope to determine the failure types at the cement-dentin interface. Ten slice specimens in each group were evaluated under SEM at 3 different sites to determine the tubular density. Comparisons were performed using the Mann-Whitney U test (P < .05). RESULTS: Diabetic patients exhibited significantly lower push-out bond strength of MTA to root canal dentin (P < .05). The pattern of failure at the MTA-dentin interface was different between the 2 groups. The tubular density was significantly higher in diabetic patients (P < .05). CONCLUSIONS: The dentin in diabetic patients exhibited different physicochemical properties. The failure patterns and modes in diabetic patients might be explained by the changes in the push-out bond strength, the calcification mechanism of the dentin-pulp complex, a higher dentinal tubule density, and less peritubular dentin. These differences could explain the higher failure rate of root canal treatment in these patients.

Topographic changes in NiTi rotary instruments after the clinical use.

Surface alterations of instruments were investigated after single and multiple uses in the root canals. XP-endo Shaper (n = 5) and WaveOne GOLD (n = 5) files were used until the separation of the instruments occurred. The apical 3-mm and separated fragments were analysed by SEM to determine the changes in the instruments and the cross-sections of the separated fragments. Each group was divided into five subgroups: control, first, second, third and fourth molar. The results were reported descriptively for each group. In the XP-endo Shaper group, microcracks started to appear after the second use, and pitting and galvanic corrosion occurred after the third use. During the fourth use, microcracks propagated, resulting in ductile fracture while it happened after the third use in the second group. The single use of XP-endo Shaper and WaveOne GOLD was safe without any major changes on their surfaces. Reciprocating motion was not necessarily superior to full rotation motion.

Biometric Analysis of C-shaped Root Canals in Mandibular Second Molars Using Cone-Beam Computed Tomography.

Introduction: The configuration of C-shaped root canals, root canal wall thickness and orientation of the thinnest area using CBCT in mandibular second molars were assessed. Methods and Materials: Seventy five CBCT scans were evaluated. Axial sections were evaluated to determine the configuration of C-shaped canals in the coronal, middle and apical regions. The root canal path from the orifice to the apex, the thinnest root canal wall and its orientation were all determined. Data were analyzed using one-way ANOVA and post hoc Tukey's test. Results: The most common configurations were Melton's type I in the coronal and middle and types I and IV in the apical region. The mean thicknesses of the thinnest root canal wall were 1.94±0.43, 1.42±0.57 and 1.10±0.52 mm in the coronal, middle and apical regions, respectively. The lingual wall was the thinnest wall in the coronal, middle and apical regions and it was thinner in the apical than in the middle and coronal regions. The lingual wall was thinner in the middle third of the mesial root compared to the distal root (P<0.05). Conclusion: The lingual wall was the thinnest in C-shaped root canals of mandibular second molars of an Iranian population. Type, number and pathway of canals may vary from the orifice to the apex.

Cleanliness of Canal Walls following Gutta-Percha Removal with Hand Files, RaCe and RaCe plus XP-Endo Finisher Instruments: A Photographic in Vitro Analysis.

INTRODUCTION: Gutta-percha must be removed from the root canal space during retreatment to ensure a more favorable outcome. The aim of this study was to compare the efficacy of hand instruments, RaCe and RaCe plus XP-endo finisher instruments in removal of gutta-percha from root canal walls during retreatment. METHODS AND MATERIALS: Thirty single-rooted premolars were prepared, obturated, and divided into three groups according to retreatment method; in group 1, retreatment was carried out by hand instruments, while in groups 2 and 3 retreatment was done using RaCe rotary files alone or accompanied by XP-endo finisher instruments, respectively. After retreatment, teeth were sectioned longitudinally and photographic images were taken. The amount of remaining gutta-percha in coronal, middle and apical thirds was quantified using Image J software. The two-way ANOVA and post hoc Tukey's tests were used to analyze data. The level of significance was set at 0.05. RESULTS: RaCe cleaned the apical third significantly better than hand instrumentation. In the coronal third, RaCe+XP-endo finisher was more effective than RaCe. RaCe+XP-endo finisher was more effective than hand instrumentation in the entire root canal. The amount of remaining gutta-percha was the least in the apical part and increased toward the coronal part with the use of XP-endo finisher (P<0.05). CONCLUSION: Rotary instrumentation was more effective in removing gutta-percha from the canal walls. Furthermore, use of XP-endo finisher file resulted in cleaner canal walls and was more effective in removing gutta-percha from the coronal toward the apical part of the canal.

Comparison of antibacterial effect of photodynamic therapy using indocyanine green (Emundo) with 2% metronidazole and 2% chlorhexidine gel on Porphyromonas gingivalis (an in-vitro study).

BACKGROUND: The treatment of periodontal disease focuses on eradication or suppression of the pathogenic microbiota within the periodontal pocket. There are some mechanical and chemical ways, and recently antimicrobial photodynamic therapy to eliminate the bacteria. The aim of this in vitro study was to compare the effects of 2% chlorhexidine gel, 2% metronidazole in Orabase, antimicrobial photodynamic therapy with Emundo solution and Emundo solution on P. gingivalis. METHODS: The antibacterial activities of 2% CHX gel, 2% Metronidazole in Orabase, Emundo+Laser (an infra-red laser diode of 810nm, 300mW, continuous mode radiation, 30s and energy density of 11.5J/cm2), and Emundo against P. gingivalis was tested in vitro using two different methods; (1) Counting CFU/mL and (2) agar diffusion test (ADT). Data of CFU/mL were analyzed using one way ANOVA and Post hoc Tukey test (p<0.05). Data obtained from ADT test were analyzed using Kruskal-Wallis. RESULTS: The percentage of colony-forming units reduction was (99.75, 99.98) in Metronidazole, (99.66, 99.85) in CHX, and (96.68, 96.68) in Laser+Emundo (96.68, 96.68) groups after 24 and 48h, respectively. The amount of bacterial reduction in terms of log10 CFU/mL was decreased in the Metronidazole, CHX, Laser+Emundo and, Emundo groups, respectively after 48h (p<0.05). The inhibition zone radius was decreased in CHX, Metronidazole and, Laser+Emundo, respectively (p<0.05). CONCLUSIONS: It can be concluded that within the limitations of this in-vitro study, although photodynamic therapy with Emundo reduced the amount of P. gingivalis significantly, the use of metronidazole 2% in Orabase performed better in terms of reducing the amount of the bacteria. Also, the antibacterial effect of 2% CHX gel on P. gingivalis was significantly more than photodynamic therapy with Emundo.

Subcutaneous connective tissue reactions to various endodontic biomaterials: an animal study.

BACKGROUND AND AIMS: Biocompatibility of root-end filling materials is a matter of debate. The aim of this study was to compare the biocompatibility of a variety of commercial ProRoot WMTA cements and a resin-based cement (Geristore®) with different pH values of setting reaction and different aluminum contents, implanted into the subcutaneous connective tissue of rats at various time intervals. MATERIALS AND METHODS: Fifty Sprague-Dawley rats were used in this study. Polyethylene tubes were filled with Angelus WMTA, ProRoot WMTA, Bioaggregate, and Geristore. Empty control tubes were implanted into subcutaneous tissues and harvested at 7-, 14-, 28- and 60-day intervals. Tissue sections of 5 µm were stained with hematoxylin and eosin and observed under a light microscope. Inflammatory reactions were categorized as 0, none (without inflammatory cells); 1, mild (inflammatory cells ≤25); 2, moderate (25-125 inflammatory cells); and 3, severe (>125 inflammatory cells). Statistical analysis was performed with Kruskal-Wallis and Mann Whitney U tests. RESULTS: ProRoot WMTA and Angelus elicited significantly less inflammation than other materials (P<0.05). After 7 days, however, all the materials induced significantly more inflammation than the controls (P<0.05). Angelus-MTA group exhi-bited no significant differences from the Bioaggregate group (P=0.15); however, ProRoot WMTA elicited significantly less inflammation than Bioaggregate (P=0.02). Geristore induced significantly more inflammation than other groups (P<0.05). CONCLUSION: Geristore induced an inflammatory response higher than ProRoot WMTA; therefore, it is not recommended for clinical use.

Effect of laser irradiation on root canal walls after final irrigation with 17% EDTA or BioPure MTAD: X-ray diffraction and SEM analysis.

OBJECTIVE: To evaluate the effect of diode laser irradiation on crystallographic and morphologic characteristics of root canal walls after final irrigation with either 17% EDTA or BioPure MTAD. METHOD AND MATERIALS: Root canals in 60 single-rooted teeth were instrumented using a rotary Ni-Ti system. The teeth were randomly divided into three groups (n = 20) based on the final irrigants: group 1, saline; group 2, 17% EDTA; and group 3, MTAD. Each group was further divided into two subgroups (n = 10). Subgroup A received diode laser irradiation at a wavelength of 810 nm and an output power of 2 W for 5 × 5 seconds, while subgroup B received no irradiation. A paired t test was used to compare mean dentinal erosion before and after irradiation in each group. Specimens were analyzed using SEM and x-ray diffractometery. One-way ANOVA and a post hoc Tukey test were used to evaluate dentinal erosion between groups. Kruskal-Wallis and Mann-Whitney U tests were used to evaluate any significant differences in the amount of dentin erosion between the groups. RESULTS: SEM micrographs showed closed dentinal tubules in the control group, while in unlased BioPure MTAD and EDTA groups, clean root canal walls were evident. Erosion was mostly seen in EDTA-treated teeth, while an increase of erosion degree was noted on root canal walls after additional laser irradiations. After irrigation and laser irradiation, the XRD spectrums indicated sharper peaks of EDTA, which showed a slight crystallographic change compared with the other groups. EDTA made changes in the mineralization of dentin due to its higher accumulation on the dentinal wall surface and produced significant degrees of erosion in comparison with MTAD by changing the physical properties of the root canal wall surface. These undesirable changes can be enhanced by further laser irradiation. CONCLUSION: Results confirm that a diode laser in combination with BioPure MTAD have minimum effect on the chemical properties of root canal dentin while having good smear layer removal properties. The results of the present study indicated that a diode laser in combination with Biopure MTAD might be suggested as a final management of the root canal system prior to canal obturation.

The efficacy of foam cleaners in removing debris from two endodontic instruments.

OBJECTIVE: To compare the efficacy of ProFile File cleaner and a nanostructured foam in removing debris from two rotary nickel-titanium instruments during and after instrumentation. METHOD AND MATERIALS: Twenty mandibular premolars were decoronated and instrumented up to either no. 40.04 RaCe (no. 40.04) or K3 (no. 40.04) instruments (n = 10). Each group of files was randomly divided into two groups: ProFile File cleaner and Nano Foam cleaner. The instruments were examined under a scanning electron microscope (SEM) before and after placement into the canals. Subsequently, instruments were introduced into each cleaner and examined again under SEM. The amount of debris removal from the instruments was determined by ImageJ software. Data were subjected to Kruskal-Wallis and Mann-Whitney tests at a .05 level of significance. RESULTS: The amount of debris removal was significantly different between the groups (P = .002). The amount of debris removed was significantly higher in K3 with Nano Foam cleaner than ProFile File cleaner (P = .009). CONCLUSION: Nanostructured foam can remove debris from endodontic files, especially from those with complex cross-section. This method is recommended to help optimize debris removal with the further possibility of instrument sterilization and reduced risk of cross-contamination.

Back-scattered and secondary electron images of scanning electron microscopy in dentistry: a new method for surface analysis.

OBJECTIVE: A scanning electron microscope (SEM) is a popular tool for investigating the root canal surface to visualize dentinal tubules, the smear layer and various root canal filling materials in endodontics. Most of the SEM micrographs taken in endodontic research are in secondary electrons (SE) mode, in which the topographic view of a subject can be demonstrated without giving any information about the real structure. Back-scattered electron (BSE) images are also used, which reveal some information about the internal structure while providing no topographic details. The aim of this study was to investigate the possibility of using back-scattered (BSE) and secondary electron (SE) mode of scanning electron microscopy (SEM) together for obtaining detailed information about biomaterials in relation to dental structures. MATERIALS AND METHODS: Mesiobuccal roots of four permanent maxillary molars were cleaned and shaped with rotary instruments. Two samples were obturated with gutta-percha and sealer. After 2 weeks, gutta-perch was removed using rotary instruments and chloroform. In the other phase of the study, white mineral trioxide aggregate was mixed and packed into five glass tubes and exposed to blood, deionized water, synthetic tissue fluid and egg white. All the samples were prepared for visualization under SE and BSE modes of SEM to observe the characteristics of material remnants and surface structures. RESULTS: BSE mode illustrated different grey scale views which made it possible to differentiate dentin chips from filling material remnants on the surface of root canal dentin. In addition, SE mode focused on image topography, while a BSE detector showed new texture formation on the surface of white mineral trioxide aggregate exposed to proteinaceous fluids such as blood or egg white. CONCLUSIONS: Mapping BSE and SE micrographs helped us to better understand the structure of materials on the surface of root canal dentin and MTA. Moreover, analysis of structure of materials on the surface of root canal dentine and MTA can be performed better by mapping of BSE and SE micrographs.

Application of mercury intrusion porosimetry for studying the porosity of mineral trioxide aggregate at two different pH.

OBJECTIVE: To evaluate a novel method of detecting and comparing the porosity of white Mineral Trioxide Aggregate and Portland cement at two different pH. MATERIALS AND METHODS: Cylindrical specimens (n = 120) were prepared from hydrated ordinary white Portland Cement (WPC) (n = 60) and white Mineral Trioxide Aggregate (WMTA) (n = 60) and exposed to environments with pH of 4.4 (n = 30) or 7.4 (n = 30). The pore size distribution and total pore volume were detected using Mercury Intrusion Porosimetry. Data were analyzed by analysis of variance and post-hoc Tukey or Tamhane test (p = 0.05). RESULTS: The pore volume of WMTA was significantly lesser than WPC at both pH (p < 0.05). The surface tension of mercury was taken as 480 (N/m) and the contact angle 141.3° for both materials. Pores were consistently found in all specimens. Total pore volumes for WPC and WMTA (cubic centimeter/gram) were 0.1954 and 0.1023, respectively, while the diameter of the pores ranged from 50-100 Å and 20-50 Å, respectively. CONCLUSIONS: Mercury Intrusion Porosimetry technique is a promising and reliable technique for assessing the porosity of endodontic materials.

Effect of storage temperature on sealing ability and solubility of white mineral trioxide aggregate.

OBJECTIVE: Knowledge about the effect of storage conditions on the clinical performance of Mineral Trioxide Aggregate (MTA) is of great importance for clinicians. The aim of this study was to evaluate the effect of storage temperature on sealing ability and solubility of white MTA. MATERIALS AND METHODS: This study was divided into two parts: sealing ability and solubility tests. Forty single-rooted human pre-molars were divided into three experimental (n = 10) and two control groups (n = 5). The root canals were instrumented and root apices were resected. Root-end cavities were prepared and filled with white MTA stored at 4°C, 25°C or 40°C. Microleakage was evaluated using a protein leakage test with bovine serum albumin at 24-h intervals for 120 days. The solubility test was also performed based on ISO specifications (ISO 2001-6876). Data were analyzed by one-way analysis of variance and post-hoc Tukey test, with a significance level set at p = 0.05. RESULTS: The highest bovine serum albumin microleakage and the highest solubility rates were observed in 4°C followed by 25°C and 40°C groups. At higher temperatures, leakage needed significantly longer times to occur (p < 0.05). CONCLUSIONS: Based on these findings, storage temperature appears to play an important role in the properties and hence clinical outcomes of MTA.

Effect of gravity and capillarity on human saliva penetration in coronally unsealed obturated root canals.

AIM: The purpose of this study was to evaluate the effect of gravity and capillarity on penetration of human salivary bacteria into the entire length of obturated root canals, and to demonstrate the dye penetration configuration. MATERIALS AND METHODS: Fifty single-rooted premolars were decoronated, prepared to a standardized length of 15 mm, instrumented, and randomly divided into two groups (A and B) of 25 teeth each. Each group consisted of experimental (15 samples) and negative and positive controls (five samples each). The experimental groups were obturated with gutta-percha and root canal sealer. The positive control groups were obturated with a single cone of gutta-percha and root canal sealer. The outer surfaces (except for the apical 2 mm) were covered with two layers of nail varnish. An apparatus containing Brain Heart Infusion broth was designed, in which the teeth were placed. The samples in Group A were placed upside down, while Group B was placed normally. The coronal portions of the samples were placed in contact with fresh saliva. The number of days required for bacteria to penetrate the entire length of canals was determined. The samples were then immersed in India ink to determine the dye penetration configuration. Data were analyzed using Student's t-test. RESULTS: The extent of dye penetration was significantly greater in Group B compared to Group A, and they were in a pattern rather than linear form. CONCLUSIONS: Gravity and capillarity insignificantly affected bacterial leakage. Although gravity and capillarity did not affect bacterial penetration when applied to the coronal access of endodontically treated teeth, it seems that they can promote penetration of India ink into the canal after the bacterial test on the same tooth.

Additive effect of a diode laser on the antibacterial activity of 2.5% NaOCl, 2% CHX and MTAD against Enterococcus faecalis contaminating root canals: an in vitro study.

This in vitro study was performed to evaluate the effect of a diode laser and common disinfectants used in combination on mono-infected dental canals. One hundred and six single-rooted human premolars were prepared and contaminated with Enterococcus faecalis. After two weeks of incubation, samples were divided into two experimental groups (n = 48) and two control groups (n = 5). In the first group, the teeth were rinsed for 5 min with either sterile saline, 2.5% NaOCl, or MTAD, or for 1 min with 2% chlorhexidine gluconate (CHX). In the other group, samples were additionally irradiated with a 810-nm diode laser at 2 W output for 5 × 5 s. Intracanal bacterial sampling was done, and the samples were plated to determine the CFU count. In the first group, 2.5% NaOCl was as effective as 2% CHX and significantly more effective than MTAD (P < 0.008). In the second group, either MTAD, 2% CHX or 2.5% NaOCl in combination with laser treatment had a similar effect. Absence of growth was seen only for MTAD plus laser treatment. Complete elimination of E. faecalis was seen only for the combination of MTAD with diode laser irradiation. Combination therapy with MTAD irrigation and diode laser irradiation, within the parameters used in this study, can be recommended as an effective treatment option for complete elimination of E. faecalis from the root canal system.

Management of an extensive invasive root resorptive lesion with mineral trioxide aggregate: a case report.

External invasive resorption is an uncommon but aggressive type of external resorption. This report outlines the management of an advanced case of external invasive resorption with mineral trioxide aggregate (MTA). The clinical and radiographic follow-up after 60 months revealed a functional tooth with a stable periodontal condition and no evidence of any further resorption.