Temperature variation during apicectomy with Er:YAG laser.

OBJECTIVE: The purpose of this in vitro study was to evaluate the generated temperature of the Er:YAG laser, with three different pulse durations for apicectomy, compared with tungsten bur and surgical saw. BACKGROUND DATA: Apicectomy is an endodontic surgery performed to remove the root apex and curette adjacent periapical tissue because of lesions of the apical area that are not healing properly. METHODS: Sixty single-rooted extracted human teeth were resected by three cutting methods: tungsten bur, surgical saw, and Er:YAG laser irradiation with three different pulse durations; pulse duration 50 µs, pulse duration 100 µs, and pulse duration 300 µs. Teflon-insulated, type K thermocouples were used to measure temperature changes during the apicectomy process. Data were analyzed using the general linear models procedure of the SPSS statistical software program. RESULTS: Although there was no statistically significant difference for the mean values of temperature changes at 1 mm away to the cutting site of teeth, there was statistically significant difference among groups for the mean values of temperature changes at 3 mm away to the cutting site of teeth. Additionally, there was statistically significant difference among groups for the total time required for apicectomy. CONCLUSIONS: The laser irradiation with pulse duration 50 µs appears to have the lowest temperature rise and the shortest time required for apicectomy of the three pulse durations. However, Er:YAG laser for apicectomy in all pulse durations could be used safely for resection in endodontics in the presence of sufficient water.

Effect of F-File on removal of the smear layer: a scanning electron microscope study.

The aim of this study was to evaluate the effectiveness of F-File with NaOCl on removal of the smear layer. A total of 48 single-rooted teeth were instrumented using crown-down technique with one of the irrigation agents: distilled water, 5.25% NaOCl, RC-Prep, Glyde, MTAD or F-File with NaOCl. The remaining smear layer was scored at cervical, middle and apical thirds of the roots with SEM. In all the canals of experimental groups the coronal sections were cleaner than the middle and apical sections except with distilled water (P<0.001). In the coronal third, intensive smear layer was observed in distilled water, NaOCl and F-File groups and less smear layer in MTAD (P<0.05) and least in RC-Prep and Glyde groups. In the middle third, RC-Prep and Glyde groups had less smear layer than the other groups (P<0.001). In the apical third, there was intensive smear layer in all specimens and statistical analyses showed no significant difference among the groups (P>0.05). The F-file failed to improve the effect of NaOCl in removing smear layer.

The effect of irrigation solutions on the apical sealing ability in different root canal sealers

The aim of this study was to assess the effect of three root canal irrigation solutions on the apical sealing ability of three root canal obturation materials: gutta-percha/AH plus or MM-seal and Resilon/Epiphany SE. A total of 100 teeth with single straight root canals were randomly divided into three equal groups of 30 samples each, with the other 10 teeth (5 positive and 5 negative) used as controls. Each irrigation group was divided into three groups according to the use of three different root canal obturation materials (n = 10): Gutta-percha with AH plus or MM-seal, Resilon with Epiphany SE. The crowns were removed at the cementoenamel junction with a diamond disc under water coolant. The root canals were prepared using step-back technique and irrigation with either sodium hypochlorite (2.5 percent), chlorhexidine (2 percent), or MTAD solutions. The roots were obturated with lateral condensation technique using one of the obturation materials. The root surfaces was coated with two layer nail varnish (except apex), placed in 2 percent methylene blue dye solution, and centrifuged at 3,000 rpm for 5 minutes. Irrigation solutions affected the apical sealing ability of all the sealers. The chlorhexidine irrigation solution exhibited higher apical leakage values than did MTAD and NaOCl in all canal sealers, although the MTAD irrigation solution groups showed the least leakage values. The apical sealing ability of AH plus, Epiphany SE and MM-seal root canal sealers decreased when the chlorhexidine was used as an irrigation solution.

Can radiotherapy affect the apical sealing ability of resin-based root canal sealers?

BACKGROUND: The authors conducted a study to assess the influence of radiotherapy on the apical sealing ability of one recently introduced resin-based root canal sealer and two sealers that have been in use for several years. METHODS: The authors divided 90 human maxillary anterior teeth into three groups according to the type of root canal sealer used and, using lateral condensation, obturated the roots with gutta-percha. They randomly divided all roots into two main groups according to the presence or absence of radiotherapy. For the groups that received irradiation, a dose of 60 gray was delivered in fractions of 1.8 Gy per day, five days a week for seven weeks. The authors then performed the centrifuging dye penetration test to determine apical leakage for each specimen. RESULTS: The authors compared the specimens in the groups that received radiotherapy after endodontic treatment with the specimens in the groups that did not undergo radiotherapy after endodontic treatment. They found that mean apical leakage was slightly higher in the radiotherapy groups, but they did not observe any statistical difference between the groups (P > .05). In the groups that did not undergo radiotherapy, the mean apical leakage for the specimens in the MM-Seal (MicroMega, Besançon, France [not marketed in the United States]), AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) and AH 26 (Dentsply DeTrey GmbH) groups was 2.52 +/- 0.42 millimeters, 2.85 +/- 0.52 mm and 3.73 +/- 0.41 mm, respectively. In the groups that underwent radiotherapy, the mean apical leakage for the specimens in the MM-Seal, AH Plus and AH 26 groups was 2.72 +/- 0.55 mm, 2.96 +/- 0.47 mm and 3.93 +/- 0.61 mm, respectively. CONCLUSION: The apical sealing ability of the resin-based root canal sealers decreased slightly when radiotherapy was administered, although there was no statistically significant difference. CLINICAL IMPLICATIONS: Clinicians can safely use a resin-based root canal sealer in patients receiving radiotherapy.

Solubility of root canal sealers with different organic solvents.

OBJECTIVE: The aim of this study was to assess the solubility of the new root canal sealer Epiphany and to compare it with 2 conventional sealers against 2 organic solvents commonly used in retreatment. STUDY DESIGN: Standardized cylindric glass molds 5 mm wide and 2 mm high were filled with freshly mixed root canal sealers AH Plus, Ketac-Endo, and Epiphany. Samples were stored at 37 degrees C for 2 weeks. Each sample was immersed in chloroform or eucalyptus oil for 2 min, 5 min, and 10 min. The mean percentage loss of weight was determined for each material in each solvent and for each immersion period. RESULTS: There were no significant differences at 2 and 5 min (P > .05) for all tested sealers in all immersed solvents. AH Plus and Epiphany sealers showed significantly higher solubilities (P < .05) in chloroform than in eucalyptus oil. Epiphany was the most soluble root canal sealer in both the solvents. Ketac-Endo was the least soluble sealer in both chloroform and eucalyptus oil at all exposure times (P < .05). CONCLUSION: The root canal sealers Epiphany and AH Plus dissolved to some extent and more than Ketac-Endo, using either eucalyptus oil or chloroform as the solvent.

Radiopacity of a new root canal sealer, Epiphany.

OBJECTIVE: The purpose of this study was to evaluate the radiopacity of a new root canal sealer, Epiphany, relative to 3 other root canal sealing materials, AH 26, Sealapex, and Ketac-Endo. STUDY DESIGN: Radiographs were taken of 1-mm-thick specimens of 4 root canal sealers and dentine slides, as well as a range of aluminum thicknesses, by using a step-wedge. The radiographic density of each specimen was measured and correlated with the equivalent thickness of aluminum. RESULTS: All sealers were found to be more radiopaque than dentine (1.05 +/- 0.2-mm aluminum) and to possess radiopacity of greater than 3-mm aluminum. The radiopacity values reported in this study were 11.27 +/- 0.18-mm, 10.88 +/- 0.16-mm, 10.35 +/- 0.15-mm, and 9.78 +/- 0.21-mm aluminum for Sealapex, Ketac-Endo, Epiphany, and AH 26, respectively, which were significantly different from each other (P < .01). CONCLUSION: Radiopacity measurements for Epiphany, Ketac-Endo, Sealapex, and AH 26 exceeded the minimum standard for root canal sealers. Epiphany has higher radiopacity than dentine. Therefore, this sealer is suitable for endodontic usage in terms of radiographic assessment.

Use of a pin and bar-retained composite bridge in anterior tooth loss: a case report.

A pin and bar-retained composite bridge can be used to replace missing teeth in cases when minimal tooth reduction is desired and patients refuse implant surgery for psychological reasons. This case report describes the clinical procedure for a pin and bar-retained composite bridge as a conservative solution for replacing missing teeth. The location and width of the toothless region, the patient's occlusion state, and poor oral habits may significantly affect the success of this alternative treatment. Compared with other restorative systems, this conservative approach is a minimally invasive technique that has a minimal effect on adjacent teeth.

Influence of immediate and delayed post space preparation on sealing ability of resilon.

OBJECTIVE: The purpose of this study was to evaluate the effect of immediate and delayed post space preparation on the sealing ability of a new root canal filling material. STUDY DESIGN: Seventy-two extracted teeth were prepared and obturated with gutta-percha/AH-Plus and Resilon/Epiphany sealer by the lateral compaction technique. The teeth were divided randomly into 4 groups, and the post space was prepared either immediately after filling or after the obturated teeth had been stored in saline at 37 degrees C for a week. Leakage was determined by a fluid-transport device. RESULTS: The results showed that immediate post space preparation of the Resilon/Epiphany-filled group had a mean leakage value of 0.81 microL/h, whereas the delayed preparation had a mean leakage value of 0.75 microL/h. No difference (P > .05) in microleakage was found between gutta-percha/AH-Plus and Resilon/Epiphany-filled groups after immediate preparation. There was significant difference between gutta-percha/AH-Plus and Resilon/Epiphany groups in the delayed post space preparation (P < .05). CONCLUSION: Epiphany/Resilon obturation achieved better sealing than gutta-percha/AH-Plus at the apical end, especially in delayed post space preparation when mechanical techniques were used.

A case of tularemia presenting as a dental abscess: case report.

OBJECTIVE: The purpose of this report is to present a tularemia case accompanied by a neck mass that easily may be confounded with dental abscess. SUMMARY: Francisella tularensis is a potential agent of biologic terrorism. Thirty percent of the symptoms seen in tularemia localize in the head and neck region and are sometimes mistaken for complications of a dental abscess. To our knowledge, reports of the differential diagnostic characteristics of tularemia are lacking in the dental literature and, to date, no dental journal articles have focused on the disease. In this present case, a 51-year-old woman arrived at the public health department with high fever and facial swelling. The findings suggested a dental origin and the patient was directed to dentistry. Radiology and a detailed intraoral and extraoral examination failed to reveal a dental problem. Fortunately, the patient was known to come from a tularemia region; with the suspicion of tularemia the patient was referred to the faculty of medicine. Serologic tests showed that the patient had a Francisella tularensis infection.