Spectrophotometric analysis of discoloration and internal bleaching after use of different antibiotic pastes.

OBJECTIVES: To investigate teeth's antibiotic-induced color differences after bleaching using two different techniques. MATERIALS AND METHODS: One hundred twenty extracted maxillar human incisors were examined. The specimens were randomly divided into six groups, each receiving one of six antibiotic paste fillings: (1) triple antibiotic paste (TAP) with minocycline, (2) double antibiotic paste (DAP), (3) TAP with amoxicillin, (4) TAP with cefaclor, (5) TAP with doxycycline, and (6) no filling (control group). Spectrophotometric measurements were obtained at baseline and then during the first, second, and third weeks after paste placement. The specimens discolored by antibiotics pastes were randomly divided into two subgroups: (1) internal bleaching with hydrogen peroxide (H2O2) and (2) internal bleaching with H2O2 plus Nd-YAG laser irradiation. The ∆E value was calculated and analyzed using a two-way analysis of variance and post-hoc Tukey's test (α = 0.05). RESULTS: The ∆E for all groups showed color differences exceeding the perceptibility threshold (∆E Ëƒ 3.7) at all time points except in the control and DAP groups. Minocycline-induced TAP showed the most severe coronal discoloration (32.42). When the ∆E was examined, thermo/photo bleaching (22.01 ± 8.23) caused more bleaching than walking bleaching (19.73 ± 5.73) at every time point (P = 0.19). No group returned to the original color after bleaching (P < 0.05). CONCLUSIONS: Except for DAP, all antibiotic pastes caused discoloration. Internal bleaching with Nd-YAG laser can be useful for bleaching/removing this discoloration. CLINICAL RELEVANCE: For clinically successful final appearances, understanding the effects of bleaching procedures on antibiotic paste discoloration is important.

Evaluation of the preventive efficacy of three dentin tubule occlusion methods against discoloration caused by triple-antibiotic paste.

The aim of this in vitro study was to evaluate the preventive efficacy of three dentin tubule occlusion methods against discoloration caused by triple-antibiotic paste (TAP). Sixty extracted human incisors were sectioned, and the access was opened. The specimens were randomly allocated to the following four groups (n = 15): bonding application (BD), teethmate desensitizer (TM), Nd:YAG laser application (LS), and no surface treatment (control, C). Specimens were discolored with TAP over a period of 3 weeks. The color was measured by spectrophotometry at two time-points: initially and after 3 weeks of TAP placement. Color differences (∆E) were calculated and analyzed. Discoloration was visually noticed in all teeth after 3 weeks. The differences between the control group and the three dentin tubule occlusion methods were statistically significant (p < 0.05); however, there were no statistically significant differences among the BD, TM, and LS groups (p > 0.05).

Does Adding Various Accelerators to Mineral Trioxide Aggregate Have a Negatively Effect on Push-Out Bond Strength?

OBJECTIVE: This study compares the effect of the white mineral trioxide aggregate (WMTA) accelerators, including disodium hydrogen orthophosphate (Na2HPO4; 2.5 wt%), calcium chloride (CaCl2; 5 and 10 wt%), and KY jelly, on the push-out bond strength of WMTA. The null hypothesis was that the WMTA accelerators would not affect the push-out bond strength of WMTA. MATERIALS AND METHODS: Slices (2-mm-thick) were obtained from 75 human mandibular molar distal roots. The slices were enlarged up to size 6 Gates-Glidden burs to obtain a 1.5-mm canal diameter. The slices were randomly divided into 4 experimental groups and a control group (n = 15 in each group). Freshly prepared WMTA mixture was placed into the root slices and stored at 37°C in a 100% humidified atmosphere for 60 days. The force required to dislodge the WMTA cement from the root slice was determined using a universal testing machine. The push-out bond strength was calculated. RESULTS: Push- out bond strength of 5- and 10-wt% CaCl2, and 2.5-wt% Na2HPO4 WMTA groups was significantly lower than in the KY-jelly and control groups (p < 0.05). The mean push-out bond strength of KY jelly was lower than in the control group but not statistically significant. CONCLUSION: The addition of KY jelly to WMTA did not have an adverse effect on the push-out bond strength of WMTA, in contrast to the other accelerators, including Na2HPO4 and CaCl2, which reduced the push-out bond strength.

Influence of Instruments Used in Root Canal Preparation on Amount of Apically Extruded Debris.

The aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented using ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne systems. Eppendorf tubes containing apically extruded debris were weighed three times, and mean values were calculated. The net mass of the extruded debris was calculated by subtracting the initial mass from the final mass. The groups were compared using one-way analysis of variance and Tukey's post hoc tests at a significance level of P < 0.05. The PTG group extruded less debris than the PTU group, and the WOG group extruded less debris than the WO group (P < 0.05). All the instrumentation systems tested in the present study were associated with apical extrusion of debris.

Evaluation of bond strength of various epoxy resin based sealers in oval shaped root canals.

BACKGROUND: The aim of this study was to evaluate the bond strength of AH plus, Acroseal, and Adseal to the root canal dentin. METHODS: A total of 36 single-rooted, mandibular premolar teeth were used. Root canal shaping procedures were performed with ProTaper rotary instruments (Dentsply Maillefer) up to size F4. The prepared samples were then randomly assembled into 3 groups (n = 12). For each group, an ultrasonic tip (size 15, 0.02 taper) which was also coated with an epoxy resin based sealer and placed 2 mm shorter than the working length. The sealer was then activated for 10 s. A push-out test was used to measure the bond strength between the root canal dentine and the sealer. Kruskal-Wallis test to evaluate the push-out bond strength of epoxy based sealer (P = 0.05). The failure mode data were statistically analyzed using Pearson's chi square test (P = 0.05). RESULTS: Kruskal-Wallis test indicated that there were no statistically significant difference among the push out bond strength values of 3 mm (p = 0.123) and 6 mm (P = 0.057) for groups, there was statistically significant difference push out bond strength value of 9 mm (P = 0.032). Pearson's chi square test showed statistically significant differences for the failure types among the groups. CONCLUSION: Various epoxy resin based sealers activated ultrasonically showed similar bond strength in oval shaped root canals. Apical sections for all groups have higher push out bond strength values than middle and coronal sections.

The comparative of chitosan and chitosan nanoparticle versus ethylenediaminetetraacetic acid on the smear layer removal: A systematic review and meta-analysis of in vitro study.

The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan nanoparticles (Ch-NPs). A search was performed in four electronic databases (Web of Science, PubMed, Scopus, and Cochrane). The included studies were assessed by two reviewers using Joanna Briggs Institute's critical appraisal checklist for the quasi-experimental studies. Outcomes obtained by scanning electron microscopy (SEM) and conventional methods were presented as standardized mean differences alongside 95% confidence intervals. Seven investigations employed 212 single-root teeth. In the apical section (p = .317, 95% CI = -0.820 to 0.266, Tau2 = 0.387), middle segment (p = .914, 95% CI = -1.019 to 0.912, Tau2 = 1.027), and coronal segment (p = .277, 95% CI = -1.008 to 0.289, Tau2 = 0.378). This meta-analysis found no difference between Ch, Ch-NPs, and EDTA in removing the smear layer in the three segments. This systematic review is designed to show evidence related to the PICO question, in which our outcome is smear layer removal and not the clinical success of such a treatment. RESEARCH HIGHLIGHTS: The study aimed to compare the effectiveness of chitosan and chitosan nanoparticles with ethylenediaminetetraacetic acid (EDTA) in removing the smear layer, a layer of debris and organic material on the tooth surface, through a systematic review and meta-analysis. The removal of the smear layer is crucial for successful dental treatments, as it enhances the adhesion of restorative materials and improves the penetration of antimicrobial agents into dentinal tubules. The researchers conducted a systematic review and meta-analysis, searching various databases of electron microscopy results for relevant in vitro studies comparing the effects of chitosan or chitosan nanoparticles with EDTA on smear layer removal. The results encourage further exploration of chitosan and chitosan nanoparticles for clinical use in dentistry, while considering their specific applications and long-term effects.

Evaluation of the effect of graphene oxide-based nanocomposites on smear layer by a scanning electron microscope: Laboratory investigation.

This study is to examine the effect of graphene oxide (GO) and GO-based nanocomposites (GO_EDTA, GO_CHIT) on the smear layer by scanning electron microscopy (SEM). Sixty human single-rooted anterior teeth were used. Samples were randomly categorised into six groups. Distilled water in group 1, 17% EDTA in group 2, chitosan (CHIT) solution in group 3, GO solution in group 4, GO_EDTA solution in group 5 and GO_CHIT in group 6 were used as irrigation solutions. Photomicrographs were acquired from the coronal, middle and apical parts of the samples by SEM. Statistical analyses were performed using Kruskal-Wallis, Mann-Whitney U and Wilcoxon tests. There was a statistically significant difference among the groups (p < 0.003). Adding GO to CHIT and EDTA did not affect removing the smear layer in all segments (p < 0.003). Incorporating GO into EDTA and CHIT solutions did not change their interaction with the smear layer.

Assessment of the prevalence and characteristics of dens invaginatus in a sample of Turkish Anatolian population.

OBJECTIVE: The objective of this study was to assess the prevalence and characteristics of dens invaginatus in anterior teeth and to classify the type of dens invaginatus in a sample of Turkish Anatolian population. STUDY DESIGN: A retrospective study was performed using full-mouth periapical and panoramic radiographs of 1012 patients. Maxillary and mandibular anterior teeth were evaluated for the presence and characteristics of dens invaginatus. Statistical evaluation of the presence of dens invaginatus related to gender was performed by the Pearson chi-squared test. RESULTS: Dens invaginatus was observed in 13 out of 1012 subjects and in only maxillary lateral incisors. There were no periapical lesions in teeth with types I and II, whereas both of the subjects with type III had apical periodontitis at the time of referral. Males and females were equally affected by dens invaginatus (P=0.98). CONCLUSION: The anomaly was detected in only maxillary lateral incisors with no gender difference and the most commonly observed type of dens invaginatus was type I (81.25%).

The prevalence of root dilacerations in a Turkish population.

OBJECTIVES: The aim of this study was to determine the prevalence of root dilaceration in a Turkish dental patient population, considering factors such as dental localization and the relationship between the sexes in this anomaly. STUDY DESIGN: A retrospective study was performed using periapical radiography of 2,124 patients, who ranged in age from 15 to 65 years old. All data (age, sex and systemic disease or syndrome) were obtained from the patient files and analyzed for root dilaceration. Descriptive characteristics of sexes, jaws, and dental localization were recorded. The Pearson chi-squared test was used. RESULTS: Of the 2,251 patients, 214 (9.5%) were found to have root dilaceration. Root dilacerations were determined in 276 (4.3%) of 6386 teeth, belonging to a total of 2251 patients. Anomalies were found in 9.8% of males, compared with 9.3% of females, a difference that was not statistically significant (p>0.05). Root dilacerations were distributed fairly evenly between the maxilla and mandible. The most frequently root dilacerated teeth were found to be mandibular third molars (12.8%), followed by maxillary third molars (7.4%), and maxillary first molars (6.7%). Root dilaceration was not detected in maxillary central incisors, mandibular central incisors or mandibular lateral incisors. CONCLUSION: root dilaceration is an uncommon developmental anomaly which occurs mostly in the posterior teeth, which are not prone to suffer trauma. The radiographic diagnosis of this anomaly is important before surgery, and especially before endodontic treatment or orthodontic treatment.

Comparison of newly formed microcracks after instrumentation using protaper next, reciproc and self-adjusting file systems.

PURPOSE: The purpose of the present study is to assess the rate of newly formed microcracks comparatively during root canal instrumentation by using ProTaper Next, Reciproc, and Self-Adjusting File systems using micro-computed tomography. SUBJECTS AND METHODS: Thirty mesial roots of mandibular molars were randomly assigned to 3 experimental groups (n = 10) as follows, ProTaper Next, Reciproc and Self-Adjusting File system. Preoperative and postoperative scans were obtained at the isotropic resolution of 13.68 µm. Cross-section images were examined to identify the presence of newly formed dentinal microcracks. RESULTS: The Self-Adjusting File and Reciproc systems caused a higher rate of new microcrack formation than the ProTaper Next group (p<0.001). There were also significant differences in the new microcrack formation between Reciproc and Self-Adjusting File groups (p<0.001). CONCLUSION: Reciproc and Self-Adjusting File systems caused a higher rate of newly formed microcraks compared to ProTaper Next system.

Evaluation of apically extruded debris during root canal retreatment with two different rotary systems followed by a self-adjusting file.

PURPOSE: To compare the amount of apically extruded debris during root canal retreatment using ProTaper retreatment system (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper retreatment system with Self-Adjusting File (SAF) system (ReDent-Nova, Ra'anana, Israel), Mtwo retreatment system (VDW, Munich, Germany), Mtwo retreatment system with SAF instruments. METHODS: In total, 72 extracted human mandibular incisor teeth were used. All root canals were prepared with ProTaper universal (Dentsply Maillefer) up to F2 file and filled with gutta percha and AH plus sealer using cold lateral condensation before being assembled randomly into 4 groups (n = 18 each). Root canal filling materials were removed using the ProTaper retreatment system, the ProTaper retreatment system followed by SAF system, Mtwo retreatment system and Mtwo retreatment system followed by SAF system. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The data obtained were analyzed using Kruskal-Wallis test. RESULTS: All retreatment techniques caused the apical extrusion of debris. There was no significant difference between the groups statistically (p>0.05). CONCLUSIONS: The results of this study showed that SAF system after Mtwo retreatment system and ProTaper retreatment system for improving retreatment has no significant effect on the amount of debris extruded apically.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis.

INTRODUCTION:: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). METHODS:: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. RESULTS:: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). CONCLUSION:: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

Apically extruded debris during root canal preparation using ProTaper Gold, ProTaper Universal, ProTaper Next, and RECIPROC instruments.

PURPOSE: The aim of this study was to determine the amount of apically extruded debris during root canal preparation with ProTaper Gold (PTG) (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Universal (PTU) (Dentsply Maillefer), ProTaper Next (PTN) (Dentsply Maillefer), and RECIPROC (VDW, Munich, Germany) in curved canals. METHODS: Eighty human mandibular molar teeth were divided into 4 groups according to the system used for root canal preparation: PTG, PTU, PTN, and RECIPROC groups. The mean weight of extruded debris was statistically analyzed using one-way analysis of variance and post-hoc Tukey's test (α = 0.05). RESULTS: The PTU was associated with significantly more extruded debris than the PTG, PTN, and RECIPROC (p<0.05). The PTG was associated with significantly more extruded debris than the PTN and RECIPROC (p<0.05), whereas no significant difference was found between the RECIPROC and PTN (p>0.05). CONCLUSIONS: All systems caused apical debris extrusion during curved canal preparations. However, the PTG, PTN, and RECIPROC systems resulted in significantly less debris extrusion than the PTU system.

Micro push-out bond strength of resin cement in roots exhibiting the butterfly effect.

The aim of this study was to determine the bond strength of resin cement in root sections with or without butterfly effect. Fifteen single-rooted human maxillary central incisors were decoronated and prepared up to size 40. After post space preparation, the resin cement was placed into the post space and the fiber posts were luted. 1 mm thickness slices were obtained and the presence of the butterfly effect was recorded. A push-out test was then used to measure the bond strength between the resin cement and root dentin. Data were analyzed using independent samples of t and χ(2) tests (p = 0.05). The sections exhibiting butterfly effect showed higher push-out bond strength values than those of without butterfly effect (p < 0.05). Butterfly effect can influence the push-out bond strength. Thus, this phenomena should be taken into account, when push-out bond strength test is performed. Root sections exhibiting butterfly effect resulted in higher push-out bond strength values to root sections without butterfly effect.

The effect of medicaments used in endodontic regeneration technique on the dislocation resistance of mineral trioxide aggregate to root canal dentin.

INTRODUCTION: The aim of this study was to evaluate the effect of calcium hydroxide (CH) and antibiotic pastes, including a mixture of metronidazole and ciprofloxacin, with and without minocycline or cefaclor, on the dislocation resistance of mineral trioxide aggregate (MTA) to root dentin. METHODS: Eighty single-rooted human mandibular premolars were selected. The teeth were prepared by using the ProTaper system. The prepared teeth were then instrumented to a #6 Peeso reamer to obtain a standard internal diameter of 1.5 mm. The reamers were passed 1 mm beyond apex to simulate immature teeth. The specimens were then randomly divided into a control group (no intracanal medicament was used) and 4 experimental groups that were treated with an intracanal medicament: CH, double antibiotic paste (DAP) with metronidazole and ciprofloxacin, triple antibiotic paste (TAP) with minocycline, or TAP with cefaclor (n = 16). After 3 weeks, the medicaments were removed, and approximately 3 mm of MTA was placed in the coronal third of the canals. A push-out test was used to measure the dislocation resistance between the root dentin and MTA. Data were analyzed by using one-way analysis of variance and Tukey post hoc tests. RESULTS: The dislocation resistance values of the CH, TAP with minocycline, and TAP with cefaclor groups were similar to those of the control group (P > .05), whereas the DAP group had the lowest dislocation resistance when compared with the other groups (P < .05). Overall, there was a predominance of cohesive failures between root dentin and MTA. CONCLUSIONS: The results of this study indicate that the application of DAP as an intracanal medicament reduced the dislocation resistance of MTA to root dentin.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis

ABSTRACT Introduction: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). Methods: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. Results: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). Conclusion: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar a prevalência de anomalias dentárias em uma subpopulação de pacientes ortodônticos com agenesia de incisivos laterais superiores (ILS). Material e Métodos: o material do presente estudo incluiu os registros de 1964 pacientes ortodônticos. Radiografias panorâmicas e modelos de estudo foram usados para analisar outras anomalias dentárias associadas, incluindo a agenesia de outros dentes, dens invaginatus, dens evaginatus, ILS conoides, taurodontismo, calcificação pulpar, dilaceração radicular e impacção do canino superior. Resultados: dos 1964 pacientes examinados, constatou-se que 90 tinham agenesia do ILS, o que representa uma prevalência de 4,6%. As anomalias associadas mais comumente encontradas foram a agenesia de outros dentes (23,3%), ILS conoides (15,6%), taurodontismo (42,2%) e dentes com dilaceração (18,9%). Conclusão: a agenesia de dentes permanentes, o taurodontismo, incisivos laterais superiores conoides e dilaceração radicular estão frequentemente associados à agenesia de incisivos laterais superiores.