Comparison of rotary instrumentation and continuous wave obturation to reciprocating instrumentation and single cone obturation with a hydrophilic sealer.

This in vitro study compared the effectiveness between ProFile 29 Series rotary system followed by continuous wave obturation and the Endo-Eze system. Thirty-six human mandibular canine and premolar teeth were randomly separated into 2 groups of 18. Each tooth was embedded in resin and sectioned at 2, 6, and 12 mm from the apex and viewed under the scanning electron microscope at 50-150x magnification. The percentages of canal space occupied by gutta-percha, sealer, debris, and voids were measured and analyzed with Image J software. Results were calculated by using an analysis of variance model with fixed effects for method, distance, and distance interaction. Repeatability of measurements and intraclass correlation coefficients were calculated. These results demonstrated that obturation with the continuous wave technique achieved significantly more gutta-percha occupying the canal space than the Endo-Eze system. Under the conditions of this study, the continuous wave technique was less likely to exhibit voids than the Endo-Eze technique. Furthermore, neither the Profile Series 29 nor the Endo-Eze system cleaned and shaped elliptical canals consistently.

Push-out bond strength of a new endodontic obturation system (Resilon/Epiphany).

Endodontic sealers should demonstrate adhesive properties to dentin to reach the objectives of the obturation of the canal space and seal the canal space both apically and coronally, thus decreasing the chance of endodontic treatment failure. Adhesion to dentin with bonding to the tooth structure in the canal may provide greater resistance to tooth fracture and greater clinical longevity of an endodontically treated tooth. In this study, human single-canal canines were endodontically treated and obturated with two different endodontic obturation systems (Epiphany/Resilon system and gutta-percha/AH 26). Thirty roots (divided into two groups) were horizontally sliced for a push-out strength test, which was performed from apical to coronal in the universal testing machine. Differences in push-out bond strength between the two different material systems were obtained using repeated measures analysis of variance on ranks. Gutta-percha had significantly higher push-out bond strength than Epiphany (p<0.0001).

An in vitro evaluation of the contents of root canals obturated with gutta percha and AH-26 sealer or Resilon and Epiphany sealer.

The purpose of this study was to compare the contents of root canals obturated with gutta percha and AH-26 sealer (Dentsply, Tulsa, OK) to canals obturated with the Resilon and Epiphany (Pentron, Wallingford, CT) system. Canal contents were assessed by determining the percentage of canal space occupied by core material, sealer, voids, and debris. Forty extracted human maxillary anterior teeth were instrumented, and the teeth were randomly assigned to either the gutta percha/AH 26 group or the Epiphany/Resilon group. Canals were obturated, and the teeth were subsequently embedded in resin and sectioned horizontally at 2, 4, and 6 mm from the anatomic apex. Sections were photographed by using a low vacuum scanning electron microscope. Image-J (Wayne Rasband; National Institute of Health, Bethesda, MD) software was used to quantify the proportion of core material, sealer, voids, and debris in each canal. Percentages and statistical comparisons for each method were compared. There were no significant differences found among the two groups in terms of the percentage of core (p = 0.9), sealer (p = 0.58), debris (p = 0.999), or voids (p = 1.00). Additionally, there were no differences in the percentage of core material, sealer, debris, or voids at any of the examined levels (2, 4, or 6 mm).

An in vitro comparison of microleakage between Resilon and gutta-percha with a fluid filtration model.

This investigation compared microleakage of teeth obturated with gutta-percha and teeth obturated with Resilon by using a fluid filtration model. Forty-six human, single-rooted, mandibular premolars were studied. Teeth were randomly assigned to 2 experimental groups of 21 teeth each, designated as group G (gutta-percha) and group R (Resilon). Two control groups, both containing 2 teeth, served as positive and negative controls. Group G, gutta-percha and AH 26 sealer, and group R, Resilon and Epiphany sealer, were obturated by using warm vertical condensation. The specimens were tested for microleakage with an in vitro fluid filtration apparatus at 10 psi at 4 intervals: 1, 7, 30, and 90 days. A two-way repeated measures analysis of variance model with fixed effects for group, time, and group by time interaction was used to analyze microleakage data. This study demonstrated that canals obturated with Resilon and Epiphany sealer leaked statistically less than canals obturated with gutta-percha and AH 26 sealer at day 1 (P < .0014), day 7 (P < .0002), day 30 (P < .0015), and day 90 (P < .0170). The mean fluid microleakage for both group G and group R increased from day 1 to day 90. The results showed that Resilon is a suitable replacement for gutta-percha as a root canal filling material on the basis of its increased resistance to fluid microleakage.

Using a Checklist to Improve Family Communication in Trauma Care.

Modern concepts of patient-centered care emphasize effective communication with patients and families, an essential requirement in acute trauma settings. We hypothesized that using a checklist to guide the initial family conversation would improve the family's perception of the interaction. Institutional Review Board-approved, prospective pre/post study involving families of trauma patients admitted to our Level I trauma center for >24 hours. In the control group, families received information according to existing practices. In the study group, residents gave patient information to a first-degree family member using a checklist that guided the interaction. The checklist included a physician introduction, patient condition, list of known injuries, admission unit or intensive care unit, any consultants involved, plans for additional studies or operations, and opportunity for family to ask questions. An 11-item survey was administered 24 to 48 hours after admission to each group that evaluated the trauma team's communication in the areas of physician introduction, patient condition, ongoing treatment, and family perception of the interaction. Responses were on a Likert scale and analyzed using the Wilcoxon-Mann-Whitney test. There were 130 patients in each group. The study group had significantly (P < 0.05) better responses in 8 of 11 items surveyed: physician spoke to family, physician introduction, understanding of their relative's injuries, admitting unit, consultants involved, urgent surgical procedures required, ongoing diagnostic studies, and understanding of the treatment plan. In conclusion, using a checklist improves the perception of the initial communication between the trauma team and family members of trauma patients, especially their understanding of the treatment plan.