Comparison of resilon and gutta-percha filling materials on root canal fracture resistance following restoring with quartz fiber posts.

OBJECTIVE: Bacterial leakage and root fractures are the most important reasons of root canal treatment failure. Due to the lack of adhesion of gutta percha to the canal walls, Resilon has been introduced as a root-filling material able to bond to the root walls. Metal posts may predispose the tooth walls to oblique and vertical fracture which usually leads to tooth loss; whereas, fiber posts may reinforce the remaining tooth structure. The purpose of this study was to compare the effect of Resilon and gutta-percha on the fracture resistance of root canal following restoring with quartz fiber posts. MATERIALS AND METHODS: Forty-four maxillary incisor root canals were chemo-mechanically prepared, then randomly divided into three groups: 1-Control group (n=20), 2-Experimental group (n=20) and a negative control group (n=4). Root filled teeth were restored with quartz fiber posts and composite resin cores. Four teeth with a conservative prepared access cavities and without any further post preparation were used as a negative control group. After simulating the clinical situation, specimens were loaded in the Universal Testing Machine for compressive strength test. All data were statistically analyzed by the T-test. RESULTS: The mean compressive strengths for group 1 was 535.8 ± 155.23 N and 645.93 ± 182.98N for group 2, which were statistically significant (p-value= 0.047). CONCLUSION: Root canals filled with Resilon were significantly more resistant than that of gutta-percha, following restoration with quartz fiber posts.

A new approach for locating the minor apical foramen using an artificial neural network.

AIM: To develop a new approach for locating the minor apical foramen (AF) using feature-extracting procedures from radiographs and then processing data using an artificial neural network (ANN) as a decision-making system. METHODOLOGY: Fifty straight single-rooted teeth were selected and placed in a socket within the alveolar bone of a dried skull. Access cavities were prepared and a file was place in the canals to determine the working length. A radiograph was taken to evaluate the location of the file in relation to the minor foramen and further checked after retrieving the tooth from the alveolar socket. The location of the file tip was categorized into: beyond the AF (long), within the root canal (short) and just at the minor AF (exact). Each radiograph was used to extract relevant features using K-means, Otsu method and Wavelet protocol. Thirty-six extracted features were used for training and the rest were used for evaluating the multi-layer Perceptron ANN model. RESULTS: Analysis of the images from radiographs (test samples) by ANN showed that in 93% of the samples, the location of the AF had been determined correctly by false rejection and acceptation error methods. CONCLUSION: Artificial neural networks can act as a second opinion to locate the AF on radiographs to enhance the accuracy of working length determination by radiography. In addition, ANN can function as a decision-making system in various similar clinical situations.

Effects of three oral analgesics on postoperative pain following root canal preparation: a controlled clinical trial.

AIM: To compare the effects of single doses of three oral medications on postoperative pain following instrumentation of root canals in teeth with irreversible pulpitis. METHODOLOGY: In this double-blind clinical trial, 100 patients who had anterior or premolar teeth with irreversible pulpitis without any signs and symptoms of acute or chronic apical periodontitis and moderate to severe pain were divided by balanced block random allocation into four groups of 25 each, a control group receiving a placebo medication, and three experimental groups receiving a single dose of either Tramadol (100 mg), Novafen (325 mg of paracetamol, 200 mg ibuprofen and 40 mg caffeine anhydrous) or Naproxen (500 mg) immediately after the first appointment where the pulp was removed, and the canals were fully prepared. The intensity of pain was scored based on 10-point VAS before and after treatment for up to 24 h postoperatively. Data were submitted to repeated analysis of variance. RESULTS: At the 6, 12 and 24 h postoperative intervals after drug administration, the intensity of pain was significantly lower in the experimental groups than in the placebo group (P < 0.01). Tramadol was significantly less effective (P < 0.05) than Naproxen, and Novafen that were similar to each other (P > 0.05). CONCLUSION: A single oral dose of Naproxen, Novafen and Tramadol taken immediately after treatment reduced postoperative pain following pulpectomy and root canal preparation of teeth with irreversible pulpitis.

Comparison of dentine removal using V-taper and K-Flexofile instruments.

AIM: To compare the dentine removal ability of V-Taper and K-Flexofile instruments in mesiobuccal canals of extracted mandibular first molar teeth. METHODOLOGY: Preoperative images of 40 mesiobuccal canals of mandibular first molars (with a curvature between 20° and 35°) were obtained at 2, 4.5, and 7 mm from the root apices by CT-scan and divided into two groups. Group F was prepared with K-Flexofiles and Gates Glidden drills and Group V with V-Taper Ni-Ti rotary and stainless steel hand instruments. Post-instrumentation images were then obtained and compared with the preoperative images. The ratio of dentine removal based on pre- and postoperative images was calculated, and data was analysed by anova and Tukey post hoc test. RESULTS: In group F in the coronal sections, the least ratio of the dentine removal to the initial root thickness was on the buccal aspect (15.14% ± 6.72), and the greatest ratio was found on the distolingual (29.38% ± 8.19). In group V in the coronal, the least ratio of the dentine removal to the initial root thickness was on the buccal aspect (9.81% ± 3.26); the greatest ratio was found on the distolingual surface in the coronal sections (34.38% ± 10.51). In the middle sections, the least ratio was on the buccal (10.51% ± 3.39) and the greatest on the distolingual aspects (27.46% ± 12.34) of the roots. In the apical sections, the amount of the dentine removed from the mesial and distal surfaces in group V was significantly more than group F (P < 0.01). CONCLUSION: The distolingual aspect of the root canal is a danger zone for the mesiobuccal canal of the mesial root in mandibular molar teeth, and preparation of that area should be performed with caution. Except the apical part of the canal, no significant difference was found between the two preparation files or techniques used. Apart from the apical part of the canal, neither instrument maintained the original shape of the coronal and middle parts of the canal.