Evaluation of relationship between endodontic access cavity types and secondary mesiobuccal canal detection.

BACKGROUND: The aim of this study was to evaluate the relationship between Endodontic Access Cavity (EAC) types with MB2 canal detection ratio in the upper first molars. METHODS: A total of 60 roots of extracted human maxillary first molars were selected. All teeth were prepared with Point EAC (PEAC), Conservative EAC (CEAC) and Traditional EAC (TEAC) respectively. After each group were completed, extra canal was searched. Preoperative and postoperative tooth weigh was calculated using precise scale. McNemar's chi-square test and a paired test significant difference were used for statistical analyses. RESULTS: The EAC types statistically were changed of tooth tissue loss quantity (p = 0.000). MB2 detection rate of CEAC (%53,3) and TEAC (%60) are higher than statistically that of PEAC (%31.6) (p < 0.05). 8 teeth MB2 canal was detected only with the CBCT images. CONCLUSIONS: In upper molars, CEAC seems reasonable in terms of detected the MB2 canal and removed hard tissue.

Comparative evaluation of cyclic fatigue resistance of four different nickel-titanium rotary files with different cross-sectional designs and alloy properties.

OBJECTIVE: The purpose of the present study was to evaluate the cyclic fatigue resistance of F6 SkyTaper (Komet Brasseler, Lemgo, Germany), K3XF (SybronEndo, Orange, CA, USA), new generation OneShape (Micro Mega, Besancon, France) and TRUShape 3D conforming files (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA). MATERIAL AND METHODS: Ten instruments from each group were selected and allowed to rotate using a low-torque motor in a stainless steel block with 1.5 mm diameter, 3 mm radius of 60° angle of curvature at the manufacturer's recommended speed, and the number of cycles (NCF) from the beginning to the fracture was recorded. The data were analyzed using one-way ANOVA followed by post-hoc Tukey's test (P = 0.05). RESULTS: The ranking of the groups from the highest to the lowest NCF was as follows: F6 SkyTaper (959 ± 92), K3XF (725 ± 71), TRUShape (575 ± 84) and OneShape (289 ± 58). Statistically significant differences were detected between all groups (P < 0.05). CONCLUSION: Within the limitations of this study, F6 SkyTaper instruments presented the highest cyclic fatigue resistance among the tested instruments. The S-shaped cross-sectional design of F6 SkyTaper instruments could be the most important factor on the superior cyclic life span of these instruments. CLINICAL RELEVANCE: In endodontic practice, preferring the instruments with higher cyclic fatigue resistance would help to minimize the risk of instrument fractures; therefore especially during the preparation of curved canals, instruments with smaller core area and less cross-sectional metal mass, which could lead higher flexibility, can be proposed.

Evaluation of the Cyclic Fatigue and Torsional Resistance of Novel Nickel-Titanium Rotary Files with Various Alloy Properties.

INTRODUCTION: The purpose of this study was to evaluate the cyclic fatigue and torsional resistance of Hyflex EDM, ProTaper Gold (PTG), and ProTaper Universal (PTU) instruments. METHODS: For the cyclic fatigue test, 10 instruments from each group were tested by using a stainless steel block with 1.5-mm diameter and 3-mm radius of 60° angle of curvature. The instruments were allowed to rotate by using a low-torque motor, and number of cycles from the beginning to the fracture was recorded. Torsional resistance of the instruments (n = 10) was evaluated according to ISO 3630-1. The rotational speed of the instruments was set in the clockwise direction at 2 rpm. The maximum torque and angular deflection until fracture of the instrument were recorded. The data were analyzed by using one-way analysis of variance followed by post hoc Tukey test (P = .05). RESULTS: HyFlex EDM instruments exhibited the highest cyclic fatigue resistance and were followed by PTG and PTU groups, respectively. The mean fragment length for PTU instruments was significantly shorter than that for Hyflex EDM and PTG instruments. PTG instruments demonstrated significantly higher torsional resistance than HyFlex EDM files (P = .025), and the distortion angle of the instruments ranged as follows: PTU < PTG < Hyflex EDM files. CONCLUSIONS: Hyflex EDM files demonstrated significantly higher cyclic fatigue resistance. Although PTG and PTU have similar cross-sectional design, PTG instruments presented higher cyclic fatigue and torsional resistance than PTU instruments. The enhanced alloy properties of PTG might be considered as the main reason for those differences.

Cyclic fatigue analysis of Reciproc R25® instruments with different kinematics.

This study aimed to compare the cyclic fatigue resistance of Reciproc® instruments when used with different kinematics (150° counterclockwise (CCW)-30° clockwise (CW), 270° CCW-30° CW, 360° CCW-30° CW and continuous rotation). Various kinematics were tested in steel canals with a 3 mm radius and a 60° angle of curvature as follows (n = 20): 150° CCW-30° CW, 270° CCW-30° CW, 360° CCW-30° CW and 360° CCW (rotary motion). Reciproc R25® instruments were used until fracture occurred. The time to fracture was recorded in seconds. The data were statistically analysed using a one-way analysis of variance and Tukey's post-hoc tests (P = .05). The cyclic fatigue resistance of Reciproc R25® instruments used with various kinematics in decreasing order was as follows: 150° CCW-30° CW > 270° CCW-30° CW = 360° CCW-30° CW > 360° CCW rotary motion. The 150° CCW-30° CW reciprocating motion had the best performance in time to fracture. All reciprocating motions (150° CCW-30° CW, 270° CCW-30° CW and 360° CCW-30° CW) resulted in a longer mean duration to failure compared with the 360° CCW rotary motion.

Comparison of the effect of MTAD and conventional irrigation agents on apical leakage and push-out bond strength of root canal filling.

The aim of this study was to evaluate the effect of MTAD (a mixture of tetracycline isomer, an acid, and a detergent) and conventional irrigation agents on the apical leakage and push-out bond strength of root canal filling and to correlate the apical leakage and push-out bond strength. Root canals of 120 maxillary central incisors were prepared with a ProTaper file up to F3 and distributed to six groups. Saline, 1% NaOCl, 17% EDTA, 17% EDTA/1% NaOCl, and 2% chlorhexidine (CHX) solutions were used between each file change, and 5 mL of the same irrigating solution was used for the final flush. In the MTAD group, the root canals were irrigated with 1.3% NaOCl between each file and 5 mL of MTAD for the final flush. All the root canals were filled with AH Plus sealer and gutta-percha cones. Apical leakage was evaluated using a fluid transport system. After the apical leakage test, each tooth was prepared for the push-out assessment. The statistical analysis revealed that the irrigation solutions had no effect on the apical leakage of the root canal fillings (p = 0.258). The root fillings of the groups irrigated with MTAD showed significantly lower push-out bond strength values than the other groups (p < 0.001). These commonly used irrigating solutions did not affect the apical leakage of the root canal sealer. MTAD reduced the bond strength of the root canal sealer to the root canal dentin.

An in vitro analysis of separation of multi-use ProTaper Universal and ProTaper Next instruments in extracted mandibular molar teeth.

This study investigated the separation incidence of reused ProTaper Universal and ProTaper Next rotary instruments and identified the location of separated fragments. The root canals of extracted human mandibular molars were prepared with 10 assorted sets of ProTaper Universal and ProTaper Next instruments. After each preparation, instrument sets were autoclaved. This arrangement was repeated until an instrument fractured. The number of prepared teeth until fracture occurred was recorded for each instrument set. Teeth in which the instruments fractured were analyzed to determine the separation grade, apical relation, and coronal position. Fracture surfaces of the instruments were examined with scanning electron microscope. ProTaper Universal instruments fractured after application to a mean of 7.3 teeth, and ProTaper Next instruments after application to a mean of 5.7 teeth (p > 0.05). In the ProTaper Universal and ProTaper Next groups, F2 and X1 were the most commonly fractured instruments, respectively. Torsional and cyclic failures were evenly distributed in both the groups. The mean lengths of the fractured fragments of the instruments showed no statistically significant difference. The distance between the tip of the fractured instruments and apical constriction was similar (p > 0.05). However, the mean distance between the root canal orifice and coronal part of the fractured instrument was shorter in the ProTaper Next group (p < 0.05). The life span of ProTaper Universal and ProTaper Next instruments was the same for preparation of mandibular molar teeth. None of the instruments were fractured in the first usage.

A cone-beam computed tomographic study of root canal systems in mandibular premolars in a Turkish population: Theoretical model for determining orifice shape.

OBJECTIVE: The purposes of this retrospective study were to represent a newly designed theoretical model for determining orifice shape and morphologic properties of mandibular premolars and to correlate these findings with each other. MATERIALS AND METHODS: A total of 287 mandibular premolar images obtained from 88 patients by cone-beam computed tomography were included in this study. The measurements were performed below the cementoenamel junction, and different orifice configurations were defined in accordance with various ratios. The age and gender of the patient, the tooth type and position, the number of roots, orifice configuration, root canal configuration, presence of C-shaped canal, and the presence of radicular groove were recorded. It was also recorded whether the root canal becomes round or not and if any, length of the root canal from the orifice to the section in which it becomes round. Furthermore, the theoretical model for determining orifice shape was defined after measurements. The orifice shape was determined as round, oval, flat, keyhole-shaped, and T-shaped, and orifices with short, normal length, and long isthmus. Statistical analyses were performed using Chi-square and Spearman's rank correlation tests (P = 0.05). RESULTS: Orifice configurations were, usually, flat (37%), or keyhole-shaped (23%). The prevalence of T-shaped was found to be 3.8%. The prevalence of C-shaped canals was found to be 2.1%. The percentage of root canals that became round in the middle or apical thirds was 95.1%. Radicular grooves were detected in 37 (24%) of first premolars and six (4.5%) of second premolars. Statistical analysis revealed that the mean length of distance until the canal reached a round shape varied according to age group (r = -0.270; P < 0.001). There was a statistically significant difference between radicular groove and tooth type (P < 0.001). CONCLUSIONS: The mean length of distance until the canal reached a round shape correlated with the patient's age. The new theoretical model could be beneficial to determine orifice configurations.

A retrospective comparative study of cone-beam computed tomography versus rendered panoramic images in identifying the presence, types, and characteristics of dens invaginatus in a Turkish population.

INTRODUCTION: This study assessed the presence, characteristics, and type of dens invaginatus (DI) by using cone-beam computed tomography (CBCT) and panoramic images rendered from CBCT images. In addition, the findings of the imaging techniques were compared. METHODS: We evaluated 300 CBCT images to determine the type of DI, the presence of an impacted tooth near the DI, and the presence of apical pathosis. The McNemar test was used to compare the prevalence of DI according to CBCT and panoramic images rendered from CBCT images. RESULTS: The presence of DI was lower on panoramic images rendered from CBCT images (3% of the patients) compared with on CBCT images (10.7% of the patients) (P < .001). According to the CBCT images, the distribution of teeth with DI was as follows: maxillary lateral incisors (75%), maxillary central incisors (6.8%), mandibular premolars (4.6%), mesiodens (9%), maxillary canines (2.3%), and mandibular canines (2.3%). Type I DI was the most commonly observed type of invaginatus (65.9%), followed by type II (29.5%) and type III (4.6%). All patients with type III DI and 25% of the patients with type II DI had apical pathosis at the time of referral, but periapical lesions were not observed in teeth with type I DI. In total, 13.6% of DI cases had impacted teeth. CONCLUSIONS: CBCT can be recommended as an effective diagnostic device for identifying DI because it provides an accurate representation of the external and internal dental anatomy.

Effect of PIPS technique at different power settings on irrigating solution extrusion.

The aim of this study was to determine the effect of photon-induced photoacoustic streaming (PIPS) technique at different power settings on extrusion of irrigating solution. Root canal preparation was performed up to a #30 file on 64 extracted single-rooted mandibular premolar teeth, which were then divided into four groups. Each group was irrigated with one of the following irrigation methods: (a) irrigation with conventional irrigation open-ended needles, (b) continuous ultrasonic irrigation, (c) 0.3 W PIPS, or (d) 0.9 W PIPS. Apical extrusion of irrigating solution was evaluated using a modified model. The net weight of the extruded irrigating solution was measured for each group, and the resulting data were analysed statistically using Kruskal-Wallis at a 95 % confidence level (P < 0.05). Although the 0.9 W PIPS group resulted in the largest quantity of irrigation solution, the ultrasonic group was the smallest. However, the difference between these groups was not statistically significant at the 95 % level of confidence (P > 0.05). PIPS at both 0.3 W and 0.9 W resulted similar solution extrusion to the conventional irrigation or ultrasonic irrigation.

Effects of root canal preparation, various filling techniques and retreatment after filling on vertical root fracture and crack formation.

AIM: To investigate the incidence of cracks in root dentin after rotary instrumentation and filling with cold lateral condensation (CL), single-cone obturation (SC), and warm vertical compaction (WV) and retreatment of each filling system. METHODOLOGY: One-hundred sixty mandibular incisors were selected. Twenty teeth were left unprepared and served as a control, and the remaining 140 teeth were instrumented. Twenty teeth were assigned to an only prepared group. The remaining 120 teeth were assigned to three root canal filling groups and three retreatment groups (n = 20), as follows: CL, WV, SC, and retreatment of each filling system. All the roots were sectioned perpendicular to the long axis at 2, 4, 6, and 8 mm from the apex, and the sections were then observed under a stereomicroscope. The absence/presence of cracks and vertical root fractures were recorded, and the data were analyzed with a Pearson's chi-square test (P = 0.05). RESULTS: No complete vertical root fractures were observed in the unprepared and only prepared groups. However, vertical fractures were observed in the filling and retreatment groups. There were significantly more cracks in the retreatment after WV group than the other groups, with the exception of the retreatment after SC, WV, and CL resulted in significantly more cracks than the only prepared and SC. CONCLUSIONS: The filling techniques (except SC) caused more cracks than preparation only. The SC caused fewer cracks compared to the other filling techniques. The retreatment following the different filling techniques (except CL) caused more cracks than the original fillings.

Comparison of the cyclic fatigue resistance of 5 different rotary pathfinding instruments made of conventional nickel-titanium wire, M-wire, and controlled memory wire.

INTRODUCTION: This study compared the cyclic fatigue resistance of current nickel-titanium rotary path-finding instruments. METHODS: Five types of nickel-titanium rotary pathfinding instruments were used in steel canals with a 90° curvature and a curvature radius of 3 mm (n = 10) and 5 mm (n = 10). The cyclic fatigue of the following instruments was tested at 4 mm from the tip: PathFile (#16 and a .02 taper; Dentsply Maillefer, Ballaigues, Switzerland), G-File (#12 and a .03 taper; Micro-Mega, Besançon Cedex, France), Scout Race (#15 and a .02 taper; FKG Dentaire, La Chaux-de-Fonds, Switzerland), HyFlex GPF (#15 and a .02 taper; Coltene-Whaledent, Allstetten, Switzerland), and ProGlider (#16 with a mean taper of .04125 and a .02 at the first 4 mm from the tip, Dentsply Maillefer). The length of the fractured parts was measured, and the number of cycles to fracture (NCF) was calculated. The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (α = .05). After Bonferroni correction, the new P value was set as .005. RESULTS: The difference in the cyclic fatigue of all the files at both curvatures was statistically significant (P values from .0035 to less than .0001). The ranking of the instruments from the highest to the lowest NCF was as follows: HyFlex GPF, G files, ProGlider, PathFile, and Scout Race. The length of the fractured part of the instruments was similar in all the groups (P > .05). All the tested instruments had a lower NCF at a curvature radius of 3 mm when compared with a curvature radius of 5 mm (P < .0001). CONCLUSIONS: Within the limitations of this study, the cyclic fatigue resistance of the HyFlex GPF instrument was the highest, and the curvature radius had a significant effect on the fatigue resistance.

Comparison of cyclic fatigue resistance of novel nickel-titanium rotary instruments.

New files (ProTaper Next/HyFlex/OneShape) are made from novel nickel-titanium (NiTi) alloys/treatments. The purpose of this study was to compare the cyclic fatigue resistance of these new instruments with that of Revo-S instruments. Four groups of 20 NiTi endodontic instruments were tested in steel canals with a 3 mm radius and a 60° angle of curvature. The cyclic fatigue of the following NiTi instruments with a tip size 25 and 0.06 taper that were manufactured with different alloys was tested: ProTaper Next X2 (M-Wire), OneShape (conventional NiTi), Revo-S Shaping Universal (conventional NiTi) and HyFlex 25/0.6 (controlled memory NiTi wire). A one-way anova and post-hoc Tukey's test (α = 0.05) revealed that the HyFlex files had the highest fatigue resistance and the Revo-S had the least fatigue resistance among the groups (P < 0.001).

An in vitro comparison of apically extruded debris and instrumentation times with ProTaper Universal, ProTaper Next, Twisted File Adaptive, and HyFlex instruments.

INTRODUCTION: The purpose of this study was to compare the in vitro amount of apically extruded debris with new endodontic rotary nickel-titanium instruments. METHODS: Sixty mandibular premolars were instrumented up to size 25 using ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (Dentsply Maillefer), Twisted File Adaptive (SybronEndo, Orange, CA), and HyFlex (Coltene-Whaledent, Allstetten, Switzerland) rotary systems. The apically extruded debris was collected and dried in preweighed Eppendorf tubes. The amount of extruded debris was assessed with an electronic balance. The total time required to complete root canal shaping with the different instruments was also recorded. The significance level was set at P = .05. RESULTS: The instrumentation time with the ProTaper Universal rotary system was significantly longer than with all the other instruments (P < .05). The Twisted File Adaptive and ProTaper Next systems extruded significantly less debris than the ProTaper Universal and HyFlex systems (P < .05). CONCLUSIONS: The ProTaper Next and Twisted File Adaptive instrumentation systems were associated with less debris extrusion compared with the ProTaper Universal and HyFlex systems.

Push-out bond strength of different mineral trioxide aggregates.

OBJECTIVE: This study was aimed to evaluate and to compare the push-out bond strength of different brands of mineral trioxide aggregate (MTA) with a calcium enriched mixture cement (CEM). MATERIALS AND METHODS: Fifteen extracted, single-rooted human teeth were used. The middle-third of the roots were sliced perpendicular to the long axis into 1.00 ± 0.05 mm thick serial slices (15 root × 4 slice = 60 specimen). The specimens were then divided into three groups (n = 20). The standardized root discs were filled with white CEM, ProRoot MTA, MTA-Angelus and wrapped in a serum-soaked gauze. After 3 days at relative humidity, the push-out bond strengths were measured with a universal testing machine. Data were analyzed using one-way analysis of variance and post hoc Tukey tests. RESULTS: The mean push-out bond strength value of the ProRoot MTA group (12.7 ± 2.5 MPa) was the highest and statistically significant difference was recorded between ProRoot MTA and other groups (P < 0.001). There was no significant difference between the mean bond strength of CEM cement (4.6 ± 1.1 MPa) and MTA-Angelus (4.5 ± 1.5 MPa) (P = 0.982). CONCLUSION: The push-out bond strength of MTA was changed with the brands and ProRoot MTA had the highest push-out bond strength.

Efficacy of needle irrigation, EndoActivator, and photon-initiated photoacoustic streaming technique on removal of double and triple antibiotic pastes.

INTRODUCTION: Photon-induced photoacoustic streaming (PIPS) is a novel technique used for the removal of material on root canal walls, such as bacteria and the smear layer. This study evaluated the efficacy of needle irrigation, the EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK), and PIPS on the removal of antibiotic pastes from an artificial groove created in a root canal. METHODS: Root canal preparation was performed up to size #40 on 84 extracted single-rooted teeth using ProTaper rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland). The specimens were then split longitudinally, and 2 standardized grooves were prepared in the coronal and apical part of each segment. Double (DAP) and triple antibiotic pastes (TAP) were placed in the grooves for 4 weeks, and the root halves were reassembled. Needle irrigation, the EndoActivator System, and PIPS were used for the removal of DAP and TAP. The root segments were disassembled, and the amount of remaining antibiotic pastes was evaluated under a stereomicroscope at 20× magnification using a 4-grade scoring system. The data were evaluated statistically using Mann-Whitney U tests with a 95% confidence level (P = .05). RESULTS: PIPS removed significantly more antibiotic pastes than the EndoActivator and needle irrigation (P < .001). The EndoActivator was superior to needle irrigation in removing antibiotic pastes (P < .001). There were no statistically significant differences between DAP and TAP and between coronal and apical thirds in their removing from artificially created grooves (P > .05). CONCLUSIONS: PIPS was more effective in removing both DAP and TAP from artificial grooves in root canals than the EndoActivator System and needle irrigation. The EndoActivator was also more effective than needle irrigation. It is difficult to completely remove antibiotic pastes from root canals.

A comparative study of different radiographic methods for detecting occlusal caries lesions.

OBJECTIVES: The aim of this in vitro study was to compare the diagnostic accuracy of different radiographic imaging modalities in detecting occlusal caries lesions. MATERIALS AND METHODS: Under standardized conditions, 125 extracted human permanent molar teeth with sound or occlusal caries lesions were radiographed using a conventional film system (F-speed), a direct digital imaging system (complementary metal oxide semiconductor sensor), an indirect digital imaging system (photostimulable phosphor plate) and a cone beam computed tomography system (CBCT). Two observers scored the resultant images for the presence or absence of caries. Then, the teeth were histologically prepared and a definite diagnosis was determined by stereomicroscopic assessment. The area under the receiver operating characteristic curve (Az), sensitivity, specificity and accuracy of each imaging modality were calculated, as well as the intra- and interexaminer reproducibility. RESULTS: For both thresholds, interexaminer agreement were higher for CBCT. For intraexaminer agreement, observers had different scores for both thresholds, but the scores were generally higher for CBCT. Similar Az values were achieved with all imaging methods at a diagnostic D1 threshold. The Az values of the CBCT system were found to be statistically higher than those of the other imaging modalities at a diagnostic D3 threshold (p > 0.05); no significant differences were found among the other imaging modalities. All radiographic methods showed similar sensitivities, specificities and accuracy in detecting D1 threshold. The CBCT system showed higher sensitivity and accuracy in detecting dentine lesions. CONCLUSIONS: Within the limitations of this study, CBCT exhibited better performance in detecting deep occlusal caries lesions than the other radiographic systems.

Comparison of cyclic fatigue resistance of nickel-titanium coronal flaring instruments.

INTRODUCTION: The purpose of this study was to compare the cyclic fatigue resistance of coronal flaring instruments. METHODS: Three groups of nickel-titanium (NiTi) endodontic coronal flaring instruments were tested in steel canals with a 3-mm curvature radius and 60° (n = 18) and 45° of curvature (n = 18). The cyclic fatigue of the following NiTi instruments was tested: ProTaper Sx (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex 25.08 (Coltene-Whaledent, Allstetten, Switzerland), and Revo-S SC1 (Micro-Mega, Besancon, France). The length and diameter of the fractured fragment and the total area of the fractured surface of each instrument were measured. The data were then statistically analyzed using a 1-way analysis of variance and the post hoc Tukey test (α = .05). RESULTS: At the 60° of curvature, Revo-S had the highest fatigue resistance, HyFlex had the second highest fatigue resistance, and ProTaper Universal had the least fatigue resistance. At the 45° of curvature, the Revo-S and HyFlex showed superior cyclic fatigue resistance compared with the ProTaper. The length of the fracture fragment of the ProTaper instrument was longer than that of the other groups at the 60° of curvature. At the 45° of curvature, the length of the fracture fragment of the ProTaper and HyFlex instruments was longer than that of Revo-S. The mean diameter and surface area of the HyFlex instruments in the fractured part was higher than that of other groups at both angles of curvature. CONCLUSIONS: The Revo-S SC1 and HyFlex 25.08 instruments showed better cyclic fatigue resistance than the ProTaper Sx instrument.

Effect of photo-activated disinfection on bond strength of three different root canal sealers.

INTRODUCTION: The aim of this in vitro study was to evaluate the bond strength of Photo-Activated Disinfection (PAD) system to dentin with different root canal sealers by using a push-out test design. MATERIALS AND METHODS: A total of 30 extracted mandibular premolar teeth with single and straight roots were used. The crowns were removed and the root canals were prepared by using ProTaper rotary files. The smear layer was removed and the roots were randomly divided into two groups (n = 15) according to the use of PAD system as the final disinfecting agent. Each group was then divided into 6 (n = 5) subgroups and obturated with gutta-percha and 3 different root canal sealers. The groups were Group 1: Sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA)-AH Plus sealer; Group 2: NaOCl + EDTA + PAD-AH Plus; Group 3: NaOCl + EDTA-Sealapex; Group 4: NaOCl + EDTA + PAD-Sealapex; Group 5: NaOCl + EDTA-mineral trioxide aggregate (MTA)-Fiallapex; and Group 6: NaOCl + EDTA + PAD-MTA-Fillapex. 1-mm thickness horizontal sections (n: 5 × 4 = 20) were sliced for the push-out bond strength measurement. RESULTS: Group 3 and 4 showed significantly lower bond strengths compared with all the other groups (P < 0.05). No statistically significant difference was found among Groups 1, 2 and 5, but there was statistically significant difference between Group 5 and 6 (P < 0.05). CONCLUSION: This in vitro study indicated that the PAD system adversely affected the bond strength of the MTA Fillapex root canal sealer.

Effects of physical and morphological properties of roots on fracture resistance.

OBJECTIVE: The aim of this study was to determine how physical and morphological properties affect the fracture resistance of roots, and which criteria are important for root specimen standardization in fracture resistance studies. MATERIALS AND METHODS: Seventy-five freshly extracted human canine teeth were selected. Crowns were sectioned from the cement-enamel junction and the root lengths were set at 16 mm. Then they were prepared up to ProTaper F3 file. Each root was numbered and data were obtained by measuring mesiodistal and buccolingual dimensions, volume, weight, and density. Tests for fracture strength were performed using an Instron Testing Machine (Instron Corp. MA, USA). The force was applied axially, angled at 45 degrees with a constant speed of 1 mm/min. For each sample, the force at the time of fracture was recorded in Newtons. Results were evaluated statistically using linear regression analysis. RESULTS: Volume and weight of the roots had more effect than mesiodistal or buccolingual dimensions on root fracture resistance. CONCLUSIONS: In root fracture resistance studies, volume or weight of the roots must be standardized when distributing roots to groups.

Comparison of cyclic fatigue resistance of original and counterfeit rotary instruments.

INTRODUCTION: In recent years, with the advances in counterfeiting methods, counterfeit products have reached the dental market. The purpose of this study was to compare the cyclic fatigue resistance of original and counterfeit rotary root canal instruments. MATERIALS AND METHODS: The cyclic fatigue of original and counterfeit ProTaper F2 endodontic instruments was tested (n = 20) in 3 mm radius steel canals with a 60° angle of curvature. The number of cycles to fracture (NCF) was calculated, and the data were subjected to the Student's t-test (α = 0.05). RESULTS: The original instruments showed better cyclic fatigue resistance than the counterfeit ones (p < .001). The mean NCF was 483 ± 84 for the original files and 186 ± 86 for the counterfeit files. CONCLUSIONS: The cyclic fatigue resistance of the counterfeit instruments was very low. As a result, clinicians should be careful not to purchase counterfeit products.