Comparison of Setting Time of White Mineral Trioxide Aggregate with and without Disodium Hydrogen Phosphate at Different Liquid-to-powder Ratios.

AIM: The present study was conducted with the objective of evaluating the effect of different liquid-to-powder ratios on setting time of white mineral trioxide aggregate (WMTA) and the effect of adding disodium hydrogen phosphate (Na2HPO4) to white MTA (NAMTA). MATERIALS AND METHODS: Sixty samples were prepared in plastic annular molds with a diameter of 10 mm and a height of 2 mm in order to record setting time where white MTA was placed in 30 samples and 2.5 wt% mixture of Na2HPO4 with white MTA was placed in other 30 samples. Setting times in different ratios of liquid to powder (50, 60, and 70%) and at different times including 5, 10, 15, 20, 25, 30, 40, and 50 minutes as well as 1, 1.5, 2.5, 3, 3.5, and 4 hours were measured with Vicat. Statistical Package for the Social Sciences version 16 software was used to examine the differences between groups. The values of p < 0.05 were considered to be statistically significant in this study. RESULTS: The average setting time of samples in two WMTA and NAMTA was 182.17 ± 57.86 and 67.00 ± 14.42 respectively, and this difference was statistically significant (p < 0.001). Also, the average setting time of samples in ratio groups of 50, 60, and 70% were 146.00 ± 75.90, 85.00 ± 31.71, and 142.5 ± 64.47 respectively, and results showed that there was no significant difference between groups. CONCLUSION: Adding 2.5 wt% of Na2HPO4 mixture to white MTA reduces the setting time, which is lower than the WMTA in 50, 60, and 70% liquid-to-powder ratios. CLINICAL SIGNIFICANCE: According to the findings of this study, it can be seen that adding Na2HPO4 to white MTA is a good way to reduce setting timing in clinical dentistry, especially in one-visit treatments.

Bond Strength of White Mineral Trioxide Aggregate with and without Disodium Hydrogen Phosphate with Different Liquid-to-Powder Ratios.

INTRODUCTION: Mineral trioxide aggregate (MTA) can be used in the treatment of irritated vital pulp and repair of root perforations. However, the initial reaction of inflammatory cells to this material and also its setting time are not ideal. Studies have shown that disodium hydrogen phosphate (DHP), decreases the setting time of MTA, with no effect on its pH. This study was undertaken to evaluate the effect of DHP on push-out bond strength of MTA at different liquid-to-powder ratios. METHODS AND MATERIALS: A total of 120 samples were prepared from the middle third of the roots of single-rooted teeth for evaluation of push-out bond strength. The push-out bond strength was measured in both groups after 72 h at different liquid-to-powder ratios, including 0.33:1, 0.5:1 and 0.6:1. Factorial ANOVA and Tukey's HSD post-hoc tests were used to compare the differences between the independent groups. Statistical significant was set at P<0.05. RESULTS: The push-out bond strengths of pure MTA and MTA+DHP groups were 10.96±5.78 and 13.32±5.03, respectively. Tukey's HSD post-hoc test revealed significant differences between the two groups. Furthermore, there were no interactive effect between material and the liquid: powder ratio. CONCLUSION: Incorporation of DHP into MTA resulted in an increase in push-out bond strength of MTA, and an increase in liquid-to-powder ratio resulted in a decrease in push-out bond strength.

Accuracy of Cone-Beam Computed Tomography in Determining the Root Canal Morphology of Mandibular First Molars.

INTRODUCTION: The aim of the present in vitro study was to compare the accuracy of cone-beam computed tomography (CBCT) in determining root canal morphology of mandibular first molars in comparison with staining and clearing technique. METHODS AND MATERIALS: CBCT images were taken from 96 extracted human mandibular first molars and the teeth were then evaluated based on Vertucci's classification to determine the root canal morphology. Afterwards, access cavities were prepared and India ink was injected into the canals with an insulin syringe. The teeth were demineralized with 5% nitric acid. Finally, the cleared teeth were evaluated under a magnifying glass at 5× magnification to determine the root canal morphology. Data were analyzed using the SPSS software. The Fisher's exact test assessed the differences between the mesial and distal canals and the Cohen's kappa test was used to assess the level of agreement between the methods. Statistical significance was defined at 0.05. RESULTS: The Kappa coefficient for agreement between the two methods evaluating canal types was 0.346 (95% CI: 0.247-0.445), which is considered a fair level of agreement based on classification of Koch and Landis. The agreement between CBCT and Vertucci's classification was 52.6% (95% CI: 45.54-59.66%), with a significantly higher agreement rate in the mesial canals (28.1%) compared to the distal canals (77.1%) (P<0.001). CONCLUSION: Under the limitations of this study, clearing technique was more accurate than CBCT in providing accurate picture of the root canal anatomy of mandibular first molars.

Evaluation of apical leakage in root canals obturated with three different sealers in presence or absence of smear layer.

INTRODUCTION: Microleakage can result in failure of endodontic treatment. An important characteristic of endodontic sealer is sealing ability. The aim of this experimental study was to compare the apical leakage of teeth obturated with gutta-percha and three different sealers (resin- and zinc oxide eugenol-based) with/without smear layer (SL). MATERIALS AND METHODS: In this study, 100 single-rooted teeth were used after cutting off their crowns. Cleaning and shaping was carried out with step-back technique and the samples were randomly divided into three groups (n=30) which were then divided into two subgroups (n=15) according to the presence/absence of SL. Two negative and positive control groups (n=5) were also prepared. In the various groups, the canals were obturated with gutta-percha and either of the test sealers (AH-26, Adseal or Endofill). The samples were submerged in India ink for 72 h. Then they were longitudinally sectioned and observed under a stereomicroscope at 20× magnification. Data were analyzed with descriptive statistical methods and one-way ANOVA. The significance level was set at 0.05. RESULTS: The mean penetration length of dye in AH-26, Adseal and Endofill samples were 2.53, 2.76 and 3.03 mm, respectively. The differences between three groups were not significant (P>0.05); also, the mean dye penetration in AH-26, Adseal and Endofill samples in presence or absence of the SL was not significantly different. CONCLUSION: AH-26, Adseal and Endofill were similarly effective in prevention of apical microleakage. Differences in the mean dye penetration between the groups with/without the SL were not statistically significant.

Comparison of Push-out Bond Strength of Gutta-percha to Root Canal Dentin in Single-cone and Cold Lateral Compaction Techniques with AH Plus Sealer in Mandibular Premolars.

Background and aims. The single-cone technique has gained some popularity in some European countries. The aim of the present study was to compare the push-out bond strength of gutta-percha to root canal dentin with the single-cone and cold lateral compaction canal obturation techniques. Materials and methods . The root canals of 58 human mandibular premolars were prepared using modified crown-down technique with ProTaper rotary files up to #F3as a master apical file (MAF) and divided randomly into groups A and B based on canal obturation technique. In group A (n = 29) the root canals were obturated with single-cone technique with #F3(30/.09) ProTaper gutta-percha, which was matched with MAF in relation to diameter, taper and manufacturer; in group B (n = 29) the canals were obturated with gutta-percha using cold lateral compaction technique. In both groups AH plus sealer were used. After two weeks of incubation, three 2-mm slices were prepared at a distance of 2 mm from the coronal surface and push-out test was carried out. Data were analyzed with descriptive statistics using independent samples t-test. Results. There were statistically significant differences between two groups. The mean push-out bond strength was higher in group B (lateral compaction technique) compared to group A (single-cone technique; P < 0.05). Conclusion . Use of single-cone technique for obturation of root canals resulted in a lower bond strength compared to cold lateral compaction technique.

Cone-Beam Computed Tomography Comparison of Canal Transportation after Preparation with BioRaCe and Mtwo Rotary Instruments and Hand K-Flexofiles.

INTRODUCTION: The aim of this in vitro study was to evaluate the transportation of mesiobuccal canals of mandibular first molars prepared with either BioRaCe or Mtwo rotary instruments or hand K-Flexofile, by means of cone-beam computed tomography (CBCT). METHODS AND MATERIALS: Forty-five mandibular molars were selected and randomly divided into three groups (n=15). Mesiobuccal roots of these teeth were prepared by BioRaCe, Mtwo, or hand K-Flexofile. Transportation was measured by pre- and post-operative CBCT images. Two-way ANOVA analysis was applied to detect any differences between the groups followed by the post hoc Tukey's tests. The level of significance was set at 0.05. RESULTS: The non-parametric Friedman test was used to compare the behavior of each file at 3-, 6- and 9-mm levels. There were no significant differences between different levels in Mtwo group (P=0.15); however, the differences in K-Flexofile and BioRaCe groups were significant (P>0.05). The post hoc Tukey's test revealed significant differences between BioRaCe and K-Flexofile and also between Mtwo and K-Flexofile, both in the 3-mm depths (P<0.05). CONCLUSION: Under the limitations of the present study, BioRaCe and Mtwo rotary instruments are considered suitable for canal preparation to greater apical sizes provided that the recommended sequences are observed.

Evaluation of the effect of blood contamination on the compressive strength of MTA modified with hydration accelerators.

OBJECTIVES: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time. MATERIALS AND METHODS: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with CaCl2 (RMTA-C); Group 3, RMTA modified with Na2HPO4 (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr. RESULTS: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3 hr, the CS of specimens in the RMTA groups (with and without blood contamination) was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups, the CS of specimens significantly increased over time (p < 0.05). CONCLUSIONS: Blood contamination decreased the CS of both original and accelerated RMTA.