Anti-inflammatory and antiresorptive functions of melatonin on experimentally induced periapical lesions.

AIM: To investigate the effects of systemically administered melatonin on inflammation and alveolar bone resorption in rats with experimentally induced periapical lesions. METHODOLOGY: Thirty adult Sprague Dawley rats were divided equally into negative, positive control and melatonin groups. The pulp chambers of their mandibular first molars were exposed to the oral environment to induce experimental periapical lesions in the positive control and melatonin groups. The melatonin group received daily intraperitoneal injections of melatonin at a dose of 10 mg kg-1 . After 21 days, the animals were euthanized; the hemi-mandible parts were prepared for radiological, histopathological, immunohistochemical (IL-1ß, RANK, RANKL, OPG and tartrate-resistant acid phosphatase (TRAP) and Brown-Brenn (bacteria) evaluations. Data were analysed by Kruskal-Wallis (for non-parametric data) and one-way anova tests (for parametric data) (P < 0.05). RESULTS: The area of radiographic periapical bone loss was significantly smaller in rats that were given daily intraperitoneal injections of melatonin (P < 0.01). The histopathological scores of the melatonin group were significantly lower than those of positive control group (P < 0.01). Histomorphometrically, the area of periapical bone loss in the melatonin group was significantly smaller than the positive control group (P < 0.01). The expression of IL1-ß, RANK and RANKL was significantly higher in the positive control group, whereas OPG was significantly higher in the melatonin group (P < 0.01). The number of osteoclasts was significantly greater in the positive control group by TRAP staining analyses (P < 0.01). The scores for bacteria localization using Brown-Brenn staining in the melatonin group was significantly lower than that of the positive control group (P < 0.01). CONCLUSIONS: Melatonin demonstrated antiresorptive effects on bone associated with experimentally induced periapical lesions in rats via its anti-inflammatory activity. Further studies are necessary to evaluate its possible effects on the healing of periapical lesions.

Mechanical reduction in intracanal Enterococcus faecalis when using three different single-file systems: an ex vivo comparative study.

AIM: To evaluate the bacterial reduction achieved by WaveOne Gold (Dentsply Sirona Endodontics, Ballaigues, Switzerland), Hyflex EDM (Coltene-Whaledent, Altstätten, Switzerland), and XP-endo Shaper (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) in canals infected with Enterococcus faecalis. The null hypothesis (H0 ) was that there would be no difference amongst the NiTi systems in reducing the root canal bacterial load. METHODOLOGY: Seventy-four mandibular premolar teeth with straight and round root canals were selected. Sixty-two root canals were contaminated with E. faecalis for 4 weeks and subjected to mechanical preparation with one of three single-file NiTi rotary systems (WaveOne Gold, Hyflex EDM, and XP Endo Shaper). Twelve non-contaminated root canals were used as negative controls. Bacterial samples were collected with sterile paper points (Dentsply Sirona Endodontics) before and after rotary instrumentation to quantify the bacterial load. Five roots from each instrumentation group were evaluated topographically from the coronal, middle and apical thirds by SEM. The bacterial reduction was calculated and analysed statistically by the Kruskal-Wallis and Dunn post hoc tests, all at 5% significance. RESULTS: The samples taken before instrumentation showed approximately 9.64 log CFU bacterial load. Instrumentation with the Hyflex EDM and XP-endo Shaper resulted in significantly greater bacterial reduction than those with WaveOne Gold (P = 0.00). All specimens had bacterial growth. SEM images supported the CFU/mL data. Thick and dense debris was observed in WaveOne Gold samples. Instrumentation resulted in the disruption of the biofilm-like structure, and both areas of clean and open dentinal tubules and areas with thick debris were observed in Hyflex EDM and XP-endo Shaper samples. CONCLUSIONS: Instrumentation in straight and round canals of premolar teeth with the Hyflex EDM and XP-endo Shaper resulted in significantly greater bacterial reduction than WaveOne Gold. No instrumentation system rendered root canals completely free from bacteria.

Efficacy of endodontic applications of ozone and low-temperature atmospheric pressure plasma on root canals infected with Enterococcus faecalis.

UNLABELLED: This study aimed to compare the antimicrobial efficacy of low-temperature atmospheric pressure plasma (LTAPP) design and gaseous ozone delivery system with 2.5% NaOCl on Enterococcus faecalis in root canal walls and dentine tubules. The samples were divided into LTAPP (n = 12), ozone (n = 12), NaOCl (positive control, n = 12) and saline (negative control, n = 6) groups. Microbial samples were collected using paper points and dentin chips from root canals. Antimicrobial efficacy was assessed by counting the colony-forming units of Ent. faecalis before and after each irrigation protocol. Data were analysed using Kruskal-Wallis, Wilcoxon signed-rank, Friedman and Bonferroni t (Dunn's test)-tests (P = 0.05). The microbial sampling with paper points showed antibacterial efficacy of NaOCl, LTAPP, ozone and saline in descending order, respectively (P < 0.05). The microbial sampling with dentin chips demonstrated a superior efficacy of LTAPP compared with NaOCl in the middle third (P < 0.05), while both had similar effects in coronal and apical thirds (P > 0.05). NaOCl and LTAPP were better than ozone at the coronal and middle parts of the root canals (P < 0.05). These findings led us to suggest that LTAPP, which has no thermal and chemical effects, may be of great aid in endodontic treatment. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study handles different perspectives on chemomechanical preparation of root canals. Ozone and low-temperature atmospheric pressure plasma (LTAPP) were investigated to determine whether they could be an alternative for NaOCl. Up to now, chemical solutions (NaOCl, chlorhexidine digluconate, etc...) have been used to disinfect the root canals. When the reported effects of LTAPP on biological and chemical decontamination were taken into consideration, a question rose whether it has antimicrobial efficacy in root canals infected with E. faecalis. According to the findings of the present study, LTAPP may constitute a promising aid in endodontics in disinfection of root canals.

A retrospective radiographic study of coronal-periapical status and root canal filling quality in a selected adult Turkish population.

OBJECTIVE: To investigate the oral health (with regard to the periapical status, quality of root fillings and coronal restorations) in an urban adult Turkish subpopulation using digital panoramic radiographs. MATERIALS AND METHODS: One thousand digital panoramic radiographs involving 28,000 teeth were selected from the archive of the Public Oral and Dental Health Center of Isparta. Coronal status (the type of restoration, signs of marginal leakage or decay), root filling quality (length and lateral seal) and periapical status (according to Periapical Index, PAI) were evaluated. Correlations between apical periodontitis (AP) and the quality of root fillings or coronal restorations were statistically analyzed using the χ(2) test. RESULTS: Of the 28,000 teeth evaluated, 22,380 (80.0%) were sound, 4,732 (16.9%) were missing, 753 (2.6%) were filled and 135 (0.5%) were decayed. Of the 753 coronal restorations, 400 (53.1%) were radiographically acceptable. Of the 23,268 teeth, 601 (2.6%) were root filled and 247 root fillings were adequate. Ninety-five (15.8%) root-filled teeth had AP (PAI 3-5). Out of the total, the AP prevalence was 0.4% in root-filled teeth and 0.8% in teeth without root fillings. The presence of AP was significantly correlated with inadequate coronal restorations and root canal fillings (p = 0.000). CONCLUSION: Tooth type, quality and type of coronal restorations, and length and homogeneity of root fillings significantly affected periapical status.

Micropush-out bond strengths of gutta-percha versus thermoplastic synthetic polymer-based systems - an ex vivo study.

AIM: To compare the interfacial strength and failure mode of root fillings consisting of different technique-material combinations. METHODOLOGY: Human mandibular premolars (n = 144) instrumented to apical size 40 and .06 taper were divided into 12 experimental groups. The root canals were filled with either gutta-percha (groups 1-6) or Resilon (groups 7-12) core materials combined with AH Plus (groups 1, 4, 7, 10), Ketac-Endo (groups 2, 5, 8, 11) or Epiphany (groups 3, 6, 9, 12) using cold lateral compaction (groups 1-3, groups 7-9) or System B with Obtura II (groups 4-6, groups 10-12). Three serial 1.00 +/- 0.05-mm-thick root slices were prepared and push-out tests on the filling material were performed. Interactions amongst the compaction techniques, core materials and sealers were analysed using a three-way analysis of variance (anova) (P < 0.05). One-way anova and Duncan's Multiple Range tests were used to compare the bond strengths of the 12 groups. Fracture modes of all root slices were evaluated stereomicroscopically at x40 magnification. RESULTS: All the parameters except compaction techniques had significant interactions (P < 0.05). A significant difference was found amongst the groups (P < 0.05). Gutta-percha/Ketac-Endo/cold lateral compaction and gutta-percha/AH Plus/cold lateral compaction groups had the highest micropush-out bond strength values (P < 0.05). The number of overall cohesive failures was significantly more than that of adhesive failures (P < 0.05). CONCLUSIONS: The push-out bond strengths of Resilon/Epiphany combinations were lower than those of gutta-percha/conventional root canal sealer combinations. Core materials and sealers may affect the push-out bond strengths of root canal filling materials.

Micro push-out bond strengths of four fiber-reinforced composite post systems and 2 luting materials.

OBJECTIVE: The aim of this study was to compare the bond strengths of 2 types of dual-cured luting agents used for cementation of 4 different fiber-reinforced composite (FRC) posts by using a push-out test and to evaluate the failure modes of these systems. STUDY DESIGN: Eighty human maxillary central incisors were divided into 8 groups (n = 10), decoronated, and roots filled and restored with one of the following post systems: groups 1 to 4: translucent quartz FRC posts; groups 5 and 6: opaque glass FRC post; and groups 7 and 8: individually formed electrical glass fiber post. Cementation was performed with 2 types of dual-polymerizing resin luting agents: Variolink II (groups 1, 3, 5, and 7) and a new self-adhesive resin cement, RelyX Unicem (groups 2, 4, 6, and 8). Slices with a thickness of 1.00 +/- 0.05 mm were prepared from the coronal third of each root by using a low-speed saw. Push-out tests were performed at a crosshead speed of 1 mm/min by using a universal testing machine, and the data was statistically analyzed (analysis of variance [ANOVA] and Duncan tests; P < .05). Fracture modes were evaluated at original magnification x40. RESULTS: Micro push-out bond strengths were significantly affected by the type of luting agent and the type of post (P < .05, 2-way ANOVA). A significant difference was found among the groups (1-way ANOVA, P < .05). Fiber-reinforced composite posts luted with Variolink II showed higher bond strengths, and the groups ordered as 5, 1, 3, 7, 6, 2, 4, and 8, with the values (MPa, mean +/- SD): 13.80 +/- 5.00, 13.77 +/- 3.78, 12.20 +/- 4.79, 9.39 +/- 2.48, 9.21 +/- 7.76, 7.25 +/- 1.56, 3.89 +/- 4.41, and 3.77 +/- 1.20, respectively. Adhesive failures between dentin and cement were observed more than cohesive failures in cement or post. CONCLUSIONS: Push-out bond strengths can be affected by luting agent and post type. Variolink II and fiber post combinations resulted in high bond strength values.